%PDF-1.6
%
1 0 obj
<>
endobj
2 0 obj
<>stream
Han-Siong Toh, Jeni Maharjan, Ruby Thapa, Kapil Dev Neupane, Mahesh Shah, Suwash Baral, Deanna A. Hagge, Indra Bahadur Napit, Diana N. J. Lockwood
Diagnosis and impact of neuropathic pain in leprosy patients in Nepal after completion of multidrug therapy
www.plosntds.org
www.plosntds.org
endstream
endobj
3 0 obj
<>/XObject<>>>/CropBox[0 0 612 792]/MediaBox[0 0 612 792]/Parent 10 0 R/Annots 11 0 R/Contents 12 0 R/TrimBox[0 0 612 792]>>
endobj
11 0 obj
[13 0 R 14 0 R 15 0 R 16 0 R 17 0 R 18 0 R 19 0 R]
endobj
13 0 obj
<>/Border[0 0 0]/Dest(Rpntd.0006610.ref001)>>
endobj
14 0 obj
<>/Border[0 0 0]/Dest(Rpntd.0006610.ref002)>>
endobj
15 0 obj
<>/Border[0 0 0]/Dest(Rpntd.0006610.ref003)>>
endobj
16 0 obj
<>/Border[0 0 0]/Dest(Rpntd.0006610.ref004)>>
endobj
17 0 obj
<>/Border[0 0 0]/Dest(Rpntd.0006610.ref005)>>
endobj
18 0 obj
<>/Border[0 0 0]/Dest(Rpntd.0006610.ref006)>>
endobj
19 0 obj
<>/Border[0 0 0]/A 20 0 R>>
endobj
20 0 obj
<>
endobj
12 0 obj
[21 0 R 22 0 R 23 0 R 24 0 R 25 0 R 26 0 R 27 0 R 28 0 R]
endobj
21 0 obj
<>stream
q
0.955 g
0 w
199.9998 622.9103 m
575.9997 622.9103 l
575.9997 461.9106 l
199.9998 461.9106 l
f*
0.45 0.36 0.35 0.01 k
575.9997 647.9101 m
199.9998 647.9101 l
199.9998 648.4102 l
575.9997 648.4102 l
f*
0.83 0.64 0.02 0 k
203.4142 341.915 m
208.1764 341.915 l
h
f*
234.9921 315.9496 m
239.7543 315.9496 l
h
f*
396.2268 198.9354 m
400.989 198.9354 l
h
f*
405.4677 198.9354 m
410.2299 198.9354 l
h
f*
203.4142 146.948 m
208.1764 146.948 l
h
f*
356.7118 120.926 m
361.474 120.926 l
h
f*
0 g
1 j
1 J
11.4998 0 0 11.4998 200.0125 706.3937 cm
BT
/F2 1 Tf
1 TL
-0.0035 Tc
0 0 Td
(Conclusions)Tj
ET
Q
q
1 j
1 J
0 w
9.5 0 0 9.5 200.0125 689.3858 cm
BT
/F0 1 Tf
1 TL
-0.0042 Tc
0 0 Td
(In)Tj
1.0443 0 Td
(our)Tj
1.6471 0 Td
(study,)Tj
2.8644 0 Td
(35%)Tj
2.2021 0 Td
(of)Tj
1.0443 0 Td
(RFT)Tj
2.1603 0 Td
(patients)Tj
3.6821 0 Td
(had)Tj
1.8619 0 Td
(ongoing)Tj
3.7298 0 Td
(NP.)Tj
1.8738 0 Td
(Risk)Tj
2.1484 0 Td
(factors)Tj
3.1927 0 Td
(include)Tj
3.3419 0 Td
(nerve)Tj
2.6914 0 Td
(tenderness)Tj
-33.4845 -1.474 Td
(and)Tj
1.8619 0 Td
(reaction.)Tj
4.0162 0 Td
(They)Tj
2.4229 0 Td
(suffer)Tj
2.6973 0 Td
(from)Tj
2.2081 0 Td
(more)Tj
2.4765 0 Td
(daily)Tj
2.2439 0 Td
(life)Tj
1.474 0 Td
(interference)Tj
5.4425 0 Td
(and)Tj
1.8619 0 Td
(psychological)Tj
6.1467 0 Td
(distress.)Tj
3.9028 0 Td
(Lep-)Tj
-36.7547 -1.468 Td
(rosy)Tj
2.0886 0 Td
(patient)Tj
3.1868 0 Td
(care)Tj
2.1423 0 Td
(should)Tj
3.1271 0 Td
(include)Tj
3.3419 0 Td
(recognition)Tj
5.0427 0 Td
(and)Tj
1.8678 0 Td
(management)Tj
5.9975 0 Td
(of)Tj
1.0503 0 Td
(NP.)Tj
ET
Q
q
1 j
1 J
0 w
11.9999 0 0 11.9999 209.9905 604.9133 cm
BT
/F0 1 Tf
1 TL
-0.0033 Tc
0 0 Td
(Author)Tj
3.137 0 Td
(summary)Tj
ET
Q
q
1 j
1 J
0 w
10 0 0 10 209.9905 586.885 cm
BT
/F6 1 Tf
1 TL
-0.004 Tc
0 0 Td
(Leprosy)Tj
3.3958 0 Td
(could)Tj
2.4492 0 Td
(present)Tj
3.1634 0 Td
(with)Tj
2.0012 0 Td
(chronic)Tj
3.2882 0 Td
(neuropathic)Tj
5.0627 0 Td
(pain,)Tj
2.211 0 Td
(which)Tj
2.6532 0 Td
(might)Tj
2.5965 0 Td
(severely)Tj
3.3789 0 Td
(disturb)Tj
3.0784 0 Td
(daily)Tj
-33.2785 -1.2982 Td
(life)Tj
1.4456 0 Td
(and)Tj
1.7291 0 Td
(mental)Tj
2.9934 0 Td
(health)Tj
2.6759 0 Td
(of)Tj
1.0148 0 Td
(leprosy-infected)Tj
6.65 0 Td
(patients.)Tj
3.5943 0 Td
(This)Tj
1.9899 0 Td
(complication)Tj
5.4765 0 Td
(could)Tj
2.4548 0 Td
(also)Tj
1.7632 0 Td
(occur)Tj
-31.7875 -1.2983 Td
(even)Tj
2.0692 0 Td
(years)Tj
2.2677 0 Td
(after)Tj
2.0353 0 Td
(antibiotics)Tj
4.3993 0 Td
(therapy)Tj
3.2428 0 Td
(completion,)Tj
5.006 0 Td
(and)Tj
1.7291 0 Td
(we)Tj
1.3266 0 Td
(noticed)Tj
3.2202 0 Td
(that)Tj
1.7744 0 Td
(it)Tj
0.7881 0 Td
(is)Tj
0.8447 0 Td
(associated)Tj
4.2576 0 Td
(with)Tj
-32.961 -1.2982 Td
(recent)Tj
2.7099 0 Td
(leprosy)Tj
3.101 0 Td
(reactions)Tj
3.8551 0 Td
(and)Tj
1.7292 0 Td
(nerve)Tj
2.4434 0 Td
(tenderness)Tj
4.5071 0 Td
(on)Tj
1.2755 0 Td
(physical)Tj
3.447 0 Td
(examination.)Tj
5.4594 0 Td
(This)Tj
1.99 0 Td
(is)Tj
0.8447 0 Td
(the)Tj
1.474 0 Td
(first)Tj
-32.8363 -1.304 Td
(study)Tj
2.3924 0 Td
(that)Tj
1.7745 0 Td
(describes)Tj
3.8891 0 Td
(the)Tj
1.4683 0 Td
(epidemiology)Tj
5.6466 0 Td
(of)Tj
1.0148 0 Td
(neuropathic)Tj
5.0626 0 Td
(pain)Tj
1.9899 0 Td
(in)Tj
1.0375 0 Td
(leprosy)Tj
3.1011 0 Td
(patients)Tj
3.3675 0 Td
(in)Tj
1.0318 0 Td
(Nepal.)Tj
-31.7761 -1.2982 Td
(More)Tj
2.4151 0 Td
(than)Tj
2.0295 0 Td
(one-third)Tj
4.0422 0 Td
(of)Tj
1.0148 0 Td
(leprosy)Tj
3.1011 0 Td
(patients)Tj
3.3675 0 Td
(who)Tj
1.9389 0 Td
(had)Tj
1.7065 0 Td
(completed)Tj
4.4107 0 Td
(multidrug)Tj
4.2689 0 Td
(therapy,)Tj
3.4753 0 Td
(are)Tj
1.4456 0 Td
(still)Tj
-33.2161 -1.2983 Td
(suffering)Tj
3.7587 0 Td
(from)Tj
2.211 0 Td
(neuropathic)Tj
5.0626 0 Td
(pain,)Tj
2.211 0 Td
(and)Tj
1.7348 0 Td
(this)Tj
1.6725 0 Td
(study)Tj
2.3867 0 Td
(demonstrated)Tj
5.76 0 Td
(that)Tj
1.7801 0 Td
(it)Tj
0.788 0 Td
(has)Tj
1.5421 0 Td
(caused)Tj
2.914 0 Td
(a)Tj
0.6576 0 Td
(great)Tj
-32.4791 -1.3039 Td
(impact)Tj
2.982 0 Td
(to)Tj
1.0261 0 Td
(their)Tj
2.1033 0 Td
(daily)Tj
2.1543 0 Td
(activities)Tj
3.7134 0 Td
(and)Tj
1.7291 0 Td
(psychological)Tj
