Lucio Phenomenon: A Rare Manifestation of Leprosy in Selangor, Malaysia

Author(s):  
Shahrizan Majid Binti Allapitchai

Leprosy is a chronic infectious disease caused by Mycobacterium leprae, predominantly affecting the skin and peripheral nerves. Lucio phenomenon is a rare reactional state presenting in patient with lepromatous leprosy and described as acute cutaneous necrotising vasculitis. We discussed the case of a 38-year-old male patient presenting with oedematous and dusky discolouration of bilateral hands and feet associated with diffuse facial involvement. His skin condition gradually worsened to form multiple ulcers with bizarre shaped purpuric lesion over bilateral upper and lower limbs, trunk, and face. Histopathological examination of the skin biopsy showed multiple acid-fast bacilli and diagnosis of Lucio’s phenomenon was made in the background of lepromatous leprosy. He was treated with multi drug therapy (MDT) as recommended by the WHO guidelines. A better understanding of rarer manifestation of this illness is important for early diagnosis and to prevent significant morbidity associated with it.International Journal of Human and Health Sciences Supplementary Issue-2: 2021 Page: S20

2020 ◽  
Vol 13 (3) ◽  
pp. 288-294
Author(s):  
Dwi Sepfourteen ◽  
Tutty Ariani

Clinical features of Lucio’s phenomenon (LP), shows a nectorizing erythema, may mimicking Erythema Nodosum leprosum with vasculonecrotic. A 46 years old man presented with diagnosis lepromatous leprosy with Lucio’s phenomenon and diferential diagnosis borderline lepromatous (BL) with vasculonecrotic erithema nodosum leprosum. The patients complained there were painless ulcers on his lower limbs and scrotum, with surrounded by purpuric patches which subsequently became gangrenes and ulcerated for 3 weeks. There was numbness of both hands and feet, the eyelashes, eyebrows baldness since 5 years ago. Patient never got the treatment before. Bacteriological examination showed bacterial index 6+ Histopathology: there were Flattened epidermis by narrow grenz zone, and lymphocyte in perivascular with macrophage. There was endothelial proliferation of capiller. Fite faraco stain showed macrophage infiltration around the perivasculer, with colonization of the endothelial cell by acid fast bacilli and epidermal necrosis and diagnosis as Lepromatous leprosy with Lucio phenomenon. This patient is given adult multiple drug therapy (MDT) therapy, methylprednisolone, neurotrophic vitamins. Lucio’s phenomenon most commonly affects patients with untreated leprosy. Clinically, it may be difficult to differentiate Lucio phenomenon from Erythema nodosum leprosum with vasculonecrotic. In this case, the histopathological examination were colonization of endothelial cell by acid fast bacilli, epidermal necrosis and endothelial proliferation of the vessel.


Revista EIA ◽  
2020 ◽  
Vol 17 (34) ◽  
pp. 1-11
Author(s):  
Mauro Callejas Cuervo ◽  
Manuel A. Vélez-Guerrero ◽  
Andrea C. Alarcón-Aldana

A proposed measurement protocol for the lower limbs movement analysis during walking is presented, with the use of a measurement system based on inertial-magnetic motion processing units and an optical system. Initially, the state of the art in terms of methods and tools for the biomechanical capture of movements is shown, to finally explore the protocols used in the health sciences for the gait analysis. The measurement proposal made in this document uses robust features of inertial-magnetic and optical technology that can be used in medical diagnosis. The application of this proposal can generate tools that have a positive impact in the fields of health and medicine.


