scholarly journals A 10 year retrospective analysis of Hansen’s disease patients in an urban leprosy centre of Himachal Pradesh

Author(s):  
Renu Rattan ◽  
Gita R. Tegta ◽  
Anuj Sharma ◽  
Meena Chauhan

Background: Leprosy is a chronic disease caused by Mycobacterium leprae, which is a non culturable, slowly multiplying bacillus. The incubation period is variable and may take as long as twenty years for the symptoms to appear. It mainly affects the skin and peripheral nerves, but has a wide range of clinical presentations. The disease is associated with deformities and social stigma. Methods: Records of Hansen’s disease patients from January 2007 to December 2016 were taken and analysed retrospectively. A total of 288 patients were registered during this period. Results: Out of 288 registered patients, 78.8% were males and 21.2% were females. Maximum number of patients (62.15%) was in the age group of 20-40 years. Multibacillary patients constituted 86.11% and only13.88% were paucibacillary patients. 66.66% patients had grade 0 deformities, 22.56% had grade 1 deformities and 10.76% had grade 2 deformities. Conclusions: The study recommends that continuous efforts should be made for early detection of cases to prevent spread of disease in the community and to avoid development of deformities. 

e-CliniC ◽  
2014 ◽  
Vol 2 (1) ◽  
Author(s):  
Patricia I. Tiwow ◽  
Renate T. Kandou ◽  
Herry E. J. Pandaleke

Abstract: Hansen’s Disease is a chronic infection disease caused by Mycobacterium leprae. The transmission of this disease is by direct contact with Hansen’s Disease patients in a long period of time, and by inhalation. This study aimed to evaluate the profile of hansen’s disease patients in Dermatovenereology clinic of Prof. Dr. R. D. Kandou Hospital Manado during the period from January – December 2012. This is a descriptive retrospective study. The result of this study showed that among 112 patients with hansen’s disease, the highest rate was within 25-44 age group (46.4%), where male patients outnumbered females (64.3%). Most of the patients reside in the district of Singkil (12.5%). Multibacillary leprosy was most frequent (89.3%). There were 16% patients with ENL reactions. The disability stage 2 were found in 8,1% patients. Most patients had no history of treatment with MDT (54.5%). Keywords: Hansen’s Disease, profile.   Abstrak: Morbus Hansen (MH) adalah penyakit infeksi kronik yang disebabkan oleh Mycobacterium leprae. Penularan terjadi melalui kontak langsung dalam jangka waktu yang lama dan melalui inhalasi. Penelitian ini bertujuan untuk mengetahui profil penderita morbus hansen di poliklinik kulit dan kelamin BLU RSUP Prof. Dr. R.D. Kandou Manado periode Januari-Desember 2012. Penelitian bersifat deskriptif retrospektif. Hasil penelitian memperlihatkan dari 112 penderita MH (10,22%) terbanyak berasal dari kelompok umur 25-44 tahun (46,4%), jenis kelamin laki-laki (64,3%), tempat tinggal kecamatan Singkil (12,5%), tipe MH terbanyak tipe Multibasiler (89,3%), terdapat reaksi ENL sebanyak 16%, kecacatan tingkat 2 sebanyak 8,1%, dan riwayat pengobatan terbanyak belum pernah melakukan pengobatan MDT sebelumnya (54,5%). Kata Kunci: Morbus Hansen, profil.


Author(s):  
Alexander Scarborough ◽  
Robert J MacFarlane ◽  
Michail Klontzas ◽  
Rui Zhou ◽  
Mohammad Waseem

The upper limb consists of four major parts: a girdle formed by the clavicle and scapula, the arm, the forearm and the hand. Peripheral nerve lesions of the upper limb are divided into lesions of the brachial plexus or the nerves arising from it. Lesions of the nerves arising from the brachial plexus are further divided into upper (proximal) or lower (distal) lesions based on their location. Peripheral nerves in the forearm can be compressed in various locations and by a wide range of pathologies. A thorough understanding of the anatomy and clinical presentations of these compression neuropathies can lead to prompt diagnosis and management, preventing possible permanent damage. This article discusses the aetiology, anatomy, clinical presentation and surgical management of compressive neuropathies of the upper limb.


