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Somenath Sarkar - One of the best experts on this subject based on the ideXlab platform.
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effectiveness and safety of autologous platelet rich plasma therapy with total contact casting versus total contact casting alone in treatment of Trophic Ulcer in leprosy an observer blind randomized controlled trial
Indian Journal of Dermatology Venereology and Leprology, 2020Co-Authors: Supratim Saha, Aparesh Chandra Patra, Srinivas P Gowda, Nasiruddin Mondal, Sufiur Rahaman, S Sahriar K Ahmed, Sujit Debbarma, Khune Prateek Kumar Vitthal, Somenath SarkarAbstract:Background: Trophic Ulcers secondary to leprosy pose a great stigma to patients and remain a challenge to the treating dermatologists. Platelet-rich plasma (PRP) introduces growth factors directly into the wound and aids in rapid healing. The role of PRP in the treatment of Trophic Ulcers in leprosy patients has not yet been established by randomized controlled trials. Aims: To study the effectiveness and safety of autologous PRP therapy with total contact casting versus total contact casting alone in the treatment of Trophic Ulcers in leprosy. Methods: In an observer-blind, randomized (1:1) controlled study, 118 patients were enrolled. PRP was prepared by the manual double-spin method (1600 rpm for 10 min followed by 4000 rpm for 10 min). After wound bed preparation, activated PRP was injected intra- and perilesionally, and platelet-poor plasma gel was applied over the Ulcer bed. Occlusive dressings and total contact casting were then applied in Group A, and only total contact casting was applied in Group B. The same procedure was repeated every 2 weeks for 8 weeks. Results: In all, 56 patients were analyzable in Group A and 52 in Group B. The surface area of the Ulcer decreased significantly from first follow-up onward in both the groups (P Limitation: Short duration of treatment (8 weeks). Conclusion: PRP combined with total contact casting accelerates the healing of Trophic Ulcers of leprosy and is more effective than total contact casting alone. Complete remission is more likely to occur when the duration and surface area of Ulcer are less and in the paucibacillary spectrum.
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bacteriological profile of aerobic and anaerobic isolates of Trophic Ulcer in leprosy a study from eastern india
Indian Journal of Dermatology, 2019Co-Authors: Revanta Saha, Somenath Sarkar, Monalisa Majumder, Goutam BanerjeeAbstract:Introduction: Trophic Ulcer is a dreaded complication of leprosy. Secondary infection compounds the damage to the already neglected Ulcer. Aims: To find out the bacterial pathogens in the isolates from Trophic Ulcers of leprosy and to find the drug sensitivity of the aerobic isolates so as to start a suitable antibiotic therapy. Methodology: An institution-based, cross-sectional study done over a period of 2 years. Swab was taken from the deeper part of the Ulcer. It was put on a suitable culture media. Bacteriological profile was determined and antibiogram was done subsequently. Results: Sixty patients with Trophic Ulcer secondary to leprosy were screened, among which all were screened for aerobic isolates and 38 were screened for anaerobic isolates. Among the aerobic isolates, 88% of patients were culture-positive. The most common organism was Staphylococcus aureus(37.7%), followed by Pseudomonas aeruginosa (22.64%), Proteus mirabilis (15.09%), Escherischia coli (13.2%), Klebsiella (9.43%). Maximum overall sensitivity was seen with amikacin (93.1%) and linezolid (89.65%). Maximum overall resistance was noted with cotrimoxazole (58.62%) and coamoxiclav (51.72%). Among the 38 patients cultured for anaerobic isolates, 17 were culture-positive for anaerobic organisms. Isolates showing Peptococcus were 6 (15.7%), purely Peptostreptococcus were 4 (10.5%), purely bacteroides were 3 (7.8%), and mixed growths were 4 (10.5%). Conclusion: Secondary bacterial infection is quite common in leprosy Trophic Ulcers. The most common organism was Staphylococcus aureus. Isolates were mostly sensitive to amikacin and linezolid and resistant to cotrimoxazole and coamoxiclav. Anaerobic isolates were not uncommon, with Peptococcus being the most common among them.
Supratim Saha - One of the best experts on this subject based on the ideXlab platform.
