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The economic burden of lymphatic filariasis in India.

Lymphatic filariasis affects 119 million people living in 73 countries, with India accounting for 40% of the global prevalence of infection. Despite its debilitating effects, lymphatic filariasis is given very low control priority. One of the reasons for this is paucity of information on the economic burden of the disease. Recent studies in rural areas of south India have shown that the treatment costs and loss of work time due to the disease are considerable. Based on the results of these studies, Kapa Ramaiah et al. here estimate the annual economic loss because of lymphatic filariasis for India and discuss the implications of their findings.

Adolescent↗

Pathogenesis of lymphatic disease in bancroftian filariasis: a clinical perspective.

The pathogenesis of lymphatic filariasis has been a matter of debate for many decades. Here, Gerusa Dreyer and colleagues propose a dynamic model of bancroftian filariasis, integrating clinical, parasitological, surgical, therapeutic, ultrasonographic and histopathological data. This model has profound implications for filariasis control programs and the management of the individual patient.

Albendazole↗

Cutaneous nocardiosis. Case reports and review.

Two cases of cutaneous nocardial infection are reported. The Nocardia species are gram-positive, partially acid-fast bacteria. Cutaneous involvement may develop as one of four types: (1) mycetoma, (2) lymphocutaneous (sporotrichoid) infection, (3) superficial skin infection, or (4) systemic disease with cutaneous involvement. A review of each of these types of infection is included, as well as potential clues that may suggest the diagnosis of nocardiosis.

Abscess↗

Sexually related trauma: a review.

Every type of sexual trauma is overlaid with the sexual mores and taboos of society and the individual psychosexual values of the patient. Informed and appropriate treatment should give good results for the patient physically as well as psychologically. Fortunately for the human species, wounds from Cupid's bow are much more common than any injury discussed by us. For those unfortunates who sustain such injuries in the pursuit of happiness, however, these guidelines for diagnosis and treatment are submitted for your review and their benefit.

Adult↗

Current aspects of bacterial infections of the skin.

The practicing dermatologist is faced with an ever-changing epidemiologic spectrum of cutaneous bacterial diseases. Studies have stated that bacterial skin infections may account for up to 17% of clinical visits. It is hoped that the information presented in this article will enable the practicing dermatologist to provide improved patient care in the diagnosis and management of bacterial infections of the skin.

Erysipelas↗

Otitis externa.

Explore the source record for details and available documents.

Aluminum↗

Lymphangitic sporotrichosis: an uncommon bilateral localization.

Sporotrichosis is a mycotic disease caused by cutaneous inoculation of the dimorphic fungus Sporothrix schenckii. The primary lesion can spread and often develop a unilateral lymphocutaneous lesions or, rarely, disseminated disease. We report a lymphangitic sporotrichosis case with ulcerated erythematous nodules distributed bilaterally on the posterior and medical aspect of the both legs, probably due to multiple inoculations. The treatment with oral potassium iodide was satisfactory.

Administration, Oral↗

Treatment costs and work time loss due to episodic adenolymphangitis in lymphatic filariasis patients in rural communities of Orissa, India.

OBJECTIVE: To determine the economic loss in terms of treatment costs and loss of productive time because of acute episodes of adenolymphangitis (ADL) caused by lymphatic filariasis (LF) in a rural population of coastal Orissa, India. METHODS: Data on expenditure on treatment and loss of work along with other epidemiological information were collected through a 1-year surveillance of 113 acute episodes of ADL from 72 individuals of the study population (5.42%). The activity patterns of patients for 24 h of one episode were documented, and data on age- and sex-matched controls were also collected. Standardized Z-test, paired t-test, logistic and multiple regressions were used. RESULTS: Those patients who did incur expenses spent Indian Rupees 92 on average (approximately US$ 1.85) on each episode. The ADL episodes curtailed the productive activity of patients. Patients (88%) were unable to attend to any economic activity compared with 47% of controls who had no history of disease. Similarly during 55% of episodes, females (vs. 8% of controls) could not attend to any domestic work. The mean number of hours spent on economic or domestic activities was significantly lower among patients. Disease status and sex had significant influence on total absenteeism from gainful employment; and similarly, age, family type and disease status influenced total domestic work hours among women. CONCLUSIONS: The results demonstrate the extent of the economic burden caused by acute LF and provide justification for strengthening the ongoing LF elimination programme.

