Determination of length of human upper limb long bones from their fragments

It is impossible to measure directly the length of fragmentary or broken long bones. It is in order to calculate the height (stature) of the individual, using magnification factors. An attempt has been made to devise a method of calculating the length from such fragments for the three long bones of the upper limb.

Changing pattern of cutaneous tuberculosis. A prospective study

During the past 3 years, we have seen a changing pattern of cutaneous tuberculosis, in which its incidence was recorded to show an upward trend affecting predominantly the adult men. The latter was true in reinfection--lupus vulgaris and tuberculosis verrucosa cutis, whereas a substantial number of children were victims of reactivation--scrofuloderma. The duration of the disease was usually short in reactivation tuberculosis. Its clinical expression, however, conformed largely to the ritual text except that apple-jelly nodules were infrequently demonstrated. Similarly, the morbidity was low. The affliction of the extremities in lupus vulgaris, in particular, was a contrasting feature. The histopathology invariably either confirmed or supplemented the clinical impression. The ultimate confirmation of cutaneous tuberculosis was done only by the demonstration of Mycobacterium tuberculosis in smears, or its recovery in vitro. In view of the limitations of the preceding parameters, the diagnosis may reasonably be made based on the history and evolution of the disease, cardinal morphologic features of reinfection and reactivation tuberculosis, and histopathologic characteristics. A response to antitubercular drugs may be of assistance.

Determination of length of human long bones of hands from their fragments

In cases of fragment/broken long bones, it becomes difficult to measure the length of bones for the purpose of calculation of total height (stature) of the individual with the help of magnification factors. An attempt has been made to devise a method of calculating the bones length from fragments on three long bones of the upper extremity.

Comprehensive evaluation of complement components in the course of type I (Lepra) and type II (ENL) reactions

Complement components C1q and C4 of classic pathway; C3d, a breakdown product of C3, and factor B of alternate pathway: and C3, a component both of classic and alternate pathways, were studied in 35 patients, comprising 18 type I (Lepra) and 17 type II (ENL) reactions. There was a significant decrease in C3 and factor B with a concomitant rise of C3d during ENL. These changes indicate their preeminent role in immunogenesis of type II (ENL) reaction. The changes in the classic pathway components, on the other hand, were insignificant, apparently suggesting its limited involvement in ENL. Furthermore, reversion of factor B and C3d after subsidence of reaction is intriguing and may indicate that they are not substantially affected even with contemporary treatment. Complement components, of both classic and alternate pathways, showed no significant alterations either during type I (Lepra) reaction or after its amelioration.

Solubilization of preformed immune complexes in sera of patients with type 1 and type 2 lepra reactions

Serum complement activity in leprosy patients has been studied using solubilization of preformed immune complexes as an index. The solubilization capacity of sera from lepromatous patients with or without erythema nodosum leprosum (ENL) as well as from type 1 reactional patients was found markedly reduced as compared to controls. Solubilization did not improve at all in the ENL patients after remission of the reaction phase. The addition of fresh normal sera failed to bring about any significant restoration of solubilizing capacity of the deficient sera. Mycobacterium leprae sonicate significantly reduced the solubilization capacity. Our results suggest that circulating mycobacterial breakdown products possibly interfered with the capacity of the ENL patients' sera to solubilize immune complexes.

Clinicopathology and immunohistochemistry of genital warts

Genital warts are a fairly common sexually transmitted disease and often affect young, illiterate subjects of poor socioeconomic status in India. The mean incubation period was 2.4 months, and the duration varied from 10 days to 4 years. Hyperplastic sessile, verruca vulgaris-like, and flat variants of warts were seen in that sequence, with distinct clinical features. The epidermal and the dermal changes were largely identical; however, the flat type in the epidermal changes were inconspicuous. Koilocytosis was a pathognomonic feature in 28, whereas human papilloma virus (HPV) antigens were detected through peroxidase-antiperoxidase technique in 18 patients.