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effectiveness and safety of autologous platelet rich plasma therapy with total contact casting versus total contact casting alone in treatment of Trophic Ulcer in leprosy an observer blind randomized controlled trial
Indian Journal of Dermatology Venereology and Leprology, 2020Co-Authors: Supratim Saha, Aparesh Chandra Patra, Srinivas P Gowda, Nasiruddin Mondal, Sufiur Rahaman, S Sahriar K Ahmed, Sujit Debbarma, Khune Prateek Kumar Vitthal, Somenath SarkarAbstract:Background: Trophic Ulcers secondary to leprosy pose a great stigma to patients and remain a challenge to the treating dermatologists. Platelet-rich plasma (PRP) introduces growth factors directly into the wound and aids in rapid healing. The role of PRP in the treatment of Trophic Ulcers in leprosy patients has not yet been established by randomized controlled trials. Aims: To study the effectiveness and safety of autologous PRP therapy with total contact casting versus total contact casting alone in the treatment of Trophic Ulcers in leprosy. Methods: In an observer-blind, randomized (1:1) controlled study, 118 patients were enrolled. PRP was prepared by the manual double-spin method (1600 rpm for 10 min followed by 4000 rpm for 10 min). After wound bed preparation, activated PRP was injected intra- and perilesionally, and platelet-poor plasma gel was applied over the Ulcer bed. Occlusive dressings and total contact casting were then applied in Group A, and only total contact casting was applied in Group B. The same procedure was repeated every 2 weeks for 8 weeks. Results: In all, 56 patients were analyzable in Group A and 52 in Group B. The surface area of the Ulcer decreased significantly from first follow-up onward in both the groups (P Limitation: Short duration of treatment (8 weeks). Conclusion: PRP combined with total contact casting accelerates the healing of Trophic Ulcers of leprosy and is more effective than total contact casting alone. Complete remission is more likely to occur when the duration and surface area of Ulcer are less and in the paucibacillary spectrum.
C.d. Narayanan - One of the best experts on this subject based on the ideXlab platform.
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Squamous Cell Carcinoma Masquerading as a Trophic Ulcer in a Patient With Hansen’s Disease
The International Journal of Lower Extremity Wounds, 2010Co-Authors: Sandhya Venkatswami, S. Anandan, Nikilesh Krishna, C.d. NarayananAbstract:Nonhealing Trophic Ulcers in leprosy are a common phenomenon, but acute malignant transformations of the same are relatively rare. This study reports on a 35-year-old man previously treated for Hansen’s disease with a squamous cell carcinoma involving the right foot with rapid lymphatic spread. He was being treated as a benign Trophic Ulcer for more than 12 months until he started developing huge inguinal lymph nodes and the Ulcer rapidly increased in size. Squamous cell carcinomas are known to occur in Ulcers of considerable duration but such rapid growth in such a short duration and rapid lymphatic spread is unusual in Marjolin’s Ulcer as the lymphatics are usually destroyed because of previous inflammation and scarring.
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squamous cell carcinoma masquerading as a Trophic Ulcer in a patient with hansen s disease
The International Journal of Lower Extremity Wounds, 2010Co-Authors: Sandhya Venkatswami, S. Anandan, Nikilesh Krishna, C.d. NarayananAbstract:Nonhealing Trophic Ulcers in leprosy are a common phenomenon, but acute malignant transformations of the same are relatively rare. This study reports on a 35-year-old man previously treated for Hansen’s disease with a squamous cell carcinoma involving the right foot with rapid lymphatic spread. He was being treated as a benign Trophic Ulcer for more than 12 months until he started developing huge inguinal lymph nodes and the Ulcer rapidly increased in size. Squamous cell carcinomas are known to occur in Ulcers of considerable duration but such rapid growth in such a short duration and rapid lymphatic spread is unusual in Marjolin’s Ulcer as the lymphatics are usually destroyed because of previous inflammation and scarring.
Mahesh Kumar - One of the best experts on this subject based on the ideXlab platform.
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Autologous platelet-rich fibrin matrix in non-healing Trophic Ulcers in patients with Hansen's disease
Journal of Cutaneous and Aesthetic Surgery, 2020Co-Authors: Umashankar Nagaraju, Priya Kootelu Sundar, Priyanka Agarwal, Belliappa Pemmanda Raju, Mahesh KumarAbstract:Background: Non-healing Trophic Ulcers in Hansen's disease patients is one of the major causes for disability. It has been shown that autologous platelet-rich fibrin matrix (PRFM) is effective in healing chronic non-healing leg Ulcers. Aim: The objective of this study is to demonstrate the efficacy of autologous platelet-rich fibrin matrix (PRFM) in non-healing Trophic Ulcers in patients treated for Hansen's disease. Design: A prospective study. Setting: An institution-based clinic. Participants: Seven treated patients with Hansen's disease, with a mean age of 38.33 years, with nine non-healing Trophic Ulcer of more than 6 weeks duration. Measurements: Photographs were taken before treatment and at every subsequent sitting. Area and volume were calculated at baseline and every subsequent sitting till the closure was achieved. Materials and Methods: The healthy Ulcers were treated with PRFM at weekly intervals, repeated once a week for a maximum of five sittings as per requirement. Results: The mean percentage improvement in the area was 93.52%, and volume was 97.74% at the end of the second sitting. All Ulcers closed by a maximum of five sittings. No adverse events were noted. Conclusion: PRFM for the treatment of Trophic Ulcers in treated patients with Hansen's disease is a feasible, safe, simple and inexpensive method.
