Involvement of tongue in leprosy.
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Biomedical subjects
Publications and source records attributed to B Kumar.
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Twenty one patients of leprosy were studied for gastrointestinal symptoms and submitted to detailed intestinal absorption tests and jejunal biopsy before and after the institution of Clofazimine therapy. Fifteen patients were administered 100 mg orally daily for 3 months, while six patients with ENL received 300 mg of the drug for 6 weeks initially and then 100 mg daily. Mild diarrhoea and abdominal symptoms occurred in four patients, fecal fat excretion increased in one patient but Schilling's and d-Xylose tests did not alter. No significant changes were produced by Clofazimine therapy in jejunal mucosa. Clofazimine crystals were seen in the lamina properia of one patient, the overlying mucosa was normal. No correlation was found between the abnormality in mucosal pattern, crystal deposition, absorption parameters or symptomatology and doses of drug taken.
Lymph node aspiration was performed from the inguinal group of lymph nodes in 16 patients having lepromatous or borderline leprosy. In the same group of patients impression smears of excised lymph node and slit smears of the skin were also studied. This study made it obvious that the aspiration biopsy technic gave similar information regarding the Bacteriologic (BI) and Morphologic Indices (MI) as the impression smears of excised lymph nodes. The technic of aspiration being simple and nontraumatic is recommended for the follow-up of patients on antileprosy drugs and in reactional phases.
Responses to various tests of cardiovascular reflexes were studied in 15 patients with leprosy. Heart rate was continuously monitored by electrocardiogram and blood pressure was recorded simultaneously. Three patients showed evidence of cardiac dysautonomia, showing involvement of both the sympathetic and parasympathetic systems. These three patients belonged to the bacilliferous group.
Skin slit smears from fingers and ear lobules and lymph node aspiration smears stained with Ziehl-Neelsen stain were studied in 43 patients of LL or BL disease. All the patients had taken dapsone monotherapy for 3-7 years. None of the patients had clinical evidence of dapsone resistance. Small number of bacilli were detected in 16 patients. Lymph node aspirate was positive in 5 cases, whereas ear lobule and fingers yielded bacilli in 12 and 13 cases respectively. It is recommended that in addition to the traditional ear lobe it is imperative to study other sites as well. Study from fingers is recommended for the sake of simplicity. Where facilities are available sampling of the lymph node may also be attempted to advantage.
Closely bred Swiss albino normal mice (Lecca Strain) were inoculated in the footpad with M. leprae, at room temperature. The animals were harvested at 3, 6 and 9 months post inoculation, and bacillary counts were made. Trophic changes were observed in the tail-tips, ears, footpads and forepaws 12-14 months post inoculation in a group which was allowed to survive. The histopathological changes and bacillary infiltration was found in many tissues/organs. The possibility of studying this normal strain of mice as an experimental model for human leprosy has been discussed.
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The latest time bound WHO regimens for the treatment of paucibacillary (I, TT, BT) and multibacillary leprosy is discussed. The rationale, indications of above regimens and cautions necessary are highlighted.
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BACKGROUND: The relationship of hepatitis B virus infection with drug use and sexual activity in Indian college students has not been studied earlier. METHODS: We studied this relationship in Chandigarh, using a prospective, cross-sectional questionnaire-based survey and blood tests for hepatitis B markers. The responders were assured of the confidentiality of their responses and blood test results. RESULTS: Of the 1311 students who participated, 192 (15%) were sexually active. Eight-four per cent of them were heterosexual, 7.3% homosexual and 8.7% bisexual. Thirty-seven per cent of heterosexuals and 36% of homosexuals had more than one partner. Condoms were used by 24% heterosexuals, 11% bisexuals and 7% homosexuals. Of the sera tested, 2.9% were hepatitis B surface antigen positive and 10.4% were positive for the antibody to hepatitis B surface antigen. Fifteen per cent consumed alcohol, but only 1.6% were addicted to other drugs. Two students were intravenous drug users. Eleven per cent had donated blood at least once and a third of these had suffered from jaundice in the past. CONCLUSION: The pattern of sexual behaviour, low condom use and the small but definite prevalence of hepatitis B virus infection in this population of students suggests that the human immunodeficiency virus infection may spread rapidly when it enters this community.
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