Oral Hygiene status of Leprosy Patients from Raichur district, South India

Patients with leprosy may not be commonly reporting to the dental professionals. This study describes the oral hygiene status of the leprosy patients from a developing district of South India. A descriptive crosssectional study was conducted to assess the oral hygiene status of leprosy patients in Raichur district, Karnataka. A total of 225 patients were examined during 2012 as a part of the study. These are patients who registered at Raichur and Mudgal leprosy centres during this period for leprosy treatment. Oral Hygiene Index – Simplified was recorded according to the criteria given by Greene and Vermillion in 1964. Data was analyzed using SPSS version 16.0 software package. Male : female ratio was 2:1 and age of these patients ranged from 6-80 years, mean 33.25 ± 15.49 years. The mean Debris Index-Simplified score was 1.94 ± 0.66; mean Calculus Index-Simplified score 2.08 ± 0.64 and the mean Oral Hygiene Index-Simplified score was 4.02 ± 1.22. Percentage of leprosy patients with poor oral hygiene increased with increasing age. There was also association with habits of pan chewing, smoking, alcohol use and cleaning practice of not using tooth brush or neemstick. No relationship could be found with broader classification of leprosy, socio-economic status and other parameters. Patients with good and fair oral hygiene reported of lower dental problems than those with a poor oral hygiene. Lack of association with socioeconomic status and type of leprosy suggests a general awareness problem but this issue deserves in depth studies. The current study among leprosy patients in Raichur district is the first kind of study from this area which highlights the poor plight of these patients with respect to their oral hygiene status. Periodic surveys and interventions in terms of awareness campaigns among the leprosy patients as well as care providers and community in general will be useful. Orientation of health systems accordingly will be required to bring desired changes in the situation.

Antioxidant factors, nitric oxide levels, and cellular damage in leprosy patients

Introduction The immune response caused by Mycobacterium leprae is a risk factor for the development of oxidative stress (OS) in leprosy patients. This study aimed to assess OS in leprosy patients before the use of a multidrug therapy. Methods We evaluated the nitric oxide (NO) concentration; antioxidant capacity; levels of malondialdehyde, methemoglobin and reduced glutathione; and the activity of catalase and superoxide dismutase (SOD) in leprosy patients. Results We observed lower SOD activity in these leprosy patients; however, the NO levels and antioxidant capacity were increased. Conclusions The infectious process in response to M. leprae could primarily be responsible for the OS observed in these patients. .

Clinical Characteristics of New Leprosy Patients for 15 Years (1992~2006) in Daegu / 대한피부과학회지

BACKGROUND: The prevalence and number of new cases of leprosy have recently markedly decreased in Korea. Therefore, the concerns about leprosy have also gradually decreased. For this reason, making the diagnosis of leprosy is not as easy as it was in the past, and it is more difficult to find new cases of leprosy. OBJECTIVE: The purpose of this study is to evaluate the epidemiologic and clinical features of recently diagnosed cases of leprosy in Daegu city, Korea. METHODS: Fifteen patients were diagnosed with leprosy according to the clinical features, histopathologic findings and bacteriologic examinations at Yeungnam University Hospital from 1992 to 2006. The epidemiological and clinical features according to age, gender, the place of residence, the duration of disease, the location of lesions, the cutaneous findings and the type of disease were evaluated retrospectively using the patients' medical records. The patients enrolled in this study were divided by the Madrid classification: the lepromatous type, the tuberculoid type and the intermediate or borderline group. RESULTS: Fifteen patients were diagnosed with leprosy during the past 15 years. The ratio of males to females was 1.5:1. Most of the patients (66.6%) were aged in their 40's and 60's. This shows that the rate of patients 40 years or older is on the increase. The male patients were younger than the female patients. The male patients were in their 20's and 40's, whereas the female patients' ages ranged from their 50's to 80's. The skin lesions showed various features and six (40%) of the 15 patients had sensory change. Eleven (73.3%) of the 15 patients were in the borderline group, followed by 3 patients with the tuberculoid type (20%) and 1 patient with the lepromatous type (6.7%). CONCLUSION: New leprosy patients have been persistently found and the findings of this study suggest that dermatologists play an important role in diagnosing and treating leprosy and they have to pay attention to diagnose new cases of leprosy.

Clinical, bacteriological and immunological follow-up of household contacts of leprosy patients from a post-elimination area - Antioquia, Colombia

Follow-up of the household contacts (HHC) of leprosy patients is still the best strategy for early detection of leprosy. HHC from a post-elimination region of Colombia studied in 2001-2002 were re-contacted in 2007. They were tested at both times by clinical examination, bacillary index (BI), PCR from a slit skin smear (SSS) and anti PGL-1 IgM titres. Thirty-two of 61 HHC (52 percent) were re-contacted. Nine HHC (28 percent) showed sero-conversion and one had a skin lesion (BI negative, nested PCR positive). Periodic evaluation of HHC can contribute to the detection of infected HHC as well as new and early leprosy cases.

Levels of tumor necrosis factor alpha and soluble interleukin-2 receptor in serum of the cured leprosy persons / 中国免疫学杂志

Objective:In order to study the immunofunction and cytokine’s role in sIL-2R and TNF? in clinical remission leprosy patients, and get more knowledge of leprosy’s immunopathogenesis.Methods:Serum TNF? and sIL-2R were measured in 62 clinical remission lerosy patients and their 28 direct relatives in Lanxi of Zhejiang Province. Local normal persons were randomly selected as controls.Results:The TNF? in all clinical remission leprosy patients lowered significantly( P

Mycobacterium leprae mediated stimulation of macrophages from leprosy patients and hydrogen peroxide production.

Macrophages cultured from the peripheral blood of normal individuals, tuberculoid leprosy patients and long-term-treated, bacteriologically negative lepromatous leprosy patients are able to release hydrogen peroxide on stimulation with Mycobacterium leprae. Macrophages from lepromatous leprosy patients who are bacteriologically positive produce considerably lower levels of hydrogen peroxide, even though stimulation of these cells with Mycobacterium leprae is definitely demonstrable. This differential stimulation of macrophages appears to be largely specific to Mycobacterium leprae. There is also a good indication that decreased stimulation of macrophages from positive patients could be due to an after-effect of infection. It is possible that while other factors aid survival of Mycobacterium leprae in the macrophages, hydrogen peroxide may not be as effective in the killing of the bacteria in infected patients as it would be, perhaps, in other infections.

Superoxide production from macrophages of leprosy patients after stimulation with Mycobacterium leprae.

The macrophages from peripheral blood of normal healthy individuals respond to live or killed Mycobacterium leprae by producing superoxide. On the other hand, the macrophages from bacteriologically positive (B + LL) or long term treated bacteriologically negative (B – LL) and tuberculoid leprosy patients are unable to produce superoxide when stimulated with live Mycobacterium leprae. While killed Mycobacterium leprae induce superoxide with the cells from tuberculoid and B(–)LL patients, cells from B(+)LL patients fail to respond. The deficiency in B(–)LL patients to produce superoxide appears to be specific with Mycobacterium leprae and the defect can be counteracted by the addition of colchicine. These observations indicate a preexisting membrane disposition which does not favour superoxide production. A similar situation is seen in the cells from tuberculoid leprosy patients. Thus it appears that both cured and active lepromatous leprosy patients have defective macrophages, unable to respond to live Mycobacterium leprae to produce superoxide anion, in contrast to the situation with the cells from normal healthy individuals.