Pulmonary dysfunction-an overt leprosy sequel: study done in a rehabilitation centre

Background:In India, a total of 1.35 Lakh new cases were detected during the year 2012-13, which gives annual new case detection rate (ANCDR) of 10.78 per 100,000 populations. The proportion of multibacillary cases is 49.92 %. New cases continue to occur in almost all the endemic countries indicating that high burden pocket can exist against a low burden back ground. Leprosy is a mono neuritis multiplex complex of immunological origin that results in autonomic, sensory and motor neuropathy. This impairs pulmonary chemo sensitivity because of the block of vagus and sympathetic plexus in leprosy patients. Even after the treatment, a predisposition to nerve damage continues, as the clearance of bacterial antigens is extremely slow. The study aims at assessing the respiratory function in treated leprosy patients.Methods: 23 treated leprosy patients were selected after written and informed consent according to the inclusion and exclusion criteria. After obtaining the clearance from Institutional ethical committee, pulmonary function test was performed and the lung parameters were measured using computerized spirometry.Results: The statistical analysis revealed significant decrease in FVC%, FEV1%, FEV1/FVC% in lepromatous patients compared with tuberculoid patients. The restrictive pattern predominates in both lepromatous and tuberculoid patients.Conclusions: The study concluded that there is a definite impairment of lung functions in the patients treated for leprosy, causing spontaneous respiratory arrest and unexplained sudden deaths. Since the results have statistical significance, the study warrants early detection of respiratory abnormalities in leprosy patients who don’t have any clinically detectable symptoms.

Pattern visual evoked potential in newly diagnosed hypertensive individuals

Background: Neuronal dysfunction in hypertension with multifactorial aetiology involves white matter involvement and strongly associated with presence of retinal micro vascular lesions. Cortical lesions associated with optic nerve damage and retinopathy leads to visual disturbances. VEPs are the potential changes recorded from the scalp in response to visual stimuli. Since optic nerve is considered to be the part of brain, its subclinical involvement is likely hypertension. It is in this connection the present study involving visual evoked potential was done to see if there was any change in functional integrity of visual pathways in hypertension. The aim of the study was to evaluate the visual evoked potential in newly diagnosed hypertensive patients who have not taken any antihypertensive drugs before.Methods: 50 cases were selected based on inclusion and exclusion criteria and compared with 50 age, sex matched controls. Study was conducted after getting informed consent, by using the Medicaid polyrite instrument and VEP readings had been taken by standard procedure.Results: Study shows significant P100 latency when analysed through Levene’s test for equality of variances having p100 latencies for right eye 4.19±0.4 with p value of 0.003 and left eye 5.30±0.02 with p value of 0.000 substantiating prechiasmal lesion.Conclusions: Statistically significant delay in p100 suggests that the development of hypertensive retinopathy sub clinically, occurs in very early stages of Hypertension, which is not detectable on routine clinical examination. VEP can be suggested for screening in high-risk individuals to evaluate the functional integrity of visual pathway in hypertension and as a key to unravel the mystery of hidden Hypertensive Morbidity and Mortality. 

Pulmonary dysfunction-an overt leprosy sequel: study done in a rehabilitation centre

Background: In India, a total of 1.35 Lakh new cases were detected during the year 2012-13, which gives annual new case detection rate (ANCDR) of 10.78 per 100,000 populations. The proportion of multibacillary cases is 49.92 %. New cases continue to occur in almost all the endemic countries indicating that high burden pocket can exist against a low burden back ground. Leprosy is a mono neuritis multiplex complex of immunological origin that results in autonomic, sensory and motor neuropathy. This impairs pulmonary chemo sensitivity because of the block of vagus and sympathetic plexus in leprosy patients. Even after the treatment, a predisposition to nerve damage continues, as the clearance of bacterial antigens is extremely slow. The study aims at assessing the respiratory function in treated leprosy patients. Methods: 23 treated leprosy patients were selected after written and informed consent according to the inclusion and exclusion criteria. After obtaining the clearance from Institutional ethical committee, pulmonary function test was performed and the lung parameters were measured using computerized spirometry. Results: The statistical analysis revealed significant decrease in FVC%, FEV1%, FEV1/FVC% in lepromatous patients compared with tuberculoid patients. The restrictive pattern predominates in both lepromatous and tuberculoid patients. Conclusions: The study concluded that there is a definite impairment of lung functions in the patients treated for leprosy, causing spontaneous respiratory arrest and unexplained sudden deaths. Since the results have statistical significance, the study warrants early detection of respiratory abnormalities in leprosy patients who don't have any clinically detectable symptoms. [Int J Res Med Sci 2016; 4(7.000): 2843-2849