1) Leprosy reactions are acute inflammatory episodes that can occur during active leprosy disease. They are caused by the body's immune response to M. leprae and can lead to worsening of symptoms or development of new symptoms.
2) Nerve damage and disabilities are common complications of leprosy that occur due to delayed treatment, advanced disease, reactions, and lack of self-care of insensate areas. Management involves prevention education and reconstructive surgeries.
3) Anti-leprosy drugs can cause minor side effects like rashes but also serious and potentially life-threatening reactions in some cases that require close monitoring during treatment.
This document discusses various complications that can arise from leprosy, including:
1. Leprosy reactions which cause inflammation and damage nerves
2. Adverse effects from long-term use of anti-leprosy drugs
3. Disabilities and deformities caused by nerve damage leading to loss of sensation and muscle paralysis
4. Psycho-social problems from the stigma and rejection associated with leprosy
It provides details on evaluating and grading disabilities, managing nerve damage, and treating specific issues like ulcers, clawing, eye problems, and social stigma. Surgical interventions and lifestyle adaptations are also described to prevent further impairment and support rehabilitation.
Deformities in leprosy Dr Manasa Shettisara JanneyManasa Janney
1) Leprosy causes deformities through direct tissue infiltration, nerve damage, and secondary to anesthesia. Nerve damage in leprosy can impair sensation, motor function, or both.
2) Common deformities in leprosy include claw hand, claw toes, foot drop, and plantar ulcers. Deformities occur most often in the hands and feet.
3) Management of leprosy deformities focuses on early detection of nerve damage, prompt treatment to prevent further damage, rehabilitation to prevent disability, and management of existing deformities and injuries.
Disabilities and deformities in leprosy patients and managementdalal8
This document discusses disabilities and deformities that can occur in leprosy patients. It defines key terms like impairments, deformities, and defects. It describes risk factors for deformities like type and extent of leprosy, number of involved nerves, and duration of untreated disease. Common types of deformities are specific deformities from local infection and paralytic or anesthetic deformities from nerve damage. Nerve involvement is discussed, including the stages of involvement and commonly affected nerves. Guidelines are provided for managing nerve damage, neuritis, and abscesses. Common hand problems in leprosy patients are also summarized.
COMPLICATIONS OF LEPROSY & ITS MANAGEMENTKushal kumar
This document discusses leprosy (Hansen's disease), including its types, symptoms, complications, treatment, and rehabilitation. It covers the types of leprosy reactions (Type I and II), as well as the specific reaction erythema nodosum leprosum. Disabilities caused by leprosy are described, including paralytic deformities and anesthetic deformities. The adverse effects of anti-leprotic drugs are listed. It also summarizes the milestones of India's National Leprosy Eradication Program and concludes by stating that modern medicine has cured most of the world of leprosy, though it remains a problem in some undeveloped countries.
This document discusses reconstructive surgery for complications of leprosy, including lagophthalmos (eyelid paralysis), foot drop, and claw hand. It describes the causes and assessment of these conditions and outlines surgical procedures to restore function, such as temporalis muscle transfer for lagophthalmos and tibialis posterior transfer for foot drop. The goals of reconstructive surgery in leprosy are to restore function and form, prevent further disability, and facilitate rehabilitation.
Disabilities prevention and management in leprosyDILEEPSAUGAT
The document discusses disability prevention and management in leprosy. It defines key terms like impairment, deformity, and disability. It describes risk factors for deformities and classifications of nerve involvement. It discusses preventing impairments through early treatment, steroid use, nerve decompression, and self-care practices. Management involves assessing nerve function, physiotherapy including splinting and exercises, footwear, and corrective surgeries. Close monitoring and rehabilitation aims to restore function and independence.
Scleroderma is a multisystem collagen vascular disease characterized by fibrosis of the skin and internal organs. It results from endothelial cell injury, fibroblast activation, and immune system involvement. The two main types are limited cutaneous systemic sclerosis, which affects the skin of the hands and face, and diffuse cutaneous systemic sclerosis, which has more extensive skin involvement. Major organ manifestations include pulmonary fibrosis, gastrointestinal tract abnormalities, heart and kidney involvement. Treatment focuses on preventing further organ damage through immunosuppression and addressing specific organ system complications.
This document discusses various complications that can arise from leprosy, including:
1. Leprosy reactions which cause inflammation and damage nerves
2. Adverse effects from long-term use of anti-leprosy drugs
3. Disabilities and deformities caused by nerve damage leading to loss of sensation and muscle paralysis
4. Psycho-social problems from the stigma and rejection associated with leprosy
It provides details on evaluating and grading disabilities, managing nerve damage, and treating specific issues like ulcers, clawing, eye problems, and social stigma. Surgical interventions and lifestyle adaptations are also described to prevent further impairment and support rehabilitation.
Deformities in leprosy Dr Manasa Shettisara JanneyManasa Janney
1) Leprosy causes deformities through direct tissue infiltration, nerve damage, and secondary to anesthesia. Nerve damage in leprosy can impair sensation, motor function, or both.
2) Common deformities in leprosy include claw hand, claw toes, foot drop, and plantar ulcers. Deformities occur most often in the hands and feet.
3) Management of leprosy deformities focuses on early detection of nerve damage, prompt treatment to prevent further damage, rehabilitation to prevent disability, and management of existing deformities and injuries.
Disabilities and deformities in leprosy patients and managementdalal8
This document discusses disabilities and deformities that can occur in leprosy patients. It defines key terms like impairments, deformities, and defects. It describes risk factors for deformities like type and extent of leprosy, number of involved nerves, and duration of untreated disease. Common types of deformities are specific deformities from local infection and paralytic or anesthetic deformities from nerve damage. Nerve involvement is discussed, including the stages of involvement and commonly affected nerves. Guidelines are provided for managing nerve damage, neuritis, and abscesses. Common hand problems in leprosy patients are also summarized.
COMPLICATIONS OF LEPROSY & ITS MANAGEMENTKushal kumar
This document discusses leprosy (Hansen's disease), including its types, symptoms, complications, treatment, and rehabilitation. It covers the types of leprosy reactions (Type I and II), as well as the specific reaction erythema nodosum leprosum. Disabilities caused by leprosy are described, including paralytic deformities and anesthetic deformities. The adverse effects of anti-leprotic drugs are listed. It also summarizes the milestones of India's National Leprosy Eradication Program and concludes by stating that modern medicine has cured most of the world of leprosy, though it remains a problem in some undeveloped countries.
This document discusses reconstructive surgery for complications of leprosy, including lagophthalmos (eyelid paralysis), foot drop, and claw hand. It describes the causes and assessment of these conditions and outlines surgical procedures to restore function, such as temporalis muscle transfer for lagophthalmos and tibialis posterior transfer for foot drop. The goals of reconstructive surgery in leprosy are to restore function and form, prevent further disability, and facilitate rehabilitation.
