RESUMO
Abstract Background and objectives: Leprosy remains a leading cause of peripheral neuropathy and disability in the world. Primary objective of the study was to determine the incidence of deformities present at a time of diagnosis and new deformities that patients develop over follow up period. Material and methods: An open, retrospective cohort study was performed at a tertiary medical center in western India. Recruitment phase of the study was of 2 years (2009-2010) followed by observation/follow up phase of 7 years till 31st December 2017. New patients with leprosy and released from treatment cases who presented with deformity as defined by WHO disability grade (1998) and subsequently developing new deformities during the follow up period of up to 7 years were included in the study. Results: The study included 200 leprosy patients. Of the total 254 deformities, 168 (66.14%) deformities were noticed at the moment of diagnosis, 20 (7.87%) deformities occurred during the follow up phase. Of all patients, 21.25% had Grade 1 deformity and 6.31% had Grade 2 or more severe deformity. Deformities of hand were most common in 44.48%, followed by feet 39.76%, and face 15.74% respectively. Limitation of study: Mode of inclusion of patient was self-reporting during follow up phase so there is possible under reporting of the disabilities. Conclusion: New deformities continue to develop in certain forms of leprosy even after release from treatment. Long-term & regular follow up of patients who have been released from treatment is required.
Assuntos
Humanos , Masculino , Feminino , Avaliação da Deficiência , Hanseníase/fisiopatologia , Hanseníase/patologia , Nervos Periféricos/fisiopatologia , Fatores de Tempo , Índice de Gravidade de Doença , Deformidades Adquiridas do Pé/fisiopatologia , Deformidades Adquiridas do Pé/patologia , Deformidades Adquiridas da Mão/fisiopatologia , Deformidades Adquiridas da Mão/patologia , Prontuários Médicos , Estudos Transversais , Estudos Retrospectivos , Seguimentos , Progressão da Doença , Face/anormalidades , ÍndiaRESUMO
BACKGROUND AND OBJECTIVES: Leprosy remains a leading cause of peripheral neuropathy and disability in the world. Primary objective of the study was to determine the incidence of deformities present at a time of diagnosis and new deformities that patients develop over follow up period. MATERIAL AND METHODS: An open, retrospective cohort study was performed at a tertiary medical center in western India. Recruitment phase of the study was of 2 years (2009-2010) followed by observation/follow up phase of 7 years till 31st December 2017. New patients with leprosy and released from treatment cases who presented with deformity as defined by WHO disability grade (1998) and subsequently developing new deformities during the follow up period of up to 7 years were included in the study. RESULTS: The study included 200 leprosy patients. Of the total 254 deformities, 168 (66.14%) deformities were noticed at the moment of diagnosis, 20 (7.87%) deformities occurred during the follow up phase. Of all patients, 21.25% had Grade 1 deformity and 6.31% had Grade 2 or more severe deformity. Deformities of hand were most common in 44.48%, followed by feet 39.76%, and face 15.74% respectively. LIMITATION OF STUDY: Mode of inclusion of patient was self-reporting during follow up phase so there is possible under reporting of the disabilities. CONCLUSION: New deformities continue to develop in certain forms of leprosy even after release from treatment. Long-term & regular follow up of patients who have been released from treatment is required.
