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Biomedical subjects

R Premkumar

Publications and source records attributed to R Premkumar.

13 recordsLinked to original sources
PubMed1998

Quantitative assessment of facial sensation in leprosy.

The trigeminal and great auricular nerves which supply sensation to the face are affected in leprosy. No objective sensory testing methods have been devised for testing sensation in the face. Testing for corneal sensation to ascertain trigeminal nerve or visualization and palpation of the great auricular nerve alone may not be enough to establish the involvement of these nerves. In a sample of leprosy patients, face sensation threshold measurements were done using a set of three Semmes-Weinstein (SW) monofilaments that gave a force of 0.05-0.07, 0.2 and 2 g. Sensation was tested by three examiners and intra- and inter-observer testing was used as a means to validate the findings. Within the limitations of this study, the results indicate that use of SW monofilaments is a fairly reliable and repeatable method for sensory testing in the face. During follow up, a single filament with a force of 0.5-0.7 g (2.83 marking number in SW filament or any other filament with a corresponding gram force) could be used to assess sensation. A simple procedure of quantifying sensation in these nerves is suggested. A method to incorporate trigeminal or great auricular nerve sensory testing into the existing sensory assessment charts is also discussed.

Face↗
PubMed1994

Understanding the attitude of multidisciplinary teams working in leprosy.

This study investigated the attitude of health personnel who were working for the National Leprosy Eradication Programme (NLEP) in India to their leprosy patients. These personnel were studied individually and as homogeneous groups so that comparisons were possible within and among the groups, and between the groups in different regions who were conducting similar health programmes, with a difference in length of between 1 and 5 years. The sample population was the NLEP employees of 2 state governments, consisting of 8 health professional groups. A questionnaire was developed for each of these groups to elicit information on 5 aspects of the relationships with their patients. The main outcome of the study was that two-thirds of the personnel tested possessed the 'minimum desirable' interaction with their patients. The quality of their relationships differed only among work specialities, but was consistent within the same speciality in different regions; this pattern was unchanged after 5 years of a multidrug (MDT) programme. A further analysis showed that although they possessed a caring attitude towards patients from low socioeconomic classes, a domineering attitude towards these same patients was also prevalent. Analysis according to speciality revealed that laboratory technicians had the highest "desirable attitude" (74.67%) and health educators had the lowest (57.5%), while the rest of the team members fell in between. The stigma shown towards leprosy was higher among doctors when compared to the rest of the team members. Discussion is based on the performance, overall and in each of its 5 facets, of each the professional groups with reference to their job descriptions and with similar studies undertaken earlier.

Adult↗
PubMed1993

Leprosy workers.

Explore the source record for details and available documents.

Career Mobility↗
PubMed1992

Relationship problems between doctors and paramedical professionals working in leprosy with reference to a possible solution.

An empirical investigation was conducted on the in-group dynamics of health personnel working in leprosy. The sample populations were taken from the National Leprosy Eradication Programme (NLEP) employees of two state governments in India. They consisted of 21 doctors and 335 paramedicals, the former constituting a formal group and the latter a semiformal group. Two separate scales were developed for each of these groups to elicit information on five potential areas of intergroup relationships. The results indicated that there was very poor acceptance of the out-group and its roles, i.e. poor acceptance of the paramedicals by the doctors and vice versa. Three reasons were elicited from this study. First, doctors held their professional standing to be on a higher level than the paramedicals, leading to excessive social distancing between doctors and paramedicals. Second, multiprofessional involvement in NLEP work has increased the trend of professional overlapping, leading to a significant apprehension of the encroachment of skills. Third, there was a mutual lack of trust of each others professional skills. Despite these problems the otherwise more severe human relationship problems, such as domineering behaviour and prejudiced perception against the out-group were found to be significantly less in this study. In order to improve working relationships between these groups a method that has been used at Karigiri is recommended. The method has two parts. The first is aimed at intrapersonal understanding and the second at the development of interpersonal skills. Role play that mimics their original work situation and an analysis of case histories were the methods of teaching that were found to be more advantageous in internalizing these skills.

Allied Health Personnel↗
PubMedDate not supplied

Foot soaks for callosities and fissures.

A study to assess the effect of soap soaks and plain water soaks on the dry anaesthetic sole of 15 leprosy patients bearing multiple fissures and callouses is reported. A callous scraper devised by us was found effective. It is recommended that a hypotonic keratolytic solution such as toilet soap or plain water be used for soaking which has the effect of softening the keratin. It may be better to use soap solution for this purpose.

Balneology↗
PubMedDate not supplied

Professional freedom of government leprosy personnel.

BACKGROUND: Government employment in India is known for its lack of flexibility. We studied whether this also involved professional freedom among health personnel working for the National Leprosy Eradication Programme. METHODS: The sample population consisted of National Leprosy Eradication Programme employees from Tamil Nadu and Andhra Pradesh and 8 health professional groups. A questionnaire was developed for each of them to elicit information on 5 aspects of their autonomy. They were studied individually and as homogeneous groups so that comparisons were possible both within and between groups in different regions who were conducting similar health programmes. RESULTS: National Leprosy Eradication Programme personnel enjoy a high degree of autonomy within the organization. This autonomy was evident in both states investigated, despite different administrations and it was not connected with the professional positions they held. Professional freedom correlated with the training activities, promotional prospects and commitment to the organization. CONCLUSIONS: The National Leprosy Eradication Programme job is not rigid because the organization is small and the intellectual needs of the professionals are met within it.

Adult↗
PubMedDate not supplied

Impact of multidrug therapy on health personnel in their level of job satisfaction.

This study examines the "service" factors of the health professionals working in the National Leprosy Eradication Programme (NLEP) resulting from the introduction of multidrug therapy (MDT) technology, and their impact on their job satisfaction. The findings show that both among physicians and paramedicals, the significant chemotherapeutic dissatisfaction observed before the introduction of multidrug therapy has been replaced by a moderately positive satisfaction. This was much higher than the other incentives like pay, promotional prospect and job significance within NLEP and the community. It was also consistent over five years which was not the case with hydnocarpus and monotherapy technologies. Intercorrelation matrix test revealed three positive intercorrelations. First, personnel associated technology with personal progress which provided a sense of accomplishment while also satisfying their economic needs; second, they saw it as a mode of developing relationships with their clients; and third, it improved their self-image in the community. However, this satisfaction may not be static when there is a reduction of work load, or, the leprosy programme is integrated into general health services. Therefore, while planning these changes, care must be taken that the present level of technological satisfaction is maintained or further improved.

Allied Health Personnel↗