Background Information for Sunday School Teachers World Leprosy Day Leprosy is a mildly infectious disease caused by a bacterium called Mycobacterium leprae (a relative of the tuberculosis bacterium or 'TB' germ). Leprosy is not hereditary and it cannot be caught by touch. Scientists believe it is passed through droplets of moisture, carried on the air, from someone who has leprosy but has not yet started treatment. Leprosy starts by damaging the smaller nerves in the cooler parts of the body – especially in the skin and surface areas of the fingers and toes, legs, arms and face. It can stay in the body for up to 20 years without showing symptoms.
The first signs of leprosy are numb patches on the skin which look a slightly different colour from the person's normal skin tone. If treated during these early stages there will be no further damage.
Leprosy is most common in places of poverty. Dirty surroundings, overcrowding and poor nutrition and housing all make people more susceptible to leprosy infection. Many people are terrified of catching leprosy and some even see it as a curse. This means that, for some, a diagnosis of leprosy can lead to divorce, loss of work, home and friends. Not only are they stigmatised but so are their relatives. Therefore people will often hide their symptoms rather than seeking help and medication, which eventually causes more physical damage and leads to disability. If leprosy is not treated it will attack the larger nerves that supply feeling to the hands, feet, eyes and parts of the face. So when a person hurts themselves - for example through treading on something sharp or holding something hot - they do not feel pain, and so it is easy for them to ignore their injuries. This can lead to serious ulcers and infection. Over time, repeated injury and infection cause the bones to shorten, so the fingers, toes and hands and feet may get smaller.
If larger nerves stop working they will also stop sending signals to the muscles and tendons so there is no movement. This can lead to 'clawing' of the fingers, where the fingers bend into the palm, and 'drop foot', where the foot drags along the ground. Leprosy can also affect sweat glands, which keep the skin soft. If these stop working, the skin on the hands and feet will get very dry and cracked and wounds will develop more easily.
Leprosy can damage the eye nerves so that the eyelid muscles stop working, which would normally make the eyes blink regularly to keep them moist and clean. If this happens the person will not be able to close their eyes, even if they try. Without this natural cleaning and protection a person can eventually become blind.
Leprosy can damage the bones of the nose. In time this causes the nose to collapse and flatten.
In the past various drugs have been used to treat leprosy with differing levels of success, but thankfully in 1982 scientists discovered a very effective cure: multidrug therapy (commonly known as MDT). This is a combination of three drugs, Dapsone, Rifampicin and
Clofazimine, taken for six or 12 months, depending on the strength of the person's immune system. People with leprosy can take their medication at home and many can continue their normal jobs and activities. It is not necessary to isolate a person with leprosy at any time.
Research is still being carried out to try to find a suitable vaccine.
A 'clawed' hand or 'drop foot' can be restored with surgery and physiotherapy.
Surgery can also restore eyelid movement, so a person can blink. However, surgery cannot bring feeling back to numb areas of the body.
People with feet damaged by leprosy are encouraged to examine them regularly for signs of injury. They should also use footwear that will protect their feet, especially in countries where it is normal to go barefoot. Soaking feet in water and then rubbing the skin with oil keeps them supple and also helps prevent serious injury from cracked skin. If you wish to extend your knowledge and understanding of the effects of leprosy and the history of leprosy in Australia we recommend:
Google ‘Channel Island’ or ‘East Arm’ or Leprosy in Australia View the film ‘Molokai’ Read the book ‘Ten Fingers for God’ The Leprosy Mission has stock of both film and book along with other resources that will assist you. Should you require other assistance please do not hesitate to call you state office or the national office.The Leprosy Mission Australia 37 Ellingworth Pd Box Hill, Victoria 3128 Tel : 1800 617 679 www.leprosymission.org.au
CASE REPORT & Hastal›klar› Dergisi Journal of Diseases of the Colon and RectumComplicated Fecalith Impaction in a Patientwith Psychosis‹LHAN KARABIÇAK, TU⁄RUL KES‹C‹O⁄LU, FERKAT AYRANCILAR19 May›s Universitesi T›p Fakültesi, Genel Cerrahi Anabilim Dal› Samsun-TürkiyeElli alt› yafl›nda kad›n hasta, abdominal distansiyon ileA 56-year-old woman presented to
SYMPTOM QUESTIONNAIRE HEADACHES Please fill out only the sections that apply to you. Skip sections that do not relate to your condition. WHEN DO YOU USUALLY GET YOUR HEADACHES? WHAT USUALLY HELPS YOUR HEADACHES? DESCRIBE HOW YOUR HEADACHE USUALLY FEELS: Pounding Where does most of your headache pain focus? (Check all that apply) Neck area