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YAWS TREATMENT in Nepal

YAWS

It is a chronic contagious non-venereal disease, belongs to a group of chronic bacterial infections (endemic treponematoses, nonvenereal spirochetal diseases) caused by treponemes. yaws (endemic treponematoses) are chronic, tropical, nonvenereal spirochetal infections spread by body contact.

Yaws is caused by Treponema pallidum subspecies pertenue. Yaws is not a fatal disease, but causes disabilities and visible deformities of the face and extremities contributing to stigma and discrimination. It affects the skin, bone and cartilage; if left untreated it can lead to deformities of the nose and bones of the leg.

In India the disease is mostly known by the name of the tribes affected most in any region. Thus for example, the disease is called ‘Madia Roga’ and ‘Gondi Roga’ in Bastar area of Chattishgarh and Sironcha area of Maharashtra respectively and ‘Koya rogam’ in Andhra Pradesh and Orissa. Some synonyms of Yaws are based on clinical features like ‘Domaru Khahu’ in Assam which indicates fig like eruption. Chakawar is a term used for chronic ulcers in Central India and part of Uttar Pradesh.

SYMPTOMS:

Primary yaws, a circular, solid swelling on the skin, with no visible fluid develops at the site of entry of the bacterium. A large yellow papule or papillomata at the site of inoculation. Papules are highly infectious. Nocturnal bone pain and bone lesions may also occur in the early stage.

Late yaws appears characterized by disfigurement of the nose and bones, and thickening and cracking of the palms of the hand and soles of the feet. These complications on the soles of the feet make it difficult for patients to walk.

  • Periostitis (particularly of the tibia)
  • Proliferative exostoses of the nasal portion of the maxillary bone (goundou)
  • Juxta-articular nodules
  • Gummatous skin lesions
  • Ultimately, mutilating facial ulcers, particularly around the nose (gangosa)

CAUSES:

Treponema pertenue which closely resembles to T.pallidium, Man is the only known reservoir of yaws.

DIAGNOSIS: CLINICAL  EVALUATION.

Serology

  • Venereal Disease Research Laboratory (VDRL) test
  • Rapid plasma reagin (RPR) test
  • Rapid treponemal tests are widely used in the diagnosis of syphilis

Polymerase chain reaction (PCR)

HOMOEOPATHY   MANAGEMENT:

Silicea - Imperfect assimilation and consequent defective nutrition. Diseases of bones, caries and necrosis , Pain in knee, as if tightly bound. Calves tense and contracted. Pain beneath toes. Soles sore (Ruta).  

Mer sol - lymphatic system is especially affected with all the membranes and glands, and internal organs, bones. Ulcers, irregular in shape, edges undefined. Pimples around the main eruption. Itching, worse from warmth of bed. Crusta lactea; yellowish-brown crusts, considerable suppuration. Glands swell every time patient takes cold. Buboes.

Nitric acid - Ulcers bleed easily, sensitive; splinter-like pains; zigzag, irregular edges; base looks like raw flesh. Exuberant granulations.

Syphilinum - Ulceration of mouth, nose, genitals, skin. Succession of abscesses. Caries of ossicles in ear of syphilitic origin. Reddish-brown eruption, with a disagreeable odor. Extreme emaciation.