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Dermatology

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Leprosy

Question
6 out of 28
 

Most sensitive index to assess the drug effectiveness in skin smears of leprosy patient is:



A Culture of lesion
B Granuloma index

C Morphological index
D Bacteriological index

Ans. C
Morphological index

Two indices which depend on observation of Mycobacterium leprae in smears from skin or nasal smears are useful in assessing the amount of infection, and the viability of the organisms and also the progress of the patient under treatment. They are the morphological index and the bacteriological index.

1). The bacteriological index (BI) is an expression of the extent of bacterial loads. It is calculated by counting 6 to 8 stained smears under the 100 x oil immersion lens in a smear made by nicking the skin with a sharp scalpel and scraping it; the fluid and tissue obtained are spread fairly thickly on a slide and stained by the Ziehl-Neelsen method and decolorized (but not completely) which 1 % acid alcohol.

2). It is a QUANTITATIVE ASSAY

3). The results are expressed on a logarithmic scale.

a. 1 + At least 1 bacillus in every 100 fields.

b. 2+ At least 1 bacillus in every 10 fields.

c. 3+ At least" 1 bacillus in every field.

d. 4 + At least 10 bacilli in every field.

e. 5+ At least 1 00 bacilli in every field.

f. 6+ At least 1000 bacilli in every field.

4). The morphological index (MI) is calculated by counting the numbers of solid-staining acid-fast rods. Only the solid-staining bacilli are viable. It is a QUALITATIVE ASSAY.

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