Assuntos
Avaliação da Deficiência , Hanseníase/patologia , Hanseníase/fisiopatologia , Estudos Transversais , Progressão da Doença , Face/anormalidades , Feminino , Seguimentos , Deformidades Adquiridas do Pé/patologia , Deformidades Adquiridas do Pé/fisiopatologia , Deformidades Adquiridas da Mão/patologia , Deformidades Adquiridas da Mão/fisiopatologia , Humanos , Índia , Masculino , Prontuários Médicos , Nervos Periféricos/fisiopatologia , Estudos Retrospectivos , Índice de Gravidade de Doença , Fatores de TempoAssuntos
Falanges dos Dedos da Mão/diagnóstico por imagem , Deformidades Adquiridas do Pé , Deformidades Adquiridas da Mão , Hanseníase , Osteólise , Radiografia/métodos , Falanges dos Dedos do Pé/diagnóstico por imagem , Idoso de 80 Anos ou mais , Diagnóstico Diferencial , Falanges dos Dedos da Mão/patologia , Deformidades Adquiridas do Pé/diagnóstico por imagem , Deformidades Adquiridas do Pé/etiologia , Deformidades Adquiridas da Mão/diagnóstico por imagem , Deformidades Adquiridas da Mão/etiologia , Humanos , Hanseníase/complicações , Hanseníase/diagnóstico , Masculino , Osteólise/diagnóstico por imagem , Osteólise/etiologia , Falanges dos Dedos do Pé/patologiaRESUMO
Leprosy is a medical - social disease, it is associated with stigma in the society due to the resulting deformities in some persons. Although stigma has decreased after the widespread use of MDT, some disabilities do occur which are mostly due to late initiation of treatment and inappropriate care. Besides the nerve and skin involvement bone changes have been reported to be common in leprosy. These bony changes need to be understood in the present MDT era specially in the context of clinical spectrum and duration of disease/ deformities. Fifty clinically diagnosed and histologically classified leprosy patients with deformities/ disabilities of either hands/feet/face who attended the OPD of Department of Dermatology, Venereology and Leprosy, Government Medical College, Amritsar were examined and evaluated in the study. Radiological examination of hands, feet and skull was done in each case and the bone changes in hands and feet; and skull and paranasal sinus changes were correlated with clinical parameters. Bone changes were observed in 90% of cases radiologically. Specific bone changes in hands and feet, non-specific bone changes in hands, feet, skull and paranasal sinuses were seen in 66%, 82% and 32% of cases respectively. Common specific bone changes in hands and feet observed were primary periostitis (14%), honey combing (46%), bone cyst (36%), thinning and irregularity of cortex (28%) and area of bone destruction (20%); Among the non-specific bone changes observed were contracted fingers/claw hands/claw toes (64%) and absorption of terminal phalanges (40%). The maxillary sinus, and paranasal sinus changes were the most common radiological findings observed in skull. The study of the radiological changes may help the clinicians to understand the gravity of the situation and undertake steps for timely prevention of permanent loss of function and the occurrence of deformities and disabilities.
Assuntos
Deformidades Adquiridas do Pé/diagnóstico por imagem , Deformidades Adquiridas da Mão/diagnóstico por imagem , Cabeça/diagnóstico por imagem , Hanseníase/diagnóstico por imagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Cistos Ósseos/diagnóstico por imagem , Criança , Pessoas com Deficiência , Feminino , Cabeça/anormalidades , Humanos , Masculino , Pessoa de Meia-Idade , Radiografia , Adulto JovemAssuntos
Pessoas com Deficiência , Sobrancelhas/patologia , Deformidades Adquiridas do Pé/patologia , Deformidades Adquiridas da Mão/patologia , Hanseníase Virchowiana/complicações , Hanseníase Virchowiana/patologia , Deformidades Adquiridas do Pé/etiologia , Deformidades Adquiridas da Mão/etiologia , Humanos , Hansenostáticos/uso terapêutico , Hanseníase Virchowiana/tratamento farmacológico , Masculino , Pessoa de Meia-IdadeRESUMO
Seventy four patients, who underwent tibialis posterior transfer between 1960 and 1970 at the Schieffelin Leprosy Research & Training Centre, were reviewed more than 10 years follow up. Sixty four patients (86.5%) improved from a high stepping gait to a heel toe gait. The foot at rest position and the range of movement which were seen after surgery were retained. Postoperative complications were minimal. Interosseous method was better than the circumtibial. Tibilais posterior tendon transfer has served the gait and foot function in the long term.
Assuntos
Deformidades Adquiridas do Pé/cirurgia , Hanseníase/complicações , Transferência Tendinosa/métodos , Adolescente , Adulto , Criança , Feminino , Seguimentos , Deformidades Adquiridas do Pé/fisiopatologia , Marcha , Humanos , Masculino , Pessoa de Meia-Idade , Amplitude de Movimento ArticularRESUMO
OBJECTIVES: The aim of this study was to access the postoperative functional results of posterior tibial tendon transfer for foot drop as a consequence of nerve palsy in leprosy. MATERIAL AND METHODS: Thirteen patients (9 males and 4 females) with ages ranging from 9 to 69 years were submitted to posterior tibial tendon transfer by the circumtibial route to correct foot drop in leprosy. The length of postoperative follow-up ranged from 1 to 5 years. The Stanmore system was used as a method for evaluating the functional results of postoperative posterior tibial tendon transfer. This system is made up of 7 different categories and the total score is 100. RESULTS: According to the Stanmore system, the results were poor in 1 patient (7.6%), moderate in 2 feet (15.3%), good in 5 feet (38.4%), and excellent in 5 feet (38.4%). All the patients were satisfied with the final outcome. CONCLUSION: The posterior tibial tendon transfer for foot drop in leprosy was efficient in restoring normal function of the foot and gait without changing foot posture. In the absence of a standardized method for assessing the results of posterior tibial tendon transfer, the Stanmore system seems to be a good tool for an objective evaluation.
