Biomedical subjects
M F Mascarenhas
Publications and source records attributed to M F Mascarenhas.
Pattern of reactions in leprosy: a clinical appraisal.
The term 'reactions' is applied in the present text, to describe the acute episodes, recognized with the different types of leprosy. The incidence of reactions was found to be 9.7% of 1053 cases examined. They were seen in all types of leprosy, but their frequency and severity was marked in lepromatous and borderline cases, and in majority of them, the age ranged from 20-40 years. The precipitating factor(s) could not be established in many; in some dapsone was incriminated, followed by bacterial infection and malnutrition. The exacerbations of the existing lesion(s) either alone or in combination with new lesions (E.N.L.) and E.N.L. lesions alone, were the presenting clinical features. The constitutional symptoms were observed largely in the types other than the tuberculoid. Foot drop and contractures of the fingers were the common sequels of the reactions. An attempt has been made to explain their mechanisms in the light of the recent literature.
Epidemiological and clinical patterns of genital lesions.
A 5-year study of 668 patients with genital lesions revealed that teenagers and those in the age group of 20 to 40 are most vunerable. The poor, the uneducated and unmarried persons are at high risk. Chancroid and syphilis are the majority of cases. Inguinal bubo, herpes pregenitalis, condylomata acuminata, erosive balanitis and traumatic ulcers were seen less frequently. Most of the genital lesions had the classic clinical features. The findings of this study suggest that the pattern of genital lesions is showing borderline changes.
The prevalence and pattern of leprosy in a school survey.
The prevalence of leprosy in a school survey conducted in Panaji, India was found to be 5.3 per 1,000 with males predominating. The majority of patients had a single lesion on exposed parts of the body showing the clinical characteristics of tuberculoid leprosy. However, clinical features of indeterminate leprosy were seen in two patients and borderline tuberculoid in a single case. On the other hand, histopathologically, the majority of the patients were classified as having borderline tuberculoid or indeterminate leprosy. A disparity between the clinical and histopathologic diagnosis was evident. This observation emphasizes the importance of studying both the clinical and histopathologic features in deciding the precise status of a patient in the leprosy spectrum.
Dapsone syndrome in Goa.
Daspone syndrome was noted within six weeks of starting treatment in 1.3% of about 700 leprosy patients on MDT reporting to the skin department of Goa Medical College. Skin rash, photosensitivity, fever, lymphadenopathy, sore throat, hepatosplenomegaly, abnormal liver function tests and raised reticulocyte count were consistent features in all the patients. Other drugs, infectious mononucleosis and viral exanthemata were considered in differential diagnosis. Withdrawal of dapsone and administration of prednisolone controlled the condition within three to four weeks in majority of the patients. One patient died of ischemic heart disease unrelated to dapsone syndrome.