Ocular disability--WHO grade 2 in persons affected with leprosy.

Leprosy remains to be a leading cause of peripheral neuropathy and disability. In recent years under Leprosy control programme more stress is being laid on disability assessment. This study was aimed to find prevalence of grade of Ocular disability among persons affected with leprosy (PAL) according to WHO disability grading scale and to find Ocular contributors to grade 2 disability in PAL. A cross sectional study was carried out in tertiary care hospital in Lucknow, Uttar Pradesh. About 302 PAL were interviewed and their eyes clinically examined during 2 years. Data was analysed in percentages, x2 test, Anova. Ocular disability was found in 39.40% persons affected with leprosy (PAL). Of 604 eyes, 13.07% had grade 1 disability and 19.86% had grade 2 disabilities. Bilateral disability was more common than unilateral disability. Ocular disability was more common in PAL with more than one year of leprosy and even higher in those staying in leprasoria (p = 0.012). The most common cause of ocular grade 2 disabilities was corneal involvement (14.23% PAL). Cataract was found to be the most common cause of visual disability (although it is not caused by leprosy). Screening for ocular disability should be incorporated as a routine protocol in PAL to reduce the severity of Ocular disability. Early diagnosis and prompt preventive measure is essential to reduce the burden of visual impairment and blindness in PALthus bringing down the load of grade 2 disability due to leprosy in the society which in itself is an indicator of leprosy control.

Psychiatric morbidity in vitiligo: prevalence and correlates in India.

BACKGROUND: Vitiligo, a common pigmentary disorder, is recognized to be associated with a high psychiatric morbidity, yet compared to other dermatological disorders like leprosy, psoriasis, etc., it has not been subjected to detailed evaluation of its psychological consequences. The data from the developing countries on this aspect in particular is meager. METHODS: One hundred and thirteen cases with vitiligo were evaluated along with 55 healthy controls comparable for sociodemographic profile and matched on attitude to appearance scale. Clinical details, impact of illness, associated dysfunction and psychological morbidity were additionally assessed. RESULTS: Twenty-eight patients with vitiligo were found to have psychiatric morbidity, a clinic prevalence rate of 25% (95% confidence interval 20.3-29.3%). The majority of the cases had a diagnosis of adjustment disorder. Psychiatric morbidity was significantly correlated with dysfunction arising out of illness. CONCLUSIONS: Vitiligo is associated with high psychiatric morbidity. There is a need to develop cross-cultural database on psychosocial aspects and psychiatric morbidity associated with vitiligo.