Publications by authors named "Rajesh D Mehta"

6 Publications

  • Page 1 of 1

Clinco-epidemiologic study of cutaneous leishmaniasis in Bikaner, Rajasthan, India.

Am J Trop Med Hyg 2013 Jul 28;89(1):111-5. Epub 2013 May 28.

Department of Dermatology, Sandar Patel Medical College, Bikaner, Rajasthan, India.

Cutaneous leishmaniasis is endemic to the Thar Desert of Rajasthan, Bikaner, India. The present study describes clinico-epidemiologcial data of all cases of cutaneous leishmaniasis CL in this region during 2001-2011. A total of 1,379 patients with 2,730 lesions were reported during the study period. Ages of patients ranged from 3 months to 86 years, and there was a predominance of infections in males. Most patients were from urban areas and lower middle socioeconomic groups. Lesions were dry, ulcerated nodules or plaques of different sizes commonly over face and upper limb. Skin smears were positive for parasites in 958 (69.5%) patients, and the remaining 45.8% (193 of 421) patients were positive by skin biopsy. Histopathologic analysis of the skin showed mixed granulomas consisting of macrophages, lymphocytes, epitheloid, and plasma cells. Species identification was conducted for 45 randomly selected patients by polymerase chain reaction, the infective species was Leishmania tropica. Most patients were treated with intra-lesional injections of sodium stibogluconate.
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http://dx.doi.org/10.4269/ajtmh.12-0558DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3748465PMC
July 2013

Long-term efficacy of radiofrequency ablation in treatment of common and palmo-plantar warts.

Australas J Dermatol 2013 Nov 6;54(4):307-9. Epub 2012 Nov 6.

Department of Skin, STD and Leprosy, SP Medical College, Bikaner, Rajasthan, India.

Current treatments for warts induce significant local tissue damage and do not prevent recurrence. We evaluated the efficacy of localised radiofrequency heat (RFH) therapy in inducing the long-term resolution of common and palmo-plantar warts in a placebo-controlled randomised single blind trial. Our data show that RFH therapy is a safe, cosmetically acceptable and long-term effective treatment for warts.
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http://dx.doi.org/10.1111/j.1440-0960.2012.00966.xDOI Listing
November 2013

Successful treatment of canine cutaneous leishmaniasis using radio-frequency induced heat (RFH) therapy.

Am J Trop Med Hyg 2012 Aug;87(2):261-3

Department of Clinical Veterinary Medicine, RAJUVAS, Bikaner, Rajasthan, India.

Canine cutaneous leishmaniasis (CCL) is a significant veterinary problem. Infected dogs also serve as parasite reservoirs and contribute to human transmission of cutaneous leishmaniasis (CL). Current treatments for CCL are cumbersome and toxic because they are prolonged and involve multiple injections of antimonials. Radio-frequency induced heat (RFH) therapy has been found to be highly effective against CL in humans. Here, we examined the efficacy of topical RFH therapy in the treatment of CL in two pet dogs. We found that RFH therapy induced complete clinical cure and lesion healing within 45 days and both dogs have remained disease free for the last 16 months. This report is the first to demonstrate that a single topical application of RFH therapy is safe and effective in inducing long-term cure of CCL.
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http://dx.doi.org/10.4269/ajtmh.2012.11-0756DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3414561PMC
August 2012

Efficacy of Intralesional Bleomycin in Palmo-plantar and Periungual Warts.

J Cutan Aesthet Surg 2011 Sep;4(3):188-91

Departments of Dermatology, Venereology and Leprosy, SP Medical College, Bikaner, Rajasthan, India.

Background/aim: Intralesional bleomycin gained increasing popularity in the recent past for treatment of warts particularly in palmo-plantar and periungual regions as other modalities are not very effective. Hence we evaluated the role of intralesional bleomycin in periungual and palmo-plantar warts to know its efficacy in Indian patients.