5.6012 0 Td
(status.)Tj
2.7269 0 Td
(Therefore,)Tj
4.3881 0 Td
(prompt)Tj
3.2541 0 Td
(recognition)Tj
-29.6785 -1.2983 Td
(and)Tj
1.7291 0 Td
(management)Tj
5.4368 0 Td
(of)Tj
1.0148 0 Td
(neuropathic)Tj
5.0683 0 Td
(pain)Tj
1.9842 0 Td
(are)Tj
1.4514 0 Td
(mandatory)Tj
4.6147 0 Td
(while)Tj
2.3698 0 Td
(taking)Tj
2.7269 0 Td
(care)Tj
1.8709 0 Td
(of)Tj
1.0148 0 Td
(the)Tj
1.474 0 Td
(patients)Tj
-30.7557 -1.2982 Td
(with)Tj
1.9955 0 Td
(leprosy.)Tj
ET
Q
q
1 j
1 J
0 w
11.9999 0 0 11.9999 200.0125 425.0267 cm
BT
/F2 1 Tf
1 TL
-0.0033 Tc
0 0 Td
(Introduction)Tj
ET
Q
q
1 j
1 J
0 w
10 0 0 10 200.0125 408.0188 cm
BT
/F6 1 Tf
1 TL
-0.004 Tc
0 0 Td
(Leprosy,)Tj
3.6169 0 Td
(also)Tj
1.7688 0 Td
(known)Tj
3.0047 0 Td
(as)Tj
1.0148 0 Td
(Hansen's)Tj
3.8778 0 Td
(disease,)Tj
3.2428 0 Td
(is)Tj
0.8504 0 Td
(a)Tj
0.652 0 Td
(chronic)Tj
3.2882 0 Td
(infectious)Tj
4.1328 0 Td
(disease)Tj
3.0161 0 Td
(caused)Tj
2.9196 0 Td
(by)Tj
/F11 1 Tf
1.1793 0 Td
[()47()3()7()13()4()6()-4()11( )]TJ
-32.5642 -1.3039 Td
[(\n)-9()12()12(\r)]TJ
2.1543 0 Td
[()4()2()11(\n)20()6()]TJ
/F6 1 Tf
2.5625 0 Td
(\()Tj
/F11 1 Tf
[()]TJ
/F6 1 Tf
(.)Tj
/F11 1 Tf
1.6554 0 Td
[()4()2()11(\n)20()6()]TJ
/F6 1 Tf
(\).)Tj
3.1294 0 Td
(It)Tj
0.8561 0 Td
(is)Tj
0.8504 0 Td
(characterized)Tj
5.5558 0 Td
(by)Tj
1.1849 0 Td
(the)Tj
1.4684 0 Td
(inflammation)Tj
5.6976 0 Td
(of)Tj
1.0147 0 Td
(skin)Tj
1.8936 0 Td
(and)Tj
1.7291 0 Td
(nerve,)Tj
2.6702 0 Td
(which)Tj
2.6476 0 Td
(could)Tj
-35.07 -1.2982 Td
(lead)Tj
1.8481 0 Td
(to)Tj
1.0262 0 Td
(disabling)Tj
3.8437 0 Td
(peripheral)Tj
4.32 0 Td
(neuropathy.)Tj
5.057 0 Td
(Since)Tj
2.3584 0 Td
(the)Tj
1.4683 0 Td
(introduction)Tj
5.3121 0 Td
(of)Tj
1.0148 0 Td
(multidrug)Tj
4.269 0 Td
(therapy)Tj
3.2484 0 Td
(\(MDT\),)Tj
-33.766 -1.2983 Td
(leprosy)Tj
3.101 0 Td
(became)Tj
3.2485 0 Td
(a)Tj
0.6576 0 Td
(treatable)Tj
3.6511 0 Td
(disease;)Tj
3.2428 0 Td
(and)Tj
1.7348 0 Td
(its)Tj
1.1451 0 Td
(prevalence)Tj
4.4844 0 Td
(decreased)Tj
4.1386 0 Td
(globally)Tj
3.3222 0 Td
(over)Tj
1.9785 0 Td
(the)Tj
1.4684 0 Td
(past)Tj
1.8311 0 Td
(two)Tj
-34.0041 -1.3039 Td
(decades.)Tj
3.5659 0 Td
(However,)Tj
4.0762 0 Td
(it)Tj
0.788 0 Td
(continues)Tj
4.1216 0 Td
(to)Tj
1.0261 0 Td
(persist)Tj
2.8176 0 Td
(as)Tj
1.0148 0 Td
(an)Tj
1.2019 0 Td
(important)Tj
4.286 0 Td
(public)Tj
2.7099 0 Td
(health)Tj
2.6759 0 Td
(issue)Tj
2.16 0 Td
(in)Tj
1.0374 0 Td
(endemic)Tj
3.651 0 Td
(areas)Tj
-35.1323 -1.2983 Td
([)Tj
0.83 0.64 0.02 0 k
(1)Tj
0 g
(].)Tj
1.5987 0 Td
(As)Tj
1.2642 0 Td
(one)Tj
1.7008 0 Td
(of)Tj
1.0148 0 Td
(the)Tj
1.4683 0 Td
(13)Tj
1.1736 0 Td
(most)Tj
2.2053 0 Td
(highly)Tj
2.7099 0 Td
(endemic)Tj
3.651 0 Td
(countries,)Tj
4.1726 0 Td
(more)Tj
2.3414 0 Td
(than)Tj
2.0296 0 Td
(3000)Tj
2.126 0 Td
(new)Tj
1.8765 0 Td
(cases)Tj
2.2223 0 Td
(are)Tj
1.4457 0 Td
(diagnosed)Tj
-33.0007 -1.2982 Td
(annually)Tj
3.6566 0 Td
(in)Tj
1.0375 0 Td
(Nepal;)Tj
2.8006 0 Td
(and)Tj
1.7348 0 Td
(18)Tj
1.1679 0 Td
(districts)Tj
3.3958 0 Td
(still)Tj
1.6385 0 Td
(report)Tj
2.7099 0 Td
(prevalence)Tj
4.4843 0 Td
(rates)Tj
2.109 0 Td
(higher)Tj
2.8063 0 Td
(than)Tj
2.0239 0 Td
(1/10,000)Tj
3.6283 0 Td
(population)Tj
-33.1934 -1.2983 Td
(in)Tj
1.0318 0 Td
(2016)Tj
2.1259 0 Td
([)Tj
0.83 0.64 0.02 0 k
(2)Tj
0 g
(].)Tj
-1.9615 -1.3039 Td
(Nerve)Tj
2.6305 0 Td
(involvement)Tj
5.2157 0 Td
(in)Tj
1.0318 0 Td
(leprosy,)Tj
3.3279 0 Td
(or)Tj
1.0998 0 Td
(leprosy)Tj
3.1011 0 Td
(neuropathy,)Tj
5.0513 0 Td
(is)Tj
0.8504 0 Td
(primarily)Tj
3.9685 0 Td
(caused)Tj
2.9196 0 Td
(by)Tj
1.1792 0 Td
(the)Tj
1.4684 0 Td
(infection)Tj
-33.0404 -1.2983 Td
(of)Tj
1.0147 0 Td
(Schwann)Tj
3.8608 0 Td
(cells)Tj
1.9219 0 Td
(by)Tj
/F11 1 Tf
1.1792 0 Td
[()]TJ
/F6 1 Tf
(.)Tj
/F11 1 Tf
1.3209 0 Td
[()4()2()11(\n)20()6()]TJ
/F6 1 Tf
2.5625 0 Td
(which)Tj
2.6476 0 Td
(can)Tj
1.6271 0 Td
(leave)Tj
2.1996 0 Td
(persistent)Tj
4.0932 0 Td
(antigen)Tj
3.2032 0 Td
(capable)Tj
3.2031 0 Td
(of)Tj
1.0148 0 Td
(stimulating)Tj
4.7565 0 Td
(inflam-)Tj
-34.6051 -1.2983 Td
(matory)Tj
3.101 0 Td
(episodes)Tj
3.6113 0 Td
(years)Tj
2.2621 0 Td
(after)Tj
2.0352 0 Td
(cure.)Tj
2.194 0 Td
(Inflammatory)Tj
5.7827 0 Td
(or)Tj
1.0942 0 Td
(immune)Tj
3.6283 0 Td
(complication)Tj
5.4765 0 Td
(episodes)Tj
3.6113 0 Td
(are)Tj
1.4457 0 Td
(called)Tj
-34.2423 -1.3039 Td
(leprosy)Tj
3.101 0 Td
(reactions)Tj
3.8551 0 Td
(and)Tj
1.7291 0 Td
(are)Tj
1.4457 0 Td
(classified)Tj
3.8211 0 Td
(into)Tj
1.8425 0 Td
(three)Tj
2.262 0 Td
(types:)Tj
2.5002 0 Td
(neuritis)Tj
3.2881 0 Td
(\(nerve)Tj
2.778 0 Td
(involvement)Tj
5.2157 0 Td
(only\),)Tj
2.5398 0 Td
(Type)Tj
2.228 0 Td
(1)Tj
-36.6063 -1.2982 Td
(reactions)Tj
3.855 0 Td
(\(T1R,)Tj
2.4888 0 Td
(Th1-mediated)Tj
5.9074 0 Td
(inflammation)Tj
5.6976 0 Td
(of)Tj
1.0148 0 Td
(skin)Tj
1.8935 0 Td
(with)Tj
2.0013 0 Td
(possible)Tj
3.4072 0 Td
(nerve)Tj
2.4435 0 Td
(involvement\))Tj
5.5502 0 Td
(and)Tj
-34.2593 -1.2983 Td
(Erythema)Tj
4.1158 0 Td
(Nodosum)Tj
4.2066 0 Td
(Leprosum)Tj
4.286 0 Td
(\(ENL,)Tj
2.6305 0 Td
(occurs)Tj
2.8346 0 Td
(in)Tj
1.0375 0 Td
(high)Tj
/F11 1 Tf
2.0069 0 Td
[()]TJ
/F6 1 Tf
(.)Tj
/F11 1 Tf
1.3153 0 Td
[()4()2()11(\n)20()6()]TJ
/F6 1 Tf
