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Biomedical subjects

R Ganapati

Publications and source records attributed to R Ganapati.

At least 109 records · Page 6Linked to original sources
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 The analysis showed that all the patients improved remarkably and steroids could be withdrawn.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↗
PubMedDate not supplied

Prevalence of leprosy in slums in Bombay including a leprosy colony.

Transmission of leprosy which is related directly to the total quantum of infection in the community as a whole is decided by the existence of patients suffering from progressive and infectious forms of leprosy and their movement from place to place. This information is of great importance in cities like Bombay to identify the priority areas as targets towards which control efforts should be directed. In this presentation an attempt has been made to compare the leprosy survey figures from three different situations in the city. Selection is arbitrary, not made on statistical basis. The data of particular importance is from a leprosy colony located in North Bombay representing a hyperendemic situation and a normal slum adjacent to this colony, movement of population between these two colonies being free. Age specific prevalence rates of leprosy after examining more than 80% of population from these colonies are compared with data derived from normal slums situated elsewhere in the city. The figures reveal varying prevalence rates marked by an increasing trend in the prevalence figures, leprosy colony representing the largest pool of infection. These figures indicate that wider statistically planned investigations on similar lines in urban areas may provide epidemiological data useful for planning control measures on a more rational basis.

Adolescent↗
PubMedDate not supplied

An approach to leprosy work in south Bombay--a preliminary communication.

The city of Bombay with its teeming eight million citizens is characterised by varied types of living pattern in its different parts and the approach to leprosy control work should be flexible to suit these facets of living conditions. Earlier reports (Ganapati and Girija 1979) have indicated the possibility of the successful application of techniques based on mass surveys in North Bombay where people belonging to low socio-economic strata live in somewhat organised slums or shanty towns. However, extreme South Bombay is marked by the paucity of such vast slums and one is struck by the more permanent multistoreyed housing structures. Living in commercial establishments as well as footpath dwelling are common. This presentation consists of an attempt to gauge the leprosy problems in this part of the city taking advantage of 425 patients registered at a leprosy clinic run in conjunction with the dermatology out patient department of a big general hospital over a period of 40 months. 212 cases (50%) hailing from South Bombay proper were the subject matter for analysis. 66% (140) belonged to progressive types of leprosy classifiable as BT through LL and of the Ridley-Jopling classification and 30.7% were bacteriologically positive. 42.9% of the patients had some degree of deformity. Males formed 80% of the sample and 76% were above 15 years of age. Analysis of duration of residence revealed that 68% were living in Bombay for over six years and 53.5% were residing in the city for 11 years or more. This finding is contrary to the expectation of leprosy patients in Bombay belonging to a "floating population". Attempts at field work revealed the following findings: Slum pockets being few (only four), patients were expected to live in residential buildings; but it was found that 25% of population were staying in work places. 17% were footpath dwellers and 18.9% shared their accommodation with people other than family members. 10.4% were domestic servants staying in the residences of their employees. The labour class constituted 50.5% the unemployed housewives group formed 21.7% and beggers 0.9%. 4.2% only were slum dwellers. Locating and examining contacts of patients was difficult as 42.9% could not be traced owing to faulty addresses or patients having changed residences or shifted to native places. Of the 111 patients (52.3%) contacted, 26.4% were living with families and 26.1% were staying alone or with others.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMedDate not supplied

Leprosy detection through non-survey techniques.

Most practical and cheap techniques other than mass surveys to detect leprosy in urban slums are still not known. The population inhabiting a large somewhat isolated slum in North Bombay was exposed to intensive health education programmes over a period of two years. Leprosy cases reporting as a result of these measures as well as those detected by trained workers casually or through contact examination were registered at two weekly clinics conducted within the slum. A total of 184 patients out of whom 27 were smear +ve, were identifiable by these means. The population of the slum was found to be 18228. Total prevalence rate of leprosy after examining 14723 subjects in the colony was revealed to be 24 per 1000 (smear +ve cases: 2.2. per 1000) out of which a prevalence of 12.4 per 1000 (smear +ve cases: 1.8 per 1000) had actually come to our knowledge even before instituting mass surveys. The results of this study indicate that in comparable urban situation it should be possible to identify 54% of total leprosy cases by techniques other than surveys. More significantly a striking feature of this study is that 82% of cases of true public health significance namely smear +ve patients could be unearthed by these means.

Health Education↗
PubMedDate not supplied

Evaluation of standard Dharmendra lepromin.

Dharmendra lepromin standardized at Central JALMA Institute for Leprosy (CJIL) by bacterial counts was used by different observers in four different Centres to assess the early and late reactions. Patients taken into the study were from different ethnic groups in different regions of the country. Comparable skin reactions were found at the Bombay Leprosy Project (BLP), Bombay and at the CJIL, Agra wherein a large number of patients were taken in the study. Similarly, when a smaller number of patients were taken in the study at the Base Hospital (BH), Barrackpore, and at the Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, the skin reactions noted in patients at these Centres were again found to be statistically comparable.

Evaluation Studies as Topic↗
PubMedDate not supplied

Field follow-up of leprosy cases in an urban area.

To achieve effective case holding in SET programme "treatment reminder" through home visits by field personnel is of much importance as drug compliance of leprosy cases is known to be very poor in general. A field study was undertaken to followup (A) school detected 158 leprosy cases (B) patients residing within project area especially 350 infectious cases as well as those 329 patients taking treatment elsewhere (C) 28 infectious patients from outside control area. (A) 70% Children diagnosed as leprosy through earlier surveys were available. 14% were believed to be regular for treatment 78% patients did not go for treatment. From this untreated group 73% showed features ranging from marked improvement to total regression of lesions. (B) 22% smear positive leprosy cases registered for treatment who dropped out from treatment over a period of 5 years were followed up. 21% dropped out cases had left the control area and their whereabouts were not known. From a group of 329 patients living in the control area of the same project who were believed to be taking treatment elsewhere only 48% could be contacted. The rest of them could not be contacted for various reasons. (C) During home visits to 28 infectious leprosy cases coming from far away places 21% said that they were taking treatment elsewhere. The figures in this study indicate the need for planning priority oriented home visit programme according to local situations to maintain at least infectious cases under regular treatment in view of the multiplicity of drugs as per the recent recommendations from experts.

Child↗