Comparative study of short term results in two multidrug regimens in multibacillary leprosy.

Thirty lepromatous and Borderline lepromatous leprosy patients were treated with multidrug therapy in an open trial. Fifteen of them received the standard WHO multidrug regimen ie., rifampicin 600 mg and clofazimine 300 mg monthly, supervised, and dapsone 100 mg daily and clofazimine 100 mg on alternate days as self administered; the other 15 received a modified multidrug therapy regimen comprising of rifampicin 600 mg, clofazimine 100 mg and dapsone 100 mg daily for 21 days as suggested by the Indian Association of Leprologists, followed by the standard WHO regimen. The observation period was six months. Clinical, bacteriological, histological and immunological parameters were studied. The fall in morphological index was much faster in patients receiving modified multidrug therapy regimen compared to those receiving the standard WHO regimen. Otherwise, there was no difference between the two groups of patients. Five patients developed type I (upgrading) reaction with one developing ulnar nerve paralysis. No untoward effects of drugs were noted in the study subjects except for darkening of skin colour of all the patients.

Multidrug therapy in hospitalised leprosy cases.

Fifty eight cases including 44 paucibacillary and 14 multibacillary leprosy diagnosed at Command Hospital SC Pune were hospitalised for the entire period of multidrug therapy. 76% cases belonged to high endemic states of India. Reactions occurred in 13 cases during treatment, type I in 10 and type II in three. 7 Multibacillary cases experienced reaction. 69% reaction patients developed reaction within two months of starting MDT and all of them were multibacillary. Usually it took 3-6 months for majority (61.5%) of reactions subside completely. In 65.5% paucibacillary patients activity subsided within twelve months, however 70.5% paucibacillary cases took more than six months to exhibit subsidence of activity. In 13 multibacillary cases activity subsided by 18 months though bacteriological negativity was obtained from fourth to twelve months.

Leprosy with pellagroid features (a case report).

A case of leprosy with pellagroid features is presented. Diagnosis of leprosy was confirmed by bacteriological and histopathological examination. A therapeutic trial with nicotinic acid did not result in any improvement. Occurrence of scaling in leprosy is discussed.

Study of finger print patterns in leprosy.

Finger print patterns of 150 male leprosy patients (100 paucibacillary and 50 multibacillary leprosy) were compared with 50 matched controls. Significant differences were found in finger print patterns of multibacillary leprosy patients and controls. No differences in dermatoglyphic patterns were observed between paucibacillary leprosy and controls. The total finger ridge count (TFRC) in both types of leprosy was slightly lower than controls. A significant difference in individual finger ridge count on digit 1 of right hand was noted in paucibacillary leprosy cases as compared to controls.

Quantification of thermal sensory loss in follow up of progress in leprosy.

Thermal sensory perception quantitatively was studied in follow up of 10 lesions (4 TT, 3 BT and 1 Indeterminate case) of cases put on poly therapy as per WHO regime, for 6 months. Significant thermal sensory improvements was noticed in 4 lesions after 4 months of therapy. Within 2 months of therapy, 3 cases showed improved perception of heat sensation but 1 showed deterioration. Recovery of sensations did not correspond to other clinical parameters of improvement in all the cases. The utility of quantitative evaluation of thermal sensory perception in follow up of leprosy cases is discussed.

Inoculation leprosy developing after tattooing--a case report.

A case of Inoculation Leprosy following tattooing in a soldier is being reported. Escape of infection in one tattoo and occurrence of disease in another when tattooing was done simultaneously, is of interest. Possible mechanism for such occurrence is discussed.

Quantification of thermal sensory perception in leprosy (a preliminary report).

An instrument called 'Thermosense' was designed and developed for quantitative assessment of thermal sensory perception. Preliminary testing on 20 healthy adult males showed that 39 degrees C was perceived as hot in 19 individuals on the forearm and arm. The perception on the finger tips was less than forearms. In 5 cases of leprosy (BT 4, TT 1) testing showed detectable difference in thermal perception within the lesion, in the skin, in the vicinity of the lesion and the uninvolved skin.

Epidemiological and clinical aspects of leprosy in Indian armed forces.

Epidemiological and clinical aspects of leprosy in 1911 cases of the disease in armed forces personnel were studied. Typewise distribution of cases was Tuberculoid 53.53%, Lepromatous 20.57%, Indeterminate 8.74%, Borderline 11.67% and Polyneuritic 5.49%. Maximum leprosy cases occurred in those belonging to Uttar Pradesh 17.11%. Maximum number of cases were detected (88.55%) in age group 20-39 years. Incidence of leprosy increased with increased years of service. 11.82% patients were illiterate. 89.85% patients earned Rs. 200 to 499 per month. 56.08% patients had no landed property. Houses of 47.29% cases were located in congested areas. 68.23% patients had to support larger families. In 95.94% cases no family members were examined for leprosy. Diet, smoking and alcohol appear to have had no relation to disease in cases studied. Clinical presentation of cases was classical and typespecific. Skin eruption and loss of sensation were the commonest symptoms. Leprosy lesions were detected on almost all parts of body. Thermal sensation was the commonest modality lost. Ulnar, lateral popliteal and greater auricular were the frequently affected nerves. Amongst complications paralytic deformities were common (16.09%). 545 complications were detected in 1911 cases. While 84.29% patients had put in more than 4 years of service, the source of infection was known only in 0.57% positively (intrafamilial).

Inoculation leprosy subsequent to dog bite. A case report.

Development of leprosy lesion at the site of inoculation or injury is described by many workers off and on. An interesting case of indeterminate leprosy developing at the site of dog bite is being reported.