Socio-demographic profile of leprosy patients in two districts of western Uttar Pradesh.

Despite achieving the goal of national elimination of leprosy, it remains a serious public health problem in the high prevalence states of Uttar Pradesh, Bihar and Orissa. A significant percentage of newly detected cases are Multibacillary. It underscores the importance of developing a more effective strategy to combat the disease in high prevalence pockets of the country. A glance into sociodemographic profile of the leprosy patients of one the high prevalence states might help in understanding the current ground situation better. A questionnaire based study was conducted at health care center of two districts of Uttar Pradesh (Rampur and Moradabad). Data on demographic profile of leprosy patients attending these centers were collected. The leprosy patients were more frequently males (63.8%). The duration of time before presentation was significantly longer for semiskilled workers (Kuppuswami Scale classification), p = 0.029. Patients with multibacillary disease were younger (mean age 31.04 yrs) as compared to paucibacillary leprosy (mean age 38.7yrs), p value = 0.041. These observations suggests that a specific population based approach is required to detect new cases early. Certain groups of the population might benefit from active surveillance.

Hansen's disease with bilateral tarsal disorganisation.

A 37-year old male patient with Hansen's disease midborderline spectrum, presented with bilateral pedal edema. X-ray examination of the feet showed disorganisation and disintegration of the tarsal bones. Bilateral tarsal disorganisation which can develop in Hansen's disease is usually not recognised by the clinician.

Acrokeratosis paraneoplastica.

A 60-year old man with squamous cell carcinoma of hypopharynx and acrokeratosis paraneoplastica (Bazex syndrome) is reported.

Complicated Cataract by Syphilitic Cyclitis.

A case of latent syphilis presented with unilateral cataract, which developed most probably as a complication of syphilitic cyclitis which he had during the secondary stage of the disease. Blood VDRL was reactive at 1: 32, but CSF was normal. Aqueous humor and the extracted lens material did not contain any Treponema palfidum.

Creeping Eruption on Glans Penis.

A young male having a creeping eruption on the glans penis is reported.

Sudoriparous Angioma.

A 13-year-old girl had a painful bluish black nodule resembling a blue rubber bleb nevus in front of her ankle since birth. Stroking the lesion caused pain and sweating over the lesion. Histopathology reviewed dilated and cystic eccrine sweat gland structures on the side of thin-walled dilated blood vessels In the dcrmis.

Problems of urban leprosy control with special reference to case holding.

The prevalence of leprosy and the proportion of bacteriologically positive cases in different parts of endemic and highly dense Bombay, India, are presented. The attendance of 8574 cases is retrospectively analyzed with respect to age, sex, occupation, type of leprosy, and presence or absence of deformity. Defaulters (6090) were traced, and the reasons for nonattendance were ascertained in 22% of the cases. In those cases who could be contacted and in those who had high bacterial and morphological indexes, multidrug therapy was being given at either a clinic or, if not possible, at their homes by experienced field workers under supervision. Recommendations are made for improving urban leprosy control work in general and for case holding in particular.

Leprosy among industrial workers in Bombay, India. Studies in retrospect and prospect.

The problem of leprosy in Greater Bombay, India, is presented. Antileprosy measures carried out in this dense, industrialized, endemic urban area are briefly described. The role of survey of various groups of people in case detection is then highlighted. A retrospective study showing the proportion of industrial workers among new, resident leprosy cases is presented. In another retrospective study, various attributes of workers, such as state of origin, source of referral, religion, regularity in attendance, deformity status, nature of occupation, etc., are studied and their significance delineated. This has resulted in undertaking a cross-sectional, prospective survey of over 18,000 industrial workers where the case detection rate turned out to be over 17 per 1000. Accordingly, arguments are advanced for recommending surveys of industrial workers in the scheme of leprosy control in endemic urban areas. A study of socio-economic and cultural attributes of workers and their relatives in maintaining the endemicity is felt distinctly feasible.

Chronic Progressive Disseminated Mucocutaneous Histoplasmosis.

An unusual case of Histoplasma Capsulatum infection with cutaneous nodules, a feature of African histoplasmosis and granulomatous lesions, a manifestation of classical histoplasmosis is being reported.

Juvenile Xanthogranuloma.

A solitary skin lesion of juvenile xanthogranuloma appearing at the age of five years is reported.

A study of 922 bacteriologically positive leprosy cases.

Nine hundred twenty-two bacteriologically positive leprosy cases were registered over a period of 13 years (1962-1974) at the Acworth Leprosy Hospital in Bombay, and studied for a minimum period of five years. Two hundred eighty-eight were found to take antileprosy medication irregularly. The remaining 634 patients, who took their medication regularly, were analyzed with respect to the effects of age, sex, type of disease, frequency of reactions, and duration of treatment on the attainment of bacteriologic negativity. Overall, 57.4% of those patients taking medication regularly became bacteriologically negative; while only 20.8% of those taking medication irregularly became bacteriologically negative. Age and sex did not appear to influence the attainment of bacteriologic negativity. The type of disease, reactions, and duration of treatment all influenced the time required to attain bacteriologic negativity.

Antileprosy measures in Bombay, India: an analysis of 10 years' work.

Leprosy control measures adopted in Bombay consist of health education, case-detection, and treatment, and are carried out mainly by the Acworth Leprosy Hospital and its subsidiary, the Greater Bombay Leprosy Control Scheme. Although the data collected on different aspects of leprosy during the 10-year period 1963-72 are hospital-based and retrospective, their analysis provides a useful indicator of the possible situation in the field. Health education is provided by medical social workers, field staff, and physicians, and the significance of this activity in relation to early detection of leprosy is analysed. It is shown, however, that case-holding is a more urgent priority than case-detection. Trials have confirmed the effectiveness of chemoprophylaxis with dapsone for contacts of infectious index cases in crowded households. Comparison of annual expenditure per outpatient in leprosy clinics with that for inpatients in a leprosy hospital demonstrates greater cost-effectiveness of outpatient treatment. Some practical recommendations are made for leprosy control.