الفهرس 
LeprosyOnly 14 pages are availabe for public view
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Abstract
Leprosy is a chronic granulomatous infection caused by the obligate intracellular bacterium Mycobacterium leprae. Paucibacillary leprosy (PB leprosy, Tuberculoid leprosy) and Multibacillary leprosy (MB leprosy, Lepromatous leprosy) are the two forms with distinct bacteriological, clinical, immunological and pathological features.
During the infectious process, M.leprae is faced with the host macrophagic environment, where reactive oxygen species (ROS) are produced for bactericidal purpose. Overproduction of ROS can lead to considerable diffusion of the species, which therefore can act on host biomolecules, damage them and thereby cause cell death and tissue damage.
To defend themselves against free radical attack, cells have various antioxidant systems. Several enzymatic systems can detoxify free radical. In addition, some micronutrients can prevent the harmful effects of free radicals by non-enzymatic mode as Vit.A, Vit.E and Vit.C.
Under normal conditions, there is a steady-state balance between the production of ROS and their destruction by the antioxidant systems. An imbalance between the production of ROS and the various antioxidant defenses can result in oxidative stress, which can arise from deficiencies of antioxidants and/or from increased formation of ROS.
Determination of lipid peroxidation and antioxidant status are useful to evaluate oxidative stress.
The goal of this study was to investigate serum levels of MDA as oxidant and Vit A as antioxidant in sera of leprosy patients and correlate its levels with types of leprotic patients before, during and after release from treatments
This study included 80 PB and MB leprotic patients Those were untreated PB and MB leprotic patients, undertreatment MB leprotic patients,treated MB leprotic patients and 20 healthy controls. All studied individuals were subjected to:
-History taking as personal history: name, sex, age, residence, special habit.
-Present history: onset, duration and coarse.
-Clinical examination: type of leprosy paucibacillary or multibacillary sites and morphology of skin lesions disabilities of eye hands and feet .
-MDA seum level was detected using colorimetric method designed to its measurement and Vit.A serum level was detected using High Performance Liquid Chromatography (HPLC) .
The measurement of MDA showed highly significant difference between control group and untreated PB,untreated MB and undertreatment MB leprotic patients. the measurement of MDA showed non significant difference between control group and treated MB leprotic patients. The MDA serum level significantly increased in leprosy patients in comparison with normal human volunteers, being more accentuated in untreated leprosy patients and gradually decrease with clinical improvement with multidrug therapy.
The measurement of vit. A showed highly significant difference between control group and untreated PB,untreated MB and undertreatment MB leprotic patients. The measurement of Vit.A show significant difference between control group and treated MB leprotic patients.vitamin A serum level were significantly low in leprosy patients in comparison with normal human volunteers, being more reduced in untreated leprosy patients and gradually increase with clinical improvement with multidrug therapy.
There was an inverse relation between MDA as oxidant and Vit.A as anti oxidant in all studied groups.
No statistically significant difference was found between all the studied groups of leprosy according to gender, age , diabilities of eye, hand and feet.
The duration of illness was significantly increased in treated MB leprotic patients in comparison with all studied groups of leprosy .
There was no correlation between MDA and age in all studied groups of leprosy.
There was no correlation between Vit.A and age in all studied gorups of leprosy.
There was no correlation between MDA and duration of illness in all studied groups of leprosy
There was no correlation between Vit.A and duration of illness in all studied groups of leprosy.
ROC curve could diagnose the value of MDA level in leprotic patients with sensitivity 82.5% , specificity 80% , accuracy 82% and area under curve was 0.827 , (P- values<0.007) .
ROC curve could diagnose the value of vit. A level in leprotic patients with sensitivity 80% , specificity 90% , accuracy 85% and area under curve was 0.86, (P- values<0.001) .
The comparison of ROC curves could diagnose the value of the test according to MDA and vit. A levels in leprotic patients with sensitivity 85% , specificity 85% , accuracy 85% and with difference between the curves was 0.0325, (P- values<0.001).