Clinical and bacteriological study of urethral discharge.

A clinics-bacteriological study of 52 patients with urethritis was carried out. All the patients were evaluated clinically and bacteriologically at the beginning and end of the treatment. Majority of the patients belonged to the age group 21-30 years (58%). Incidence of gonococcal urethritis was 65% and Non gonococcal Urethritis (NGU) 35%. The common organisms causing NGU were chlamydia (28%) ureaplasma (11%) and mycoplasma (11%). Neisseria gonorrhoea was resistant to penicillin in (38%), ciprolloxacin in 67, and to noriloxaein in 6% cases. High incidence of HIV positivity was found in gonorrhoea (21%).

Hiv infection in patients of sexually transmitted disease.

A total of 1027 male patients suffering from sexually transmitted diseases (STD) during 1990 to 1996 were screened for HIV infection. All cases were in the age group 17 years to 48 years. One hundred and sixty-seven STD cases (16.3%) were found to have HIV infection. A rising trend in incidence of HIV infection in STD patients from 1990 (2.8%) to 1996 (27.8%) was noticed countrary to declining trend of STDs from 213 cases in 1990 to 79 cases in 1996. The incidence of HIV infection was 30.3% in lymphogranuloma venereum, 19.5% in chancroid, 13.5% in syphilis, 17.6% in herpes genitatis, 6.7% in gonorrhoea and 11.2% in other STD cases.

Pattern of skin diseases in paediatric age group and adolescents.

A total of 300 patients from first day of life to 17 years of age were analysed for pattern of skin disorders. School going children formed majority (41.3%) of cases followed by preschool children (32%). Infections formed the commonest disorder (31 %) followed by eczemas (24%), papulosquamous disorders (12%), infestation (8.6%) and urticaria (5.3%) while vitiligo, acne vulgaris, alopecia areata and genodermatoses were seen in 2.7% cases each.

A study of dermatological disorders in geriatric age group.

A total of 320 patients of more than 60 years of age were studied for dermatological changes with aging. The male female ratio of patients was 3:1. Majority of cases (60.6%) were between 60-65 years of age. Pruritus was present in 37.5% cases, wrinkles in 82.1%, senile lentigenes in 57.8%, seborrhoeic keratosis in 48.8%, cherry angioma in 48.1%, idiopathic guttate hypomelanosis in 43%, skin tags in 37%, xerosis in 28%, comedones in 19%, infection and infestation in 40%, eczematous disorders in 36.9%, papulosquamous disorders in 10%, metabolic disorders in 16%, pigmentary disorders in 8.7%, keratinisation disorders in 4.1%, vesiculobullous disorders in 2.8% and associated systemic disorders in 49.7% cases.

Concurrent leprosy and HIV infection: a report of three cases.

Three cases of concurrent infection with HIV and leprosy are reported. One had developed borderline lepromatous leprosy one year after identifying HIV infection, while the other two had indeterminate leprosy and both conditions were identified at the same time in these two patients. All three cases showed satisfactory response to standard antileprosy multidrug therapy.

A comparative study of liver function tests in patients of chronic liver disorders with and without cutaneous manifestations.

Forty six cases of chronic liver disorders with and without cutaneous manifestations were studied for abnormalities of liver function tests. 27 cases were associated with cutaneous manifestations and 19 cases without cutaneous manifestations. A higher serum bilirubin level was seen in all cases with cutaneous manifestations. Serum bilirubin was significantly high (P<0.05) in patients of chronic active hepatitis with cutaneous manifestations. Serum alkaline phosphatase and serum glutamic pyruvic transaminase (SGPT) levels were significantly high in chronic active hepatitis and alcoholic liver disease without cutaneous manifestations respectively.

Pattern of skin diseases among civil population and armed forces personnel at Pune.

The pattern of skin disorders among 11393 civil and 8123 defence service personnel who attended out-patient department (OPD) from January 1989 to December 1994 is presented. Infective dermatoses were more common in civil population (41.2%) as compared to defence service personnel (36.3%). Fungal infection was common in both groups (15.1% and 17.2%) whereas parasitic infestations and pyoderma were more common in civil population (12.8% and 6.1%) as compared to service personnel (7.8% and 3.6%). Among non-infective dermatoses eczemas were more common in civil population (17.3%) as compared to Armed Forces personnel (11.7%), whereas papulosquamous disorders, pigmentary disorders, acne and alopecia were more common in Armed Forces personnel (13.5%, 13.4% 8.7% and 6.2%) as compared to civil population (10.8%, 10.1%, 6.4% and 4.1%). The incidence of other skin disorders did not differ much between the two groups.

Herpes zoster in patients with HIV infection.

Five hundred twenty seven HIV seropositive male cases were observed for herpes zoster for a period of five years. Overall incidence of herpes zoster in HIV infection was found to be 11.8%. Herpes zoster was presenting symptom in 50% cases. It developed in first year of follow up in 38.8% cases, in second and third year of follow up in 4.8% cases each and in fourth year in 1.6% case. Majority of cases (89%) were in age group of 20 - 40 years. Thoracic dermatome (68%) was commonest to get involved followed by cervical (14.5%), trigeminal (9.7%) and lumbosacral (8%). Among other associations of HIV seropositive herpes zoster cases 24.2% cases had tuberculosis and 4.8% cases had hepatitis B virus infection. The skin lesions of herpes zoster in majority of cases were bullous, haemorrhagic and necrotic.