2.5625 0 Td
(burden)Tj
3.1238 0 Td
(patients,)Tj
3.5943 0 Td
(involving)Tj
3.9798 0 Td
(skin)Tj
-35.6936 -1.3039 Td
(with)Tj
1.9955 0 Td
(possible)Tj
3.4129 0 Td
(nerve)Tj
2.4378 0 Td
(involvement\).)Tj
5.777 0 Td
(Leprosy)Tj
3.3959 0 Td
(reactions)Tj
3.855 0 Td
(can)Tj
1.6215 0 Td
(affect)Tj
2.3754 0 Td
(up)Tj
1.2699 0 Td
(to)Tj
1.0205 0 Td
(3050%)Tj
3.4015 0 Td
(of)Tj
1.0148 0 Td
(leprosy)Tj
-31.5777 -1.2983 Td
(patients)Tj
3.3675 0 Td
(and)Tj
1.7291 0 Td
(can,)Tj
1.8539 0 Td
(therefore,)Tj
4.0762 0 Td
(initiate)Tj
3.0273 0 Td
(or)Tj
1.0942 0 Td
(progress)Tj
3.6 0 Td
(leprosy)Tj
3.1011 0 Td
(neuropathy)Tj
4.8302 0 Td
(at)Tj
0.9524 0 Td
(any)Tj
1.6554 0 Td
(time)Tj
2.0296 0 Td
(before)Tj
2.7383 0 Td
(diagno-)Tj
-34.0552 -1.2982 Td
(sis,)Tj
1.4343 0 Td
(during)Tj
2.9253 0 Td
(treatment,)Tj
4.3597 0 Td
(and)Tj
1.7348 0 Td
(even)Tj
2.0692 0 Td
(years)Tj
2.2621 0 Td
(after)Tj
2.0352 0 Td
(MDT)Tj
2.4605 0 Td
([)Tj
0.83 0.64 0.02 0 k
(3)Tj
0 g
(,)Tj
0.83 0.64 0.02 0 k
1.2642 0 Td
(4)Tj
0 g
(].)Tj
-19.3491 -1.304 Td
(Clinically,)Tj
4.2462 0 Td
(leprosy)Tj
3.1011 0 Td
(neuropathy)Tj
4.8302 0 Td
(can)Tj
1.6271 0 Td
(present)Tj
3.1634 0 Td
(with)Tj
1.9956 0 Td
(nerve)Tj
2.4435 0 Td
(thickening,)Tj
4.7111 0 Td
(sensory,)Tj
3.4696 0 Td
(autonomic)Tj
4.5524 0 Td
(or)Tj
-35.3364 -1.2982 Td
(motor)Tj
2.7212 0 Td
(impairment)Tj
4.9889 0 Td
(and)Tj
1.7292 0 Td
(pain.)Tj
2.211 0 Td
(The)Tj
1.7858 0 Td
(most)Tj
2.2053 0 Td
(frequently)Tj
4.3087 0 Td
(affected)Tj
3.3221 0 Td
(peripheral)Tj
4.32 0 Td
(nerve)Tj
2.4435 0 Td
(is)Tj
0.8504 0 Td
(the)Tj
1.4683 0 Td
(ulnar)Tj
2.3471 0 Td
(nerve,)Tj
-34.7015 -1.2983 Td
(and)Tj
1.7291 0 Td
(multiple)Tj
3.5659 0 Td
(nerve)Tj
2.4435 0 Td
(involvement)Tj
5.21 0 Td
(is)Tj
0.8504 0 Td
(common)Tj
3.8438 0 Td
(especially)Tj
4.0138 0 Td
(in)Tj
1.0375 0 Td
(patients)Tj
3.3675 0 Td
(with)Tj
2.0013 0 Td
(high)Tj
/F11 1 Tf
2.0069 0 Td
[()]TJ
/F6 1 Tf
(.)Tj
/F11 1 Tf
1.3152 0 Td
[()4()2()11(\n)20()6()]TJ
/F6 1 Tf
2.5626 0 Td
(burden)Tj
-33.9475 -1.2983 Td
([)Tj
0.83 0.64 0.02 0 k
(5)Tj
0 g
(].)Tj
1.5987 0 Td
(Neuropathic)Tj
5.2554 0 Td
(pain)Tj
1.9842 0 Td
(\(NP\),)Tj
2.4208 0 Td
(which)Tj
2.6532 0 Td
(is)Tj
0.8447 0 Td
(defined)Tj
3.2258 0 Td
(as)Tj
1.0148 0 Td
(pain)Tj
2.3811 0 Td
(caused)Tj
2.9197 0 Td
(by)Tj
1.1792 0 Td
(disease)Tj
3.016 0 Td
(or)Tj
1.0999 0 Td
(disorders)Tj
3.9401 0 Td
(of)Tj
1.0148 0 Td
(the)Tj
-34.5484 -1.3039 Td
(somatosensory)Tj
6.1681 0 Td
(nervous)Tj
3.4072 0 Td
(system,)Tj
3.549 0 Td
(can)Tj
1.6214 0 Td
(present)Tj
3.1634 0 Td
(concomitant)Tj
5.2894 0 Td
(with)Tj
1.99 0 Td
(leprosy)Tj
3.0954 0 Td
(reaction)Tj
3.4922 0 Td
(or)Tj
1.0885 0 Td
(as)Tj
1.0148 0 Td
(a)Tj
0.6463 0 Td
(chronic)Tj
-34.5257 -1.2982 Td
(and)Tj
1.7291 0 Td
(late-onset)Tj
4.1102 0 Td
(pain)Tj
1.9899 0 Td
(in)Tj
1.0318 0 Td
(leprosy)Tj
3.1011 0 Td
(patients)Tj
3.3675 0 Td
([)Tj
0.83 0.64 0.02 0 k
(6)Tj
0 g
(].)Tj
-14.1334 -1.2983 Td
(As)Tj
1.2699 0 Td
(a)Tj
0.6519 0 Td
(non-visible)Tj
4.6999 0 Td
(and)Tj
1.7291 0 Td
(possibly)Tj
3.4412 0 Td
(late)Tj
1.6214 0 Td
(complication,)Tj
5.709 0 Td
(NP)Tj
1.5137 0 Td
(can)Tj
1.627 0 Td
(be)Tj
1.1509 0 Td
(difficult)Tj
3.3505 0 Td
(to)Tj
1.0262 0 Td
(diagnose;)Tj
3.9798 0 Td
(and)Tj
1.7291 0 Td
(its)Tj
-34.6958 -1.3039 Td
(mechanisms)Tj
5.2043 0 Td
(are)Tj
1.4514 0 Td
(different)Tj
3.651 0 Td
(from)Tj
2.211 0 Td
(nociceptive)Tj
4.7735 0 Td
(pain.)Tj
2.211 0 Td
(Continuous)Tj
4.9776 0 Td
(intraneural)Tj
4.6885 0 Td
(inflammation)Tj
5.6976 0 Td
(is)Tj
-34.8659 -1.2983 Td
(believed)Tj
3.4922 0 Td
(to)Tj
1.0261 0 Td
(be)Tj
1.1509 0 Td
(the)Tj
1.4683 0 Td
(cause)Tj
2.3868 0 Td
(of)Tj
1.0148 0 Td
(small-fiber)Tj
4.5354 0 Td
(nerve)Tj
2.4434 0 Td
(damage,)Tj
3.549 0 Td
(which)Tj
2.6475 0 Td
(could)Tj
2.4548 0 Td
(result)Tj
2.4492 0 Td
(in)Tj
1.0374 0 Td
(central)Tj
2.965 0 Td
(and)Tj
ET
Q
q
1 j
1 J
0 w
576 737.1 m
36 737.1 l
36 737.6 l
576 737.6 l
f*
36 741.2598 183.2882 23.6976 re
W* n
q
183.2315 0 0 23.6409 36 741.3165 cm
q
/I0 Do
Q
Q
Q
q
0 0 612 792 re
W* n
1 j
1 J
0 w
7.9999 0 0 7.9999 482.1732 745.7952 cm
BT
/F0 1 Tf
1 TL
-0.005 Tc
0 0 Td
(Neuropa)Tj
3.763 0 Td
(thic)Tj
1.7504 0 Td
(pain)Tj
2.0693 0 Td
(in)Tj
0.9779 0 Td
(leprosy)Tj
ET
Q
q
1 j
1 J
0 w
36 48.0002 m
576 48.0002 l
576 47.5002 l
36 47.5002 l
f*
0.83 0.64 0.02 0 k
163.5591 34.9228 m
317.7071 34.9228 l
h
f*
0 g
7.9999 0 0 7.9999 36 36 cm
BT
/F0 1 Tf
1 TL
-0.005 Tc
0 0 Td
(PLOS)Tj
2.8559 0 Td
(Neglected)Tj
4.6417 0 Td
(Tropical)Tj
3.7135 0 Td
(Disease)Tj
3.5433 0 Td
(s)Tj
0.7158 0 Td
(|)Tj
0.83 0.64 0.02 0 k
0.4748 0 Td
(https://doi.or)Tj
5.4142 0 Td
(g/10.137)Tj
3.8197 0 Td
(1/journal.pn)Tj
5.1237 0 Td
(td.00066)Tj
3.8197 0 Td
(10)Tj
0 g
2.0905 0 Td
(July)Tj
1.9701 0 Td
(2,)Tj
1.0347 0 Td
(2018)Tj
25.923 0 Td
(2)Tj
0.7654 0 Td
(/)Tj
ET
endstream
endobj
22 0 obj
<>stream
endstream
endobj
23 0 obj
<>stream
endstream
endobj
24 0 obj
<>stream
endstream
endobj
25 0 obj
<>stream
endstream
endobj
26 0 obj
<>stream
endstream
endobj
27 0 obj
<>stream
endstream
endobj
28 0 obj
<>stream
BT
66.402 0 Td
(15)Tj
ET
Q
endstream
endobj
29 0 obj
<>/XObject<>>>/CropBox[0 0 612 792]/MediaBox[0 0 612 792]/Parent 10 0 R/Annots 32 0 R/Contents 33 0 R/TrimBox[0 0 612 792]>>
