Studies on rheological and leaching characteristics of heavy metals through selective additive in high concentration ash slurry.

The generation and disposal level of thermal power plant ash in India is a challenging task. The conventional mode of dilute phase ash slurry (10-20% solids by weight) transport through pipelines being practiced in majority of these plants not only consumes huge amount of precious water and pumping energy but also causes serious environmental problem at the disposal site. The present study investigates the rheological and leaching characteristics of an Indian ash samples at high solids concentrations (>50% by weight) using sodium silicate as an additive. The flow behaviour of ash slurry in the concentration range of 50-60% by weight is described by a Bingham-plastic model. It was indicated that the addition of sodium silicate (0.2-0.6% of the total solids) could able to reduce both the slurry viscosity and the yield stress. The analysis of the ash samples for the presence of heavy metals such as Fe, Cd, Ni, Pb, Zn, Cu, Co, As and Hg were carried out following Hansen and Fisher procedure. The addition of sodium silicate affected the leaching characteristics of the ash samples over a period of 300 days resulting in the reduction of leaching of heavy metals.

Results of surgical decompression of ulnar nerve in leprosy.

Ulnar neurolysis in 279 cases of leprosy was performed with objectives of relief in neuritic pain and impending/ existing sensory motor loss of varying extent. Of the above, 193 could be followed between 3-10 years. Neuritic pain was first to disappear. 48.7% of the 193 cases showed sensory recovery. Motor power gain and/or further fall in muscle power was prevented as a result of preventive neurolysis in 173 (89.6%) cases. In this series benefits of appropriate and timely surgical intervention have been observed.

Clinico-mycological profile of superficial mycoses.

Clinico-mycological study of 2743 clinically diagnosed cases of superficial mycoses attending skin and VD OPD of VSS Medical College during the year 1995 - 96 was conducted. Male predominance was observed. Highest incidence of tinea versicolor was found. T. rubrum was the commonest fungus isolated.

Protective sensibility--its monofilament nylon threshold equivalents in leprosy patients.

An attempt has been made to definite the levels of "protective sensibility" in terms of perception thresholds to monofilament nylon induced touch/pressure stimuli. Certain problems were observed while interpreting the observations. There appears to be a range of threshold values instead of a clear cut-off point. We suggest that a monofilament nylon stimulus two times the normal threshold value for that patient be taken as cut-off point. This will make the observations of Birke and Sims (1986) and Hammond and Klenerman (1987) reasonable without having any need to exclude the cases who defy the boundaries laid by them. Since the genesis of plantar ulcer is multifactorial, it appears logical to include all patients who have a certain degree of hypoaesthesia, for special ulcer care program. The likely problems while using monofilament nylons in the field and their possible solutions have also been outlined.

Rifampicin and isoniazid in the treatment of leprous nerve abscesses.

Thirty nine cases of borderline tuberculoid leprosy having nerve abscesses (15 with sinuses) were treated with daily dose of rifampicin and isoniazid for six months along with standard multidrug therapy. The patients were followed up for three to five years. No recurrence of abscess or sinus was observed. Observations indicate that medical approach is required at times to supplement surgical intervention for management of these cases.

Evaluation of results of surgical decompression of median nerve in leprosy in relation to sensory--motor functions.

Median nerve decompression was performed in 29 leprosy patients of which 20 were followed up for varying periods. It has been observed that the decompression was beneficial, sensory recovery was seen in 90% cases and in 45% cases the muscle strength improved and the process of deterioration was arrested in another 25% cases.

Calcification of peripheral nerves in leprosy.

A study conducted in 74 TT/TB patients, with gross thickening of nerves together with nerve abscess, showed calcification in 8 patients. Calcification was most common in the ulnar nerve followed by the lateral popliteal nerve. All eight patients were males with significantly longer duration of illness before start of treatment. Patients with late onset of nerve abscess were found to be more prone to calcium deposition in the nerves. Caseous pus of the abscess had high lipid content with raised cholesterol and cholesterol ester ratio to total lipids suggesting a dystrophic nature of calcification.

Neuritic leprosy: further progression and significance.

Sixteen neuritic cases have been seen developing cutaneous lesions. These cutaneous lesions by and large appear within 4 months after the diagnosis of neuritic leprosy. Leprosy pathology in cutaneous lesions has been found ranging between indeterminate and borderline lepromatous group. Development of cutaneous lesions does not seem to be influenced by age, sex or number of nerves or lepromin status. Neither lesions seem to appear in any particular part of the body. Therapy, duration and type i.e. monodrug or multidrug, also does not seem to influence the development of cutaneous lesions in either way. It appears that neuritic cases with either very early (indeterminate) or with advanced multibacillary neural pathology may develop skin lesions. Skin lesion possibly appear following reversal reaction in skin. Cases with newly developed skin lesions well respond to standard therapy. Development of cutaneous lesions by neuritic cases possibly indicates towards the natural history of the disease, conforming to the hypothesis that leprosy is basically neural in inception and that all other forms emerge from it.