Disabilities prevention and management in leprosyDILEEPSAUGAT
The document discusses disability prevention and management in leprosy. It defines key terms like impairment, deformity, and disability. It describes risk factors for deformities and classifications of nerve involvement. It discusses preventing impairments through early treatment, steroid use, nerve decompression, and self-care practices. Management involves assessing nerve function, physiotherapy including splinting and exercises, footwear, and corrective surgeries. Close monitoring and rehabilitation aims to restore function and independence.
Scleroderma is a multisystem collagen vascular disease characterized by fibrosis of the skin and internal organs. It results from endothelial cell injury, fibroblast activation, and immune system involvement. The two main types are limited cutaneous systemic sclerosis, which affects the skin of the hands and face, and diffuse cutaneous systemic sclerosis, which has more extensive skin involvement. Major organ manifestations include pulmonary fibrosis, gastrointestinal tract abnormalities, heart and kidney involvement. Treatment focuses on preventing further organ damage through immunosuppression and addressing specific organ system complications.
Guillain-Barré syndrome is an autoimmune disorder where the immune system attacks the peripheral nervous system, causing muscle weakness and possible paralysis. It often follows a viral or bacterial infection. The body's immune system mistakenly attacks and destroys the myelin sheath surrounding nerves. This damages nerve impulses and causes muscle weakness. Symptoms include progressive muscle weakness, numbness, pain, and difficulty walking or breathing. It can range from mild to life-threatening. The cause is unknown but molecular mimicry between infectious agents and nerve tissues may play a role.
Pulse therapy involves administering high doses of drugs intermittently to enhance therapeutic effects and reduce side effects. It is commonly used in dermatology to treat conditions like pemphigus vulgaris. The most common agents used are methylprednisolone and dexamethasone, administered intravenously in high doses over 2-3 hours. Pulse therapy works through both genomic and non-genomic mechanisms at the cellular level to produce powerful anti-inflammatory effects. It provides indications, contraindications, administration protocols, mechanisms of action, and modifications for pulse therapy.
This document provides an overview of the diagnostic workup and treatment for myasthenia gravis. Key points include:
- Common symptoms include fluctuating weakness that worsens with exertion and improves with rest. Physical exam looks for muscle weakness and fatigability.
- Diagnostic tests include acetylcholine receptor antibodies, repetitive nerve stimulation, and single fiber electromyography to confirm diagnosis.
- Treatment involves anticholinesterase medications to increase acetylcholine levels, immunosuppressants like prednisone and azathioprine to reduce antibody production, and sometimes thymectomy to remove the thymus gland.
Systemic sclerosis is a rare autoimmune disease characterized by fibrosis of the skin and internal organs. It can be classified as either limited or diffuse cutaneous systemic sclerosis. The disease mainly affects women in their 30s-50s and is characterized by Raynaud's phenomenon, skin thickening, and organ involvement such as pulmonary fibrosis, gastrointestinal issues, and renal crisis. Prognosis depends on the subtype, with diffuse disease having a worse prognosis and higher mortality rates due to organ complications.
This document summarizes key information about leprosy (Hansen's disease), including:
- It is caused by Mycobacterium leprae bacteria and primarily affects the skin, nerves, respiratory tract and testes.
- There is a spectrum of clinical forms from tuberculoid (high resistance) to lepromatous (low resistance).
- Complications include reactions, nerve damage leading to deformities, and secondary infections.
- Treatment involves multidrug therapy but nerve damage may be permanent without rehabilitation. Advocacy groups continue working to eliminate stigma and provide care.
Epidemiology and recent advances in leprosy Bhavna Jain
Leprosy is a major public health problem in India and the World. Despite of having many programs to eliminate it, India is sharing a major burden of this disease. To understand this problem and the present measures adopted this presentation has been created.
The document discusses psoriasis, including its epidemiology, pathophysiology, clinical presentations, diagnosis, differential diagnosis, and management. Psoriasis is a chronic, inflammatory skin condition characterized by red scaly plaques. It has a genetic component and can be triggered by various environmental factors. Clinical diagnosis is usually based on appearance of lesions. Topical therapies are first-line treatment for mild-moderate disease, while phototherapy and systemic therapies may be used for more severe cases. Proper management requires a tailored approach based on individual disease characteristics and goals of improving quality of life and long-term disease control.
1) Leprous neuritis is inflammation of the peripheral nerves caused by invasion of lepra bacilli, which leads to nerve function impairment (NFI). It is mediated by Schwann cell invasion and immune/inflammatory reactions.
2) Clinical features include acute/chronic neuritis with sensory, motor, and autonomic NFI. Neuropathic pain is also common. Treatment involves continuing multidrug therapy, anti-inflammatory drugs like corticosteroids, and surgery in severe cases.
3) Preventing leprous neuritis requires early detection/treatment of leprosy and prompt initiation of multidrug therapy, with prophylactic corticosteroids during treatment to reduce reactions. Experimental
Pruritus, or itch, is a sensation that provokes the desire to scratch. Chronic pruritus lasts more than 6 weeks and can be caused by skin diseases or systemic diseases. Itch is transmitted through unmyelinated C fibers and is a distinct sensation from pain. Scratching provides temporary relief by stimulating myelinated fibers or damaging sensory nerve endings. Management of pruritus involves general skin care, topical agents like corticosteroids, calcineurin inhibitors, local anesthetics, and antihistamines, as well as treating any underlying cause.
Ageing of the skin can occur intrinsically through natural biological processes like telomere shortening over time or extrinsically from external factors like ultraviolet radiation exposure, which can cause histological changes like thinning of the epidermis and dermis, breakdown of collagen and elastic fibers, and alterations to fibroblasts. Physiological changes in aged skin include dryness, loss of elasticity and wrinkling due to reduced collagen and elastic fiber production, as well as increased risk of infections and skin cancers. Common dermatological conditions seen in older patients include xerosis, pruritus, pressure sores, viral and fungal infections,
Dr. Evith Pereira presented information on leprosy, including:
1. Leprosy cases have declined worldwide from over 5 million in 1985 to under 1 million in 1998 and around 200,000 in 2009, with 80% of cases found in 5 countries including India.
2. Over the past 20 years, more than 14 million leprosy patients have been cured, around 4 million since 2000. Prevalence rates have dropped 90% globally.
3. Leprosy is caused by Mycobacterium leprae bacteria and develops slowly over months to decades, resulting in skin lesions and nerve damage that can cause deformities. It is transmitted via droplets from the nose.
This document summarizes information about leprosy presented by Dr. Alteib Yousif. It discusses the history, classification, signs and symptoms, complications, diagnosis, and treatment of leprosy. Key points include that leprosy is caused by Mycobacterium leprae, has various clinical types defined by skin and nerve involvement, and is treated with multidrug therapy regimens recommended by the WHO to cure the disease. Prevention involves avoiding contact with untreated patients.