endobj
32 0 obj
[34 0 R 35 0 R 36 0 R 37 0 R 38 0 R 39 0 R 40 0 R 41 0 R 42 0 R 43 0 R 44 0 R 45 0 R 46 0 R 47 0 R 48 0 R 49 0 R 50 0 R 51 0 R 52 0 R 53 0 R 54 0 R 55 0 R 56 0 R 57 0 R 58 0 R 59 0 R 60 0 R]
endobj
34 0 obj
<>/Border[0 0 0]/Dest(Rpntd.0006610.ref007)>>
endobj
35 0 obj
<>/Border[0 0 0]/Dest(Rpntd.0006610.ref008)>>
endobj
36 0 obj
<>/Border[0 0 0]/Dest(Rpntd.0006610.ref009)>>
endobj
37 0 obj
<>/Border[0 0 0]/Dest(Rpntd.0006610.ref010)>>
endobj
38 0 obj
<>/Border[0 0 0]/Dest(Rpntd.0006610.ref011)>>
endobj
39 0 obj
<>/Border[0 0 0]/Dest(Rpntd.0006610.ref012)>>
endobj
40 0 obj
<>/Border[0 0 0]/Dest(Rpntd.0006610.ref014)>>
endobj
41 0 obj
<>/Border[0 0 0]/Dest(Rpntd.0006610.ref015)>>
endobj
42 0 obj
<>/Border[0 0 0]/Dest(Rpntd.0006610.ref007)>>
endobj
43 0 obj
<>/Border[0 0 0]/Dest(Rpntd.0006610.ref013)>>
endobj
44 0 obj
<>/Border[0 0 0]/Dest(Rpntd.0006610.ref015)>>
endobj
45 0 obj
<>/Border[0 0 0]/Dest(Rpntd.0006610.ref009)>>
endobj
46 0 obj
<>/Border[0 0 0]/Dest(Rpntd.0006610.ref009)>>
endobj
47 0 obj
<>/Border[0 0 0]/Dest(Rpntd.0006610.ref014)>>
endobj
48 0 obj
<>/Border[0 0 0]/Dest(Rpntd.0006610.ref016)>>
endobj
49 0 obj
<>/Border[0 0 0]/Dest(Rpntd.0006610.ref023)>>
endobj
50 0 obj
<>/Border[0 0 0]/Dest(Rpntd.0006610.ref019)>>
endobj
51 0 obj
<>/Border[0 0 0]/Dest(Rpntd.0006610.ref021)>>
endobj
52 0 obj
<>/Border[0 0 0]/Dest(Rpntd.0006610.ref012)>>
endobj
53 0 obj
<>/Border[0 0 0]/Dest(Rpntd.0006610.ref018)>>
endobj
54 0 obj
<>/Border[0 0 0]/Dest(Rpntd.0006610.ref009)>>
endobj
55 0 obj
<>/Border[0 0 0]/Dest(Rpntd.0006610.ref018)>>
endobj
56 0 obj
<>/Border[0 0 0]/Dest(Rpntd.0006610.ref012)>>
endobj
57 0 obj
<>/Border[0 0 0]/Dest(Rpntd.0006610.ref023)>>
endobj
58 0 obj
<>/Border[0 0 0]/Dest(Rpntd.0006610.ref024)>>
endobj
59 0 obj
<>/Border[0 0 0]/Dest(Rpntd.0006610.ref020)>>
endobj
60 0 obj
<>/Border[0 0 0]/A 61 0 R>>
endobj
61 0 obj
<>
endobj
33 0 obj
[62 0 R 63 0 R 64 0 R 65 0 R 66 0 R 67 0 R 68 0 R 69 0 R 70 0 R 71 0 R 72 0 R 73 0 R 74 0 R 75 0 R 76 0 R 77 0 R 78 0 R 79 0 R 80 0 R]
endobj
62 0 obj
<>stream
q
0.83 0.64 0.02 0 k
393.052 706.337 m
397.8142 706.337 l
h
f*
402.2929 706.337 m
407.0551 706.337 l
h
f*
408.0756 680.315 m
412.8378 680.315 l
h
f*
440.5606 667.3323 m
450.085 667.3323 l
h
f*
454.5638 667.3323 m
464.0315 667.3323 l
h
f*
310.5638 628.3276 m
320.0882 628.3276 l
h
f*
325.2472 628.3276 m
334.7717 628.3276 l
h
f*
290.5512 615.3449 m
300.0756 615.3449 l
h
f*
251.7165 576.3402 m
256.422 576.3402 l
h
f*
260.9008 576.3402 m
270.4252 576.3402 l
h
f*
274.8472 576.3402 m
284.3717 576.3402 l
h
f*
296.8441 563.3008 m
301.5496 563.3008 l
h
f*
528.4913 550.3181 m
533.2535 550.3181 l
h
f*
538.4126 550.3181 m
547.937 550.3181 l
h
f*
552.4157 550.3181 m
561.9402 550.3181 l
h
f*
200.0126 537.3354 m
209.537 537.3354 l
h
f*
449.2913 524.2961 m
458.8157 524.2961 l
h
f*
463.2378 524.2961 m
472.7622 524.2961 l
h
f*
235.3323 498.3307 m
244.8 498.3307 l
h
f*
249.2787 498.3307 m
258.8031 498.3307 l
h
f*
561.7134 485.348 m
566.4756 485.348 l
h
f*
200.0126 472.3087 m
209.537 472.3087 l
h
f*
359.8299 433.3039 m
369.3543 433.3039 l
h
f*
245.8205 394.2992 m
255.2882 394.2992 l
h
f*
255.0047 368.3339 m
264.5291 368.3339 l
h
f*
542.4945 368.3339 m
552.0189 368.3339 l
h
f*
0 g
1 j
1 J
0 w
10 0 0 10 200.0125 707.4141 cm
BT
/F6 1 Tf
1 TL
-0.004 Tc
0 0 Td
(peripheral)Tj
4.3199 0 Td
(sensitization)Tj
5.2101 0 Td
(leading)Tj
3.1351 0 Td
(to)Tj
1.0261 0 Td
(chronic)Tj
3.2882 0 Td
(pain)Tj
1.9842 0 Td
([)Tj
0.83 0.64 0.02 0 k
(7)Tj
0 g
(,)Tj
0.83 0.64 0.02 0 k
1.2643 0 Td
(8)Tj
0 g
(].)Tj
1.2585 0 Td
(Meanwhile,)Tj
4.8926 0 Td
(nerve)Tj
2.4434 0 Td
(thickening)Tj
4.4844 0 Td
(and)Tj
1.7291 0 Td
(ten-)Tj
-35.0359 -1.3039 Td
(derness)Tj
3.2371 0 Td
(have)Tj
2.0579 0 Td
(been)Tj
2.1203 0 Td
(documented)Tj
5.2498 0 Td
(to)Tj
1.0261 0 Td
(be)Tj
1.1509 0 Td
(related)Tj
2.9423 0 Td
(to)Tj
1.0261 0 Td
(NP,)Tj
1.7405 0 Td
(suggesting)Tj
4.405 0 Td
(that)Tj
1.7745 0 Td
(ongoing)Tj
3.5319 0 Td
(inflammation)Tj
5.6976 0 Td
(in)Tj
-35.96 -1.2982 Td
(peripheral)Tj
4.3199 0 Td
(nerves)Tj
2.8006 0 Td
(might)Tj
2.5966 0 Td
(be)Tj
1.1508 0 Td
(responsible)Tj
4.7565 0 Td
(for)Tj
1.3833 0 Td
(the)Tj
1.4684 0 Td
(pain)Tj
1.9899 0 Td
([)Tj
0.83 0.64 0.02 0 k
(9)Tj
0 g
(].)Tj
1.5987 0 Td
(NP)Tj
1.5194 0 Td
(is)Tj
0.8447 0 Td
(usually)Tj
3.016 0 Td
(moderate)Tj
4.0252 0 Td
(to)Tj
1.0261 0 Td
(severe,)Tj
2.9027 0 Td
(and)Tj
-35.3988 -1.2983 Td
(it)Tj
0.7823 0 Td
(is)Tj
0.8504 0 Td
(commonly)Tj
4.5467 0 Td
(found)Tj
2.6192 0 Td
(in)Tj
1.0318 0 Td
(patients)Tj
3.3732 0 Td
(who)Tj
1.9389 0 Td
(had)Tj
1.7065 0 Td
(completed)Tj
4.405 0 Td
(MDT)Tj
2.4604 0 Td
([)Tj
0.83 0.64 0.02 0 k
(10)Tj
0 g
(,)Tj
0.83 0.64 0.02 0 k
1.7405 0 Td
(11)Tj
0 g
(].)Tj
-24.2587 -1.2983 Td
(Studies)Tj
3.101 0 Td
(in)Tj
1.0375 0 Td
(Brazil)Tj
2.5342 0 Td
(have)Tj
2.0579 0 Td
(demonstrated)Tj
5.76 0 Td
(a)Tj
0.6519 0 Td
(prevalence)Tj
4.4901 0 Td
(of)Tj
1.0148 0 Td
(about)Tj
2.4945 0 Td
(56%)Tj
1.9275 0 Td
(to)Tj
1.0261 0 Td
(64%)Tj
1.9276 0 Td
(for)Tj
1.3833 0 Td
(NP)Tj
1.5194 0 Td
(in)Tj
1.0318 0 Td
(all)Tj
1.1508 0 Td
