Epidemiological scenario of leprosy in marginalized communities of India: Focus on scheduled tribes

The Scheduled Tribes (STs) are designated among the most disadvantaged social groups in India. Until the year 2005 (pre-elimination era of leprosy in India), several leprosy-specific control field programmes were implemented, which have been discontinued subsequently. Since then, leprosy diagnosis and treatment have been integrated with General Health Services. Thereafter, specialized expertise for the early diagnosis of leprosy has been gradually diminishing, especially at the peripheral clinics in remote areas. Hence, leprosy cases usually remain undetected for a long time and persist as endemic reservoirs. The tribal population of India accounts for just 8.6 per cent of the overall population. However, 18.5 per cent of the new leprosy cases were detected within the tribal community in the year 2020, indicating a disproportionately high burden of leprosy among the tribal population. Recent data suggest that these health disparities can be mainly related to the increased marginalization of STs as compared to other communities. This shows the need to further explore the current situation of leprosy in STs so that suitable interventions can address the contributing factors, leading to health inequalities in disadvantaged socio-economic groups. Therefore, this review aims to present the current distribution of leprosy in marginalized communities with a special emphasis on STs. Further, this review discusses how resources might be mobilized for such communities to find and treat undetected leprosy patients in STs to enable effective control of leprosy through early detection and timely treatment.

A Case of Pulmonary Hydatid Cyst Misdiagnosed as Encysted Effusion

Echinococcosis or hydatid disease is caused by larvae of the tapeworm Echinococcus. In cystic echinococcosis, humans are an accidental host and are usually infected by handling an infected dog. The liver and lungs are the most frequently involved organs. Pulmonary disease appears to be more common in younger individuals. Although most patients are asymptomatic, some may occasionally expectorate the contents of the cystor develop symptoms related to compression of the surrounding structures. Other symptoms of hydatid disease can result from the release of antigenic material andsecondary immunological reactions that develop from cyst rupture.

A Case of Asthma COPD Overlap

Asthma and COPD are the pulmonary diseases most frequently encountered in clinical practice. Usually, each disease is caused by a different etiology and shows a different clinical picture and course. However, these two diseases sometime present within the same patient, and it is now recognized that asthma and COPD can coexist as asthma COPD overlap (ACO), which is clinically important for several reasons. First, it is estimated that the number of patients with ACO will increase significantly together with the recent increase in numbers of patients with asthma and COPD. Secondly, patients with ACO are prone to experience more frequent and severe exacerbations. Patients who have asthma with a COPD component tend to present with severe hypoxia because of Irreversible/fixed airway obstruction and impairment of the alveolar diffusion capacity by emphysematous changes. In contrast, patients with COPD who have an asthma component not only have exertional dyspnea but also develop paroxysmal wheezing or dyspnea at night or in the early morning. Here we report a case of 60 yr old male diagnosed as a case of asthma COPD overlap.