Chronic Inflammatory Demyelinating Polyradiculoneuropathy (CIDP) is a rare neurological disorder characterized by progressive weakness and impaired sensory function caused by damage to the peripheral nervous system. It has an incidence rate of 1-2 per 100,000 people and predominantly affects males over 50 years old. CIDP is diagnosed based on progressive muscle weakness, reduced reflexes, nerve conduction studies showing demyelination, elevated CSF protein, and nerve biopsy with signs of demyelination. Treatment involves intravenous immunoglobulin, plasma exchange, steroids, or other immunosuppressants, with around 50% of patients experiencing improvement with therapy.
The document presents an overview of leprosy including its history, epidemiology, classification, clinical features, pathogenesis and immunology. It discusses the different types of leprosy including tuberculoid, borderline, and lepromatous leprosy. The presentation was given by Biniyam Simeneh at ALERT Hospital to review leprosy etiology, transmission, risk factors, and clinical manifestations.
This document provides an overview of Hansen's disease (leprosy), including its history, transmission, classification, clinical manifestations, diagnosis and treatment. It describes leprosy as a chronic infection caused by Mycobacterium leprae that commonly presents with skin lesions and nerve involvement. The classification systems discussed divide leprosy into tuberculoid, borderline, and lepromatous forms based on immunological response and clinical features. Diagnosis involves examination of skin and nerve lesions as well as demonstration of M. leprae via skin smears or biopsy.
Topical corticosteroids are powerful anti-inflammatory drugs that are classified based on their potency from mild to very potent. More potent corticosteroids are associated with greater risk of side effects. They work by preventing the formation of inflammatory molecules. Their absorption and effect can be enhanced by certain vehicle formulations, occlusion, damaged skin barriers, and other factors. Guidelines recommend restricting very potent corticosteroid use to small areas for short periods to reduce risk of side effects like skin atrophy.
This document provides information on defining and classifying leprosy through various case definitions and classification systems used historically and presently. It begins by outlining the WHO definition of a leprosy case from 1997 and then describes several influential classification systems for leprosy including the Ridley-Jopling spectral classification from 1962, the Madrid classification from 1953, and the WHO's PB and MB classification for treatment purposes introduced in 1982 and revised in 1998. It also provides detailed descriptions of the clinical presentations of different leprosy types within these classification systems.
This document discusses skin failure, which is defined as the loss of normal temperature regulation and ability to maintain core body temperature and fluid/electrolyte balance. It causes various physiological changes including altered hemodynamics, impaired thermoregulation, metabolic complications, fluid/electrolyte imbalances, infections, and more. The management of skin failure requires intensive monitoring and care of fluid/electrolyte balance, nutrition, infection prevention, and topical therapies to address the systemic effects.
This document summarizes phototherapy, including the types used, mechanisms of action, effects on the skin and immune system, and basic principles of phototherapy devices. The main types discussed are narrowband UVB, PUVA, and UVA1. The mechanisms of action include DNA damage, generation of reactive oxygen species, effects on cytokines and immune cells like T cells, Langerhans cells, mast cells, and melanocytes. Devices use different lamp technologies like incandescent, gas discharge, and fluorescent to generate the desired wavelengths of UV or visible light.
This document provides information on disabilities and deformities that can occur in leprosy patients. It discusses terminology used to describe impairments, deformities, and defects. It outlines risk factors for deformities and describes specific, paralytic, and anesthetic deformities that can arise. The WHO classification system for grading impairments in hands/feet and eyes is presented. Details are given on nerve involvement in leprosy and management of neuritis. Common problems in hands like ulcers and deformities are covered, along with foot issues like ulcers and drop foot. Management of various deformities affecting face and eyes is summarized. The GPAS scale for assessing daily activities is briefly described, and economic rehabilitation is mentioned.
1. Peripheral nerves can be injured through various mechanisms including ischemia, compression, traction, laceration, or burning. This causes a spectrum of damage from mild and reversible to complete interruption.
2. Following nerve injury, the distal axon degenerates and the myelin sheath breaks down. New axonal growth occurs as the axon regenerates slowly into old endoneurial tubes.
3. Peripheral nerve injuries are classified based on severity from neurapraxia (mild and reversible) to axonotmesis (axon degeneration but endoneurium preserved allowing regeneration) to neurotmesis (severe damage with endoneurium disruption and poor recovery).
Guillain-Barré syndrome is an autoimmune disorder where the immune system attacks the peripheral nervous system, causing muscle weakness and possible paralysis. It often follows a viral or bacterial infection. The body's immune system mistakenly attacks and destroys the myelin sheath surrounding nerves. This damages nerve impulses and causes muscle weakness. Symptoms include progressive muscle weakness, numbness, pain, and difficulty walking or breathing. It can range from mild to life-threatening. The cause is unknown but molecular mimicry between infectious agents and nerve tissues may play a role.
Pulse therapy involves administering high doses of drugs intermittently to enhance therapeutic effects and reduce side effects. It is commonly used in dermatology to treat conditions like pemphigus vulgaris. The most common agents used are methylprednisolone and dexamethasone, administered intravenously in high doses over 2-3 hours. Pulse therapy works through both genomic and non-genomic mechanisms at the cellular level to produce powerful anti-inflammatory effects. It provides indications, contraindications, administration protocols, mechanisms of action, and modifications for pulse therapy.
This document provides an overview of the diagnostic workup and treatment for myasthenia gravis. Key points include:
- Common symptoms include fluctuating weakness that worsens with exertion and improves with rest. Physical exam looks for muscle weakness and fatigability.
- Diagnostic tests include acetylcholine receptor antibodies, repetitive nerve stimulation, and single fiber electromyography to confirm diagnosis.
- Treatment involves anticholinesterase medications to increase acetylcholine levels, immunosuppressants like prednisone and azathioprine to reduce antibody production, and sometimes thymectomy to remove the thymus gland.
Systemic sclerosis is a rare autoimmune disease characterized by fibrosis of the skin and internal organs. It can be classified as either limited or diffuse cutaneous systemic sclerosis. The disease mainly affects women in their 30s-50s and is characterized by Raynaud's phenomenon, skin thickening, and organ involvement such as pulmonary fibrosis, gastrointestinal issues, and renal crisis. Prognosis depends on the subtype, with diffuse disease having a worse prognosis and higher mortality rates due to organ complications.
This document summarizes key information about leprosy (Hansen's disease), including:
- It is caused by Mycobacterium leprae bacteria and primarily affects the skin, nerves, respiratory tract and testes.
- There is a spectrum of clinical forms from tuberculoid (high resistance) to lepromatous (low resistance).
- Complications include reactions, nerve damage leading to deformities, and secondary infections.