Author(s):  
Ganesh Kumar ◽  
Purnima Pachori

Background: Hysterectomy is one of the commonest gynecological surgeries being performed in India for various pelvic pathologies like fibroid uterus, endometrial hyperplasia, dysfunctional uterine bleeding, etc. But pre-operative diagnosis of adenomyosis and making it an indication for hysterectomy is not as common as pathologists find it in histo-pathology of hysterectomized specimens. The aim of the study was to study the frequency of adenomyosis in comparison to leiomyoma as a uterine pathology in hysterectomized specimens and correlate them clinically.Methods: A retrospective comparative study was carried out on 1646 hysterectomy specimens, during January 2014 to December 2016, which showed either adenomyosis or leiomyoma or both. Clinical records of these cases were retrieved and histo-pathology was correlated to clinical presentations and pre-operative ultrasonography.Results: Of the 1646 specimens taken for comparision between adenomyosis and leiomyoma, 49% showed only adenomyosis, 37% only leiomyoma and 14% had dual pathology showing findings of both. The peri-menopausal age group (45-54 years) accounted for the maximum number of patients undergoing hysterectomy (37.12%). But adenomyosis was found maximum in 35 - 44 years age group (38.04%). The clinical presentations for these two pathologies were similar and maximum patients presented with abnormal uterine bleeding and pelvic pain. Ultrasonography was able to diagnose only 32% cases of adenomyosis pre-operatively whereas this figure was 87% for fibroids.Conclusions: Adenomyosis and leiomyoma both account for the most frequent findings in hysterectomy specimens. Fibroids are easily diagnosed pre-operatively, but adenomyosis needs to be diagnosed pre-operatively by high index of clinical suspicion and imaging techniques. Adenomyosis is not just a disease of middle age, it needs to be addressed for infertility, recurrent pregnancy loss (RPL), bad obstetric history, IVF failures and adherent placenta as well.


Author(s):  
Tatiana Borges DIAS ◽  
Rosângela Fátima da COSTA

A hanseníase é uma doença infectocontagiosa crônica, transmitida pelo Mycobacterium leprae, parasita intracelular que acomete células cutâneas e células nervosas periféricas. A enfermidade tem cura, porém se tratada tardiamente pode evoluir para deformidades físicas permanentes, repercutindo nos aspectos físicos, psicológicos, econômicos e sociais da vida do indivíduo. Além disso, o estigma se constitui como fator desencadeante para o surgimento de transtornos mentais, como ansiedade e depressão. Diante disso, o presente estudo teve por objetivo investigar a prevalência dos indicadores de ansiedade e depressão em pessoas com hanseníase atendidas pela rede pública de saúde de um município do noroeste paulista, bem como caracterizar a população pesquisada em suas condições sociodemográficas. Trata-se de um estudo quantitativo e descritivo, realizado com 21 indivíduos que estão ou que estiveram em tratamento contra a hanseníase num período de dois anos. Foram utilizados Inventários Beck de Depressão (BDI) a fim de avaliar graus de depressão, Inventários Beck de Ansiedade (BAI) para verificar sintomas ansiosos e Questionários Sociodemográficos para levantar as características dos entrevistados. Os resultados revelaram que 43% dos participantes manifestaram níveis leves nos protocolos BAI, enquanto nos protocolos BDI foram demonstrados níveis mínimos por 48%. Quanto ao perfil sociodemográfico, observou-se que a maior parte dos pesquisados são homens (71%), com 60 anos ou mais (52%), casados (71%), brancos (71%), católicos (57%), com ensino fundamental incompleto (48%), assalariados (43%), com renda familiar entre 1 e 3 salários mínimos (71%).  Logo, concluiu-se que os participantes, em sua maioria, apresentaram níveis leves para ansiedade e mínimos para depressão.   SOCIO-DEMOGRAPHIC PROFILE AND THE PREVALENCE OF ANXIETY AND DEPRESSION IN PEOPLE WITH HANSEN’S DISEASE   ABSTRACT Hansen’s disease is a chronic infectious and contagious disease, transmitted by Mycobacterium leprae, an intracellular parasite that attacks the skin and peripheral nerve cells. Such disease is curable, however, when belatedly treated it may evolve to permanent physical deformities, affecting the physical, psychological, economic, and social factors of the subject’s life. Moreover, a stigma is constituted as a triggering factor for mental disorders occurrences, such as anxiety and depression. Accordingly, the present paper aims at investigating the prevalence of anxiety and depression markers in people with Hansen’s disease assisted by the public unit care in a municipality in northwest of São Paulo State, as well as describing the researched population in their socio-demographic conditions. It is a quantitative descriptive study, which was undertaken with 21 subjects who are/were under treatment for Hansen’s disease for a period of two years. Beck Depression Inventory (BDI) was used in order to evaluate the depression levels, Beck Anxiety Inventory (BAI) was used to verify anxiety symptoms and a Socio-demographic Questionnaire for collecting data about the characteristics of the interviewees.  The results revealed that 43% of the participants presented mild levels for BAI protocols, whereas for BDI mild levels were found for 48% of them. Regarding socio-demographic profile, it was observed that most of the researched subjects were male (71%), 60-year-old or more (52%), married (71%), white (71%), catholic (57%), incomplete elementary school (48%), employed (43%), monthly family income between 1 and 3 minimum wages (71%). Thus, we conclude that the participants, in their majority, present mild levels of anxiety and depression.   Descriptors: Hansen’s disease. Anxiety. Depression.


