Evaluation of hearing impairment in leprosy patients taking multidrug therapy.

Present descriptive study was carried out for the assessment of hearing capability in leprosy patients. After getting approval from Institutional ethical committee, the present descriptive study was carried out on 60 subjects. All the patients were indoor-patients at the Leprosy Rehabilitation Center Maharogi Sewa Samiti Anandvan Warora, and were on multidrug therapy described by World Health Organization from an average period of 6 months. Study Group I consisted of 30 diagnosed Leprosy patients taking multidrug therapy from an average period of 6 months. Group II (Control group) consisted of 30 normal healthy individuals of same age. Patients suffering from acute or chronic ear discharge, Presence of wax in external auditory canal, diabetes mellitus, hypertension, impaired renal function and patients having history of trauma were excluded from the study. All the subjects underwent Pure tone audiometry, Tuning Fork test to check the level of hearing loss and type of hearing loss and detailed clinical examination for cranial nerve function was done in all the patients of study group and control group. Audiometry findings in study group patients showed that 23 patients (76.66%; 45 ears) of the leprosy patients had sensory neural hearing impairment and 7 patients (23.33%) showed normal hearing. Out of these affected patients, 10 patients (43.47%; 19 ears) had mild sensory neural hearing impairment, 10 patients (43.47%; 20 ears) had moderate sensory neural hearing impairment. 2 patients (8.69%; 04 ears) had moderate to severe hearing impairment, 1 patient (4.34%; 02 ears) showed severe sensory neural hearing impairment. In the absence of any local or systemic disease or drugs likely to have side effects on the cochleovestibular function, leprosy affects the cochleovestibular system, and effect on cochlear function is seen more often than effect on the vestibular system. Thus hearing loss which is seen in patients suffering from Hansen's disease is of cochlear origin.

An evaluation of efficacy of ultrasonography in the diagnosis of head and neck swellings.

OBJECTIVE: The aim of this study was to evaluate the efficacy of ultrasonography in the diagnosis of swellings in the head and neck regions. METHODS: For this study, 70 cases with clinically obvious swellings in head and neck regions were selected randomly. The ultrasonographic features considered were shape, boundary, echo intensity, ultrasound architecture of lesion, posterior echoes and ultrasound characteristic of tissues. Intergroup comparisons were made between four different types of swellings: inflammatory; cystic; benign; and malignant. RESULTS: A comparison was made between benign and malignant neoplasms, and the criteria of boundary, echo intensity and ultrasound architecture of lesions are statistically significant as the P-value is <0.05. The comparison of inflammatory swellings and malignant neoplasms shows that criteria of boundary and ultrasound architecture of lesions are statistically significant. The comparison of cystic swellings and benign neoplasms concluded that only the criterion of ultrasound characteristics of tissues is statistically significant. The comparison of inflammatory swellings and benign neoplasms shows that the criteria of boundary and echo intensity are statistically significant. The comparison of inflammatory swellings and cystic swellings concluded that the criteria of boundary, shape, echo intensity, posterior echoes and ultrasound characteristics of tissues are statistically significant. The comparison of cystic swellings and malignant neoplasms concluded that the criteria of ultrasonography, boundary, shape, echo intensity, ultrasound architecture of lesion, posterior echoes and ultrasound characteristics of tissues are statistically significant as the P-value is <0.05. CONCLUSION: It can be concluded that clinical diagnosis had a sensitivity and accuracy of 85.7% and ultrasonographic diagnosis had a sensitivity and accuracy of 98.5%.

Oral health status and alveolar bone loss in treated leprosy patients of central India.

A descriptive cross sectional study was carried out, in a group of 160 leprosy patients treated with multi drug therapy. The patients with age group of 25 to 60 year were considered. Out of 160 patients 50 patients were selected by simple random sampling technique for radiological assessments. Intra-oral periapical radiographs (6 for each patient) were taken. The paralleling long cone technique was used and radiographs were attached with grids so as to enable measuring the bone height. The grid was spaced in 1 mm marking and placed directly over the film. Clinical examination revealed that Prevalence of dental caries was 76.25% and periodontal disease was 78.75%. Mean DMFT score was 2.26. Mean OHI-S score was 3.50. Score for Gingival index was 1.60 and average loss of gingival attachment was 1.2 mm. Radiographic findings showed mean alveolar bone loss in maxillary anterior region to be 5.05 mm and in maxillary posterior region it was 4.92 mm. Alveolar bone loss in mandibular anterior region was 4.35 mm and in mandibular posterior region was 5.14 mm. Overall Dental Health Status of the leprosy patients was poor and needed more attention for dental care. There was also an increase in the alveolar bone loss, which was generalized. This bone loss could be due to advance stage of the disease or late approach to rehabilitation center, these patients also had peripheral neuropathy leading to hand and feet deformity in the form of claw hand or ulcer on hand, making maintenance of oral hygiene difficult.