The rare coexistence of leprosy and psoriasis.
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Biomedical subjects
Publications and source records attributed to B Kumar.
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The management of a preterm neonate with systemic candidiasis using oral itraconazole is described. Oral itraconazole was well tolerated and effected a clinical and mycological cure.
Urinary epithelial cell counts were determined in 102 patients with active plaque psoriasis. Cell counts were significantly higher in psoriatic patients than in the controls. A significant fall in the cell counts was observed after regression of psoriasis.
Serum samples collected from 45 untreated leprosy patients and 10 healthy subjects were studied for the activities of alkaline phosphatase, N-acetyl beta-glucosaminidase and beta-glucuronidase. A highly significant increase in the specific activity of these enzymes was observed in all types of leprosy patients as compared to controls. Increase in the level of circulatory hydrolytic enzymes could be a tissue damaging factor and may be responsible for many of the lesions seen in leprosy.
Release of acid hydrolases by blood monocytes (BM) of leprosy patients both before and after 6 months of chemotherapy was measured fluorimetrically. Monocyte cultures were set up for spontaneous as well as zymosan dependent enzyme release measured after 2 hrs and 24 hrs of culture. In the untreated multibacillary group (BL/LL) a significantly higher (P < 0.001) release of both B-glucuronidase (BG) and N-acetyl glucosaminidase (NAG) was observed compared to the paucibacillary group (BT/TT) and healthy controls. On comparing the BT/TT group with controls a significant decrease (P < 0.001) in zymosan dependent NAG release was observed in the former group at 2 hrs culture. After 6 months of antileprosy therapy, a significant decrease (P < 0.05) in BG release was observed from BM of multibacillary patients, whereas NAG activity increased significantly (P < 0.05) in the paucibacillary group compared to the controls. The results of the present study suggest that non-oxidative metabolic status of BM vary within the leprosy spectrum.
Serum samples were collected from eighty-three leprosy patients and twenty-five healthy controls supposedly not exposed to Mycobacterium leprae infection. Phenolic glycolipid-1 coated latex agglutination test (PGL-LAT) was carried out with the serum samples to detect antibodies specific to M. leprae. Samples showing positive agglutination were 50% in the lepromatous leprosy (LL) group showing no erythema nodosum leprosum (ENL) complications, 66.6% in LL group with ENL complication, 60% in borderline lepromatous (BL) group, 50% in borderline (BB) and 33.3% in borderline tuberculoid (BT). The patients belonging to the tuberculoid (TT) group and most of the long-term treated patients were interestingly negative, and so were sera from all the healthy controls. PGL-LAT developed by us therefore is specific and a fairly sensitive technique to detect antibodies specific to M. leprae and will be very useful in field conditions.
A case of a chronic alcoholic, found dead in the afternoon after consuming an intoxicant early in the morning and showing post-mortem skin slippage with a blackened charred-like appearance, is reported. Viscera chemical analysis gave a positive test for significant quantities of cyanide. However, on histopathological examination, since no evidence of blister formation or vital reaction in the skin tissues were found, this was thought to be a very short duration, accelerated postmortem change phenomenon, due to local heating from contact with the sun-baked terrace.
Four patients with deep mycoses were treated with itraconazole. Two patients had chromoblastomycosis, one patient each had aspergillosis and Rhinofacial zygomycosis. These patients were either resistant to or showed poor response to Amphotericin B and/or ketoconazole. After the initial clinical and mycological evaluation, itraconazole was given in a daily dose of 200 mg orally. All patients responded to the drug very well. No adverse effects attributable to itraconazole were detected.
Serum levels of C-reactive protein (CRP) and plasma levels of fibronectin (Fn) were studied in 74 untreated leprosy patients. CRP was detected by latex agglutination in 25.6% of the patients. A significant increase in Fn levels was seen in all the groups of leprosy patients, as compared to the controls.
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During a period of eight years, 132 new leprosy cases were detected in children ages 3 to 19 years. Borderline tuberculoid leprosy was present in 59%, tuberculoid in 7.6%, and indeterminate type in 3.8% patients. Single skin lesions were seen in a significant number (43.9%) of patients. Bacillus-positive disease was detected more often (17.4%) than in adults. A high frequency (66.6%) of nerve involvement was also detected. Deformities were uncommon. Males were more often affected than females, especially in the ages 10 to 14 and 15 to 19 years. A history of contact was available in only 19.7% patients, and the contact was intrafamilial in 84.6%.
Ten men with bubo associated with chancroid were studied for bacterial flora especially anaerobes. Anaerobes were isolated from all 10 buboes and eight out of 10 ulcers of chancroid. Anaerobic cocci, B melaninogenicus and B fragilis were the most common isolates. anaerobes probably play a role in the pathogenesis of bubo in chancroid.
Five clinical types of genital warts were identified, studied histopathologically and stained for human papilloma virus (HPV) antigen. HPV antigen was found in all degrees of koilocytosis and it was present more often in the hyperplastic warts than in other types of genital warts. However, as reported earlier, the presence of HPV antigen did not decrease proportionately as the degree of atypia increased.
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Microbial flora especially anaerobes were studied in 67 patients with genital ulcers due to chancroid (diagnosed clinically) and 53 controls with genital ulcers due to other causes. The aerobic flora was similar in patients of chancroid with or without associated bubo and in controls. Anaerobes were however, isolated with higher frequency from chancroid ulcers associated with fluctuant bubo compared to those without bubo (P less than 0.01) and with non-fluctuant bubo (P less than 0.05). Anaerobic bacteria like Bacteroides melaninogenicus, B. fragilis and anaerobic cocci may play a role in the perpetuation of genital ulcers and development of bubo in chancroid.
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Eight cases of unreduced traumatic posterior dislocation of the hip were treated by heavy traction and abduction. In four out of eight cases a concentric reduction was obtained. In two patients where a concentric reduction was not obtained, open reduction was performed. In these patients, there was an excellent or good result. In the remaining two patients a non-concentric reduction was accepted, and they had poor clinical results.
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