2021 ◽  
Vol 63 (1) ◽  
Author(s):  
Lehlohonolo Makhakhe

Leprosy (Hansen’s disease) can affect multiple organs and body structures. Skin signs are typically observed in the early phase of the disease, hence being the first identifiable signs to propel clinical suspicion. Leprosy predominantly affects the skin and peripheral nerves. The disease has been documented many centuries preceding the biblical era. Over many decades, the classification of Hansen’s disease has changed as modern medical science evolved. Patients with leprosy are usually subjected to discrimination, rejection from society and can suffer from social stigma, poor quality of life (QoL), low self-esteem and permanent disfigurements. Studies have shown that leprosy has a significant negative impact on the patients’ QoL. Leprosy is often not suspected by practicing clinicians because it is no longer emphasised in the medical curricula. In modern years, attention has gradually shifted from leprosy to tuberculosis (TB) and human immunodeficiency virus (HIV).


2020 ◽  
Vol 14 (52) ◽  
pp. 924-935
Author(s):  
Bianca Cândida Martins ◽  
Ednardo De Souza Nascimento ◽  
Viviane Amaral Toledo Coelho ◽  
Carla Giselly De Souza ◽  
Creonice Santos Bigatello ◽  
...  

Resumo: Hanseníase é uma doença infectocontagiosa, causada pelo Mycobacterium leprae. A principal característica da doença é o comprometimento dos nervos periféricos, que pode implicar em incapacidades físicas e deformidades.  Objetivo: Esta pesquisa objetivo apontar e caracterizar as incapacidades físicas que foram diagnósticas em pacientes com hanseníase multibacilar no município de Almenara-MG no período entre os anos de 2015 e 2019.  Metodologia: Trata-se de uma pesquisa bibliográfica, exploratória e descritiva. No primeiro momento foram buscados artigos e publicações em português, compreendendo os anos de 2002 a 2020. As buscas foram realizadas nas bases de dados como: Scielo, Portal Periódicos da Capes, Medline, revistas de enfermagem, e concomitantemente com um estudo prático realizado a partir de dados obtidos da cidade de Almenara – MG (SINAN) durante o período de 2015 á 2019. Resultados: Com o estudo pode-se constatar que no período compreendido a classificação operacional multibacilar foi a mais prevalente com um percentual de 79,01 % do total de casos, sendo neste percentual a prevalências em pacientes do gênero masculino (73,43%). Conclusão: A hanseníase HM (hanseníase multibacilar) é predominante no município de Almenara. Mais da metade dos pacientes analisados apresentaram incapacidades físicas de classificação grau I, o que gera incapacidade e diminuição da qualidade de vida ao indivíduo. Palavras – chave: Description; Multibacillary leprosy; Quality of life; Late diagnosis. 


