ABSTRACT
A pilot study has been undertaken to compare the efficacy of small dose pulsed betamethasone therapy with need based oral steroids in chronic recurrent erythema nodosum leprosum (ENL) patients. Though this mode of therapy was well tolerated, no advantage with intermettnt steroid administration was observed. This coul have been on account of small dose of steroid given monthly. Treatment of chronic recurrent erythema nodosum leprosum (ENL) patients continues to be unsatisfactory, particularly, because of non-availability of thalidomide. Though corticosteroids are effective in suppressing all the manifestations and even restoring partially or fully the functional impairment, their side effects and dependence are equally troublesome. Based on (a) the reported efficacy and safety of intermittent use of corticosteroids in several immune complex mediated disorders (Cathcart et al 1976, Kimberly et al 1979), Lieblin et al 1981 and Pasricah & Gupta 1984) and (b) ENL (type II) reactions having similar pathology, a pilot study has been undertaken to see the efficacy and the tolerance of pulsed steroids in chronic ENL patients
Subject(s)
Humans , Erythema Nodosum/classification , Erythema Nodosum/diagnosis , Erythema Nodosum/etiology , Erythema Nodosum/immunology , Erythema Nodosum/drug therapy , Steroids/administration & dosage , Leprosy, Lepromatous/complications , Pulse Therapy, Drug , Pulse Therapy, Drug/trends , Betamethasone/administration & dosage , Betamethasone/adverse effects , Fever/etiology , Eye Infections/etiology , Peripheral Nerves/injuries , Kidney/injuriesABSTRACT
This population sample survey conducted in rural and urban areas of the Agra District in India showed an active leprosy caseload of 60.1/10,000 in the rural and 39.1/10,000 in the urban areas against a targeted prevalence of < 1/10,000. The disease appeared to be widespread since almost 65% of the villages or urban pockets surveyed had at least one prevalent case of leprosy. Significantly larger numbers of leprosy patients were found among males, agricultural/manual workers, persons with no formal schooling, individuals living in unkept households with dirty surroundings, and among those living in dark and poorly ventilated houses. The epidemiological significance of this study reveals the endemic nature of leprosy in Agra and suggests the need to intensify and widen case-detection activities to achieve leprosy control.
Subject(s)
Leprosy/epidemiology , Leprosy/ethnology , Leprosy/prevention & control , India/epidemiology , India/ethnologyABSTRACT
Se comparan dos grupos de pacientes MB: uno tratado hasta negatividad en frotis (TSN) y el otro con terapia de duración fija (24 dosis MB OMS) (FDT), para determinar los índices de recidivas durante el tratamiento y el período post-tratamiento, encontrando 20 recidivas (2.04/100 pacientes/año) durante el seguimiento de 980.2 personas/año en 260 pacientes tratados en FDT. En el otro grupo , 301 pacientes recibieron tratamiento hasta negativización, detectándose 12 recidivas en 1085.46 personas/año (1.10/100 pacientes año). La comparación de los índices de supervivencia (sin recidivas) revela que aunque no hay diferencia significativa hasta los 4 años, el riesgo de recidiva es significativamente mayor en el grupo FDT durante un período mayor de seguimiento. Además, cuando se compara en los pacientes la carga bacilar inicial, se observa un índice de recidivas mayor en el grupo con IB≥4, significativamente mayor (p<0.01) que en el grupo FDT comparado con el grupo que recibe tratamiento hasta la completa negativización del frotis (4.29 años 1.27/100 pacientes/años). Todos los pacientes con recidivas respondieron al tratamiento con la misma combinación de medicamentos, indicando qu la exacerbación de su condición es por insuficiente tratamiento. Se sugiere para prevenir o reducir recidivas, el continuar cuando sea posible el tratamiento hasta negativización del frotis, al menos en pacientes con IB elevado.
Subject(s)
Leprosy/prevention & control , Leprosy/drug therapy , Recurrence/prevention & controlABSTRACT
While leprosy does not primarily affect the kidneys, secondary involvement of kidneys has been reported in lepromatous leprosy and especially in lepra-reaction. In the present study the authors have investigated the functional status of the kidneys of lepromatous leprosy patients by focussing attention to parameters like acidification of urine, glomerular filtration rate and excretion of a foreign dye administered intramuscularly. This study revealed a decreased ability to acidify urine and to excrete the dye as well as a drop in glomerular filtration rate in untreated LL patients. The said disturbances were more pronounced in lepra reaction.
Subject(s)
Male , Humans , Adult , Middle Aged , Leprosy/complications , Kidney Diseases/etiology , Kidney Diseases/metabolism , Glomerular Filtration RateABSTRACT
Six cases of phlebitis of leprous origin affecting the superficial veins have been recorded. This lesion does not seem to be as rare as was previously believed. The clinical and histopathological details of these cases are presented
Subject(s)
Humans , Phlebitis/etiology , Phlebitis/pathology , Leprosy/complicationsABSTRACT
A comparison of intradermal response to injection of Dharmendra type of coded antigens, prepared from different species of Mycobacteria by Prof. G.P. Talwar has been made over 3 weeks period. The results are reported.