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4.
Trop Doct ; 52(1): 226-227, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34787533

RESUMO

We read with interest the short report by Rani et al. entitled "An uncommon variant of erythema nodosum leprosum responding well to methotrexate: Report of two cases." The article describes two cases of erythema nodosum leprosum (ENL) with 'atypical features' and good response to low dose methotrexate. The authors address a few concerns regarding methotrexate in ENL, emphasizing the rational usage of this agent.


Assuntos
Eritema Nodoso , Eritema Nodoso/diagnóstico , Eritema Nodoso/tratamento farmacológico , Humanos , Metotrexato/uso terapêutico
16.
Fontilles, Rev. leprol ; 29(2): 123-136, mayo-ago. 2013.
Artigo em Espanhol | IBECS | ID: ibc-119688

RESUMO

Antecedentes: La pauta de 12 meses de multiterapia (MDT) pauta multibacilar (MBR) fue implantada en la India en 1998, pero todavía adolece de información fiable sobre su posible eficacia. Objetivo: Evaluar la eficacia de la MDT MBR de 12 meses en apcientes multibacilares (MB) en nuestro centro. Metodología: Es un estudio retrospectivo que analiza las historias clínicas de 1210 pacientes registrados en la clínica para lepra de nuestra institución desde 1999 hasta 2010. Se observó un elevado Índice Bacteriano (IB) ≥ 3+, en 313 pacientes en el momento del registro. Cuatrocientos un pacientes experimentaron leproreacciones (54,9%9. ENL recurrente sólo se detectó en 14 pacientes incluso 5 años después de haber recibido el alta. La correlación clínico-histológica se examinó en 361 (49,5%) de los pacientes. Durante el periodo de seguimiento desde 9 meses a 10 años, casi todos los pacientes presentaron una aclaración evidente de sus lesiones cutáneas, incluyendo la mejoría histopatológica. Solo recidivaron 13 (1.7%). Conclusiones: Todos los pacientes respondieron sin problemas a la pauta MDT-MBR de 12 meses sin efectos adversos destacables. El índice total de recidivas fue de sólo 1,7%. Por tanto, la recomendación de la MDT MBR de 12 meses para todos los pacientes MB es robusta y práctica (AU)


Backgorund: Shortened (12 months) multidrug multibacillary regimen (MDT MBR) was implemented in India in 1998, however there is yet a paucity of crucial data on its long term outcome. Objetive. To assess the efficacy of 12 months MDT MBR in multibacillary (MB) patients at our centre. Design:This eas a retrospective study undertaken analyzing the clinic records of 1210 patients registered at the leprosy clinic of our institute form 1999-2010. Results. 730 MB patients were treated with 12 months MDT MBR over this period. High bacillary index (BI) ≥ 3+, was observed in 313 patients at the time of registration. Four hundred and one (54,9%) patients experienced lepra reactions. Recurrent ENL was observed in only 14 patients which manifested even after 5 years of stopping treatment. Clinico-histological correlation was noted in 361 (49,5%) patients. During follow up period ranging from 9 months to 19 years, nearly all patients had clearance of skin lesions including histopathological/bacteriological improvement. Only 13 (1.7%9 patients relapsed. Conclusions: all patients responded well with 12 months MDT MBR without significant side effects. The overall relapse rate was only 1.7%. Thus, the recommendation for 12 months MDT MBR for all MB patients is robust and operationally practical, a decision which seems logical (AU)


Assuntos
Humanos , Hanseníase Multibacilar/tratamento farmacológico , Hansenostáticos/administração & dosagem , Mycobacterium leprae/patogenicidade , Estudos Retrospectivos , Resultado do Tratamento
17.
Lepr Rev ; 84(1): 65-75, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23741883

RESUMO

BACKGROUND: Shortened (12 months) multidrug multibacillary regimen (MDT MBR) was implemented in India in 1998, however there is yet a paucity of crucial data on its long-term outcome. OBJECTIVE: To assess the efficacy of 12 months MDT MBR in multibacillary (MB) patients at our centre. DESIGN: This was a retrospective study undertaken analysing the clinic records of 1210 patients registered at the leprosy clinic of our institute from 1999 to 2010. RESULTS: 730 MB patients were treated with 12 months MDT MBR over this period. High bacillary index (BI) > or = 3 + was observed in 313 patients at the time of registration. Four hundred and one (54.9%) patients experienced lepra reactions. Recurrent ENL was observed in only 14 patients which manifested even after 5 years of stopping treatment. Clinico-histological correlation was noted in 361 (49.5%) patients. During follow up period ranging from 9 months to 10 years, nearly all patients had clearance of skin lesions including histopathological/bacteriological improvement. Only 13 (1.7%) patients relapsed. CONCLUSIONS: All patients responded well with 12 months MDT MBR without significant side effects. The overall relapse rate was only 1.7%. Thus, the recommendation for 12 months MDT MBR for all MB patients is robust and operationally practical, a decision which seems logical.