1999 ◽  
Vol 68 (2) ◽  
pp. 91-96
Author(s):  
Mikihisa Yajima ◽  
Minoru Narita ◽  
Nobutaka Yamada ◽  
Goro Asano

Author(s):  
Rauf Ahmad Bhat ◽  
Shams Ul Bari

Background: Colorectal cancer is one of the leading cause of death all over the world. It progresses slowly and may be asymptomatic for as many as 5 years. Aim of this study was to find the incidence and the initial clinical presentations of patients with colorectal cancer and its site specific correlationMethods: This was a prospective hospital-based study conducted over a period of two years from August 2015 to September 2017 in the postgraduate department of surgery, Government medical college, Srinagar. Total of fifty three patients in the age group of 10 years to 80 years were included in the study. Colorectal tumors were divided into right colon growths (caecum, ascending colon and hepatic flexure), left colon growths (splenic flexure, descending colon and sigmoid colon) and rectal growths. Data was collected from their hospital records and analysed using SPSS computer program.Results: In present study incidence of colorectal cancer was 0.2 per 100,000 people. Thirty percent of our patients were found to be in the sixth decade of their life with male preponderance in almost every age group. Mean age of presentation being 46.44 years (males= 48.5years, females= 43.76years). Out of 53 patients, rectal growths constituted 36%, left colonic growths 36% followed by 28% cases of right colonic growths. More than one symptom was present in several patients. Maximum number of patients (43%) presented with anemia (microcytic hypochromic) with Hb of <9gm% followed by constipation 38% and bleeding per rectum 28%. Pain abdomen was present in 23% of patients. Loss of weight and diarrhoea was equally seen in 19% of patients. Diarrhoea was seen in 6 males and 4 females and was statistically significant (p<0.05).Conclusions: Colorectal cancer was found to affect the Kashmiri patients at younger age (38% were 40 years or less) with peak incidence at sixth decade. Males were affected more than females. Anaemia, constipation and bleeding per rectum were the most common predominant clinical features in right colon, left colon and rectal growths respectively.


JRSM Open ◽  
2021 ◽  
Vol 12 (8) ◽  
pp. 205427042110359
Author(s):  
Paula Marques Ferreira ◽  
Inês Rueff Rato ◽  
Joana Rigor ◽  
Margarida Mota

Hansen's disease, also known as leprosy, is an infection caused by the bacteria Mycobacterium leprae. The authors present the case of a 52-year-old man, born in Tondela and living in Espinho, with no pathological antecedents. The clinical picture began in April 2017, when macular lesions appeared in the lower limbs and rapidly progressed to the trunk and upper limbs, associated with complaints of pruritus but without alterations in the analytical study. After several topical and systemic treatments with glucocorticoids, antifungals, antibacterials and unsuccessful antihistamines, he was referred to an external consultation of Dermatology. He performed a biopsy of one of the lesions that revealed the definitive diagnosis: “Lepromatous Leprosy”. After the biopsy result, he started triple treatment with rifampicin, clofazimine and dapsone with improvement of the condition.


2020 ◽  
Vol 13 (1) ◽  
pp. e233052 ◽  
Author(s):  
Ahmed Hashim ◽  
Ashley Barnabas ◽  
Rosa Miquel ◽  
Kosh Agarwal

Drug-induced cholestasis has a wide range of clinical presentations, and in a small number of patients, it can progress to severe ductopenia. A 63-year-old woman was referred to our department with progressive cholestasis and hyperbilirubinaemia following a course of flucloxacillin. Despite the comprehensive laboratory, imaging and genetic investigations, no other cause for the cholestasis was demonstrated. Sequential liver biopsies confirmed the development of vanishing bile duct syndrome. She developed significant cachexia and pruritus that did not respond to medical therapy, and hence she was listed for liver transplantation. She underwent liver transplantation 6 months after the initial drug-induced injury. She has remained well with good graft function at 1-year follow-up. The case highlights an extreme form of drug-induced ductopenia and underscores the need for meticulous hepatology input and consideration of liver transplantation in some patients.


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