Trigeminal neuralgia--a presenting feature of facial leprosy.

Trigeminal neuralgia is a well recognized clinical entity. However, it has not been reported to mimic leprosy or vice versa. Of the 3 cases reported here, 2 initially presented with neuralgic symptoms similar to that seen in trigeminal neuralgia and later developed borderline lesions on the face. The 3rd case demonstrated a tingling sensation along with firm and palpable supraorbital nerve (a branch of trigeminal nerve), and a very early skin lesion on the face pointed to the need to consider neuritic type leprosy before concluding the final diagnosis of a disease like trigeminal neuralgia which calls for a different therapeutic approach.

Evolution of early lesions in leprosy.

We observed 29 patients presenting with vague peripheral neurological symptoms for 6 months or more. During this period, 16 developed clinical leprosy, 3 developed borderline tuberculoid leprosy and the other 13 developed neuritic leprosy. Of these 13 cases 11 subsequently developed skin lesions similar to those seen in indeterminate and in borderline tuberculoid leprosy. Based on the above observations, an attempt has been made to explain the evolution of early lesions of leprosy.

Paralysis of occipitofrontalis in a borderline case of leprosy.

A patient with neuritic leprosy developed borderline skin lesions. Later, another skin lesion developed on the left side of the forehead with clinical involvement of the supraorbital branch of the ophthalmic division of the trigeminal nerve. Simultaneously, paralysis of the occipitofrontalis and mild paresis of orbicularis oculi occurred.

Analysis of circulating immune complexes from leprosy patients for Mycobacterium leprae antigens.

Circulating immune complexes (CICs) from 31 leprosy patients (16 tuberculoid, 15 lepromatous) and 12 healthy volunteers, precipitated by 3.5% polyethylene glycol, were individually subjected to SDS-PAGE and immunoblotting using a variety of monoclonal and polyclonal antibodies against Mycobacterium leprae. A common mycobacterial antigen of an apparent molecular size of 65 kDa was identified in CICs from about 40% of the patients. No correlation was observed between the positivity for this antigen and any of the following parameters: bacterial index, M. leprae-specific antibody titers, motor nerve involvement, duration of disease or treatment. Nevertheless, patients with a relatively recent and massive infection were more frequently positive for antigen than the others.

Leprosy in infants--report of two cases.

Two infants, one 4 months old and the other 2 months old, having histologically confirmed indeterminate leprosy are reported. The route of infection, mode of transmission, and incubation period are discussed with reference to these two cases of infantile leprosy.

Nerve abscess simulated by a lipoma in a leprosy patient.

A case of suspected giant nerve abscess near the radial nerve in the upper arm of a patient with borderline leprosy is reported. On exploration, it turned out to be a deep seated lipoma. Consideration should be given to exploring nerve masses in leprosy.

Drug compliance among self-motivated leprosy patients.

Regularity of DDS intake among 366 leprosy patients attending our out patient department voluntarily was assessed by urine spot test. It was found that only 54.6% of them had taken their last dose of drug within the previous three days. Those who kept their appointment showed better compliance than those who did not. Urinary DDS positivity was found to be unrelated to sex, occupation or the type of the disease. In the younger age group the compliance was low, as also among the patients coming from nearby places as compared to those who were residing in far off districts.

Leprosy deformities. II. As parameters to monitor the effectivity of leprosy control programme.

Leprosy deformities have been considered as the main reason for dehabilitation and social ostracism. Prevention of deformities is considered as one of the most important objectives of leprosy control programme. In present work based on deformity status, efforts have been made to evolve new parameters and their possible application in assessment of leprosy control programme.

Effect of supernatants of dermal leprosy granulomas on lymphocyte morphology and function.

A comparison has been made of the characteristics of dermal granulomas of tuberculoid and lepromatous leprosy by culturing them in vitro. The granulomas were derived from lesions of untreated patients and their effect was assessed on the morphology and function of lymphocytes derived from peripheral blood of normal individuals. The concentration of proteins released in the supernatants was similar in both the type of granulomas. However, the supernatants from the lepromatous granulomas markedly diminished the viability of lymphocytes when compared with supernatants derived from the tuberculoid granulomas. The supernatants from both the tuberculoid and lepromatous granulomas, contained soluble factors which depressed the 14C-leucine and 3H-thymidine incorporation by lymphocytes. The depression in 3H-thymidine uptake was more pronounced with the supernatants from the lepromatous granulomas while the diminution of 14C-leucine incorporation was more marked with supernatants from the tuberculoid granulomas. The supernatants did not show any migratory inhibitory activity in vitro. When the cells from the granulomas were dispersed and cultured in vitro, only very low concentration of proteins was detectable.