Leprosy Mailing List – August 20, 2014
Ref.: (LML) WHO disability grading and the term anaesthesia
From: Dinkar Palande, Pondicherry, India
Dear Pieter,
I endorse the suggestion by Dr. Wim Theuvenet. (LML August 12, 2014). I hope that there is a discussion on this topic and positive suggestions. It is time that we bring a new deformity grading and start using it. This will help a lot in reducing the incidence of new deformities and worsening of present ones. Hope agencies like ILEP and WHO help in bringing out the required change.
What we need to recognise is presence or absence of protective sensation. The one from Linda Lehman is an excellent communication (LML August 15, 2014). I endorse it fully especially that a proper training program is essential for the success of any new method. Ball point pen, or better a similar calibrated devise, has an advantage that it tests wider surface than a nylon filament. Wherever possible I would also recommend Texture recognition.
Texture testing: we used to do it by using different surfaces for the hand to feel and identify smooth, rough, pebbled, surfaces. For the foot walking on different surfaces with eyes closed, we used roughly 2x2 feet areas covered with sands of different texture, another surface impregnated with pebbles and a smooth rubber mat. One can choose different surfaces available easily locally. We standardised by using normal controls. In the paper on ten years follow up of nerves in leprosy treated with auto muscle grafts by Jerome Pereira, Dr Narayan Kumar and others we have given details. (British Journal of Bone and joint surgery). This work was also presented at the International Leprosy congress in Hyderabad, India. For more information readers may contact Dr. Narayan Kumar <drtsnkumar@yahoo.com>
With best regards,
Dinkar
from dinkar d. palande
LML - S Deepak, B Naafs, S Noto and P Schreuder
LML blog link: http://leprosymailinglist.blogspot.it/
Contact: Dr Pieter Schreuder << editorlml@gmail.com
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