Assuntos
Deformidades Adquiridas do Pé/cirurgia , Hanseníase/complicações , Neuropatias Fibulares/cirurgia , Transferência Tendinosa/métodos , Adolescente , Adulto , Idoso , Brasil , Criança , Estudos de Coortes , Intervalos de Confiança , Feminino , Seguimentos , Deformidades Adquiridas do Pé/etiologia , Humanos , Hanseníase/diagnóstico , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/cirurgia , Neuropatias Fibulares/etiologia , Cuidados Pós-Operatórios/métodos , Cuidados Pré-Operatórios/métodos , Amplitude de Movimento Articular/fisiologia , Recuperação de Função Fisiológica , Estudos Retrospectivos , Medição de Risco , Resultado do Tratamento , Adulto JovemRESUMO
We assessed the epidemiology of disabilities in leprosy cases treated in a rural hospital over a 10-year period. This is a retrospective data collection using leprosy registers and treatment cards in a rural private mission hospital. Over the 10-year period, 210 patients with leprosy were registered for treatment. One hundred and twenty-eight (61.5%) had disabilities (26.0% grade 1 and 35.6% grade 2): 13.5% ocular disabilities, 44.5% disabilities in hands and 44.7% foot impairment. Patients >19 years had more disabilities (66.7% versus 50.7%) (P = 0.03), especially ocular disabilities (16.7% in >20 versus 6.0% in <20 years) (P = 0.03). This study detected a high prevalence of disabilities.
Assuntos
Avaliação da Deficiência , Infecções Oculares Bacterianas/epidemiologia , Deformidades Adquiridas do Pé/epidemiologia , Deformidades Adquiridas da Mão/epidemiologia , Hospitais Rurais/estatística & dados numéricos , Hanseníase/complicações , Adolescente , Adulto , Criança , Pessoas com Deficiência/estatística & dados numéricos , Etiópia/epidemiologia , Infecções Oculares Bacterianas/etiologia , Feminino , Deformidades Adquiridas do Pé/etiologia , Deformidades Adquiridas da Mão/etiologia , Humanos , Hanseníase/diagnóstico , Hanseníase/tratamento farmacológico , Hanseníase/epidemiologia , Masculino , Prevalência , Sistema de Registros , Adulto JovemRESUMO
OBJECTIVE: To explore the relationships between perceived limitations in walking-related daily activities, walking ability (capacity), and the amount of daily walking (performance) in persons affected by leprosy and to identify their determinants. DESIGN: A cross-sectional study. SUBJECTS: Thirty-nine persons affected by leprosy. METHODS: Perceived limitations were assessed with the World Health Organization Disability Schedule II, domain "getting around". Walking capacity was assessed as covered distance in 6 min. Walking performance was recorded as mean strides/day with the Stepwatch(TM) 3 Activity Monitor. Potential determinants were sensory function, foot deformities, joint mobility, ankle muscle strength and co-morbidity. RESULTS: Perceived limitations in walking-related activities were significantly correlated with walking capacity (r = -0.47; p < 0.01) but not with walking performance, although walking capacity significantly correlated with walking performance (r = 0.38; p < 0.05). Various foot impairments independently contributed to reduced walking capacity and, to a lower degree, to perceived limitations in activities and performance. CONCLUSION: People affected by leprosy perceive limitations in walking-related activities that are determined by a reduced walking ability and the severity of foot impairments. Since perceived limitations in walking-related activities were not related to walking performance, perceived limitations are apparently weighted against the individual's needs.
Assuntos
Pé/fisiopatologia , Hanseníase/fisiopatologia , Caminhada/fisiologia , Atividades Cotidianas , Adulto , Idoso , Articulação do Tornozelo/fisiopatologia , Estudos Transversais , Feminino , Deformidades Adquiridas do Pé/fisiopatologia , Humanos , Hanseníase/complicações , Hanseníase/reabilitação , Masculino , Pessoa de Meia-Idade , Mononeuropatias/etiologia , Mononeuropatias/fisiopatologia , Força Muscular/fisiologia , Autorrelato , Participação SocialRESUMO
Stigma is almost synonymous with visible deformity and this is what makes leprosy a dreaded disease for the common man. Deformities in children are more distressing, due to the limitation of their physical, academic and social life. An 11-year-old female child was presented with trophic ulceration of right foot and triple nerve paralysis (i.e. total claw hand with wrist drop) of the left hand of 2 years duration. In addition, she had multiple hypopigmented hypoaesthetic patches on the extremities and buttocks. She was diagnosed as a case of borderline tuberculoid leprosy and was started on WHO MB MDT therapy. Leprosy in children is an indicator for disease prevalence in general population and occurrence of deformities points towards the delay in making the diagnosis and the stigma associated with the disease.
