Leprosy Training Module for Medical Officers

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( C ) Nerve Examination : Remember the cardinal sign : Involvement of peripheral nerves, as demonstrated by definite thickening with loss of sensation and weakness of the muscles of hands, feet or face. Principles of Nerve Examination : Examination of nerves in all the patients is very important for prevention of deformity. This involves two aspects : 1. Palpation of Nerves for thickening or tenderness. 2. Assessment of Nerve function. 1. Palpation of Nerves for thickening or tenderness : Nerve damage, mainly to peripheral nerve trunks, constitutes another feature of Leprosy. There may be loss of sensation in the skin and the weakness of muscles supplied by the affected nerve. In the absence of these signs, nerve thickening by itself, without sensory loss, and / or muscle weakness is often not a reliable sign of Leprosy. Remember : In a healthy subject, most peripheral nerves are palpable. • When palpating the nerves, you should look for thickening and / or tenderness. • When palpating the nerves, the patient should be properly positioned. The examiner should also be positioned correctly. • Always compare both sides to assess thickness. 15
• Look at the patient’s face while palpating the nerve to illicit tenderness. • Always palpate across the course of the nerve. • Feel along the nerve as far as possible, in both the directions. • Palpate gently with the pulp of the finger and not the tip. The ‘ sites of predilection ’ at which the peripheral nerves are most commonly enlarged and palpable in Leprosy. 16
Page 1 and 2: NLEP Leprosy Training Module for Me
Page 3 and 4: Task of Medical Officers for NLEP (
Page 5 and 6: The Disease - Leprosy Leprosy is a
Page 7 and 8: Epidemiology
Page 9 and 10: 30 25 25.9 Prevalence Rate of Lepro
Page 11 and 12: Spread of Leprosy Source of Infecti
Page 13 and 14: Diagnosis & Clinical Examination
Page 15 and 16: of these signs, nerve thickening by
Page 17 and 18: ( B ) Skin Examination : Remember t
Page 19: Method for testing anaesthesia : Fi
Page 23 and 24: 2. Assessment of Nerve Function : N
Page 25 and 26: VMT - Radial Nerve Ask the patient
Page 27 and 28: ST - Sensory Test - Hand Ulnar Medi
Page 29 and 30: Classification of Leprosy
Page 31 and 32: Examples showing WHO classification
Page 33 and 34: PB Leprosy PB Leprosy : Small Solit
Page 35 and 36: PB Leprosy : • Rounded lesion wit
Page 37 and 38: MB Leprosy : • One of many patche
Page 39 and 40: MB Leprosy : • Several Punched ou
Page 41 and 42: MB Leprosy : • Thick erythematous
Page 43 and 44: MB Leprosy : • Extensive • Symm
Page 45 and 46: MB Leprosy : • Marked Diffused In
Page 47 and 48: Treatment for Leprosy MDT Drugs : T
Page 49 and 50: Advantages of MDT MDT kills the
Page 51 and 52: PB MDT ( Child 10 -14 yrs. ) : Supe
Page 53 and 54: Reactions in Leprosy
Page 55 and 56: Patients with following characteris
Page 57 and 58: Type I Lepra Reactions Type I Lepra
Page 59 and 60: Type I Lepra Reaction • Inflammat
Page 61 and 62: Type II Lepra Reaction • ENL nodu
Page 63 and 64: Difference between Type I Lepra Rea
Page 65 and 66: Corticosteroid Therapy : • Cortic
Page 67 and 68: Disabilities in Leprosy
Page 69 and 70: The two most important measures for
Page 71 and 72:
Primary Disability Primary Disabili
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Ulnar Claw • Clawing of little an
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Secondary Disability Primary disabi
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Prevention of Disabilities ( POD )
Page 79 and 80:
Three Levels of Interventions for P
Page 81 and 82:
Care of Primary Disability to preve
Page 83 and 84:
Loss of Sensation in Hands & Feet (
Page 85 and 86:
Care of wounds - Simple Wounds If t
Page 87 and 88:
Exercises for Paralysis / Weakness
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Exercises for Lateral Popliteal ner
Page 91 and 92:
Eye care 2 Corneal Anaesthesia Pati
Page 93 and 94:
Elimination of Leprosy It is well k
Page 95 and 96:
Integration Why integration is esse
Page 97:
Simplified Information System ( SIS
Page 100 and 101:
2. Treatment Record ( L. F. 02 )
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Treatment Record to be attached her
Page 104 and 105:
Reports The simplified information
Page 106 and 107:
3. Child proportion among new cases
Page 108:
National Leprosy Eradication Progra
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Leprosy Training Module for Medical Officers

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