2017 ◽  
Vol 59 (1) ◽  
pp. 62-63
Author(s):  
Yan-Fei Wang ◽  
Ping Wang ◽  
Hui Huang

Author(s):  
Natalia Romano Sanchez ◽  
Cibele Isaac Saad Rodrigues

Abstract: Introduction: Medical residency in gynecology and obstetrics is unquestionably important in the training of physicians who choose this specialty of the Brazilian Ministries of Health and Education. However, studies evaluating these residency programs are scarce, especially regarding the reflexive qualitative aspects of the research. Therefore, this exploratory and descriptive study aimed to evaluate the current medical residency program in gynecology and obstetrics of the School of Medical and Health Sciences at Pontifícia Universidade Católica de São Paulo (PUC-SP) using a quantitative and qualitative approach. Method: The methodology included a comparative curriculum analysis between the program recommended by the National Committee of Medical Residency until 2018 and the program offered by PUC-SP School of Medical and Health Sciences, as well as a self-administered questionnaire completed by individuals who graduated between 2007 and 2018. Results: The most significant findings of the comparative curriculum analysis include discrepancies in the percentage arrangement of annual workload, indicating an overload of on-call duty hours, and unequal distribution of internships. The questionnaire response rate was 66% (41 of 62 participants). Most respondents were women (n=32, 78%), who worked mainly in the cities of Sorocaba (n=21, 43.7%) and São Paulo (n=10, 21%). Most medical graduates were partially satisfied with the program (n=34, 82.9%). Some responses also matched the findings of the comparative curriculum analysis, such as dissatisfaction with the number of gynecological surgical procedures performed (n=39, 95.1%). Regarding the content analysis of open-ended answers, categorized according to Bardin, the graduates appreciated activities in obstetrics, and the most relevant criticisms were related to fewer hours assigned to certain activities, especially those devoted to gynecological surgical practices and theoretical activities. Conclusions: Based on the findings, suggestions were proposed and accepted by the managers for changes that should have a positive impact on the medical residency program. This research contributes to the diagnostic evaluation of a traditional medical residency program in Brazil, proposes improvements, and uses reproducible methods, thus serving as a comparison basis for other studies so that advances can be made in the training of these specialists.


2017 ◽  
Vol 30 (11) ◽  
pp. 775 ◽  
Author(s):  
Víctor Patricio Díaz-Narváez ◽  
Ana María Erazo Coronado ◽  
Jorge Luis Bilbao ◽  
Farith González ◽  
Mariela Padilla ◽  
...  

Introduction: The controversy over the presence of empathic decline within the course in students of medicine, dentistry and health sciences in general, has not fully been studied. This controversy could be partially solved if massive studies of empathy levels are made in similar cultural, social and economic contexts.Material and Methods: Empathy levels within the course were studied in eighteen dental schools from six countries in Latin America (2013). The mean of the empathy levels were used to study the behavior between first and fifth academic years. The values of empathy levels within the course were observed by applying the Jefferson Scale of Physician Empathy, the Spanish version. All these studies were cross-sectional. The value of means observed, were subjected to regression studies and further adjustment curves were obtained and the coefficient of determination were calculated.Results: Six different models of behavior were observed, which found that five of them suffer empathic decline within the course, but with different final results: in some the decline persists until the fifth academic year and in others, this decline ‘recovers’ persistently until the fifth academic year. The sixth model is characterized by a constant and persistent increase of levels of empathy within the course until the last academic year.Discussion: There are six different models for the behavior of means of levels of empathy within the course evaluated by a common methodology in eighteen dental schools from six countries of Latin America. These findings support the existence of variability of empathic response and a comprehensive approach is needed to find the causes that give rise to this variability.Conclusion: In dental students of Latin America, there is variability in the behavior of the distribution in means between the academic years of the dentistry schools examined in this study.