Assuntos
Deformidades Adquiridas do Pé/etiologia , Deformidades Adquiridas da Mão/etiologia , Hanseníase/complicações , Criança , Feminino , Humanos , Hansenostáticos/uso terapêutico , Hanseníase/tratamento farmacológico , Paralisia , Úlcera Cutânea/etiologia , Úlcera Cutânea/prevenção & controleRESUMO
The usual protocol for correction of drop foot in leprosy, a consequence of damage to the common peroneal nerve, is a tendon transfer, immobilisation to heal the tendon juncture and post-operative exercises to put the transfer into use. Tarsal disintegrations have been reported in literature in drop foot patients when the transferred tendons were inserted into the bone making a drill hole to ensure firm anchorage. Such disintegrations are rarely seen these days because bony insertion of the tendon transfers is not performed in the leprosy-affected foot. We report here a case of drop foot that developed a fracture of the calcaneum during the post-operative period after tibialis posterior two tail transfer (to tibialis anterior and extensor digitorum longus) along with lengthening of the tendoachillis. The case is interesting in the sense that osteoporosis and walking strains resulted in a fracture of the body of the calcaneum which healed with conservative treatment and controlled mobilisation of the patient.
Assuntos
Calcâneo/diagnóstico por imagem , Deformidades Adquiridas do Pé/cirurgia , Fraturas Ósseas/etiologia , Hanseníase/complicações , Osteoporose/diagnóstico por imagem , Transferência Tendinosa/efeitos adversos , Adulto , Calcâneo/lesões , Deformidades Adquiridas do Pé/etiologia , Humanos , Masculino , Osteoporose/complicações , Complicações Pós-Operatórias , Radiografia , Resultado do TratamentoRESUMO
Neurophatic foot ulceration (NFU) is a common problem in leprosy patients. Three cases of NFU, who did not respond to conservative measures, were treated with orthopaedic surgery. The purpose of the treatment was, by using different approaches, the reduction of bone hyper pressure areas, allowing the ulcer to heal.
Assuntos
Úlcera do Pé/cirurgia , Hanseníase/complicações , Idoso , Feminino , Deformidades Adquiridas do Pé/diagnóstico por imagem , Deformidades Adquiridas do Pé/etiologia , Deformidades Adquiridas do Pé/patologia , Deformidades Adquiridas do Pé/cirurgia , Úlcera do Pé/diagnóstico por imagem , Úlcera do Pé/etiologia , Úlcera do Pé/patologia , Humanos , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
Prevention of Disability (POD) service needs to be expanded for future reducing the leprosy burden. Tibialis Posterior Transfer Surgery (TPT) is an established procedure and relatively easy to do at district level general hospitals. It can protect further damages of affected foot and consequently reduce patient's social burden as well. Totally 70 TPT surgeries were done during a joint project of JICA on leprosy control and basic health service in Myanmar for training purpose (Jan/2002-Jan/2006). A follow-up assessment was done for exploring the effectiveness of foot drop surgery, in Nov/2006 at 9-selected townships in Mid-Myanmar. 33 cases (Male 22, Female 11) were reviewed and the mean of follow up period was 29.1 months (SD=7.1, 10-48 months). Total results were; good: 25 cases (76%), fair: 4 cases (12%) and poor: 4 cases (12%). In good and fair cases, patients were satisfied with the results and TPT improved the QOL of patients. In almost all cases (32/33, 97%) after TPT, patients are free from plantar ulcer. Most serious complication of operation (4 cases, 12%) identified was inversion deformity due to loosed tension of lateral tail of grafted TP tendon sutured to Extensor Digitorum Longus. From the results of TPT surgery follow-up, it can benefit much to the patients if resources permit to make it as a routine service in more places.