Assuntos
Hansenostáticos/uso terapêutico , Hanseníase Multibacilar/tratamento farmacológico , Adolescente , Adulto , Quimioterapia Combinada , Feminino , Seguimentos , Humanos , Índia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Atenção Terciária à Saúde/estatística & dados numéricos , Fatores de Tempo , Resultado do Tratamento , Organização Mundial da Saúde , Adulto Jovem
18.
Indian J Med Res ; 137(1): 15-35, 2013 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-23481049

RESUMO

Leprosy is among the world's oldest and most dreaded diseases and it has been synonymous with stigma and discrimination due to the hideous deformities it produced, mystery around its aetiology and transmission and lack of any effective remedy till recently. Leprosy control started with the use of chaulmoogra oil and for the last three decades, multi drug therapy (MDT) has been our main tool against leprosy. In the last two decades, the reported global prevalence of active leprosy infection has dropped by almost 90 per cent by the combined efforts of the World Health Organization (WHO), local governments, health professionals, and non-governmental organizations (NGOs), however, a parallel drop in the incidence or new case detection rate (NCDR) has not occurred. From 1994 through 2011, more than 100,000 new cases are being detected annually, of whom maximum case load is from India. There is need for research on tools for early diagnosis, short and effective treatment, and prevention of deformities and disabilities. Evaluating the role of immunotherapy and immunoprophylaxis will also lead us to better understanding of their mode of action. Further molecular analysis of Mycobacterium leprae genome may provide the requisite basis for all this. The current reality is that there is a need to sustain and provide quality leprosy services to all persons through general health services, including good referral system. All these provisions in the integrated health care approach will go a long way in further reducing the stigma. Efforts need to be made to reduce deformity through early detection, self care, physiotherapy and reconstructive surgery and developing sound surveillance systems. With all the remarkable achievements in the fight against leprosy, the stage is now set for the final assault. It is hoped that with the efforts of all the stake holders and strong political will, the disease will be eradicated in the near future.


Assuntos
Hanseníase/epidemiologia , Hanseníase/terapia , Genoma Bacteriano , Humanos , Índia , Hansenostáticos/uso terapêutico , Hanseníase/genética , Hanseníase/microbiologia , Mycobacterium leprae/genética , Mycobacterium leprae/patogenicidade , Organização Mundial da Saúde
20.
Artigo em Inglês | MEDLINE | ID: mdl-20826987

RESUMO

Sexually transmitted diseases (STDs) in children are not uncommon in India, though systematic epidemiological studies to determine the exact prevalence are not available. STDs in children can be acquired via sexual route or, uncommonly, via non-sexual route such as accidental inoculation by a diseased individual. Neonatal infections are almost always acquired intrauterine or during delivery. Voluntary indulgence in sexual activity is also an important factor in acquisition of STDs in childhood. Sexual abuse and sex trafficking remain the important problems in India. Surveys indicate that nearly half of the children are sexually abused. Most at risk children are street-based, homeless or those living in or near brothels. Last two decades have shown an increase in the prevalence of STDs in children, though most of the data is from northern part of the country and from major hospitals. However, due to better availability of antenatal care to majority of women, cases of congenital syphilis have declined consistently over the past two-three decades. Other bacterial STDs are also on decline. On the other hand, viral STDs such as genital herpes and anogenital warts are increasing. This reflects trends of STDs in the adult population. Concomitant HIV infection is uncommon in children. Comprehensive sex education, stringent laws to prevent sex trafficking and child sexual abuse, and antenatal screening of all the women can reduce the prevalence of STDs in children.


Assuntos
Abuso Sexual na Infância/estatística & dados numéricos , Trabalho Sexual/estatística & dados numéricos , Infecções Sexualmente Transmissíveis/epidemiologia , Infecções Sexualmente Transmissíveis/transmissão , Criança , Humanos , Índia/epidemiologia , Prevalência , Fatores de Risco , Infecções Sexualmente Transmissíveis/prevenção & controle
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