2020 ◽  
Vol 7 (1) ◽  
pp. 3
Author(s):  
Leandro C. D. Breda ◽  
Isabela G. Menezes ◽  
Larissa N. M. Paulo ◽  
Sandro Rogério de Almeida

Chromoblastomycosis (CBM) is a neglected, chronic, and progressive subcutaneous mycosis caused by different species of fungi from the Herpotrichiellaceae family. CBM disease is usually associated with agricultural activities, and its infection is characterized by verrucous, erythematous papules, and atrophic lesions on the upper and lower limbs, leading to social stigma and impacts on patients’ welfare. The economic aspect of disease treatment is another relevant issue. There is no specific treatment for CBM, and different anti-fungal drug associations are used to treat the patients. However, the long period of the disease and the high cost of the treatment lead to treatment interruption and, consequently, relapse of the disease. In previous years, great progress had been made in the comprehension of the CBM pathophysiology. In this review, we discuss the differences in the cell wall composition of conidia, hyphae, and muriform cells, with a particular focus on the activation of the host immune response. We also highlight the importance of studies about the host skin immunology in CBM. Finally, we explore different immunotherapeutic studies, highlighting the importance of these approaches for future treatment strategies for CBM.


2010 ◽  
Vol 4 (3) ◽  
pp. 1357
Author(s):  
Antonio Adriano Rodrigues dos Santos ◽  
Ana Beatriz De Almeida Medeiros ◽  
Maria Julia Guimarães de Oliveira Soares ◽  
Marta Miriam Lopes Costa

ABSTRACTObjectives: to know how professionals of nursing are performing the dressing technique, to observe the use of technical principles in the accomplishment of the procedure and to identify the use of materials appropriated for execution of the technical procedure. Method: this is about an exploratory study, from quantitative approach, with a sample composed by 14 professionals. Data had been collected through a half-structuralized questionnaire. Is has been approved by the Ethics Commitee from Health Sciences Center of Federal University of Paraíba/UFPB and by the Ethics Commitee of the Lauro Wanderley University Hospital, under the protocol number 011/09, considering the Resolution 196/96 of the National Research Ethics Committee with human. Results: the most participants were female and they had less than five years of performance in the treatment of wounds; the practical of hygienic cleaning of the hands is not made in the correct way for the majority of them; the materials and coverings had been used in adequate way. Conclusion: the dressing technique is not made, for the majority of the nursing professionals, in agreement with what studied literature recommend. Descriptors: nursing; wounds and injuries; therapeutics.RESUMOObjetivos: conhecer como profissionais de enfermagem estão realizando a técnica de curativo, observar a utilização dos princípios técnicos na realização do procedimento e identificar a utilização de materiais adequados para execução do procedimento técnico. Método: trata-se de um estudo exploratório, de abordagem quantitativa, com amostra de 14 profissionais de enfermagem. Os dados foram coletados com um roteiro semi-estruturado, após aprovação pelo Comitê de Ética do Centro de Ciências da Saúde da Universidade Federal da Paraíba/UFPB, Campus I e pelo Comitê de Ética do Hospital Universitário Lauro Wanderley, sob protocolo 011/09, considerando a Resolução 196/96 da Comissão Nacional de Ética em Pesquisa com Seres Humanos.  Resultados: a maioria dos participantes era do sexo feminino e tinham menos de cinco anos de atuação no tratamento de feridas; a prática de higienização das mãos não é feita da maneira correta pela maioria deles; os materiais e coberturas foram utilizados de maneira adequada. Conclusão: a técnica de curativo não é feita, pela maioria dos profissionais de enfermagem, em concordância com o que a literatura pesquisada recomenda. Descritores: enfermagem; ferimentos e lesões; terapêutica.RESUMENObjetivos: conocer cómo las enfermeras están haciendo la técnica de curativo, observar el uso de los principios técnicos en la realización del procedimiento e identificar el uso de materiales adecuados para la aplicación del procedimiento técnico. Método: estudio exploratório, enfoque cuantitativo con una muestra de 14 profesionales. Los datos fueron recogidos entre marzo y junio 2009 a través de un cuestionario semi-estructurado. Este estudio fue aprobado por el Comité de Ética del Centro de Ciencias de la Salud, Universidad Federal de Paraíba, y por el Comité de Ética del Hospital Universitario Lauro Wanderley, con el número de protocolo siguiente: 011/09, teniendo en cuenta la resolución 196/96 de la Comisión Nacional de Ética en Pesquisa. Resultados: la mayoría de los participantes eran mujeres y tenían menos de cinco años de experiencia en el cuidado de heridas; la práctica de lavarse las manos no se hace de la manera correcta por la mayoría de ellos; los materiales y coberturas fueran usados correctamente. Conclusión: la técnica de curativo no se hace por la mayoría de los profesionales de enfermería, de acuerdo con lo que la literatura recomienda. Descriptores: enfermería; heridas y lesiones; terapéutica. 


