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Biomedical subjects

D M Thappa

Publications and source records attributed to D M Thappa.

102 records · Page 6Linked to original sources
PubMedDate not supplied

Radiological changes in hands and feet in disabled leprosy patients: a clinico-radiological correlation.

Seventy-six consecutive leprosy patients with disabilities were subjected to radiological examination of hands and feet, and bone changes were found in 63 of them (82.9%). Specific, nonspecific and osteoporotic bone changes were observed in 22.4%, 78.9% and 28.9% of cases respectively. Bone cysts (10.5%), subarticular erosions (10.5%) and enlargement of nutrient foramina (5.3%) were the common specific bone changes whereas bone absorptive changes (59.2%), soft tissue changes (39.5%) and concentric absorption (39.5%) were the most frequent nonspecific bone changes. Specific bone changes were more common in older patients (age 40 years) and nonspecific bone changes correlated with duration of disease, duration of deformity, and disability index. Osteoporotic bone changes were found to be affected by ageing and severity of disability of hands and feet.

Adolescent↗
PubMedDate not supplied

A clinical study of the involvement of cranial nerves in leprosy.

A clinical descriptive study was conducted to assess the frequency and pattern of involvement of cranial nerves in leprosy and to study the relationship of cranial nerve involvement with a leprosy patch or patches on facial skin. One hundred consecutive patients of leprosy, diagnosed by clinical features and/or slit skin smear and histopathology, were studied; of these, 22 patients had cranial nerve involvement. The mean age of patients with cranial nerve involvement was 41.2 years. 16 patients (72.7%) with cranial nerve involvement were in the age-group of 20-49 years. The male-to-female ratio was 3.4:1. The mean duration of the disease in these patients was 5.73 years. The duration of the disease in the majority of patients with cranial nerve involvement was less than 5 years. Impairment of cranial nerves was seen in 12 BT patients, 6 BL patients, and 4 LL patients. No significant difference was noted between involvement of cranial nerves in PB and MB patients. Among the cranial nerves, facial nerve was the most common nerve involved (10/22), followed by olfactory (9/22), trigeminal (7/22) and auditory (3/22) nerves. Among the risk factors, it was found that facial nerve impairment was significantly associated with facial patch(es) and also type 1 lepra reaction.

Adult↗
PubMedDate not supplied

Pure neural leprosy presenting with multiple nerve abscesses.

A 22-year-old male student presented to us with patchy sensory loss over the dorsum of right foot of 6 months' duration and swelling over the left index finger of 2 months' duration. Subsequently, a week later, he developed a painful swelling over the left forehead and right leg. On examination, tender soft, fluctuant subcutaneous saccular swellings were seen varying in size from 2x2 cm to 5x5 cm over the left supratrochlear, left radial cutaneous nerve, left digital nerve, right superficial peroneal nerve and left saphenous nerve. The nerves were tender and thickened above and below these cold swellings (cold nerve abscesses). Nerve biopsy of the left radial cutaneous nerve showed granulomatous infiltrate of epithelioid cells, lymphocytes and caseation necrosis of nerve. No bacilli were demonstrated with acid-fast stain. On the basis of the above findings, a diagnosis of pure neuritic leprosy (BT spectrum) in type 1 lepra reaction with multiple nerve abscesses was made. We present this case of pure neuritic leprosy exhibiting multiple nerve abscesses, for its rarity.

Abscess↗
PubMedDate not supplied

Disability index of hands and feet in patients attending an urban leprosy clinic.

189 leprosy patients including 20 from a leprosy colony having disabilities and deformities were graded by the WHO (1960) classification and their disability indices were calculated. Disabilities occurred more frequently in males and the disability index was significantly higher in those with longer duration of the disease and in multibacillary patients. Majority of the disabled patients (82.5%) were manual workers, but the highest disability index was observed in beggars. Irregularly treated and untreated patients had significantly higher disability indices (DI 2.40 and DI 1.40) than those taking regular treatment (DI 1.09). No correlation was found between severity of disability and occurrence of type I and type II reactions. Disabilities of hands and feet occurred with equal frequency.

Adolescent↗
PubMedDate not supplied

Disability grading in leprosy: current status.

The systems of classification and grading of disabilities in leprosy patients, suggested by WHO and others are reviewed. Taking into account the drawbacks observed in these classifications, a new system of grading of disabilities of hands and feet of leprosy patients based on the 1960 WHO classification is proposed for use in institutions.

Disability Evaluation↗
PubMedDate not supplied

Dapsone syndrome--a five year retrospective analysis.

Seventeen cases of dapsone syndrome were seen in five years from 1992 onwards. Their mean age was 27.8 years (range 11 to 60 years). Male to female ratio was 1.1:1. Of these cases, seven had confirmed leprosy, nine were cases of suspected leprosy and one case had lichen planus. On an average, they developed the symptoms 27 days after the intake of dapsone. The cutaneous lesions were in the form of erythematous papules and plaques (13 cases), eczematous lesions (four cases) and associated bullous lesions (two cases). The other manifestations were: fever (16 cases), pruritus (15 cases), lymphadenopathy (14 cases), hepatomegaly (10 cases), icterus and oral erosions (five cases each), photosensitivity (four cases) and splenomegaly (two cases). Previous drug allergy was present in four cases. Elevated ESR and liver enzyme levels were invariable findings. Raised bilirubin levels and hemolytic anaemia were seen in eight cases. Apart from one case with hepatic encephalopathy, all other cases had a favourable outcome either on conservative management (eight cases) or on oral corticosteroids (eight cases). Oral provocation test was done in two cases with positive response while intradermal test was not very reliable.

Adolescent↗