- Treatment involves multidrug therapy but nerve damage may be permanent without rehabilitation. Advocacy groups continue working to eliminate stigma and provide care.
Epidemiology and recent advances in leprosy Bhavna Jain
Leprosy is a major public health problem in India and the World. Despite of having many programs to eliminate it, India is sharing a major burden of this disease. To understand this problem and the present measures adopted this presentation has been created.
The document discusses psoriasis, including its epidemiology, pathophysiology, clinical presentations, diagnosis, differential diagnosis, and management. Psoriasis is a chronic, inflammatory skin condition characterized by red scaly plaques. It has a genetic component and can be triggered by various environmental factors. Clinical diagnosis is usually based on appearance of lesions. Topical therapies are first-line treatment for mild-moderate disease, while phototherapy and systemic therapies may be used for more severe cases. Proper management requires a tailored approach based on individual disease characteristics and goals of improving quality of life and long-term disease control.
1) Leprous neuritis is inflammation of the peripheral nerves caused by invasion of lepra bacilli, which leads to nerve function impairment (NFI). It is mediated by Schwann cell invasion and immune/inflammatory reactions.
2) Clinical features include acute/chronic neuritis with sensory, motor, and autonomic NFI. Neuropathic pain is also common. Treatment involves continuing multidrug therapy, anti-inflammatory drugs like corticosteroids, and surgery in severe cases.
3) Preventing leprous neuritis requires early detection/treatment of leprosy and prompt initiation of multidrug therapy, with prophylactic corticosteroids during treatment to reduce reactions. Experimental
Pruritus, or itch, is a sensation that provokes the desire to scratch. Chronic pruritus lasts more than 6 weeks and can be caused by skin diseases or systemic diseases. Itch is transmitted through unmyelinated C fibers and is a distinct sensation from pain. Scratching provides temporary relief by stimulating myelinated fibers or damaging sensory nerve endings. Management of pruritus involves general skin care, topical agents like corticosteroids, calcineurin inhibitors, local anesthetics, and antihistamines, as well as treating any underlying cause.
Ageing of the skin can occur intrinsically through natural biological processes like telomere shortening over time or extrinsically from external factors like ultraviolet radiation exposure, which can cause histological changes like thinning of the epidermis and dermis, breakdown of collagen and elastic fibers, and alterations to fibroblasts. Physiological changes in aged skin include dryness, loss of elasticity and wrinkling due to reduced collagen and elastic fiber production, as well as increased risk of infections and skin cancers. Common dermatological conditions seen in older patients include xerosis, pruritus, pressure sores, viral and fungal infections,
Dr. Evith Pereira presented information on leprosy, including:
1. Leprosy cases have declined worldwide from over 5 million in 1985 to under 1 million in 1998 and around 200,000 in 2009, with 80% of cases found in 5 countries including India.
2. Over the past 20 years, more than 14 million leprosy patients have been cured, around 4 million since 2000. Prevalence rates have dropped 90% globally.
3. Leprosy is caused by Mycobacterium leprae bacteria and develops slowly over months to decades, resulting in skin lesions and nerve damage that can cause deformities. It is transmitted via droplets from the nose.
This document summarizes information about leprosy presented by Dr. Alteib Yousif. It discusses the history, classification, signs and symptoms, complications, diagnosis, and treatment of leprosy. Key points include that leprosy is caused by Mycobacterium leprae, has various clinical types defined by skin and nerve involvement, and is treated with multidrug therapy regimens recommended by the WHO to cure the disease. Prevention involves avoiding contact with untreated patients.
Chronic Inflammatory Demyelinating Polyradiculoneuropathy (CIDP) is a rare neurological disorder characterized by progressive weakness and impaired sensory function caused by damage to the peripheral nervous system. It has an incidence rate of 1-2 per 100,000 people and predominantly affects males over 50 years old. CIDP is diagnosed based on progressive muscle weakness, reduced reflexes, nerve conduction studies showing demyelination, elevated CSF protein, and nerve biopsy with signs of demyelination. Treatment involves intravenous immunoglobulin, plasma exchange, steroids, or other immunosuppressants, with around 50% of patients experiencing improvement with therapy.
The document presents an overview of leprosy including its history, epidemiology, classification, clinical features, pathogenesis and immunology. It discusses the different types of leprosy including tuberculoid, borderline, and lepromatous leprosy. The presentation was given by Biniyam Simeneh at ALERT Hospital to review leprosy etiology, transmission, risk factors, and clinical manifestations.
This document provides an overview of Hansen's disease (leprosy), including its history, transmission, classification, clinical manifestations, diagnosis and treatment. It describes leprosy as a chronic infection caused by Mycobacterium leprae that commonly presents with skin lesions and nerve involvement. The classification systems discussed divide leprosy into tuberculoid, borderline, and lepromatous forms based on immunological response and clinical features. Diagnosis involves examination of skin and nerve lesions as well as demonstration of M. leprae via skin smears or biopsy.
Topical corticosteroids are powerful anti-inflammatory drugs that are classified based on their potency from mild to very potent. More potent corticosteroids are associated with greater risk of side effects. They work by preventing the formation of inflammatory molecules. Their absorption and effect can be enhanced by certain vehicle formulations, occlusion, damaged skin barriers, and other factors. Guidelines recommend restricting very potent corticosteroid use to small areas for short periods to reduce risk of side effects like skin atrophy.
This document provides information on defining and classifying leprosy through various case definitions and classification systems used historically and presently. It begins by outlining the WHO definition of a leprosy case from 1997 and then describes several influential classification systems for leprosy including the Ridley-Jopling spectral classification from 1962, the Madrid classification from 1953, and the WHO's PB and MB classification for treatment purposes introduced in 1982 and revised in 1998. It also provides detailed descriptions of the clinical presentations of different leprosy types within these classification systems.
This document discusses skin failure, which is defined as the loss of normal temperature regulation and ability to maintain core body temperature and fluid/electrolyte balance. It causes various physiological changes including altered hemodynamics, impaired thermoregulation, metabolic complications, fluid/electrolyte imbalances, infections, and more. The management of skin failure requires intensive monitoring and care of fluid/electrolyte balance, nutrition, infection prevention, and topical therapies to address the systemic effects.
This document summarizes phototherapy, including the types used, mechanisms of action, effects on the skin and immune system, and basic principles of phototherapy devices. The main types discussed are narrowband UVB, PUVA, and UVA1. The mechanisms of action include DNA damage, generation of reactive oxygen species, effects on cytokines and immune cells like T cells, Langerhans cells, mast cells, and melanocytes. Devices use different lamp technologies like incandescent, gas discharge, and fluorescent to generate the desired wavelengths of UV or visible light.