Settings And Design: This was a placebo-controlled study.

Materials And Methods: Fifty patients of multiple palmo-plantar and periungual warts were included in this study and categorized in groups A and B of 25 each. Alternate patients were included in groups A and B and treated respectively with intralesional bleomycin (1 mg/mL solution) and normal saline as placebo, fortnightly for maximum up to two injections. Patients were followed up weekly for 1 month, fortnightly up to 12 weeks, and then quarterly for 1 year. If warts persisted after 12 weeks of starting treatment, it was considered a failure. Statistical analysis was done by the chi-square test using M-stat software.

Results: Group A and B patients were having 85 warts and 72 warts, respectively. The cure rate in group A and B patients was 96.47% (82/85 warts) and 11.11% (8/72 warts), respectively, after one or two injections within 12 weeks. The difference in the cure rate between two groups was statistically highly significant (<0.0001). In group A patients, a haemorrhagic eschar was formed which gradually healed in 8-12 weeks without atrophy or pigmentation; this phenomenon was not seen in group B. Only moderate pain was observed by most of the patients during injection in both groups.

Conclusion: The intralesional injection of bleomycin is highly effective, safe, and non-toxic in periungual and palmo-plantar warts.
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http://dx.doi.org/10.4103/0974-2077.91250DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3263129PMC
September 2011

Unresponsive cutaneous leishmaniasis and HIV co-infection: report of three cases.

Indian J Dermatol Venereol Leprol 2011 Mar-Apr;77(2):251

Department of Dermatology, SP Medical College and PBM Group of Hospitals, Bikaner, Rajasthan, India.

Cutaneous leishmaniasis (CL) is a vector borne disease caused by various species of Leishmania parasite. CL is endemic in the Thar desert of Rajasthan state and Himachal Pradesh in India. Immune suppression caused by human immunodeficiency virus (HIV) infection is associated with atypical clinical presentation of CL which responds poorly to the standard treatment and causes frequent relapses. We are reporting three cases of localized and disseminated CL due to Leishmania tropica which failed to respond to conventional intralesional/intramuscular sodium stibogluconate (SSG) injections. Initially, we did not think of HIV infection because CL is endemic in this region. When patients did not respond to SSG injections, we performed enzyme-linked immunosorbent assay (ELISA) tests for HIV and they turned out to be HIV positive. Our report showed that CL is emerging as an opportunistic infection associated with HIV/AIDS and may be the first manifestation in HIV positive patients in an endemic area.
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http://dx.doi.org/10.4103/0378-6323.77484DOI Listing
January 2012

Cutaneous leishmaniasis caused by Leishmania tropica in Bikaner, India: parasite identification and characterization using molecular and immunologic tools.

Am J Trop Med Hyg 2007 May;76(5):896-901

Institute of Pathology (ICMR), Safdarjung Hospital Campus, New Delhi, India.

Identification of new foci of cutaneous leishmaniasis (CL), along with reports of Leishmania donovani causing the disease, is an issue of concern. Clinico-epidemiologic analysis of 98 cases in the endemic regions of Rajasthan state, India, suggested the preponderance of infection in men (62.24%) compared with women (37.75%). Species characterization by internal transcribed spacer 1 (ITS1) polymerase chain reaction (PCR)-restriction fragment length polymorphism (RFLP), kDNA-PCR, and immunofluorescence assay established L. tropica as the causative organism. When applied directly to 32 clinical samples, kDNA PCR had a sensitivity of 96.6%, whereas ITS1 PCR had a sensitivity of 82.75%, thus facilitating diagnosis and species identification. Either parasite culture or direct microscopy alone detected 48.2% and 65.5% of the positive samples, respectively, whereas culture and microscopy together improved overall sensitivity to 89.3% (25/28). Except for the kDNA PCR, all other assays were 100% specific. This study provides the first comprehensive molecular and immunologic studies of CL in India.
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May 2007
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