Sumnaia Db - One of the best experts on this subject based on the ideXlab platform.
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Remote results of using prostaglandins E1 and immunotherapy in combined modality treatment of various-aetiology Trophic Ulcers
Angiology and vascular surgery, 2020Co-Authors: Alekhin Di, Mikhaĭlova Oa, Sumnaia Db, Dodonov Np, Baltrushevich OaAbstract:: The purpose of this study was to assess short- and long-term efficacy of combined-modality therapy (comprising PGE1-group preparations and immunocorrection) used to treat indolent Trophic Ulcers in patients presenting with chronic venous insufficiency (CVI) and cutaneous angiitis. Examined herein were both immediate and remote therapeutic outcomes obtained in patients suffering from indolent Trophic Ulcers secondary to CVI (post-thrombophlebic disease [PTPD] and varicose disease [VD]), as well as Ulcers resulting from vasculitis or vasculopathy. The conventional therapy was supplemented with infusion of PGE1-group preparations and immunocorrection. Also investigated were the indices of microcirculation and the immune status, the percentage of the Trophic Ulcers having healed, the Trophic-Ulcer recurrence rate in the remote period, feasibility offurther performing a radical surgical intervention, the patients' quality of life after the treatment, and the need for repeat therapeutic courses according to the regimen proposed. The use of PGE1-group preparations in a combination with immunocorrection confirmed high efficacy of the treatment for various-aetiology Trophic Ulcers (with the preserved arterial blood flow). The Trophic Ulcers were observed to epithelialize rapidly following the initiation of treatment, thus making it possible to appropriately prepare the patient suffering from varicose disease for further surgical management. The remote-period evidence clearly showed that the use of the proposed therapeutic regimen had eventually led to a considerable improvement in the patients' quality of life, dramatically decreasing the recurrence rate of Trophic Ulcers in patients with PTPD and vasculopathies, and thus may safely be recommended both for prevention of Ulcer relapses and as part of maintaining therapeutic courses. The detected deviations in the immune status of the patients afflicted with vasculitis and those suffering from CVI confirmed the need for immunocorrection.
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Administration of prostaglandins Ei and immunotherapy in management of various-genesis Trophic Ulcers
Angiology and vascular surgery, 2020Co-Authors: Alekhin Di, Mikhaĭlova Oa, Fokin Aa, Sumnaia DbAbstract:OBJECTIVE: To study the dynamics of the indices of microcirculation and the immune status in patients suffering from indolent Trophic Ulcers with the preserved arterial blood flow, as well as a possibility of treating them by means of PGEi-group preparations combined with immunocorrection. PATIENTS AND METHODS: From 2002 to 2006 in the Clinic of Vascular Surgery of Municipal Clinical Hospital No 3 of the city of Chelyabinsk, we examined a total of 158 patients suffering from indolent Trophic Ulcers of the lower extremities with the preserved arterial blood flow (venous Ulcers and cutaneous angiitis). Also studied were the immune status and tissue perfusion indices, cytology of the Ulcers' surface. Treatment was carried out using > and immunocorrecting therapy (prednisolone and delagil). RESULTS: At baseline, all the patients were found to have decreased indices of tissue perfusion, with a direct correlation observed between lowered tissue perfusion and the duration of lingering Trophic disorders. Venous pathology and dermohypodermal angiitis were observed to be accompanied and followed by similar alterations in the immune status. Upon completion of the therapeutic course, we noted a statistically significant increase in tissue perfusion in the groups studied. Clinically noted was decreased oedema of the lower extremities, disappearance of the pain syndrome, and positive dynamics of the healing of Trophic Ulcerative defects. Complete epithelisation was achieved in 100% of the patients with venous insufficiency and the initial surface of the Ulcer up to 60 cm2. In patients presenting with vasculitis and the baseline area of the Trophic Ulcer up to 38 cm2 four months after therapy Ulcers were noted to epithelialize completely in 61% of cases. CONCLUSION: Combined therapy of various-genesis Trophic Ulcers with the preserved major blood flow by prostaglandins Ei preparations (vasaprostan) and immunocorrecting preparations (prednisolone and delagil) turned out pathogenetically substantiated and clinically efficient. The authors have for the first time proposed herein using the drugs of PGEi -group in therapy of venous Trophic Ulcers.