This document provides information on disabilities and deformities that can occur in leprosy patients. It discusses terminology used to describe impairments, deformities, and defects. It outlines risk factors for deformities and describes specific, paralytic, and anesthetic deformities that can arise. The WHO classification system for grading impairments in hands/feet and eyes is presented. Details are given on nerve involvement in leprosy and management of neuritis. Common problems in hands like ulcers and deformities are covered, along with foot issues like ulcers and drop foot. Management of various deformities affecting face and eyes is summarized. The GPAS scale for assessing daily activities is briefly described, and economic rehabilitation is mentioned.
1. Peripheral nerves can be injured through various mechanisms including ischemia, compression, traction, laceration, or burning. This causes a spectrum of damage from mild and reversible to complete interruption.
2. Following nerve injury, the distal axon degenerates and the myelin sheath breaks down. New axonal growth occurs as the axon regenerates slowly into old endoneurial tubes.
3. Peripheral nerve injuries are classified based on severity from neurapraxia (mild and reversible) to axonotmesis (axon degeneration but endoneurium preserved allowing regeneration) to neurotmesis (severe damage with endoneurium disruption and poor recovery).
compound fracture tibia is common ortthopaedic problem so hereby providing a detailed management by consulting various orthopaedic books.
good luck..!!
The document provides an overview of muscle biopsy procedures and interpretation. It discusses the normal structure and histology of muscle, types of muscle fibers, indications for muscle biopsy, procedures, sample preparation, staining, and general abnormalities seen. It describes changes seen in various neuromuscular diseases like nuclear changes, fiber necrosis, regeneration, inflammation, cores and targets, mitochondrial abnormalities, vacuolar changes, and fibrosis. The document concludes with a working classification of neuromuscular diseases.
This document discusses median nerve injuries, including locations where entrapment can occur such as the arm, elbow, forearm, wrist, and hand. It outlines associated motor effects such as paralysis of muscles supplied by the nerve and deformities. Sensory loss on the lateral palm and fingers is also described. Carpal tunnel syndrome and pronator syndrome are discussed as specific types of median nerve entrapment. Clinical features, physical exam maneuvers, diagnostics, differential diagnoses, and treatments including splinting, medications, injections, and surgery are summarized. Complications of surgery are also noted.
Orofacial pain 2 by dr. MUNTATHER MUHSEN HASSAN ,,, OMFSMuntather Muhsen
This document discusses pain in the orofacial region. It begins by defining pain and listing the cranial nerves involved in orofacial sensation. It then categorizes orofacial pain into local, neurological, vascular, psychogenic, and referred pain. For each type of pain, it provides examples and descriptions. The document outlines the history and examination process for orofacial pain patients. It discusses various methods for measuring pain. Finally, it delves into specific pain conditions like myofascial pain, trigeminal neuralgia, glossopharyngeal neuralgia, and complex regional pain syndrome, describing their characteristics, causes, and treatment approaches.
This document discusses pain in the orofacial region. It begins by defining pain and listing the cranial nerves involved in orofacial sensation. It then categorizes orofacial pain into local, neurological, vascular, psychogenic, and referred pain. For each type, it provides examples and brief descriptions. The document outlines the history and examination process for orofacial pain patients. It also discusses various pain measurement methods and diagnostic imaging/tests. Specific pain conditions are then described in more detail, including their symptoms, causes, and treatment options.
This document discusses peripheral nerve injuries, including:
1. It describes the different types and causes of peripheral nerve injuries, including trauma, disease, ischemia, and radiation.
2. It outlines the primary and secondary injury mechanisms and classifies nerve injuries using the Seddon and Sunderland classifications based on the anatomical disruption.
3. It explains the neuronal degeneration and regeneration process after a nerve injury.
classification and diagnostic methods of peripheral nerve injuryBipulBorthakur
This document discusses peripheral nerve injury, including classifications, diagnosis, and treatment. It describes the anatomy of nerves and the cellular components. There are two main types of peripheral nerve injuries - primary injuries resulting from trauma and secondary injuries from complications like infections. Two classifications of nerve injuries are described: Seddon classification divides injuries into neurapraxia, axonotmesis, and neurotmesis. Sunderland classification further divides injuries into 5 degrees based on severity. Diagnosis involves clinical exams, imaging like ultrasound and MRI, and electrodiagnostic tests like nerve conduction studies and electromyography.
Reference-Harrison text book of internal medicine -20th edition
Slides by-Dr Jayasoorya P G,Junior resident,Department of General Medicine,Azeezia medical college,Kollam,Kerala
This document discusses optic neuritis, including its anatomy, classification, clinical presentation, diagnostic evaluation, and treatment. Some key points:
- Optic neuritis is inflammation of the optic nerve that can occur in any part of its course from the eye to the brain.
- It is classified ophthalmoscopically into retrobulbar neuritis, papillitis, and neuroretinitis depending on the location of nerve involvement.
- Common causes include multiple sclerosis, infections, and autoimmune disorders.
- Clinical features include acute unilateral vision loss, eye pain on movement, and color vision changes.
- MRI of the brain and orbits with contrast is useful to evaluate for other
Tetanus - is not uncommon--3 cases seen magdi sasi 2018cardilogy
Tetanus has three forms: local, cephalic, and generalized. The local form limits muscle spasms to the injury site, while cephalic involves cranial nerve paralysis following a head/neck injury. Generalized tetanus is most common and symptoms include lockjaw, diffuse muscle spasms including of the face and neck, irritability, and spasms triggered by stimuli. Diagnosis involves a history of trauma, signs of muscle spasm, immunization history, and lab tests. Treatment focuses on muscle relaxation through medications, antitetanus immunoglobulin, antibiotics, wound care, intubation if needed, and addressing complications from the prolonged ICU stay often required.
Dupuytren's contracture is a condition causing the fingers to bend towards the palm. It is caused by a thickening of the fascia in the palm. The initial symptom is a nodule in the palm that develops into cords pulling the fingers into the palm. Surgery is the main treatment and involves excising the diseased tissue and splinting the fingers in extension post-operatively to prevent recurrence of contractures. Complications can include complex regional pain syndrome or recurrence of contractures if splinting is not continued long-term.
This document discusses various types and causes of neuropathies, including focal (mononeuropathy), multifocal (mononeuropathy multiplex), and generalized (polyneuropathy) neuropathies. Common causes include entrapment neuropathies, diabetes, vitamin deficiencies, toxins/drugs, and systemic diseases. Specific conditions discussed include Bell's palsy, trigeminal neuralgia, and hemifacial spasm. Diagnostic testing and management strategies are also outlined.
This document provides an overview of neuromuscular junction disorders including myasthenia gravis, Lambert Eaton myasthenic syndrome, botulism, and congenital myasthenic syndromes. It describes the anatomy and physiology of the neuromuscular junction and the proteins involved in neuromuscular transmission. It discusses the clinical features, diagnosis, and classification of different neuromuscular junction disorders and highlights key differences between myasthenia gravis and Lambert Eaton myasthenic syndrome. The document also provides details on different types of congenital myasthenic syndromes classified based on the affected protein and pathogenic mechanisms.
