Intranasal administration of fusidic acid cream in leprosy.

The effect of local treatment of nostrils with fusidic acid cream was investigated in 30 previously untreated lepromatous leprosy patients. The cream was applied in the nostrils after flushing the nostrils with normal saline, twice a day for a period of four weeks. It was found that 20 mg/gm of sodium fusidate was effective in reducing the morphological index of the nose-blow smear to zero in two weeks in majority of the patients. No untoward side effect was seen in any of the patients. Such nasal treatment along with multidrug therapy may help in reducing the patient's level of infectiousness to their contacts, since the nose is recognized to be an important portal of exit of M. leprae.

A study of pure neuritic leprosy: clinical experience.

Pure neuritic leprosy is a well-recognized clinical entity. Manifestations of leprosy in pure neuritic form accounted for 179 patients out of the total 3853 leprosy patients (4.6%) attending our Poona Urban Leprosy Investigation Centre clinics. Patients with pure neuritic leprosy are prone to develop nerve damage. Eight-seven (48.6%) of our pure neuritic patients presented with deformities. Involvement of upper extremity and right ulnar nerve in particular was the most common clinical feature. Patients presenting with involvement of two nerves of the same extremity was also quite common. None of our patients developed skin lesions while on anti-leprosy treatment. It is important to recognize neuritic symptoms early and suspect leprosy even in the absence of skin lesions.

Study of deformities in children with leprosy: an urban experience.

A study was conducted to assess the deformities in children with leprosy. Eyes, hands and feet were examined for leprosy-related deformities. The influence of age, sex, duration of disease, type of disease, occurrence of leprosy reactions and anti-leprosy treatment on the occurrence of deformities was studied. In our urban leprosy project the percentage of children (0-14 years) suffering from leprosy is 7% of the total number of leprosy patients. The response to multidrug therapy, health education and physiotherapy was good.

Oral zinc therapy in recurrent erythema nodosum leprosum: a clinical study.

Effect of oral zinc as an immunomodulator was studied clinically in patients with recurrent ENL over a period of one year. In this study, 40 leprosy patients with chronic ENL, requiring more than 30-40 mg of prednisolone/day for the control of their reactions, were given oral zinc sulphate for a period of four months, and, marked improvement in the frequency, duration and severity of reactions was observed after zinc therapy. Also evident was marked reduction in the steroid requirement after oral zinc therapy. It appears that zinc may be a good substitute for the present day anti-reaction treatment which is not free from disadvantages. Further investigations to know the precise action of zinc on immune-system may help to understand the role of zinc therapy and its optimum duration.

Gelatin particle agglutination assay to detect anti-PGL-I antibodies in leprosy patients and in household contacts: a preliminary study.

A preliminary study of anti-phenolic glycolipid-I (PGL-I) IgM antibody detection using M. leprae gelatin particle agglutination (MLPA) test kit is described. Antibodies were demonstrated in 70% of our leprosy patients taking antileprosy treatment. The percentage of positivity of multibacillary cases was 86.0, whereas that of paucibacillary cases was 30.0. Good correlation was found between bacteriological index and the presence of antibodies. Antibodies were detected in 28% of our patients released from treatment. Fourteen out of 27 household contacts were found to have antibodies but none of the normal controls were seropositive. These preliminary data demonstrate that MLPA test is not applicable as sero-diagnostic test or as a test of cure, but may be useful for epidemiological studies and as a research tool.

Effect of levamisole on clinical outcome and DNCB conversion in leprosy patients. A long term study.

Fifteen patients of lepromatous leprosy within first 6 months of diagnosis were studied. 7 controls received standard DDS treatment and placebo while 8 patients received cyclical levamisole treatment (150 mg daily for 3 days repeated after a gap of 2 weeks), in addition to standard DDS treatment. Patients were followed up clinically for lepra reactions, serial B.I. and DNCB test for 2 years. We observed that ENL reactions were more common and more severe in levamisole treated group while an upgrading type reaction occurred only in one of the control patients. B I. remained same in both groups throughout, while DNCB score was higher in control rather than levamisole treated groups. Thus, levamisole treatment does not seem to have caused stimulation of CMI in our patients as judged by DNCB reaction while it may have caused stimulation of humoral immunity as seen by higher incidence of ENL reaction. This may be undesirable in lepromatous patients.