(leprosy)Tj
-34.3046 -1.3039 Td
(patients,)Tj
3.5943 0 Td
(clinically)Tj
3.7757 0 Td
(defined)Tj
3.2258 0 Td
(as)Tj
1.0148 0 Td
(characteristic)Tj
5.5445 0 Td
(pain)Tj
1.9843 0 Td
(with)Tj
2.0012 0 Td
(associated)Tj
4.2576 0 Td
(symptoms)Tj
4.354 0 Td
(along)Tj
2.4208 0 Td
(a)Tj
0.6576 0 Td
(leprosy-)Tj
-32.8306 -1.2982 Td
(affected)Tj
3.3165 0 Td
(nerve)Tj
2.4377 0 Td
(distribution)Tj
4.9606 0 Td
([)Tj
0.83 0.64 0.02 0 k
(12)Tj
0 g
()Tj
0.83 0.64 0.02 0 k
(14)Tj
0 g
(].)Tj
3.5377 0 Td
(However,)Tj
4.0762 0 Td
(there)Tj
2.2563 0 Td
(is)Tj
0.8391 0 Td
(no)Tj
1.2699 0 Td
(consensus)Tj
4.2746 0 Td
(yet)Tj
1.3946 0 Td
(for)Tj
1.3777 0 Td
(making)Tj
3.2428 0 Td
(NP)Tj
1.5137 0 Td
(diagno-)Tj
-34.4974 -1.2983 Td
(sis)Tj
1.2075 0 Td
(in)Tj
1.0375 0 Td
(leprosy)Tj
3.1011 0 Td
(patients)Tj
3.3675 0 Td
([)Tj
0.83 0.64 0.02 0 k
(15)Tj
0 g
(].)Tj
2.0749 0 Td
(The)Tj
1.7859 0 Td
(guidelines)Tj
4.2746 0 Td
(of)Tj
1.0148 0 Td
(the)Tj
1.4683 0 Td
(International)Tj
5.4879 0 Td
(Association)Tj
4.8755 0 Td
(for)Tj
1.389 0 Td
(the)Tj
1.4683 0 Td
(Study)Tj
2.5058 0 Td
(of)Tj
-35.0586 -1.3039 Td
(Pain)Tj
2.0295 0 Td
(\(IASP\))Tj
2.9594 0 Td
(recommend)Tj
5.0796 0 Td
(NP)Tj
1.5194 0 Td
(screening)Tj
4.0479 0 Td
(by)Tj
1.1848 0 Td
(Douleur)Tj
3.5603 0 Td
(Neuropathique)Tj
6.2872 0 Td
(4)Tj
0.6973 0 Td
(Questionnaire)Tj
5.9414 0 Td
(\(DN4\),)Tj
-33.3068 -1.2983 Td
(which)Tj
2.6475 0 Td
(is)Tj
0.8504 0 Td
(one)Tj
1.7008 0 Td
(of)Tj
1.0148 0 Td
(the)Tj
1.4683 0 Td
(most)Tj
2.2053 0 Td
(commonly)Tj
4.5468 0 Td
(used)Tj
2.0579 0 Td
(screening)Tj
4.0535 0 Td
(tools)Tj
2.1373 0 Td
(in)Tj
1.0375 0 Td
(epidemiological)Tj
6.5593 0 Td
(studies)Tj
2.9877 0 Td
(of)Tj
1.0148 0 Td
(leprosy)Tj
-34.2819 -1.2983 Td
(neuropathy)Tj
4.8302 0 Td
([)Tj
0.83 0.64 0.02 0 k
(7)Tj
0 g
(,)Tj
0.83 0.64 0.02 0 k
1.2585 0 Td
(13)Tj
0 g
(,)Tj
0.83 0.64 0.02 0 k
1.3947 0 Td
(15)Tj
0 g
(].)Tj
1.7348 0 Td
(In)Tj
1.1055 0 Td
(a)Tj
0.6519 0 Td
(study)Tj
2.3925 0 Td
(in)Tj
1.0318 0 Td
(Mumbai,)Tj
3.8947 0 Td
(21%)Tj
1.9276 0 Td
(of)Tj
1.0091 0 Td
(released)Tj
3.8268 0 Td
(from)Tj
2.1996 0 Td
(treatment)Tj
4.5298 0 Td
(\(RFT\))Tj
2.6588 0 Td
(patients)Tj
-34.4463 -1.3039 Td
(were)Tj
2.1203 0 Td
(found)Tj
2.6191 0 Td
(to)Tj
1.0262 0 Td
(have)Tj
2.0579 0 Td
(NP)Tj
1.5194 0 Td
([)Tj
0.83 0.64 0.02 0 k
(9)Tj
0 g
(].)Tj
1.5987 0 Td
(Similar)Tj
3.1011 0 Td
(studies)Tj
2.9877 0 Td
(had)Tj
1.7064 0 Td
(been)Tj
2.126 0 Td
(performed)Tj
4.4674 0 Td
(in)Tj
1.0375 0 Td
(Brazil,)Tj
2.7552 0 Td
(Ethiopia,)Tj
3.8324 0 Td
(China)Tj
2.6589 0 Td
(and)Tj
-35.6142 -1.2982 Td
(Indonesia)Tj
4.1782 0 Td
(with)Tj
1.9956 0 Td
(findings)Tj
3.4922 0 Td
(that)Tj
1.7802 0 Td
(more)Tj
2.3414 0 Td
(than)Tj
2.0296 0 Td
(20%)Tj
1.9275 0 Td
(of)Tj
1.0148 0 Td
(patients)Tj
3.3676 0 Td
(were)Tj
2.1203 0 Td
(reported)Tj
3.6623 0 Td
(to)Tj
1.0261 0 Td
(have)Tj
2.058 0 Td
(NP)Tj
1.5137 0 Td
([)Tj
0.83 0.64 0.02 0 k
(9)Tj
0 g
()Tj
0.83 0.64 0.02 0 k
(14)Tj
0 g
(,)Tj
0.83 0.64 0.02 0 k
2.7325 0 Td
(16)Tj
0 g
()Tj
0.83 0.64 0.02 0 k
-35.24 -1.2983 Td
(23)Tj
0 g
(].)Tj
1.7347 0 Td
(Due)Tj
1.9106 0 Td
(to)Tj
1.0204 0 Td
(the)Tj
1.4741 0 Td
(differences)Tj
4.5637 0 Td
(in)Tj
1.0375 0 Td
(screening)Tj
4.0478 0 Td
(tools,)Tj
2.3698 0 Td
(types)Tj
2.2733 0 Td
(of)Tj
1.0148 0 Td
(patients)Tj
3.3676 0 Td
(studied)Tj
3.1521 0 Td
(and)Tj
1.7291 0 Td
(study)Tj
2.3924 0 Td
(setting,)Tj
3.1068 0 Td
(the)Tj
-35.1947 -1.3039 Td
(prevalence)Tj
4.4843 0 Td
(of)Tj
1.0148 0 Td
(NP)Tj
1.5137 0 Td
(in)Tj
1.0375 0 Td
(RFT)Tj
1.9786 0 Td
(patients)Tj
3.3732 0 Td
(varied)Tj
2.6929 0 Td
(from)Tj
2.211 0 Td
(11.3%)Tj
2.6248 0 Td
(to)Tj
1.0262 0 Td
(70.3%)Tj
2.6305 0 Td
([)Tj
0.83 0.64 0.02 0 k
(19)Tj
0 g
(,)Tj
0.83 0.64 0.02 0 k
1.7348 0 Td
(21)Tj
0 g
(].)Tj
-25.1261 -1.2983 Td
(The)Tj
1.7858 0 Td
(presence)Tj
3.7133 0 Td
(of)Tj
1.0148 0 Td
(NP)Tj
1.5137 0 Td
(can)Tj
1.6271 0 Td
(severely)Tj
3.3789 0 Td
(affect)Tj
2.3754 0 Td
(a)Tj
0.652 0 Td
(patient's)Tj
3.5829 0 Td
(quality)Tj
2.9537 0 Td
(of)Tj
1.0148 0 Td
(life)Tj
1.4457 0 Td
(and)Tj
1.7291 0 Td
(generate)Tj
3.6113 0 Td
(psychological)Tj
-31.5947 -1.2982 Td
(distress)Tj
3.1917 0 Td
([)Tj
0.83 0.64 0.02 0 k
(12)Tj
0 g
(,)Tj
0.83 0.64 0.02 0 k
1.7348 0 Td
(18)Tj
0 g
(].)Tj
1.7348 0 Td
(Approximately)Tj
6.2249 0 Td
(41%)Tj
1.9332 0 Td
(of)Tj
1.0148 0 Td
(leprosy)Tj
3.1011 0 Td
(patients)Tj
3.3675 0 Td
(with)Tj
1.9956 0 Td
(NP)Tj
1.5137 0 Td
(in)Tj
1.0374 0 Td
(the)Tj
1.4684 0 Td
(Mumbai)Tj
3.668 0 Td
(study)Tj
2.3924 0 Td
(were)Tj
-34.3783 -1.2983 Td
(found)Tj
2.6191 0 Td
(to)Tj
1.0262 0 Td
(have)Tj
2.0579 0 Td
(psychological)Tj
5.6012 0 Td
(distress,)Tj
3.4129 0 Td
(while)Tj
2.3698 0 Td
(a)Tj
0.652 0 Td
(higher)Tj
2.8062 0 Td
(percentage)Tj
4.5468 0 Td
(of)Tj
1.0148 0 Td
(76%)Tj
1.9275 0 Td
(was)Tj
1.7008 0 Td
(noted)Tj
2.5228 0 Td
(in)Tj
1.0375 0 Td
(Brazil)Tj
2.5341 0 Td
([)Tj
0.83 0.64 0.02 0 k
(9)Tj
0 g
(,)Tj
0.83 0.64 0.02 0 k
-35.8296 -1.3039 Td
(18)Tj
0 g
(].)Tj
1.7347 0 Td
(Another)Tj
3.583 0 Td
(Brazilian)Tj
3.7814 0 Td
(study)Tj
2.3868 0 Td
(using)Tj
2.3924 0 Td
(the)Tj
1.4683 0 Td
(World)Tj
2.8347 0 Td
(Health)Tj
2.9196 0 Td
(Organization)Tj
5.5219 0 Td
(\(WHO\))Tj
