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Biomedical subjects

G Ramu

Publications and source records attributed to G Ramu.

At least 127 records · Page 7Linked to original sources
PubMedDate not supplied

Poor correlation of systemic immunological parameters with clinical features in macular leprosy.

On the basis of clinical features and bacteriological status, macular skin lesions of nine cases of leprosy were classified as falling within a spectrum between the tuberculoid at one end and the lepromatous at the other. While histologic correlation was seen in 60% of cases, humoral and cellular systemic immunologic features were found to be uncharacteristic. It is suggested that macular lesions form an early stage in the development of leprosy where the systemic immunological response is yet to set in fully.

Adult↗
PubMedDate not supplied

Correlation of clinical, histological and immunological features across the leprosy spectrum.

The Ridley-Jopling system of classification of the variegated clinical pattern of leprosy is based on the specific cell-mediated immunity observed in the histopathology of skin lesions conforming to a spectrum from TT at one end to LL at the other. In this study a fairly large sample of 90 patients was classified on clinical grounds; the histopathology of the skin lesions was studied blind. There was an overall concordance of 90% between the clinical and histological classifications. In addition, the systemic cell-mediated and humoral immune responses were studied. The in vivo cell-mediated immune response, namely the Mitsuda skin response, mostly conformed to the clinical classification. While the in vitro lymphoproliferative responses to BCG and its sonicate were high, the lymphoproliferative responses to Dharmendra lepromin were surprisingly poor. Humoral responses to 35 kDA protein of M. leprae and PGL-1 were good in most LL, BL patients and tapered off towards TT. IgG antibodies to recombinant ML 65 kDa proteins denoted mycobacterial presence.

Adult↗
PubMedDate not supplied

Reactions in borderline leprosy.

This is a retrospective study of 276 patients consisting of 157 active and 119 reactive patients of borderline leprosy. They were followed up for 10 years after sulphone monotherapy. The presenting symptoms were carefully examined from the records and systematically presented. Frequency of reactions was least in BT cases and most in BL cases. Risk factors of reaction appear to be the type of leprosy, multiplicity of lesions, high BI and, possibly, psychological stress. Biopsy of skin lesions was performed in all cases initially, and at the subsidence of the disease. Histological findings closely correlated with clinical classification. While all the cases showed clinical subsidence, histological subsidence was found in 200 (73%) cases, and the condition was static in 36 cases (13%). Immunological upgrading was seen in 110%, while 4% showed downgrading. Bacteriological status and lepromin reaction of active and reactive cases were compared. All these factors need to be taken into consideration for instituting prompt and proper treatment.

Biopsy↗
PubMedDate not supplied

An appraisal of enzyme linked immunosorbent assay (ELISA) and serum antibody competition test (SACT) in leprosy.

Seventy-eight untreated leprosy patients, 104 treated patients and 105 healthy contacts were tested using two serological tests, SACT (serum antibody competition test based on competitive inhibition of monoclonal antibody binding to the MY2a determinant of M. leprae) and ELISA (measurement of IgM antibodies to the neoglycoproteins D-BSA and ND-BSA representing the phenolic-glycolipid antigen of M. leprae). The controls included normal healthy individuals, patients with sputum positive pulmonary tuberculosis, and active cases of rheumatoid arthritis from the department of rheumatology. The specificity of SACT was found to be very high. ELISA was found to be positive in two patients with rheumatoid arthritis, one each for D-BSA and ND-BSA ELISA. Both tests had a high sensitivity in BL and lepromatous patients. The sensitivity to both tests was considerably lower in tuberculoid and BT patients i.e., below 40%. Therefore the diagnostic value of a negative test in suspected cases of leprosy was very low employing either of the two tests. A proportion of patients with paucibacillary tuberculoid and BT leprosy were positive after six months or longer after therapy. Similarly a large number of BL and lepromatous patients were positive after considerably longer periods of treatment. The use of either tests for determining the duration of therapy is therefore limited. SACT appears to be more sensitive than ELISA with ND-BSA in detecting subclinical infection. The cumulative positivity of the two tests may be used as a measure of the infectivity of the disease in the community and for evaluating disease control methods.

Antibodies, Bacterial↗
PubMedDate not supplied

Demonstration of Mycobacterium leprae specific antigens in leprosy lesions using monoclonal antibodies.

Cryostat sections of dermal lesions from 13 untreated patients of leprosy were studied by indirect immunoperoxidase using monoclonal antibodies (MLO4 & MLO6), defining M. leprae specific antigens. The lymphocytes and macrophages in both the tuberculoid and lepromatous granulomas showed membranous staining with the above antibodies. M. leprae organisms in the lepromatous granulomas and the cells in the section of lymph nodes of patients with tuberculosis, or sections of normal skin or psoriatic lesions did not show any staining with these antibodies. These observations suggest that M. leprae specific antigens are present and expressed on the cells infiltrating the granulomas of leprosy lesions.

Antibodies, Monoclonal↗
PubMedDate not supplied

Seroepidemiological studies in subsided cases of multi and paucibacillary types of leprosy using FLA-ABS test.

FLA-ABS test was carried out in 145 subsided cases of multibacillary (BL/LL) and 197 subsided cases of paucibacillary (TT/BT/I) types. The period of subsidence varied from 0-5 years or more. It was observed that percentage positivity decreases with the subsidence of the disease. In multibacillary cases, FLA-ABS positivity was 95% (active cases), 50% (after 1 year of subsidence) and 36% (after 5 years of subsidence) whereas in paucibacillary types FLA-ABS positivity was 80% (active cases), 34% (after 1 year of subsidence) and 19% (after 5 years of subsidence). A significant proportion of multibacillary subsided cases continued to be positive at high titres (1:160 and 1:640) even after 5 years of clinical subsidence. This implies the presence of continuous antigenic stimulus resulting in high antibody titres even after several years of clinical subsidence. On the other hand percentage positivity at high titres gradually decreased with the increased duration in paucibacillary cases.

Antibodies, Bacterial↗
PubMedDate not supplied

Acute renal failure following rifampicin.

3 cases of renal toxicity to Rifampicin are reported. All cases recovered following therapy, two required haemodialysis. It is important that cases on Rifampicin be monitored for renal toxicity and appropriate measures taken in time to prevent a fatal outcome, if detected.

Acute Kidney Injury↗