The effect of anti-reactional drugs on complement components in the type II, erythema nodosum leprosum, reaction

Seventeen patients with the type II (erythema nodosum leprosum) (ENL) reaction were studied. They received multidrug therapy and also the anti-reactional drugs prednisolone clofazimine or chloroquin, and we measured serum levels of complement components before treatment and after the reaction had subsided. Factor B was significantly elevated after treatment with each of the three drugs. C3 levels were significantly increased after treatment, the largest change being in patients treated with clofazimine. In these patients there was also a concomitant decrease in C3d levels. This suggests that clofazimine has complement modulating activity and we would recommend it as the drug of choice in treatment of the ENL reaction.

Pattern of epidemics of donovanosis in the "nonendemic" region

Of the 432 genital ulcer cases seen in 1985, 36 had donovanosis, thus forming an incidence of 8.33%. In contrast, 42 (6.38%) cases of donovanosis were diagnosed among a total of 658 cases of genital ulcers in 1983. The majority of patients in both epidemics were young unmarried men who contracted the disease through extramarital sexual intercourse. Perianal lesions were seen primarily in those who had a history of sodomy. The disease chiefly affected illiterate persons of low socioeconomic strata. The incubation period varied from 1 to 90 days. Twenty (62.50%) patients in the 1985 epidemic had an incubation period of less than 7 days, in contrast to only 9 (34.61%) in the 1983 epidemic. The epidemics occurred from autumn to the start of winter. Duration of the disease varied from 1 day to 6 years. The clinical features and sites of afflication were usual; however, pseudobubo and pseudoelephantiasis were conspicuous in a significant minority.

Leprosy in young urban children

Prevalence among leprosy patients of children in the age group of 0-14 years was 3.8%, with 9 male preponderance. The children were largely immigrants from the endemic neighboring states of Uttar Pradesh and Bihar. A borderline group formed the bulk of the patients. The disease had its onset between ages 5 and 9 in more than half the patients. There was a striking contrast between the age at onset and that of reporting. Usually, the lesions were multiple. Single lesions were, however, present on the exposed parts. Skin-slit-smears were positive in borderline borderline (BB), borderline lepromatous (BL), and lepromatous lepromatous (LL) only. A good clinicopathologic correlation was apparent in most patients.

Histoid leprosy: a prospective diagnostic study in 38 patients

Histoid leprosy is a fascinating expression of multibacillary leprosy, the incidence of which was 3.6%. It was seen predominantly in males of the younger age group, who were on inadequate and irregular dosage of diaminodiphenyl sulfone. Papules, cutaneous and/or subcutaneous nodules and plaques appearing over apparently normal skin were its exquisite prospective clinical features. It was invariably supported by enormous, uniformly solid staining discrete bacilli from the lesions, in contrast to their virtual absence from the surrounding normal-appearing skin. Encapsulated tumorous mass, formed primarily by spindle-shaped histocytes, displayed either in intertwining, criss-cross or whorled fashion in haematoxylin-eosin-stained sections, were supplementary. The morphology of acid-fast bacilli was, however, similar to skin-slit smears.

An appraisal of epidemiologic, clinical, bacteriologic, histopathologic, and immunologic parameters in cutaneous tuberculosis

Cutaneous tuberculosis incidence was recorded as 0.15%. Of the 42 patients, 23 had scrofuloderma, 17 lupus vulgaris, and 2 tuberculosis verrucosa cutis. Both men and women were affected by the disease in the second and third decades. Its duration was variable. An affirmative family history was elicited in five scrofuloderma patients. The clinical expression largely conformed to the ritual text. Variation in Mantoux test positivity was unremarkable. The disparity in the demonstration of bacilli in the smear and tissue sections was, however, quite apparent in scrofuloderma. The correlation of different parameters indicates a continuous spectrum, formed at one end by lupus vulgaris, and at another by scrofuloderma. A moderate to strongly positive Mantoux text, enormous lymphocytes in the granuloma, absence of tubercle bacilli, negative culture, and an apparently normal immunoprofile were features of lupus vulgaris; whereas scrofuloderma had a moderately positive Mantoux test, lesser number of lymphocytes in the granuloma, large number of bacilli in tissue smear and/or tissue section, raised levels of immunoglobulins, and a grossly lowered C3 levels. The other variants probably occupy a position in between.