SYNOPSIS FOR PG DISSERTATION FOR MD/MS,

UNDER RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, BENGALURU.

NAME OF THE CANDIDATE
AND
ADDRESS
(IN BLOCK LETTERS) / DR. MAYUR H. KANSAGARA
DEPT. OF PATHOLOGY,
SHRI NIJALINGAPPA MEDICAL COLLEGE,
NAVANAGAR,
BAGALKOT, PIN -587 102
BAGALKOT, PIN -587 102
NAME OF THE INSTITUTION / SHRI NIJALINGAPPA MEDICAL COLLEGE AND HSK HOSPITAL AND RESEARCH CENTRE, NAVANAGAR,
BAGALKOT-587 102
COURSE OF THE STUDY AND SUBJECT / M D (PATHOLOGY)

SYNOPSIS FOR PG DISSERTATION FOR MD/MS,

UNDER RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, BENGALURU.

1. / Name and address of the candidate(in block letters) / DR. MAYUR H. KANSAGARA
DEPT. OF PATHOLOGY,
SHRINIJALINGAPPAMEDICALCOLLEGE,
NAVANAGAR,
BAGALKOT, PIN -587 102
Permanent Address / DR. H. L. KANSAGRA,
KANSAGRA PATHOLOGY LABORATORY,
NEAR HOTEL VAIBHAV, S.T.ROAD,
JUNAGADH. PIN – 362001
GUJARAT.
2. / Name of the institution / SHRINIJALINGAPPAMEDICALCOLLEGE AND HSKHOSPITAL AND RESEARCH CENTRE, NAVANAGAR,
BAGALKOT-587 102
3. / Course of study and subject / M.D. (PATHOLOGY)
4. / Date of admission to course / 29-05-2010
5. / Title of the Topic:
“Leprosy – A clinico - histopathological correlative study.”
6. / Brief resume of the intended work:
6.1 : Need for the study:
Leprosy is a chronic infection caused by Mycobacterium leprae affecting the cooler parts of the body: skin, upper respiratory tract, anterior segment of the eye, superficial portions of peripheral nerves and testes.1
Among all leprosy cases over the world 64% cases are in India. With the implementation of the WHO multi-drug therapy programme on a war footing the prevalence of the disease has come down drastically to almost WHO definition of elimination levels of 1 per 10000 population. The WHO has set a deadline of 2010 for the eradication of leprosy as a public health problem. However, there is no reduction seen in the incidence of leprosy worldwide making it clear that the transmission of leprosy has not been interrupted by multi drug therapy.2
Leprosy is a disease which, apart from causing awful disfiguration and physical pain and hardship, leads to isolation, rejection, social stigma and ostracization that still characterize attitudes towards leprosy.3
Keeping in mind the public health problem and intense research work being done in understanding its pathogenesis, this chronic granulomatous infectious disease is considered worthwhile to study clinically, pathologically and to correlate both so as to facilitate the institution of accurate mode of therapy and regular follow-up of patients to
prevent undesirable complications.
6.2 Review of literature:
Leprosy is widely prevalent in India.4 India alone represents around 60% of prevalence of the leprosy case load and 75% of new cases worldwide. Most leprosy cases are concentrated in 11 endemic states, including Bihar, Orissa, Chattisgarh, Jharkhand and Uttar Pradesh where the prevalence rate is over 4 per 10000 population. It also highlights that without effective control activities in these areas, it might not be able to reach the global elimination target.5
A histopathological correlation study done on 372 leprosy patients using Ridley Jopling classification by B Niranjana Moorthy et al in Davangere showed there was 62 % correlation between clinical & histopathological diagnosis. Correlation was highest in LL (80%) followed by BL (70%), BT (66.34%), BB (50%) and TT (46.15%). The other interesting observation was histopathologically diagnosed cases were more compared to that made clinically.6
Another study on 270 skin biopsies in Jammu by Anuja Sharma et al showed concordance of clinical & pathological diagnosis was 53.44% cases with maximum parity in LL(75.86%), followed by BL(58.82%), BT(53.01%), TT(47.37%) and least in BB(37.35%).7 However, Jha R et al in Kathmandu showed that histopathological diagnosis of leprosy did not correlate with clinical diagnosis significantly.8
6.3 Objectives of the study:
  • Primary Objective:
  • To analyse the clinico pathological correlation in different types of leprosy.
  • To study the histopathological spectrum of skin lesions in leprosy.
  • Secondary Objective:
  • To observe the disparity between the clinical and histopathological features in different types of leprosy.

