A Ten Year Study of Pediatric Leprosy Cases in a Tertiary Care Centre in South Kerala

Leprosy in children is a valuable marker of impact of programme. This study has been carried out to analyse the clinical and histopathological characteristics of pediatric leprosy cases attending a tertiary health care centre in South Kerala bordering Tamil Nadu. This is a retrospective, analytical study of pediatric leprosy cases seen from 01 January 2007 to 31 December 2016 in the Dermatology out-patient department of Dr. Somervell Memorial CSI Medical College, Karakonam, Trivandrum, Kerala. Seven of the 52 leprosy cases in this hospital during this study period children (age group of 6 to 14), of which 6 were females. Two cases among these were borderline lepromatous and the rest were indeterminate leprosy. Three patients had contact with lepromatous leprosy (familial). Histopathology correlated well with our clinical diagnosis. Grade 2 deformity was seen in one child, who had taken incomplete treatment earlier. While the number of cases reporting to this centre may or may not reflect true epidemiological picture at population level, data may be used to plan proper research cum intervention studies. The prevalence of childhood leprosy can be reduced if we are vigilant and improve the surveillance of contacts, as 43% of cases in this study had a contact of leprosy in the family.

Hypersensitivity to glucocorticoids in patients with raised ICP : report of two cases.

Corticosteroids are widely used in patients with raised intracranial pressure associated with cerebral neoplasms, cerebral vascular malformations, cerebral ischaemia and benign intracranial hypertension. In general clinical practice, anti-allergic, anti-inflammatory and immuno-suppressive properties of corticosteroids are commonly utilised in the management of allergic and immunological diseases. However in exceptionally rare circumstances, steroids may be the cause of hypersensitive reactions. Authors report two patients with raised intracranial pressure who developed steroid hypersensitivity. A review of the relevant literature is discussed.

In vitro evaluation of newer beta-lactam antibiotics against gram negative bacilli isolated from neutropenic patients.

The in-vitro susceptibility pattern to newer beta lactams namely Ticer/Clav, Azlocillin, Piperacillin and Imipenem was determined with 50 clinical strains isolated from neutropenic patients with strains isolated from neutropenic patients with sepsis, with an objective of evolving a strategy for empirical antibiotic therapy for febrile neutropenic patients. The MIC90 value for Imipenem for the Gram negative bacilli tested, other than Pseudomonas was < 0.25 mcg/ml therapy revealing a high degree of susceptibility, while for Ps. aeruginosa and related species MIC50 and MIV90 values were 2.0 and 64.0 micrograms/ml respectively. A comparatively lower degree of susceptibility was found among Gram negative bacilli included in the study to ticar/clavu, azlocillin and piperacillin indicating a moderate degree of resistance to these antibiotics. The data from this study suggests that (i) Ureidopenicillins with an aminoglycoside should be effective therapy for proven Pseudomonas and other Gram negative sepsis in febrile neutropenic patients. (ii) Imipenem would be the antibiotic of choice in Gram negative bacterial sepsis in febrile neutropenic patients where the organism is resistant to cephalosporins and ureidopenicillins.