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Biomedical subjects

C R Revankar

Publications and source records attributed to C R Revankar.

At least 55 records · Page 3Linked to original sources
PubMed1983

Field application of combined therapy for infectious leprosy cases. A feasibility study in Bombay.

The practical problems related to dapsone monotherapy for a prolonged period to infectious leprosy patients are well known to the scientific community and combined treatment of dapsone with clofazimine, rifampicin or prothionamide has been successfully carried out by several workers in hospitalised leprosy patients. The application of polytherapy in field condition was hindered by the cost of the drugs and fear of side effects. 42 infectious leprosy patients attending 5 field leprosy clinics in the slums of Bombay city were put on combined drug schedule. The drug compliance of these patients was judged along with their regularity in attendance at clinics by the persons in charge and periodic and frequent check up of urines. 27 (65%) were regular in treatment from the beginning, 8(19%) who were initially irregular after motivation and 7(17%) remained irregular through out the period. The urine samples collected from leprosy patients on monotherapy and attending the same centres revealed 31% irregularity in drug consumption. The study indicates that advocating combined therapy in field conditions by paramedical workers is quite feasible. The patients on multiple drugs are more regular in drug consumption as compared to monotherapy group. The frequent check up of urine for drug content and advice to patients who are irregular in treatment improve their regularity in drug consumption.

Adolescent↗
PubMed1983

Dapsone compliance in an urban field project.

Available reports both from rural and urban leprosy centres prove beyond any doubt that dapsone is not being consumed regularly by all those who show regular clinic attendance. No reports are available from urban field projects where SET programme is being operated. In this study surprise urine samples of 294 patients of all types (smear positive 53%) mainly on dapsone monotherapy attending (1) leprosy treatment centres in slum clinics situated in the field areas adopted for SET work by Bombay Leprosy Project and (2) general hospital clinics situated predominantly outside the project area were analysed for dapsone/creatinine ratio to judge the extent of drug compliance. 201 out of 294 (68%) were regular and 82 out of 294 (28%) were irregular in consuming DDS as judged by urine examination. 67% of smear positive cases were regular. No difference was found in regularity between patients living within the project area (intensive follow up is done in this group to remind about treatment) and outside project area patients (no reminder followup is done). Similarly no difference was observed in regularity amongst the patients attending slum clinics and general hospital clinics. It could be stated that facilities for treatment offered at general hospitals or dispensaries and encouraging voluntary reporting could be quite fruitful and economical for obtaining better drug compliance in urban areas.

Dapsone↗
PubMedDate not supplied

A comparative study of the efficacy of WHO and IAL multidrug therapy regimens for leprosy--an in-vivo and in-vitro study.

In the absence of definite evidence on utility of intensive therapy with rifampicin in multibacillary leprosy cases, a laboratory based investigation was undertaken basically to compare the efficacy of WHO and IAL regimens. In each group 4 untreated BL-LL patients were included and their skin biopsies were subjected for viability test both in vitro and in vivo systems. A consistant fall in BI with good clinical improvement was observed in both the groups. However good viability was maintained till about third pulse dose in WHO group whereas under IAL group rapid fall in viability was observed after intensive phase. Viable bacilli were seen even after 12,15,18 and 24 doses in both groups. These findings question the need for additional 21 doses of rifampicin in IAL schedule. However such studies are to be repeated on larger samples.

Clofazimine↗
PubMedDate not supplied

Thalidomide in leprosy--study of 94 cases.

Thalidomide has a beneficial effect on type II Lepra reaction especially chronic and recurrent reaction. It helps to minimise steroid dependency. Thalidomide was given to 94 cases of type II lepra reaction, who had not responded to steroids or had repeated reactions. This clinical data was analysed regarding clinical improvement, relapse of reaction, side effects of the drug, etc. The analysis showed that all the patients improved remarkably and steroids could be withdrawn. If the competence of staff using this drug is enhanced, morbidity due to leprosy can considerably be reduced.

Adolescent↗
PubMedDate not supplied

Three years assessment of multidrug therapy in multibacillary leprosy cases.

Analysis of Bacteriological Index (BI) of 584 multibacillary leprosy patients who had completed multidrug therapy (MDT) as per the recommendations of World Health Organization (WHO) and Indian Association of Leprologists (IAL) showed smear conversion rates of 56% at 24 doses and 66% at 36 doses. Taking BI as a parameter of judgement, the results indicate distinct improvement over the performance achieved through dapsone monotherapy during earlier period. IAL regimen consisting of daily initial administration of rifampicin for 21 days did not show any distinct advantage over WHO regimen. Bacteriological decline was uniformally noticeable in all patients though in cases with high initial BI, smear conversion rate was much less. All the six patients with BI more than 5, and 59 patients (70%) with BI 1 to 4.9 and 87 patients (64%) with BI 3 to 3.9 have not been rendered negative even after three years of treatment. On the contrary seventeen patients whose skin smears were still positive after receiving 24 supervised doses became bacteriologically negative subsequently, and remained so though chemotherapy was stopped. Such studies on large number of patients for a longer period is essential to establish whether chemotherapy should necessarily be continued up to the point of negativity.

Dapsone↗