3.3789 0 Td
(Quality)Tj
3.1974 0 Td
(of)Tj
1.0148 0 Td
(Life)Tj
-34.2139 -1.2983 Td
(Assessment)Tj
4.8585 0 Td
(BREF)Tj
2.5228 0 Td
(\(WHOQoL-BREF\))Tj
7.8179 0 Td
(revealed)Tj
3.5263 0 Td
(that)Tj
1.7745 0 Td
(leprosy)Tj
3.1011 0 Td
(patients)Tj
3.3732 0 Td
(with)Tj
1.9955 0 Td
(NP)Tj
1.5137 0 Td
(also)Tj
1.7688 0 Td
(had)Tj
1.7122 0 Td
(lower)Tj
-33.9645 -1.2983 Td
(quality)Tj
2.9536 0 Td
(of)Tj
1.0148 0 Td
(life)Tj
1.4457 0 Td
(scores)Tj
2.6645 0 Td
(in)Tj
1.0375 0 Td
(physical)Tj
3.4526 0 Td
(\()Tj
/F11 1 Tf
[()]TJ
/F12 1 Tf
0 Tc
1.0318 0 Td
(<)Tj
/F6 1 Tf
-0.004 Tc
0.9921 0 Td
(0.001\))Tj
2.6929 0 Td
(and)Tj
1.7291 0 Td
(psychological)Tj
5.6013 0 Td
(health)Tj
2.6758 0 Td
(\()Tj
/F11 1 Tf
[()]TJ
/F6 1 Tf
1.0375 0 Td
(=)Tj
0.7994 0 Td
(0.04\))Tj
2.211 0 Td
(domains)Tj
3.685 0 Td
(com-)Tj
-35.0246 -1.3039 Td
(pared)Tj
2.4944 0 Td
(to)Tj
1.0262 0 Td
(patients)Tj
3.3675 0 Td
(with)Tj
1.9956 0 Td
(nociceptive)Tj
4.7735 0 Td
(pain)Tj
1.9842 0 Td
([)Tj
0.83 0.64 0.02 0 k
(12)Tj
0 g
(].)Tj
-14.4452 -1.2982 Td
(In)Tj
1.1111 0 Td
(terms)Tj
2.4945 0 Td
(of)Tj
1.0148 0 Td
(activity)Tj
3.1181 0 Td
(limitation,)Tj
4.3993 0 Td
(Arco)Tj
2.2054 0 Td
(et)Tj
0.9411 0 Td
(al.)Tj
1.1282 0 Td
(found)Tj
2.6135 0 Td
(about)Tj
2.4945 0 Td
(90%)Tj
1.9275 0 Td
(of)Tj
1.0148 0 Td
(leprosy)Tj
3.1011 0 Td
(patients)Tj
3.3732 0 Td
(with)Tj
1.9956 0 Td
(NP)Tj
1.5137 0 Td
(had)Tj
-35.6426 -1.2983 Td
(Grade)Tj
2.6928 0 Td
(1)Tj
0.6917 0 Td
(or)Tj
1.0998 0 Td
(2)Tj
0.6973 0 Td
(disability,)Tj
4.0762 0 Td
(and)Tj
1.7292 0 Td
(there)Tj
2.262 0 Td
(is)Tj
0.8504 0 Td
(an)Tj
1.2019 0 Td
(association)Tj
4.6261 0 Td
(between)Tj
3.5319 0 Td
(NP)Tj
1.5137 0 Td
(and)Tj
1.7291 0 Td
(degree)Tj
2.8573 0 Td
(of)Tj
1.0148 0 Td
(disability)Tj
-30.5742 -1.3039 Td
(\()Tj
/F11 1 Tf
[()]TJ
/F12 1 Tf
0 Tc
1.0318 0 Td
(<)Tj
/F6 1 Tf
-0.004 Tc
0.9921 0 Td
(0.05\))Tj
2.2167 0 Td
([)Tj
0.83 0.64 0.02 0 k
(23)Tj
0 g
(].)Tj
2.0749 0 Td
(Although)Tj
4.0025 0 Td
(the)Tj
1.4683 0 Td
(Screening)Tj
4.1669 0 Td
(of)Tj
1.0148 0 Td
(Activity)Tj
3.3732 0 Td
(Limitation)Tj
4.4617 0 Td
(and)Tj
1.7292 0 Td
(Safety)Tj
2.5965 0 Td
(Awareness)Tj
4.5127 0 Td
(\(SALSA\))Tj
-33.6413 -1.2983 Td
(scale)Tj
2.1089 0 Td
(has)Tj
1.5421 0 Td
(been)Tj
2.1203 0 Td
(recommended)Tj
6.0377 0 Td
(to)Tj
1.0261 0 Td
(measure)Tj
3.5773 0 Td
(the)Tj
1.4684 0 Td
(degree)Tj
2.8573 0 Td
(of)Tj
1.0148 0 Td
(limitation)Tj
4.1726 0 Td
(imposed)Tj
3.6453 0 Td
(by)Tj
1.1792 0 Td
(leprosy)Tj
3.1011 0 Td
(in)Tj
1.0374 0 Td
(daily)Tj
-34.8885 -1.2983 Td
(life)Tj
1.4456 0 Td
(activities)Tj
3.7134 0 Td
([)Tj
0.83 0.64 0.02 0 k
(24)Tj
0 g
(],)Tj
2.0749 0 Td
(only)Tj
1.9786 0 Td
(one)Tj
1.6951 0 Td
(study)Tj
2.3924 0 Td
(in)Tj
1.0375 0 Td
(Indonesia)Tj
4.1726 0 Td
(applied)Tj
3.1577 0 Td
(SALSA)Tj
3.0785 0 Td
(in)Tj
1.0318 0 Td
(correlation)Tj
4.6204 0 Td
(with)Tj
1.9956 0 Td
(NP)Tj
1.5137 0 Td
([)Tj
0.83 0.64 0.02 0 k
(20)Tj
0 g
(].)Tj
2.0806 0 Td
(The)Tj
-35.9884 -1.2982 Td
(study)Tj
2.3867 0 Td
(demonstrated)Tj
5.76 0 Td
(that)Tj
1.7801 0 Td
(two-thirds)Tj
4.4164 0 Td
(of)Tj
1.0148 0 Td
(leprosy)Tj
3.101 0 Td
(patients)Tj
3.3676 0 Td
(with)Tj
1.9956 0 Td
(NP)Tj
1.5137 0 Td
(\(12)Tj
1.5136 0 Td
(in)Tj
1.0318 0 Td
(18\))Tj
1.5137 0 Td
(had)Tj
1.7122 0 Td
(moderate)Tj
4.0251 0 Td
(to)Tj
-35.1323 -1.3039 Td
(severe)Tj
2.6758 0 Td
(daily)Tj
2.1487 0 Td
(activities)Tj
3.7133 0 Td
(restrictions.)Tj
-7.3416 -1.2983 Td
(Thus,)Tj
-0.02 Tc
2.4774 0 Td
(NP)Tj
1.4797 0 Td
(is)Tj
0.8164 0 Td
(an)Tj
1.1735 0 Td
(important)Tj
4.1386 0 Td
(complication)Tj
5.2837 0 Td
(of)Tj
0.9865 0 Td
(leprosy)Tj
2.9877 0 Td
(which)Tj
2.5681 0 Td
(is)Tj
0.8164 0 Td
(usually)Tj
2.9083 0 Td
(associated)Tj
4.0932 0 Td
(with)Tj
1.9333 0 Td
(negative)Tj
-32.859 -1.2983 Td
(impact)Tj
2.8799 0 Td
(on)Tj
1.2473 0 Td
(patients')Tj
3.4355 0 Td
(daily)Tj
2.075 0 Td
(life,)Tj
1.5874 0 Td
(physical)Tj
3.3222 0 Td
(and)Tj
1.6837 0 Td
(psychological)Tj
5.3915 0 Td
(well-being.)Tj
4.4333 0 Td
(The)Tj
1.7348 0 Td
(prevalence)Tj
4.3257 0 Td
(of)Tj
0.9808 0 Td
(NP)Tj
1.4853 0 Td
(in)Tj
1.0035 0 Td
(peo-)Tj
-35.5859 -1.3039 Td
(ple)Tj
1.3606 0 Td
(affected)Tj
3.1974 0 Td
(with)Tj
1.9332 0 Td
(leprosy)Tj
2.9877 0 Td
(has)Tj
1.4967 0 Td
(not)Tj
1.5251 0 Td
(been)Tj
2.0579 0 Td
(studied)Tj
3.0387 0 Td
(in)Tj
1.0035 0 Td
(many)Tj
2.4151 0 Td
(endemic)Tj
3.5433 0 Td
(countries,)Tj
4.0138 0 Td
(including)Tj
3.8948 0 Td
(Nepal.)Tj
2.7099 0 Td
(We)Tj
-35.1777 -1.2982 Td
(hypothesized)Tj
5.278 0 Td
(that)Tj
1.7121 0 Td
(NP)Tj
1.4854 0 Td
(remains)Tj
3.3335 0 Td
(a)Tj
0.635 0 Td
(severe)Tj
2.5795 0 Td
(problem)Tj
3.5036 0 Td
(in)Tj
1.0034 0 Td
(Nepalese)Tj
3.6567 0 Td
(RFT)Tj
1.9332 0 Td
(patients.)Tj
3.4469 0 Td
(In)Tj
1.0772 0 Td
(order)Tj
2.3414 0 Td
(to)Tj
0.9921 0 Td
(evaluate)Tj
-32.978 -1.2983 Td
(this)Tj
1.61 0 Td
(population,)Tj
4.6375 0 Td
(RFT)Tj
1.9332 0 Td
(patients)Tj
3.2428 0 Td
(associated)Tj
4.0932 0 Td
(with)Tj
1.9332 0 Td
(a)Tj
0.6406 0 Td
(referral)Tj
3.0218 0 Td
(hospital)Tj
3.2484 0 Td
(were)Tj
2.058 0 Td
(interviewed)Tj
4.7338 0 Td
(and)Tj
1.6838 0 Td
(screened)Tj
3.5943 0 Td
(for)Tj
-36.4306 -1.3039 Td
(NP)Tj
1.4796 0 Td
(using)Tj
2.3131 0 Td