This document summarizes carpal tunnel syndrome (CTS), including its anatomy, pathogenesis, etiology, symptoms, clinical tests, treatments, and other related topics. It describes how CTS is caused by compression of the median nerve as it passes through the carpal tunnel. Common causes include repetitive hand motions, anatomical abnormalities, medical conditions like diabetes or hypothyroidism. Clinical tests for diagnosing CTS include Phalen's test and Tinel's sign. Treatments may involve splinting, corticosteroid injections, surgery such as open or endoscopic carpal tunnel release. De Quervain's tenosynovitis and tuberculous tenosynovitis are also summarized.
A workshop hosted by the South African Journal of Science aimed at postgraduate students and early career researchers with little or no experience in writing and publishing journal articles.
it describes the bony anatomy including the femoral head , acetabulum, labrum . also discusses the capsule , ligaments . muscle that act on the hip joint and the range of motion are outlined. factors affecting hip joint stability and weight transmission through the joint are summarized.
Physiology and chemistry of skin and pigmentation, hairs, scalp, lips and nail, Cleansing cream, Lotions, Face powders, Face packs, Lipsticks, Bath products, soaps and baby product,
Preparation and standardization of the following : Tonic, Bleaches, Dentifrices and Mouth washes & Tooth Pastes, Cosmetics for Nails.
A Strategic Approach: GenAI in EducationPeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
This presentation was provided by Steph Pollock of The American Psychological Association’s Journals Program, and Damita Snow, of The American Society of Civil Engineers (ASCE), for the initial session of NISO's 2024 Training Series "DEIA in the Scholarly Landscape." Session One: 'Setting Expectations: a DEIA Primer,' was held June 6, 2024.
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Executive Directors Chat Leveraging AI for Diversity, Equity, and InclusionTechSoup
Let’s explore the intersection of technology and equity in the final session of our DEI series. Discover how AI tools, like ChatGPT, can be used to support and enhance your nonprofit's DEI initiatives. Participants will gain insights into practical AI applications and get tips for leveraging technology to advance their DEI goals.
Macroeconomics- Movie Location
This will be used as part of your Personal Professional Portfolio once graded.
Objective:
Prepare a presentation or a paper using research, basic comparative analysis, data organization and application of economic information. You will make an informed assessment of an economic climate outside of the United States to accomplish an entertainment industry objective.
Assessment and Planning in Educational technology.pptxKavitha Krishnan
In an education system, it is understood that assessment is only for the students, but on the other hand, the Assessment of teachers is also an important aspect of the education system that ensures teachers are providing high-quality instruction to students. The assessment process can be used to provide feedback and support for professional development, to inform decisions about teacher retention or promotion, or to evaluate teacher effectiveness for accountability purposes.
How to Build a Module in Odoo 17 Using the Scaffold MethodCeline George
Odoo provides an option for creating a module by using a single line command. By using this command the user can make a whole structure of a module. It is very easy for a beginner to make a module. There is no need to make each file manually. This slide will show how to create a module using the scaffold method.
Exploiting Artificial Intelligence for Empowering Researchers and Faculty, In...Dr. Vinod Kumar Kanvaria
Exploiting Artificial Intelligence for Empowering Researchers and Faculty,
International FDP on Fundamentals of Research in Social Sciences
at Integral University, Lucknow, 06.06.2024
By Dr. Vinod Kumar Kanvaria
How to Add Chatter in the odoo 17 ERP ModuleCeline George
In Odoo, the chatter is like a chat tool that helps you work together on records. You can leave notes and track things, making it easier to talk with your team and partners. Inside chatter, all communication history, activity, and changes will be displayed.
Strategies for Effective Upskilling is a presentation by Chinwendu Peace in a Your Skill Boost Masterclass organisation by the Excellence Foundation for South Sudan on 08th and 09th June 2024 from 1 PM to 3 PM on each day.
3. -acute episodic exacerbation & remission of
symptoms and signs of inflammation during active
stage of leprosy & directly related to leprosy.
-reactions are due to heightened immunological
response of the host to M.lepre or its breakdown
products.
-two types:a) type 1
b) type 2
4. -due to rapid change in CMI either for better or for
worse.
-seen in BT,BB & BL.
-also called upgrading or reversal reaction due to
rapid increase in CMI as better response to t/t.
5. -due to antigen-antibody reaction in presence of
complment and not due to change in CMI
-it is seen in LLp & LLs and rarely in BL
6. -treat neuritis
-rest to the part affected
-analgesic
-if severe then steroid (anti inflammatory doses) can
be given
-if tenderness and thickening of nerve
persisting,perineural infiltration with triamcinolone.
7. -bed rest
-analgesics and antipyretics
-systemic steroid ,starting at 40 mg/day ,tapering at
2 wks interval
-oral thalidomide (300-400 mg/day),tapering after
the lesion subsides
8. DRUGS MINOR MAJOR
1. RIFAMPICIN RED URINE JAUNDICE
GIT UPSET HEPATITIS
FLU LIKE SYNDROME SHOCK
2. DAPSONE GIT UPSET DAPSONE SYNDROME
DRUG RASH EARLY SJS
ANAEMIA HEMOLYTIC ANAEMIA
AGRANULOCYTOSIS
3. CLOFAZAMINE GIT UPSET ACUTE PAIN
ABDOMEN
DISCOLOURATION OF SKIN
ICHTHYOSIS
9. Disabilities such as loss of sensation and
deformities of hands/feet/eyes occur because:
◦ Late diagnosis and late treatment with MDT
◦ Advanced disease (MB leprosy)
◦ Leprosy reactions which involve nerves
◦ Lack of information on how to protect
insensitive parts
10. The affected person finds it difficult or impossible
to perform some activities at home or at workplace
b/c of some impairment.
Onlyabout 10-15% of leprosy affected person
develop significant deformities and disabilities.
11. 1) Specific deformities:
- b/c of local infection with M.Leprae
- seen most often in the face(loss of eyebrow,nasal
deformity),less often in the hand and only occassionly
in the feet.
2) Paralytic deformities:
- result from damage to motor nerve.
-seen most often in the hand(claw finger),less
often in the feet &occassionly in the
face(lagopthalomos,facial palsy)
12. 3)Anesthetic deformity :
- Occur as a consequence of neglected injuries in
part rendered insensitive b/c of damage to
sensory nerve.
