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Biomedical subjects

J M Mehta

Publications and source records attributed to J M Mehta.

At least 19 recordsLinked to original sources

Coexistent lepromatous leprosy and reactive perforating collagenosis.

The cases of two young men with coexistent lepromatous leprosy and reactive perforating collagenosis are reported. Although both patients' parents were consanguineous, experimental induction of Koebner's phenomenon by superficial scratching failed to produce the lesions of reactive perforating collagenosis. The lesions of reactive perforating collagenosis showed a satisfactory response to treatment with topical retinoic acid.

Adult↗

Dapsone-induced erythroderma with Beau's lines.

A 35-year-old female with borderline lepromatous (BL) leprosy who suffered from dapsone-induced erythroderma is reported. Sudden onset of erythroderma gave rise to a temporary arrest of the function of nail matrix with the resultant Beau's lines. She rapidly recovered with omission of dapsone and therapy with systemic corticosteroids and a topical emollient. In view of the potentially fatal hypersensitivity reaction, we suggest that any patient on multidrug therapy for leprosy needs an urgent referral to a dermatologist if the patient develops a skin rash during the first two months of treatment.

Adult↗

A study of dermatological conditions in leprosy in-patients.

Three hundred and sixty six in-patients in a leprosy hospital were examined for other dermatological conditions. Eighty eight of them displayed ichthyosiform changes. A peculiar condition of a verrucous hyperkeratotic growth on the anterior aspect of ankle, not described previously, was observed in four patients. It was noted that 11 out of 12 patients with scabies did not have the classical lesions in web spaces of the hands.

Clofazimine↗

Pterygium unguis in a patient with recurrent type 2 lepra reaction.

A 35-year-old man with long-standing lepromatous leprosy and history of recurrent, severe type 2 lepra reaction was found to have pterygium unguis and destruction of the fingernails. We propose that the obliterative angiitis and endarteritis due to severe type 2 lepra reaction were responsible for these nail changes.

Adult↗

Malignant transformation in trophic ulcers in leprosy: a study of 12 cases.

Twelve cases of carcinomata arising in Trophic ulcers of Leprosy are presented. Out of these, 10 were on the plantar surface more commonly on the proximal part of foot, one on lower leg and dorsum of foot, and one in an ulcer over the lateral malleolus. Almost all presented with infected growths and regional lymphadenopathy. Three cases presented with advanced disease with fungating inguinal nodes and were fatal. Nine cases underwent below knee amputation under antibiotic cover as a definitive treatment and the lymph nodes were kept under observation. Histologically, all were low grade squamous cell carcinomas. In most cases lymph nodes regressed after removal of primary and in one case lymph nodes were positive for malignancy. This study was conducted at Dr. Bandorawalla Leprosy Hospital, Kondhawa, Pune 22 from the year 1981 to 1987.

Adult↗

'Flu' syndrome on once monthly rifampicin.

Two cases of 'flu' syndrome on once monthly rifampicin are reported. The symptoms were reproduced in one patient with the next supervised dose. In the second patient they did not recur probably because she was receiving systemic steroids for left ulnar neuritis.

Adult↗

Persistence of rabies antibody 5 years after pre-exposure prophylaxis with human diploid cell antirabies vaccine and antibody response to a single booster dose.

In 1978, 22 staff members of the National Institute of Virology, Pune, India, were given two doses of human diploid cell antirabies vaccine (HDCV) for primary pre-exposure prophylactic immunization; the interval between the two doses being approximately 4 weeks. Eighteen of these 22 vaccinees were given a booster dose 1 year later. All 18 vaccinees developed protective levels of antibody; most of them had antibody levels exceeding 10 IU/ml. In 1984, 5 years after the booster dose, 11 (79.0%) of 14 vaccinees tested still possessed neutralizing antibody levels ranging from 0.5 IU/ml to 10 IU/ml. Fourteen days after the administration of a booster dose, the antibody levels ranged from 10 to greater than or equal to 100 IU/ml for all except one vaccine (5.2 IU/ml). These findings demonstrate that the majority of vaccines retained detectable neutralizing antibody after pre-exposure prophylaxis for as long as 5 years and that a single booster dose thereafter evoked a good antibody response.

Antibodies, Viral↗

Common vocational training project for the handicapped (CVTPH).

CVTPH is a special project imparting vocational training to leprosy patients as well as other categories of the handicapped under the same roof, in order to combat the leprosy stigma which is the major obstacle in all leprosy work and to aid rehabilitation by making the trainees economically self-sufficient. The project, which offers training in the industrial sector to leprosy patients, orthopaedically handicapped individuals and able-bodied but socio-economically disadvantaged individuals, began in a small way in 1977, but has grown considerably since then, thus demonstrating the effectiveness of the concept. There have been several problems--chief among which are the leprosy stigma and the reluctance of the trainees themselves to move out from a sheltered environment into the world outside--but these are slowly being overcome by the formation of co-operative societies controlled by the handicapped. This project is hoped to serve as a model for similar vocational training programs.

Combined Modality Therapy↗

Tarsal disintegration (T.D.) in leprosy.

Tarsal Disintegration in leprosy has been a challenge as far as its prevention is concerned. It is, no doubt, a complex and less understood phenomenon influenced by many factors. In this study made at Dr. Bandorawalla Leprosy Hospital, Kondhawa, factors like insensitivity, loss of protective reflex, infection, lepromatous infiltration of bones etc. have been taken into consideration, but, more emphasis is laid on the biomechanical factors (i.e. altered muscle pulls due to muscular paralysis resulting in imbalance) and the resulting change in weight bearing areas and weight transmission lines. Sixteen cases of neuropathic feet were examined clinically and radiologically. All were burnt out cases of tuberculoid and borderline tuberculoid variety excepting one which was active being of lepromatous variety. Tracings made from actual radiographs of the patients were studied. It was found that apart from insensitivity, biomechanical factors play a lot of importance in accentuating the process of T.D. The changes are predominantly seen in Tuberculoid variety of Leprosy. Attempts have been made to understand this process more closely by drawing conclusions based on the kinetic and kinematic analysis of the normal human foot and comparing it with neuropathic feet.

Adult↗

Splinting of the hand in leprosy.

Clawing of the hand in Leprosy, which is caused due to paralysis of intrinsics can often be prevented and corrected to some extent if looked in properly. Splints can contribute a lot to this. This article emphasizes the use of variety of splints prepared from alumafoam, hexcelplast and such other materials, as an adjunct to other physiotherapy measures like wax-bath, massage and exercises.

Combined Modality Therapy↗