Absenteeism↗

Efficacy and sustainability of a footcare programme in preventing acute attacks of adenolymphangitis in Brugian filariasis.

Lymphatic filariasis is associated with considerable disability related to the intensity and frequency of acute adenolymphangitis (ADL) attacks. The global programme for elimination of lymphatic filariasis emphasizes the need to combine transmission control with alleviation of disability. Footcare aimed at the prevention of secondary bacterial infections is the mainstay of disability alleviation programmes. We evaluated the efficacy and sustainability of an unsupervised, personal footcare programme by examining and interviewing 127 patients who had previously participated in a trial that assessed the efficacy of diethylcarbamazine, penicillin and footcare in the prevention of ADL. During the trial period these patients had been educated in footcare and were supervised. During the unsupervised period, which lasted 1 year or longer, 47 patients developed no ADL, and ADL occurred less frequently in 72.5%. Most patients were practising footcare as originally advised, unsupervised and without cost, which proves that such a programme is sustainable and effective.

Acute Disease↗

Cutaneous manifestations of the Hemiscorpius lepturus sting: a clinical study.

BACKGROUND AND DESIGN: Scorpion stings are a serious problem in Khuzestan, a southwestern province of Iran. In around 5 years, 36,463 patients with scorpion stings have been seen. Most of the patients had no cutaneous findings, but a small group of patients developed various local and generalized skin manifestations. Patients were evaluated in terms of cutaneous findings early in and during the course of their illness. The correlation between the site of the sting and the severity of the cutaneous and systemic problems is discussed. RESULTS: Hemiscorpion (Hemiscorpius) lepturus (HL), which is responsible for more than 10% of the scorpion stings in this area, was found to be the only scorpion with related cutaneous findings. Different species of the Buthidae family, which were responsible for the remaining 90% of scorpion stings, have a neurotropic and noncytotoxic venom and, as a result, induce no cutaneous reaction. CONCLUSIONS: HL venom is cytotoxic, and HL is the only scorpion whose venom induces a toxic reaction. Erythema, purpuric changes, bullae, necrosis, and ulcers, or a combination of these, may be seen at different stages. The site and the severity of the cutaneous reaction may aid in the prediction of the clinical outcome for the patients and in estimating the interval between the sting and presentation.

Adolescent↗

[NMR tomographic diagnosis with Gd-DTPA in HIV-associated diseases in the head-neck area].

In a prospective study 21 patients suffering from HIV-1 infection underwent MR imaging. The following tumours were found: eight Kaposi's sarcomas, four lymphomas, two squamous-cell carcinomas, and three cases of lymphoid hyperplasia. Furthermore, three cases with lymphoepithelial cysts and one case of inflammatory changes of the parotid glands were studied. Optimal diagnostic results were obtained by using T1- and T2-weighted sequences plain and Gd-DTPA enhanced. Different signal intensities enabled the differentiation of lesions such as inflammation, lymphomas and lymphoid hyperplasia. Besides clinical examination modalities, MR imaging proves to be an important tool in investigating solid, cystic or inflamed processes in HIV-positive patients in the head and neck area.

Carcinoma, Squamous Cell↗

[Viper bites--symptoms and therapy].

A report on 2 children aged 9 and 10 who had been bitten by venomous snakes (European vipers). With immobilization of the affected limb, continuous drip infusion, intravenous injection of antibiotics and tetanus prophylaxis the course was uncomplicated, though with some severe local symptoms. Snake serum was not used since the possible side effects of the antitoxin, obtained from horses, are considered unjustified by its therapeutic value. The various therapeutic procedures described in the literature are discussed.

Anti-Bacterial Agents↗