03364nas a2200397   4500000000100000008004100001260001300042653001500055653002800070653001000098653001900108653001100127653001100138653002300149653001200172653000900184653001600193653002200209653002700231653003900258653002400297653003000321100001600351700001400367700001300381700001500394700001100409700001500420245021700435856005100652300001100703490000700714050003200721520219900753022001402952       2008                            d  c2008 Jun10aAdolescent10aAdrenal Cortex Hormones10aAdult10aCohort Studies10aFemale10aHumans10aLeprostatic Agents10aleprosy10aMale10aMiddle Aged10aNeural Conduction10aNeurologic Examination10aPeripheral Nervous System Diseases10aProspective Studies10aSeverity of Illness Index1 aKhambati FA1 aShetty VP1 aGhate SD1 aCapadia GD1 aPai VV1 aGanapati R00aThe effect of corticosteroid usage on the bacterial killing, clearance and nerve damage in leprosy: a prospective cohort study: part 1--study design and baseline findings of 400 untreated multibacillary patients.  uhttps://leprosyreview.org/article/79/2/13-4153  a134-530 v79  aInfolep Library - available3 a<p><b>OBJECTIVE: </b>To investigate possible adverse effects of therapeutic usage of corticosteroids on the killing and clearance of M. leprae and the clearance of granuloma, in patients with multibacillary (MB) leprosy.</p><p><b>DESIGN: </b>A cohort of 400 untreated MB patients were sub-grouped into those to be treated with corticosteroids (prednisolone 40 mg daily tapered to 5 mg over 12 weeks) along with MB-MDT for reaction and/or neuritis or silent neuropathy (SN) of <6 months duration (group A), and those with no reaction and to be treated with MDT only (group B). Clinical, bacteriological, histopathological and neurological test findings at fixed time points were compared. Analysis was performed using SPSS version 10.0. The significance of association was tested using Chi-square test. In the current report, we describe the study design and baseline findings of 400 untreated MB patients, with special emphasis on differences between patients in groups A and B.</p><p><b>RESULTS: </b>At baseline, applying Ridley-Jopling classification, 39% patients were BT, 20% BB, 24% BL, 12% sub-polar LL and 5% pure neural (PN). Overall, 60% patients were slit skin smear (SSS) negative and 33% presented with disability either grades 1 or 2. Overall 140/400 (35%) patients presented with reaction and/or neuritis and 11/400 (3%) presented with SN of <6 months duration. Comparing groups A and B, the percentage of patients presenting with DG2 was significantly higher in group A (43%). By clinical tests, monofilaments (MF) and voluntary muscle testing (VMT), the percentage of patients and nerves showing functional impairment was also significantly higher in group A. However, in the more sensitive nerve conduction velocity (NCV) test, the percentage of patients that showed nerve abnormalities was closely comparable; 94% and 91% in groups A and B respectively while number of affected nerves was higher in group A.</p><p><b>CONCLUSION: </b>At baseline, as recorded by NCV, peripheral nerve function abnormality was observed in almost all the MB patients regardless of reaction; but among those presenting with reaction or neuritis, the nerve damage was more severe and extensive.</p>  a0305-7518