7. / Materials and Methods:
7.1 Source of data:
The present study will be carried out in the Department of Pathology, ShriNijalingappaMedicalCollege, Bagalkot.
7.2 Method of collection of data (including sampling procedure, if any):
The present study will include skin biopsies of clinically diagnosed leprosy patients attending the department of Dermatology at HSK Teaching and General Hospital and peripheral centres of Bagalkot district during the period of June 2010 to June 2012 (24 months study).
Brief clinical data will be noted from the case records, which will include the age and sex of the patients, relevant history if any and clinical diagnosis.4-6 microns thick sectionswill beobtained from 10% formalin fixed, paraffin processed skin biopsies & will be stained routinely by hematoxylin and eosin modified Fite Faraco to demonstrate lepra bacilli. The cases will be classified according to Ridley – Jopling classification.9Indeterminate will be diagnosed as per Indian classification.10
Sample Size : Minimum50
Type of study : Cross-sectional study
Inclusion criteria:
  • Untreated leprosy patients who did not give any history suggestive of reaction will be taken for the study.
Exclusion criteria:
  • Patients who are on treatment for leprosy will be excluded from the study.
7.3Does the study require any investigation or interventions to be conducted on patients or other humans or animals? If so, please describe briefly. (As explained above). No
7.4Has ethical clearance been obtained from your institution in case of 7.3?
Yes
8. / List of references:
1)Rubina S. Bacteriology, Classification, and Diagnosis of Leprosy. Indian Journal for the Practising Doctor. 2005;2(2):56-57.
2)WHO, Global strategy for further reducing the leprosy burden and sustaining leprosy control activities. 2005; 53.
3)Cindy Brown. The Stigma of Leprosy.Final Research ProjectHIST 5950-Disease and SocietyProfessor Bjork.2003:32-40.
4)Park K. Epidemiology of communicable diseases. In: Park’s Textbook of preventive and Social Medicine.17thedn. Jabalapur : M/S Banarsidas Bhanot Publishers; 2002 : 242-253.
5)Than Sein, Kyow Lwin. Communicable disease. Regional Health Forum. 2003; 7(1):11-25.
6)Moorthy BN, Kumar P, Chatura KR et al.Histopathological correlation of skin biopsies in leprosy.Indian J Dermatol Venereol Leprol. 2001; 67(6):299-301.
7)Sharma A, Sharma R, GoswsamiK C et al.Clinico-Histopathological Correlation in Leprosy. JK Science.2008; 10(3): 120-123.
8)Jha R, Karki S. Limitations of Clinico-histopathological Correlation of Skin Biopsies in Leprosy. J Nepal Health Res Counc. 2010; 8(16):40-43.
9)Ridley DS.Histopathological classification and the immunological spectrum of leprosy. Bull World Health Organ.1974; 51: 451–465.
10)Dharmendra. Classification of leprosy. In: Hastings RC. Ed. Leprosy. 2ndedn.Edinburgh London Madrid Melbourne. New York and Tokyo: Churchill Livingstone ; 1994:179-190.
9. / Signature of the candidate
10. / Remark of the guide / Recommended
11. / 11.1 Name and
designation of Guide
11.2 Signature / DR. B.V.PATIL,
PROFESSOR,
DEPARTMENT OF PATHOLOGY,
S.N.MEDICALCOLLEGE, BAGALKOT
11.3Head of the
Department
11.4 Signature / DR. V.D.DOMBALE,
PROFESSOR AND HEAD ,
DEPARTMENT OF PATHOLOGY,
S.N.MEDICALCOLLEGE, BAGALKOT
12.1Remarks of the Principal
12.2Signature