2013 ◽  
Vol 23 (74) ◽  
pp. 23-32 ◽  
Author(s):  
Margaret Weaver ◽  
Eileen Hiller ◽  
Ian Jennings ◽  
Jennifer Brook ◽  
Heather Moreton ◽  
...  

The Library Management Group of The University Of Huddersfield set up a pilot study to examine altemative procedures for classifying and cataloguing library material in the Health sciences. The study tested the impact of using classification and subject index terms in bibliographic records for titles in the health subject area. The work of the group concentrated on two areas: -establishing a benchmark for throughput in Technical Services in terms of speed, cost and availability of externally supplied class numbers -analysis of differences in classification numbers and subject indexing terms between those human assigned and system assigned. Samples of data were analysed using SPSS software; a fuzzy matching process was undertaken for the subject string analysis. The results showed considerable savings to be made in terms of both speed and cost. lt was instrumental in the decision to change the existing method of acquiring classification numbers.The hit rate for records and the impact on the shelf arrangement were at an acceptable level. The study produced reliable information to provide a benchmark for future developments (for exarnple outsourcing shelf ready books) and performance indicators.


1988 ◽  
Vol 12 (1) ◽  
pp. 9-18 ◽  
Author(s):  
T. Pohjolainen ◽  
H. Alaranta

To assess the current epidemiological situation concerning lower limb amputations in southern Finland the data on all amputations made in the catchment area of the Helsinki University Central Hospital were analysed for the period 1984-85. During the two-year period, 880 amputations of lower limbs were performed on 705 patients. The amputation rate was 32.5 per 100,000 inhabitants in 1984 and 28.1 in 1985. Patients requiring amputation were arteriosclerotics in 43.1 per cent, and diabetics in 40.7 per cent. Diabetics underwent amputation 3 years younger on average than the arteriosclerotics. The most common site of unilateral amputations was above-knee (42.0 per cent) followed by below-knee (27.7 per cent) and toe amputations (22.2 per cent). The level of amputation tended to become more proximal with increasing age of the patients. The overall mortality figure during three postoperative months was 27.0 per cent. Amputation incidence increased sharply with increasing age. On the base of predictions, the overall age structure of the Finnish population will shift upward causing an increase in the proportion of elderly age groups. A 50% increase in amputation rate is expected in Finland within the next 20-30 years.


2018 ◽  
Vol 6 (4) ◽  
pp. 161-166
Author(s):  
Hemang Dixit

The introduction of Western medicine in Nepal took place during Jung Bahadur’s time as Prime Minister and was slowly disseminated during the tenure of subsequent Rana Prime Ministers Bir, Chandra, Bhim and Joodha. The provision of healthcare in the country was taken as a form of charity provided to the people by the rulers. Whilst the first two government hospitals were started at Kathmandu and Birgunj, others followed as would be rulers were banished to places such as Dhankuta, Tansen or Doti. It was only after the dawn of democracy in 1950 that the Department of Health Services was established. During the past 67 years more hospitals and academic centres for teaching health sciences have come up in different parts of Nepal. Strides have made in the delivery of health care and health sciences education. Much more needs still to be done.Journal of Kathmandu Medical College, Vol. 6, No. 4, Issue 22, Oct.-Dec., 2017, Page: 161-166


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