(the)Tj
1.423 0 Td
(DN4)Tj
2.1203 0 Td
(then)Tj
1.9502 0 Td
(evaluated)Tj
3.8494 0 Td
(with)Tj
1.9332 0 Td
(the)Tj
1.4173 0 Td
(short)Tj
2.2054 0 Td
(form)Tj
2.143 0 Td
(of)Tj
0.9864 0 Td
(Brief)Tj
2.0693 0 Td
(Pain)Tj
1.9616 0 Td
(Inventory)Tj
4.0251 0 Td
(\(BPI-short\))Tj
4.6205 0 Td
(for)Tj
1.3379 0 Td
(pain)Tj
-35.8353 -1.2983 Td
(severity;)Tj
3.3561 0 Td
(Eye,)Tj
1.8255 0 Td
(Hand)Tj
2.4378 0 Td
(and)Tj
1.6781 0 Td
(Foot)Tj
1.9956 0 Td
(\(EHF\))Tj
2.6872 0 Td
(assessment)Tj
4.4504 0 Td
(and)Tj
1.6838 0 Td
(WHO)Tj
2.6532 0 Td
(grading)Tj
3.1861 0 Td
(for)Tj
1.3379 0 Td
(disability)Tj
3.6907 0 Td
(severity;)Tj
3.3562 0 Td
(SALSA)Tj
-34.3386 -1.2983 Td
(for)Tj
1.3322 0 Td
(impact)Tj
2.88 0 Td
(on)Tj
1.2359 0 Td
(activities;)Tj
3.7587 0 Td
(the)Tj
1.4173 0 Td
(General)Tj
3.2655 0 Td
(Health)Tj
2.812 0 Td
(Questionnaire-12)Tj
6.9845 0 Td
(\(GHQ-12\))Tj
4.2973 0 Td
(for)Tj
1.3379 0 Td
(psychiatric)Tj
4.3824 0 Td
(morbidity)Tj
-33.7037 -1.3039 Td
(alongside)Tj
3.855 0 Td
(collection)Tj
3.9515 0 Td
(of)Tj
0.9808 0 Td
(leprosy)Tj
2.9877 0 Td
(demographics)Tj
5.6749 0 Td
(obtained)Tj
3.6057 0 Td
(from)Tj
2.1429 0 Td
(medical)Tj
3.2485 0 Td
(chart)Tj
2.194 0 Td
(review.)Tj
ET
Q
q
1 j
1 J
0 w
11.9999 0 0 11.9999 200.0125 195.9874 cm
BT
/F2 1 Tf
1 TL
-0.0033 Tc
0 0 Td
(Materials)Tj
4.5071 0 Td
(and)Tj
1.989 0 Td
(methods)Tj
/F13 1 Tf
-6.4961 -1.4976 Td
(Study)Tj
2.6173 0 Td
(design)Tj
ET
Q
q
1 j
1 J
0 w
10 0 0 10 200.0125 161.0078 cm
BT
/F6 1 Tf
1 TL
-0.004 Tc
0 0 Td
(This)Tj
1.9842 0 Td
(cross-sectional)Tj
6.1058 0 Td
(observational)Tj
5.5785 0 Td
(study)Tj
2.3868 0 Td
(was)Tj
1.7008 0 Td
(conducted)Tj
4.4276 0 Td
(using)Tj
2.3925 0 Td
(screening)Tj
4.0478 0 Td
(tools)Tj
2.143 0 Td
(and)Tj
1.7291 0 Td
(question-)Tj
-32.4961 -1.2982 Td
(naires)Tj
2.6248 0 Td
(to)Tj
1.0262 0 Td
(obtain)Tj
2.7779 0 Td
(quantitative)Tj
4.9833 0 Td
(data)Tj
1.9105 0 Td
(from)Tj
2.2053 0 Td
(RFT)Tj
1.9843 0 Td
(patients)Tj
3.3675 0 Td
(who)Tj
1.9389 0 Td
(had)Tj
1.7064 0 Td
(completed)Tj
4.4107 0 Td
(MDT)Tj
2.4548 0 Td
(at)Tj
0.9525 0 Td
(Anandaban)Tj
-32.3431 -1.3039 Td
(Hospital)Tj
3.6169 0 Td
(in)Tj
1.0375 0 Td
(Kathmandu,)Tj
5.2327 0 Td
(Nepal.)Tj
2.8063 0 Td
(The)Tj
1.7802 0 Td
(hospital)Tj
3.3788 0 Td
(is)Tj
0.8504 0 Td
(the)Tj
1.4684 0 Td
(central)Tj
2.965 0 Td
(referral)Tj
3.1464 0 Td
(hospital)Tj
3.3789 0 Td
(for)Tj
1.389 0 Td
(leprosy)Tj
3.101 0 Td
(compli-)Tj
-34.1515 -1.2983 Td
(cations)Tj
3.0557 0 Td
(management)Tj
5.4368 0 Td
(in)Tj
1.0375 0 Td
(Nepal)Tj
2.5738 0 Td
(with)Tj
2.0013 0 Td
(a)Tj
0.6519 0 Td
(patient)Tj
3.0047 0 Td
(base)Tj
1.9503 0 Td
(reporting)Tj
3.9854 0 Td
(from)Tj
2.2054 0 Td
(across)Tj
2.6815 0 Td
(the)Tj
1.4684 0 Td
(nation.)Tj
3.05 0 Td
(Purposive)Tj
-33.1027 -1.2983 Td
(sampling)Tj
3.8721 0 Td
(of)Tj
1.0091 0 Td
(RFT)Tj
1.9785 0 Td
(patients)Tj
3.3619 0 Td
(was)Tj
1.6951 0 Td
(performed)Tj
4.4617 0 Td
(in)Tj
1.0318 0 Td
(one)Tj
1.6951 0 Td
(month)Tj
2.914 0 Td
(period)Tj
2.829 0 Td
(\(August)Tj
3.4186 0 Td
(of)Tj
1.0091 0 Td
(2016\))Tj
2.4604 0 Td
(based)Tj
2.4662 0 Td
(on)Tj
1.2699 0 Td
(med-)Tj
-35.4725 -1.3039 Td
(ical)Tj
1.5873 0 Td
(records)Tj
3.2088 0 Td
(from)Tj
2.2054 0 Td
(the)Tj
1.4683 0 Td
(inpatient)Tj
3.8211 0 Td
(ward,)Tj
2.4661 0 Td
(outpatient)Tj
4.337 0 Td
(clinic)Tj
2.3981 0 Td
(and,)Tj
1.9559 0 Td
(the)Tj
1.4683 0 Td
(monthly)Tj
3.6227 0 Td
(satellite)Tj
3.2201 0 Td
(leprosy)Tj
3.1011 0 Td
(clinics)Tj
-34.8602 -1.2982 Td
(in)Tj
1.0318 0 Td
(the)Tj
1.474 0 Td
(southern)Tj
3.7814 0 Td
(flatlands)Tj
3.6056 0 Td
(\(Terai\))Tj
3.0047 0 Td
(region.)Tj
ET
Q
q
1 j
1 J
0 w
576 737.1 m
36 737.1 l
36 737.6 l
576 737.6 l
f*
36 741.2598 183.2882 23.6976 re
W* n
q
183.2315 0 0 23.6409 36 741.3165 cm
q
/I0 Do
Q
Q
Q
q
0 0 612 792 re
W* n
1 j
1 J
0 w
7.9999 0 0 7.9999 482.1732 745.7952 cm
BT
/F0 1 Tf
1 TL
-0.005 Tc
0 0 Td
(Neuropa)Tj
3.763 0 Td
(thic)Tj
1.7504 0 Td
(pain)Tj
2.0693 0 Td
(in)Tj
0.9779 0 Td
(leprosy)Tj
ET
Q
q
1 j
1 J
0 w
36 48.0002 m
576 48.0002 l
576 47.5002 l
36 47.5002 l
f*
0.83 0.64 0.02 0 k
163.5591 34.9228 m
317.7071 34.9228 l
h
f*
0 g
7.9999 0 0 7.9999 36 36 cm
BT
/F0 1 Tf
1 TL
-0.005 Tc
0 0 Td
(PLOS)Tj
2.8559 0 Td
(Neglected)Tj
4.6417 0 Td
(Tropical)Tj
3.7135 0 Td
(Disease)Tj
3.5433 0 Td
(s)Tj
0.7158 0 Td
(|)Tj
0.83 0.64 0.02 0 k
0.4748 0 Td
(https://doi.or)Tj
5.4142 0 Td
(g/10.137)Tj
3.8197 0 Td
(1/journal.pn)Tj
5.1237 0 Td
(td.00066)Tj
3.8197 0 Td
(10)Tj
0 g
2.0905 0 Td
(July)Tj
1.9701 0 Td
(2,)Tj
1.0347 0 Td
(2018)Tj
25.923 0 Td
(3)Tj
0.7654 0 Td
(/)Tj
ET
endstream
endobj
63 0 obj
<>stream
endstream
endobj
64 0 obj
<>stream
endstream
endobj
65 0 obj
<>stream
endstream
endobj
66 0 obj
<>stream
endstream
endobj
67 0 obj
<>stream
endstream
endobj
68 0 obj
<>stream
endstream
endobj
69 0 obj
<>stream
endstream
endobj
70 0 obj
<>stream
endstream
endobj
71 0 obj
<>stream
endstream
endobj
72 0 obj
<>stream
endstream
endobj
73 0 obj
<>stream
endstream
endobj
74 0 obj
<>stream
endstream
endobj
75 0 obj
<>stream
endstream
endobj
76 0 obj
<>stream
endstream
endobj
77 0 obj
<>stream
endstream
endobj
78 0 obj
<>stream
endstream
endobj
79 0 obj
<>stream
endstream
endobj
80 0 obj
<>stream