Assuntos
Deformidades Adquiridas do Pé/etiologia , Deformidades Adquiridas do Pé/cirurgia , Hanseníase/complicações , Transferência Tendinosa/métodos , Tendões/cirurgia , Adolescente , Adulto , Idoso , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Mianmar , Qualidade de Vida , Tíbia , Resultado do TratamentoRESUMO
OBJECTIVES: Determining the occurrence of leprosy amongst couples and establishing the type of leprosy in index and secondary cases. METHODS: The characteristics of leprosy were studied between 1980 and 2000 in Atlántico Department located on the Colombian Caribbean Coast. Clinical histories of patients registered in the Leprosy Control Programme were reviewed. Clinical exams were performed and personal interviews carried out with couples suffering from leprosy. RESULTS: Twenty-six married couples were found to be suffering from leprosy, representing 5.4% of leprosy cases detected during the study period. They were aged from 20 to 89. 65.4% of the index cases were men and 22 (84.6%) were multibacillary, lepromatous cases; two had indeterminate leprosy and two were suffering from tuberculoid leprosy. Sixty-one percent of the secondary cases were paucibacillary patients, 42% of them being tuberculoid. No paucibacillary cases were associated with multibacillary leprosy in the couples. Only two couples had consanguinity. None of the couples had had leprosy at the time of being married. The time between leprosy being detected in index cases and the disease being detected in secondary patients varied from 5 to 40 years. Disabilities were more common in the feet and to a higher degree in lepromatous index cases who had had the disease for a longer time than the secondary cases because these were more frequently paucibacillary patients who had a disease having shorter evolution. CONCLUSIONS: In spite of ongoing, prolonged contact, conjugal leprosy is not frequent and requires several years to develop in the second person. Lepromatous leprosy in index cases was more frequently associated with leprosy in the couple. When the primary case was paucibacillary, no multibacillary leprosy occurred in the secondary case.
Assuntos
Transmissão de Doença Infecciosa/estatística & dados numéricos , Hanseníase/epidemiologia , Cônjuges , Adulto , Idoso , Idoso de 80 Anos ou mais , Colômbia/epidemiologia , Consanguinidade , Feminino , Deformidades Adquiridas do Pé/epidemiologia , Deformidades Adquiridas do Pé/etiologia , Deformidades Adquiridas da Mão/epidemiologia , Deformidades Adquiridas da Mão/etiologia , Humanos , Ceratoconjuntivite Infecciosa/epidemiologia , Ceratoconjuntivite Infecciosa/etiologia , Hanseníase/classificação , Hanseníase/complicações , Hanseníase/transmissão , Hanseníase Virchowiana/epidemiologia , Hanseníase Virchowiana/transmissão , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de TempoRESUMO
We describe the results of arthrodesis for the treatment of recurrent acute neuropathic bone disease in 24 feet and of chronic disease with deformity in 91 feet, undertaken between January 1984 and December 2003. All were due to leprosy. Correction of the deformity was achieved in 80 of 106 feet (76%) and fusion in 97 of 110 feet (88%). In the 24 feet in which recurrent neuropathic bone disease was the reason for surgery, 17 (71%) obtained stability while in seven (29%) symptoms recurred postoperatively. Complications were experienced following 58 of the 110 operations (53%). In patients presenting primarily with deformity with a minimum follow-up of two years (79 feet), there was a reduced frequency of ulceration in 40 (51%). Normal footwear could be worn by 32 patients (40%) after surgery, while 40 (51%) required a moulded insole. Arthrodesis of the ankle in the neuropathic foot due to leprosy has a good overall rate of success although the rate of complications is high.
