Comment: ulnar abscess--4 months after release from control with paucibacillary-multidrug therapy.
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Biomedical subjects
Publications and source records attributed to A Salafia.
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The authors report on their experience of nerve abscess in leprosy. They have found that in the last 5 years there is a significant increase in this type of pathology, at a time when the total number of patients has decreased in adults. Nerve abscesses are, recently, noticed in a large number of children and teenagers. This was not the case 7-9 years ago. Abscesses were excised from one hundred forty-five nerves in one hundred and sixteen patients between May 1985 and May 1994, out of which, 14 patients (12.6%) were operated during the period May 1985 to December 1989 and 102 (87.93%) in the period January 1990 to May 1994. Children and teenagers account for 47% of all cases of nerve abscess in this series. The incidence of abscess in multiple nerves is high too in these groups. Abscess of cutaneous nerves is very common too (35% of cases) though rarely reported in the literature. There is a higher incidence of nerve abscess in male adults as compared to females. The authors believe that this sudden increase in neural pathology can be attributed, in part, to the extension of multidrug therapy (MDT) programmes without adequate infrastructure to detect and treat early neuritis.
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The authors report 3 cases of temporary generalized lymphoadenopathy directly related to Lamprene (Clofazimine) consumption. It appears that this side effect has never been reported in the literature.
The authors present their experience in the use of the JESS (Joshi External Stabilising System) for correction of proximal interphalangeal joint (PIP joint) contracture deformity in 68 fingers. The use of the JESS has made this surgery easier, faster in releasing contractures and it has given better correction than the methods so far used by the same authors, like capsulotomy, local flaps and free skin grafting. The procedure is simple and has no serious side effects; it can be repeated if need be. The JESS is easy to apply, economical, reliable, reusable, well accepted by the patient. Compared to the other distractors made in USA and Europe, the JESS has an added advantage in that it costs so very much less (US $5-10), that our leprosy hospitals can afford it. In our patients, we have achieved full extension in 75% and good extension in 10.3% of the cases. These figures are much better than what was possible, in the past, with local flaps and free skin grafting. With those procedures we had excellent results in only 53% of the cases and poor result in 28%.
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