Paediatric HIV infection.

Four cases of HIV infection in children between one to eight years of age are reported. Three were males and the other one female. One child was horn to known HIV infected mother. The female child was victim of sexual abuse and had disseminated tuberculosis with syphilis and gonorrhoea. Other two children were having systemic as well as dermatological disorders for which HIV test was done and found positive.

Evaluation of two multidrug regimen in hospitalised multibacillary cases.

Fifty three multibacillary leprosy cases were treated with two regimens of MDT L1 consisting of Rifampicin, Dapsone and Ethionamide and L2 consisting of Rifampicin, Dapsone and clofazimine. The results were compared at regular intervals and at the end of the study (24 months). Clinical inactivity, bacteriological negativity, ENL reactions, upgrading reactions were seen in L1 group in 65%, 4.54%, 50% and 41% of cases respectively while 65%, 25.8%, 30% and 45% respectively in L2 regimen group. Zero percent morphological Index was achieved in all cases in L1 regimen 90% in L2 regimen cases. No viability was found on mouse foot pad inoculation after 6 months in L1 while after 18 months in L2 cases.

Soluble antigen of M. leprae coupled with liposomes elicits both "early" and "late" delayed hypersensitivity skin reactions.

The soluble antigen(s) of Mycobacterium leprae was(were) coupled to liposomes and used for skin testing of leprosy patients, hoping that this mode of antigen presentation would be identical to that of integral lepromin. The liposomized antigen(s) elicited both early (24-48 hr) and late (3-4 weeks) delayed-type hypersensitivity reactions, true to the nature of lepromin, unlike the soluble antigen(s) alone which elicit(s) only the early reaction.

Primary hyperpigmented cutaneous lesions in tuberculoid leprosy.

Two cases of tuberculoid leprosy with primary hyperpigmented anaesthetic lesions are reported and subject is reviewed.

Immunohistologic comparison between armadillo-derived leprosin and standard lepromin skin tests in leprosy patients.

A comparison was made on the in situ immunological characteristics of dermal infiltrates of early (24-hour) and late (3-4 weeks) skin reactions in leprosy patients. The skin reactions were induced by armadillo-derived leprosin coupled to liposomes and standard Dharmendra lepromin. Most lymphocytes in the early reaction induced by both antigens were positive for Leu 4, Leu 3a, OKT8 and Ia like antigens indicating thereby the presence of activated T cells. The ratio of Leu 3a/OKT8+ cells were similar. In the late reaction elicited by both antigens, the lymphocytes in the granulomas were predominantly activated T lymphocytes expressing Leu 4, Leu 3a, OKT8 and Ia like antigens. Leu 3a+ cells were scattered diffusely amidst the epithelioid cells. In contrast, the OKT8+ cells were present mainly as 'a ring' in the periphery of the granuloma. A similar ratio of Leu 3a+/OKT8+ cells was observed in these granulomas. Macrophages in the granulomas expressed Ia like antigens. These observations indicate that the immunological characteristics of dermal infiltrates in the skin reaction induced by armadillo-derived leprosin coupled to liposomes and standard Dharmendra lepromin appear to be identical.

A study of palmar ridge malformation in leprosy.

Palmar ridge malformation of 150 male leprosy patients (50 multibacillary and 100 paucibacillary) were compared with matched controls. Significantly high incidence of ridge malformation was found on the palms of multibacillary leprosy patients. The acquired ridge atrophy was found in 32% multibacillary leprosy, 4.5% paucibacillary leprosy and 0% controls. The congenital ridge dissociation was found in 46% multibacillary leprosy, 20% paucibacillary leprosy and 22% controls. The difference is statistically significant.

Clinico-histopathological evaluation of modified pilocarpine test in early diagnosis of leprosy.

Modified pilocarpine test was done in 112 patients of which 89 cases were under investigation (Group I) and 23 cases were confirmed tuberculoid leprosy cases (Group II). In group I, 70 cases (78.6%) showed deficient sweating of varying degree and 36 cases (40.4%) showed definite histopathological changes of paucibacillary leprosy in skin. 22 cases (95.6%) in Group II showed deficient sweating. 24 cases under investigation who had deficient sweating but did not show definite histopathological changes of leprosy initially were followed up for one year and at the end of one year 10 cases (41.6%) showed confirmatory changes of leprosy on histopathological examination. The modified pilocarpine test has been found to be a simple and very useful test in early diagnosis of leprosy.

Immunotherapy in leprosy: a new approach.

An immunotherapeutic agent prepared from patient's own affected skin was tried in 30 leprosy cases. 53.6% cases of lepromatous and borderline lepromatous group showed lepromin conversion from lepromin negativity to positivity after 12 weeks of immunotherapy. The clinical and bacteriological improvement was also good. 88.1% cases of borderline tuberculoid also showed fair to good clinical recovery following 12 weeks of immunotherapy.