- Found most often on the feet and
hand(ulceration,scar contrature,shortening of
digits,multilation &skeletal disorganization of foot)
13. GRADE HAND & FEET EYES
0 NO DISABILITY FOUND NO DISABILITY FOUND
1 NON VISIBLE DAMAGE NO GRADE 1 FOR EYE
(LOSS OF SENSATION)
2 VISIBLE DAMAGE Inability to close,obvious
(wounds,ulcer,deformity due to redness,visual
muscle weakness,loss of tissue impairement,blindness.
such as foot drop,clawhand,loss or
partial resorption of fingers/toes)
14. 1)STAGE OF PARASITIZATION
- A few M.leprae found in the nerve,but no other damage
2)STAGE OF TISSUE RESPONSE
- Bacilli recognised, host tissue response present.range
from indeterminate through tuberculoid and borderline to
lepromatous
3)STAGE OF CLINICAL INVOLVEMENT
-Nerve clinically thickened with or without associated pain
or tenderness.
-no nerve funtion deficit (NFD)detected clinically
-
-
15. 4)STAGE OF NERVE DAMAGE
-clinically detectable NFD present,Recovery
possible.
5)STAGE OF NERVE DESTRUCTION
-conducting elements destroyed
-irreversible NFD
-long standing muscle paralysis with severe
wasting.
16. Refer to all the action taken to achieve the sole
aim of preventing damage to nerve trunk of the
limbs and the eyelids & thereby prevent
permanent loss of sensibility and muscle paralysis
involving these part.
M/n can be divided into;
a) No neuritis and no NFD
b) With neuritis but no NFD
c) With no neuritis but with NFD
d) With neuritis and NFD
17. a) NO NEURITIS,NO NFD
-Pt has no problem at present & so no active nerve care
is necessary.
-but,if there is risk of developing neuritis(BB or BL
leprosy with thickening of more than two nerve trunk
and past history of reaction or neuritis),pt should be
warned of that possibility & asked to report without
delay.
18. b) NEURITIS PRESENT,NO NFD
-In case of moderate neuritis,start with 30 mg
prednisolone daily and then reduce the dose by
5mg/wk.
-In severe cases,higher dose(40,60,even 80 mg per
day depending on severity),bring the dosage to
30 mg in course of 2-3 wk & maintain the dose for
3 month before tapering the dose down.
19. -In BT cases,if there is no improvement within 24-72
hrs of starting t/t or if condition worsens,despite
steroid,it suggest that drug is not reaching site of
inflammation b/c of ischemia,immediate surgical
decompression should be done.
-in BL& LL,where ENL is likely cause of neuritis,one
can wait for 6wk &consider decompression,if there
has been no significnt clinical improvement.
20. c) NO NEURITIS,NFD PRESENT
-M/n depends on;
1)Whether the NFD is capable of recovery.
2)Depends on anti leprosy t/t status of the pt.
-Recovery will not be possible if nerve has been
destroyed by inflammatory process.
-Recovery may be possible if NFD is of recent
onset,incomplete&no obvious and severe muscle
wasting.
21. a) No neuritis,NFD present &considered
irreversible;
M/m:Ignore NFD .train the pt in disability prevention
practice,provide physiotherapy & reconstructive
surgery ,if possible.
b) No neuritis,NFD present but considered
reversible,pt has had MDT
M/m:start with 30 mg of predinosolone daily for 90
days or as long as NFD shows
improvement,tepered off over 30 days.
22. c)No neuritis,NFD present but considered
reversible,pt has not had MDT
m/n:provide MDT and monitor NFD (In many cases
nerve function improves with anti leprosy
chemotherapy)
- If NFD has not improved in 3 month,start standard
course of steroid.
- Continue with steroid as long as improvement
continues,taper off steroid after 3 mnth or wen
there is no further improvement.
23. d)NFD present,considered reversible,onset or
worsening of NFD while under MDT
-start standard course of steroid.
-monitor NFD monthly.
-continue with the steroid as long as improvement
continues,taper off steroid after 3 mnth or when
there is no further improvement which ever is
later.
24. d)NFD present,neuritis present
m/n;start high dose of steroid(40-80 mg /day)
-reduce to maintence dose (30 mg/day)over 2-4 wks
or continue as long as there is improvement or for
at least 3 mnth whichever is later,then taper off,
-surgicl decompression need to be done, if there is
no significant improvement in neuritis with 3-7
days of starting steroid.
25. -Nerve trunk thickens in leprosy:
a)Accumulation of granuloma cell within the
fascicle,
b)Thickening of neural investment,
-Two consequence result from excessive
enlargement of nerve:
a)External compression
b)Internal compression
26. It is indicated:
- when medical &ancillary method are being used
&found inadequate to control the inflammatory
process,
- other indication is intractable nerve pain where
continues steroid therapy has become neccessary
just for relief of pain,
27. -In most cases,these are cold abscess with
caseation and colliquative necrosis,
-’hot abscess’ occur in ENL related acute neuritis&
are usually microscopic,
a)If nerve shows no NFD:w/w.Evacuate the abcess
&excise only if overlying skin is likely to
breakdown &form sinuses,
b)If nerve considered irrecoverable damaged:same
t/t
c)If NFD considered likely to recover:evacuate
&excise the abscess
28. impairment Direct consequence Late consequence
Damage to somatic Loss of sensibility Anesthetic
sensory fibers deformity(ulcer,hand
deformity,shortening of
digits)
Damage to motor nerve Muscle paralysis and contrature
paralytic deformity
Damage to sudomotor Dry skin Deep cracks,hand
autonomic fibers infection
Lepra rkn Inflammatory Severe fixed
edema,osteoporosis, deformity(intrinsic plus
pathological fracture finger,bizarre deformity)
29. 1) LOSS OF SENSIBILITY
-pt is deprived of an important source of information
-deprives the hand of its protective mechanism
-motor activity becomes clumsy.
2) DRYNESS OF PALMER SKIN
-due to destruction of autonomic sudomotor fibers;
-dry skin crack frequently especially at digital
creases,
30. Cracks and fissures Soak in water
Apply cooking
oil/Vaseline
Injury care -Precaution against burn
- Against cut &penetrating
wound
-covering with thick towel.
-using utensils with
insulated handle
31. c) PARALYTIC DEFORMITIES OF THE HAND
-occur due to destruction of motor fibers in the major
nerve trunk.
ULNAR PALSY
-occur when lumbrical &interossei muscles , which
balance long extensor & flexor at the MCP and PIP
jt are paralysed.
32. -when both ulnar and median nerve are paralysed,
pt has total claw hand(intrinsic zero hand)
-it lies curled up beside the palm
-it doesnot lift off the palm to oppose the other digits
33. a) PHYSICAL MEASURES
- best exercise to put all jt thr’ their range of
movement several times a day.
b) SPECIFIC EXERCISE
- to hold his clawed finger with his thumb and
index finger in total flexion at MCP jt and move
PIP jt up and down.
34. 1) ADDUCTOR BAND SPLINT
2) GUTTER SPLINT
3) FINGER LOOP SPLINT
GRIP –AIDS
- Epoxy resin grip applied on article of work helps
,hold the object & increase efficiency in working
environment.
