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V V Pai

Publications and source records attributed to V V Pai.

At least 19 recordsLinked to original sources
PubMed2005

Clinical, histopathological and bacteriological study of 52 referral MB cases relapsing after MDT.

Fifty-two BB-LL relapse cases referred to our centre during 1997-2003 were investigated in detail. Twenty-four cases had been treated with extended MB-MDT [until smear negativity (NON-FDT)]. The remaining 28 cases (54%) had received one of the fixed duration regimens (FDT), of whom 11 had 24 months and 6 had 12 months of WHO MB-MDT. Eleven cases had received rifampicin/ofloxacin (RO) treatment. Follow-up slit skin smear reports were available for 41 cases, all but three cases had been smear negative at some point after release from treatment. None of the cases showed any clinical or bacteriological evidence of upgrading, i.e. LL to BT where as downgrading BB to BL occurred in five cases. The duration between cessation of treatment and reappearance of lesions (DCTR) varied from 2 to 15 years. The mean DCTR was longest (9.4 years) for the NON-FDT and 24 months MB-MDT cases. The mean DCTR was significantly lower in the 12 months MB-MDT and RO treated cases (6.8 and 6.2 years, respectively). Four of RO treated cases and four cases with multiple episodes of reaction had DCTR less than 5 years. Inadequate treatment/poor killing of Mycobacterium leprae results in early onset relapse, whereas 'persisting' or 'drug resistant mutants' contribute to late onset relapse.

Drug Therapy, Combination↗
PubMed2004

Reactions and their management.

The uneventful response to chemotherapy in leprosy is marked by clinically disturbing episodes encountered in 20-30% of patients and these phenomena are called "reactions". Generally they are classified as reversal reaction (type-1) and erythema nodosum leprosum (type-2). The cutaneous menifestations are: (1) Type-2 reactions in LL, BL types constituting erythema nodosum leprosum, erythema multiforme, erythema necroticans, subcutaneous nodules, lepromatous exacerbation. (2) Type-1 reactions in borderline and tuberculoid leprosy. The other manifestations include: Acute neuritis, lymphadenitis, arthritis, oedema of the hands and feet, ocular lesions, etc. Sequelae of reactions are: Paralytic deformities, non-paralytic deformities, extensive scarring and renal damage. A simple guideline to identify the risk-prone cases has been narrated. Prednisolone in standard dosage schedule as recommended by WHO is now being widely used in control programmes.

Arthritis↗
PubMed2003

Viability and drug susceptibility testing of M. leprae using mouse footpad in 37 relapse cases of leprosy.

Mycobacteria leprae isolates obtained from 37 referral relapse cases of leprosy (37 skin and 10 nerve biopsy samples) received during the years 1994-2001, were tested for viability and drug sensitivity in the mouse footpad. A significant M. leprae yield in the footpads of control mice was obtained, with 32/47 (68%) isolates (from 26 cases) thus confirming viability. Of the 28 isolates successfully drug tested, 6 (21%) were resistant to one or more drugs. All except one, were multidrug treated cases (5/24 = 21%). One of the isolates was resistant to all three drugs, i.e., dapsone (di-aminodiphenyl sulphone, DDS), rifampin (RFP), and clofazimine (CLF). Two were resistant to two drugs, i.e., DDS and RFP, and each of the others were mono resistant to DDS, RFP, or CLF. Notably, one of the isolates that showed combined resistance to DDS and RFP was derived from a borderline tuberculoid case. Also, in one case skin and nerve showed that discordance viz: M. leprae derived from skin were resistant to RFP, while those derived from nerve tested sensitive to all three drugs, indicating tissue related difference.

Animals↗
PubMed1999

Serum markers of treatment success in leprosy.

UNLABELLED: Intercellular adhesion molecule-1 (ICAM-1) and E-selectin and other variables were evaluated as possible markers of the success of multidrug therapy (MDT) in leprosy. Multibacillary (MB, N = 45) and paucibacillary (PB, N = 29) leprosy patients were examined during MDT, which typically lasted 12 months for MB and 6 months for PB patients. Serum values for total protein, albumin, immunoglobulin gamma (IgG), ICAM-1, and E-selectin (selectin) were recorded, as were lesion type, number, and distribution. Response at the end of therapy was assessed as good, fair, or poor. The bacterial index (BI) of lesions was measured at the beginning and end of therapy. The earlier reported findings of this investigation are herein re-examined. RESULTS: age and lowered serum albumin correlated with the poorer condition of the patients, as did elevated selectin. Albumin was inversely correlated with the BI (p = 0.008) in MB patients, and IgG was positively correlated (p = 0.009). ICAM and E-selectin alone were not useful markers of individual patient condition. A regression combining serum albumin under 41 g/l, age and E-selectin was able to identify 85% of the patients in poorer condition. CONCLUSION: serum albumin was a useful nonspecific marker of both patient condition and infection. Age is an important negative factor in patient response. Albumin and IgG correlate with the BI and with each other (p = 0.011) in MB patients, but not in PB patients.

Adolescent↗