Assuntos
Artrodese/métodos , Artropatia Neurogênica/cirurgia , Deformidades Adquiridas do Pé/cirurgia , Doenças do Pé/cirurgia , Adolescente , Adulto , Idoso , Artrodese/efeitos adversos , Artropatia Neurogênica/etiologia , Criança , Feminino , Doenças do Pé/etiologia , Humanos , Hanseníase/complicações , Masculino , Pessoa de Meia-Idade , Reoperação , Estudos Retrospectivos , Sapatos , Resultado do TratamentoRESUMO
OBJETIVOS: Determinar la ocurrencia de lepra entre cónyuges y precisar las características de la enfermedad en el caso índice y en el secundario. MÉTODOS: Estudiamos sus características en una zona de la Costa Caribe colombiana (Departamento del Atlántico), durante 1980-2000, a través de la revisión de las historias clínicas del Programa Control de Lepra, del examen clínico y de entrevistas con los afectados. RESULTADOS: Encontramos 26 parejas con lepra conyugal, que representan el 5,4 % de los casos diagnosticados durante el periodo, con edades entre 20 y 89 años. El 65,4 % de los casos índices fueron hombres y 22 (84,6 %) lepromatosos; dos tenían lepra indeterminada y dos tuberculoide. Los casos secundarios fueron tuberculoides en su mayoría (42,3 %) y, en conjunto, 61 % paucibacilares. Ningún caso índice paucibacilar se asoció con lepra multibacilar en el cónyuge. Sólo dos parejas tenían consanguinidad. Ninguno de los cónyuges llegó enfermo al matrimonio y su convivencia entre la aparición de la enfermedad en el caso índice y el secundario, varió entre 5 y 40 años. La convivencia de los cónyuges varió entre 5 y 44 años. Las discapacidades se presentaron con mayor frecuencia en los pies y fueron más graves en los casos índices lepromatosos, con enfermedad de larga evolución, que en los secundarios, porque éstos fueron paucibacilares con mayor frecuencia y se detectaron cuando su enfermedad tenía menor tiempo de evolución. CONCLUSIONES: La lepra conyugal es poco frecuente, requiere varios años de convivencia para presentarse en el segundo cónyuge y es más común cuando el caso primario es lepromatoso. Cuando un cónyuge es paucibacilar su pareja no desarrollara lepra multibacilar.
Assuntos
Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transmissão de Doença Infecciosa , Hanseníase/epidemiologia , Cônjuges , Colômbia/epidemiologia , Consanguinidade , Deformidades Adquiridas do Pé/epidemiologia , Deformidades Adquiridas do Pé/etiologia , Deformidades Adquiridas da Mão/epidemiologia , Deformidades Adquiridas da Mão/etiologia , Ceratoconjuntivite Infecciosa/epidemiologia , Ceratoconjuntivite Infecciosa/etiologia , Hanseníase Virchowiana/epidemiologia , Hanseníase Virchowiana/transmissão , Hanseníase/classificação , Hanseníase/complicações , Hanseníase/transmissão , Estudos Retrospectivos , Fatores de TempoRESUMO
"Leprosy control and Basic health service Project" was terminated at March 2005 within the scope of the period. I was assigned to develop the Plantar protect footwear for neuropathic feet, which called "Myanmar Sandals" in common. These sandals are not made by new technologies but made by basic knowledge. I would like to report about this activity as which is a part of distinguished strategy of ODA (Official Development Assistance) for developing country, but not as the technical report of these sandals. There is only one National Leprosy Hospital in Myanmar. At the time this project started, there were only two footwear technicians for the people who had disabilities by after effect of Hansen's disease in this country. And, it would appear that the number of the people is over 50,000. Furthermore, the budget of national hospital is not enough to refill necessary consumable supplies and materials. Although, I should instruct new technique which like making in Japan in ordinary circumstances, I could not think that such technical transfer by using costly imported materials woud bring beneficial effect and be continued. We were bound to be anxious about such situations when we made the plan. As a result of examining a plan based on these situations, we reached the conclusion that development of the simplified ready-made footwear was pressing need.
Assuntos
Úlcera do Pé/etiologia , Úlcera do Pé/terapia , Hanseníase/complicações , Sapatos , Ensaios Clínicos como Assunto , Países em Desenvolvimento , Desenho de Equipamento , Deformidades Adquiridas do Pé/etiologia , Deformidades Adquiridas do Pé/terapia , Humanos , Mianmar , Programas Nacionais de SaúdeAssuntos
Doenças Ósseas/microbiologia , Hanseníase/complicações , Doenças Ósseas/terapia , Deformidades Adquiridas do Pé/microbiologia , Deformidades Adquiridas do Pé/terapia , Deformidades Adquiridas da Mão/microbiologia , Deformidades Adquiridas da Mão/terapia , Humanos , Doenças do Sistema Nervoso Periférico/microbiologiaRESUMO
Reconstructive surgery has made significant advances in correcting deformities in leprosy. However, several patients seem hesitant and unenthusiastic to take advantage of this facility. A study was therefore carried out at the Leprosy Mission Hospital in Kolkata during 1999, to assess patients' perceptions to reconstructive surgery. Of about 300 patients operated during 1991-1997, 117 were interviewed using a Visual Analogue Scale on their pre-operative expectations and satisfaction after surgery. Nearly 40% had their expectations fully met, another 40% partially, and about 10% perceived benefits more than expected. Less than 5% were not satisfied. Results are presented for surgery on hand, foot and eye among males and females, and the implications for future discussed.