35. 1) LASSO INSERTION
-attaching the motor tendon slip distally to the
fibrous flexor sheath provide correction by
augmenting flexing force at MCP jt to counter
extending force.
2) ZANCOLLI’S OPERATION
-shortening anterior capsule of the jt and flexor
pulley advancement
36. 1) PLANTER ULCERATION
2) DROP FOOT
3) FIXED DEFORMITY OF TOES & FEET
4) TARSAL DISORGANIZATION
PLANTER ULCER
-found in 10% of leprosy pt.
-80% cases occur in ball of foot at MTP jt region
-5-10% in the mid lateral part of sole.
-5-10%in the heel.
37. 1) INJURIES FROM WITHOUT
2) INFECTION THROUGH A FISSURE IN THE SKIN
3) BREAKDOWN OF TISSUE FROM WITHIN(DUE
TO WALKING)
STAGES IN THE DEVELOPMENT OF ULCER:
1) STAGE OF THREATENED ULCERATION
2) STAGE OF CONCEALED ULCERATION
3) STAGE OF OPEN ULCERATION
38. 1)STAGE OF THREATENED ULCERATION:
-foot should be rested in a splint
-no wt bearing on the affected foot
2)STAGE OF NECROSIS BLISTER:
-blister is padded well
-if danger of breaking open,it is snipped & sealed
with adhesive plaster and a below knee POP.
-cast removed after 3 wks & asked to use protective
footwear.
39. 1)ACUTE ULCER:are frankly infected,purulent,
covered with slough and are acutely inflammed.
2)CHRONIC ULCER:indolent ulcer with heaped up
hyperkeratotic edge,serosanguineous discharge &
covered with pale granulation tissue.
a) SIMPLE
b) COMPLICATED
40. ACUTE ULCER:
-absolute bed rest
-elevate the foot
-Eusol bath,irrigation,dressing
-limit surgery to drinage proced
-antibiotic if needed
-treat as chronic ulcer after acu
te phase subside.
41. 1) SIMPLE :
-Scraping floor of the ulcer
-sticking plaster or vaseline gauze
dressing.
-below knee POP cast or bulky
dressing.
-protective footwear+foot care
trainig.
42. COMPLICATED:
-Ulcer debribment
-physiological rest by below
knee POP cast
-protective footwear on POP
removal
-corrective deformity,if necc.
-identify other complication
& treat accordingly
-skin graft of large ulcer.
43. RECURRENT:
- improve quality of scar(scar rev
ision using exision and suture
local flap,distant flap,free flap)
- reduce load on scar by footwear
modification or corrective surg
-eradicate infection.
44. 1) PROTECTIVE FOOTWEAR:
-should have a tough outer sole that will resist
penetration by thorn,nails,glass,
-itself doesnt have any nails,
-upper/straps and buckle should not rub against the
toes or cause undue pressure,
-MCR(microcellular rubber ) m/c used for reducing
the stress generated during walking.
45. Infected ulcer/Cracks Clean with soap & water
Rest & apply antiseptic dressing
Apply cooking oil/Vaseline
Wounds/injury
Soak in water
Clean and apply clean bandage
Protect when working/cooking
Oil massage
weakness/paralysis Exercises
46. -about 1-2% of leprosy pt develop drop foot
due to damage to common peroneal nerve.
-pt is unable to lift the foot up & it droops down when the
leg is lifted.
-if paralysis is recent,good recovery with steroid.
-drop foot (>1yr), unlikely to recover with steroid therapy &
require surgical correction.
47. SRINIVASAN OPERATION:
-Two tailed transfer of tibialis posterior to the tendon
of extensor hallucis longus & extensor digitorum
longus in the dorsum of foot.
-when surgical correction are C/I, a drop foot
appliance can be used which hold the foot at rt
angle with the help of strap,stops or springs.
48. -One or more tarsal bone are damaged &
progressively destroyed.
- firstly,due to spread of sec infection from plantar
ulcer,
-calcaneum and cuboid are commonly damaged.
-can be t/t with appropriate antiboitics & surgical
clearance of infected tissue, healing takes place
with bony fusion and stable foot.
49. -secondly, occur as a result of injury,weakened by
osteoporosis from neighbouring infection or
prolonged immobilisation.
-Talus and navicular are m/c affected
-broken bone is not allowed to heel,walking is
continued leading to the breakdown in the skeletal
architecture & soft tissue swelling.
-T/t: immobilization in a plaster cast & rest
50. 1)LOSS OF EYEBROWS(MADAROSIS)
-results from atrophy of hair follicle as a result of
lepromatous infiltration of forehead & eyebrow
region.
-corrective surgery:
a) Transplantation of hair follicle through free grafting
of scalp skin.
b) Transfer of artery pedicled island of scalp.
c) Long pedicled scalp flap.
51. 2) PREMATURE SENILITY
-facial skin is over streatched by heavy LL
-elastic fibres in the dermis and sub dermal region are
destroyed
-’FACE LIFT OPERATION’: here excess skin is excised,
left overskin gets stretched & wrinkles flatten out.
52. 3) MEGA LOBULES:
-elongated ear lobe hangs down lose.
-corrected by excising the infero-medial segment of
lobule using curved incision(cresent wedge
resection)
4)NASAL DEFORMITY:
-ant &antero-inferior part of nasal cavity is
commonly involved in LL
53. -Nose loses its mucosal lining and internal surface
of the nose loses its skeletal support.
-nasal septum is destroyed.
-without skeletal support,nose falls back on the
face.
-internal raw surface adheres to the facial skeleton
leading to ‘SUNKEN NOSE’.
54. -regular irrigation of the nasal cavity.
-smearing the nostril with liquid paraffin,vaseline or
vegetable oil to prevent formation of crust.
-’POST NASAL EPITHELIAL ONLAY GRAFTING
OF GILLES’ ,done for sunken nose deformity.
55. -Due to direct invasion of ocular structure like
conjunctiva,sclera,and choroid by M.leprae.
-deposition of immune complexes in the ciliary apparatus
give rise to acute iridocyclitis.
-damage to upper branch of facial nerve give rise to
weakness of eyelid & lagopthalmos.
-damage to peripheral branches of trigeminal nerve result
in corneal anesthesia.
56. Redness and pain Aspirin or paracetamol
Atropine and steroid
ointment
Cover with eye pad
Injury to cornea Apply antibiotic ointment
Refer
Tear substitute eye drops
Exercises
Difficulty in closing eye Dark glasses to protect
Refer
57. -enlargement of breast in males.
-usually b/l.
-due to hormonal imbalance b/c of testicular and
liver damage.
-simple mastectomy is t/t of choice(WEBSTER’S
OPERATION)
58. -are related to widely held beliefs and prejudices
concerning leprosy & its causes.
-they often develop self stigma,low self esteem &
depression as a result of rejection and hostility,
-need to be referred for proper counselling.