BT
66.402 0 Td
(15)Tj
ET
Q
endstream
endobj
81 0 obj
<>/XObject<>>>/CropBox[0 0 612 792]/MediaBox[0 0 612 792]/Parent 10 0 R/Annots 82 0 R/Contents 83 0 R/TrimBox[0 0 612 792]>>
endobj
82 0 obj
[84 0 R 85 0 R 86 0 R 87 0 R 88 0 R 89 0 R 90 0 R]
endobj
84 0 obj
<>/Border[0 0 0]/Dest(Rpntd.0006610.ref005)>>
endobj
85 0 obj
<>/Border[0 0 0]/Dest(Rpntd.0006610.ref025)>>
endobj
86 0 obj
<>/Border[0 0 0]/Dest(Rpntd.0006610.g001)>>
endobj
87 0 obj
<>/Border[0 0 0]/Dest(Rpntd.0006610.ref026)>>
endobj
88 0 obj
<>/Border[0 0 0]/Dest(Rpntd.0006610.ref027)>>
endobj
89 0 obj
<>/Border[0 0 0]/Dest(Rpntd.0006610.ref029)>>
endobj
90 0 obj
<>/Border[0 0 0]/A 91 0 R>>
endobj
91 0 obj
<>
endobj
83 0 obj
[92 0 R 93 0 R 94 0 R 95 0 R 96 0 R 97 0 R 98 0 R 99 0 R 100 0 R 101 0 R 102 0 R]
endobj
92 0 obj
<>stream
q
0.83 0.64 0.02 0 k
411.0236 511.9937 m
415.7858 511.9937 l
h
f*
248.6551 342.9921 m
258.1795 342.9921 l
h
f*
376.7244 316.9701 m
396.2835 316.9701 l
h
f*
412.2709 179.9433 m
421.7953 179.9433 l
h
f*
291.6283 81.9213 m
301.1528 81.9213 l
h
f*
306.3118 81.9213 m
315.8362 81.9213 l
h
f*
0 g
1 j
1 J
0 w
11.9999 0 0 11.9999 200.0125 706.0535 cm
BT
/F13 1 Tf
1 TL
-0.0033 Tc
0 0 Td
(Ethics)Tj
2.7779 0 Td
(statement)Tj
ET
Q
q
1 j
1 J
0 w
10 0 0 10 200.0125 689.1023 cm
BT
/F6 1 Tf
1 TL
-0.004 Tc
0 0 Td
(The)Tj
1.7801 0 Td
(following)Tj
3.9798 0 Td
(criteria)Tj
3.0784 0 Td
(were)Tj
2.1203 0 Td
(employed)Tj
4.1386 0 Td
(for)Tj
1.3889 0 Td
(the)Tj
1.4684 0 Td
(recruitment:)Tj
5.2157 0 Td
(leprosy)Tj
3.1011 0 Td
(patients)Tj
3.3732 0 Td
(18)Tj
1.1679 0 Td
(years)Tj
2.2677 0 Td
(old)Tj
1.4966 0 Td
(or)Tj
-34.5767 -1.3039 Td
(above,)Tj
2.7722 0 Td
(who)Tj
1.9389 0 Td
(completed)Tj
4.405 0 Td
(MDT)Tj
2.4605 0 Td
(\(RFT\))Tj
2.6589 0 Td
(and)Tj
1.7291 0 Td
(agreed)Tj
2.8686 0 Td
(to)Tj
1.0262 0 Td
(sign)Tj
1.8595 0 Td
(voluntary)Tj
4.0648 0 Td
(informed)Tj
3.9685 0 Td
(consent)Tj
3.3335 0 Td
(to)Tj
1.0262 0 Td
(partici-)Tj
-34.1119 -1.2982 Td
(pate)Tj
1.8935 0 Td
(in)Tj
1.0318 0 Td
(the)Tj
1.474 0 Td
(study.)Tj
2.6135 0 Td
(This)Tj
1.9843 0 Td
(study)Tj
2.3924 0 Td
(had)Tj
1.7064 0 Td
(been)Tj
2.126 0 Td
(approved)Tj
3.9741 0 Td
(by)Tj
1.1793 0 Td
(the)Tj
1.4683 0 Td
(Ethics)Tj
2.6702 0 Td
(Committee)Tj
4.7395 0 Td
(of)Tj
1.0148 0 Td
(the)Tj
1.4683 0 Td
(London)Tj
-31.7364 -1.2983 Td
(School)Tj
2.9083 0 Td
(of)Tj
1.0148 0 Td
(Hygiene)Tj
3.5659 0 Td
(and)Tj
1.7292 0 Td
(Tropical)Tj
3.5999 0 Td
(Medicine)Tj
3.9912 0 Td
(\(LSHTM;)Tj
4.0762 0 Td
(MSc)Tj
2.0069 0 Td
(Ethics)Tj
2.6702 0 Td
(Ref:)Tj
1.7802 0 Td
(11141\))Tj
2.9366 0 Td
(and)Tj
1.7292 0 Td
(the)Tj
1.4683 0 Td
(Nepal)Tj
-33.4769 -1.3039 Td
(Health)Tj
2.9139 0 Td
(Research)Tj
3.8098 0 Td
(Council)Tj
3.4015 0 Td
(\(NHRC;)Tj
3.5717 0 Td
(Reg.)Tj
1.9559 0 Td
(no.161/2016\).)Tj
ET
Q
q
1 j
1 J
0 w
11.9999 0 0 11.9999 200.0125 608.0314 cm
BT
/F13 1 Tf
1 TL
-0.0033 Tc
0 0 Td
(Data)Tj
2.2441 0 Td
(collection)Tj
ET
Q
q
1 j
1 J
0 w
10 0 0 10 200.0125 591.0803 cm
BT
/F6 1 Tf
1 TL
-0.004 Tc
0 0 Td
(All)Tj
1.3946 0 Td
(patients)Tj
3.3675 0 Td
(were)Tj
2.126 0 Td
(interviewed)Tj
4.9096 0 Td
(in)Tj
1.0318 0 Td
(Nepali)Tj
2.8459 0 Td
(or)Tj
1.0999 0 Td
(Hindi)Tj
2.5965 0 Td
(language)Tj
3.7644 0 Td
(according)Tj
4.1896 0 Td
(to)Tj
1.0261 0 Td
(patient)Tj
3.0047 0 Td
(preference.)Tj
-31.3566 -1.3039 Td
(Demographic)Tj
5.7089 0 Td
(data)Tj
1.9162 0 Td
(and)Tj
1.7291 0 Td
(a)Tj
0.6577 0 Td
(detailed)Tj
3.3675 0 Td
(history)Tj
3.0047 0 Td
(of)Tj
1.0148 0 Td
(leprosy)Tj
3.1011 0 Td
(were)Tj
2.1203 0 Td
(collected)Tj
3.7417 0 Td
(from)Tj
2.2053 0 Td
(the)Tj
1.4684 0 Td
(medical)Tj
3.3618 0 Td
(chart)Tj
2.2791 0 Td
(and)Tj
-35.6766 -1.2982 Td
(interview.)Tj
4.1839 0 Td
(Comprehensive)Tj
6.5253 0 Td
(leprosy)Tj
3.1011 0 Td
(diagnosis)Tj
3.9571 0 Td
(according)Tj
4.1896 0 Td
(to)Tj
1.0261 0 Td
(WHO)Tj
2.6986 0 Td
(definitions)Tj
4.524 0 Td
(had)Tj
1.7122 0 Td
(been)Tj
2.1203 0 Td
(based)Tj
-34.0382 -1.2983 Td
(upon)Tj
2.3187 0 Td
(clinical)Tj
3.0784 0 Td
(exam)Tj
2.3584 0 Td
(with)Tj
2.0012 0 Td
(lesion)Tj
2.5739 0 Td
(count,)Tj
2.7496 0 Td
(physiotherapist)Tj
6.3495 0 Td
(exam)Tj
2.3641 0 Td
(for)Tj
1.389 0 Td
(neuropathy,)Tj
5.0513 0 Td
(slit)Tj
1.3946 0 Td
(skin)Tj
1.8936 0 Td
(smear)Tj
-33.5223 -1.3039 Td
(reports)Tj
3.067 0 Td
(for)Tj
1.389 0 Td
(bacterial)Tj
3.6226 0 Td
(index)Tj
2.4548 0 Td
(and)Tj
1.7291 0 Td
(skin)Tj
1.8936 0 Td
(biopsy)Tj
2.8346 0 Td
(histopathology.)Tj
6.3609 0 Td
(Leprosy)Tj
3.3959 0 Td
(is)Tj
0.8447 0 Td
(diagnosed)Tj
4.2803 0 Td
(clinically)Tj
3.7814 0 Td
(in)Tj
-35.6539 -1.2983 Td
(patients)Tj
3.3675 0 Td
(with)Tj
1.9956 0 Td
(one)Tj
1.7007 0 Td
(or)Tj
1.0999 0 Td
(more)Tj
2.3414 0 Td
(of)Tj
1.0148 0 Td
(the)Tj
1.4683 0 Td
(following)Tj
3.9798 0 Td
(signs:)Tj
2.4492 0 Td
(anaesthetic)Tj
4.6544 0 Td
(skin)Tj
1.8935 0 Td
(lesions,)Tj
3.1635 0 Td
(thickened)Tj
4.1555 0 Td
(peripheral)Tj
-33.2841 -1.2982 Td
(nerves,)Tj
3.0273 0 Td
(or)Tj
1.0999 0 Td
(acid-fast)Tj
3.5999 0 Td
(positive)Tj
3.3166 0 Td
(in)Tj
1.0374 0 Td
(skin)Tj
1.8936 0 Td
(smear)Tj
2.6305 0 Td
(or)Tj
1.0942 0 Td
(biopsy.)Tj
3.0614 0 Td
([)Tj
0.83 0.64 0.02 0 k
(5)Tj
0 g
(])Tj
1.3776 0 Td
(The)Tj
1.7801 0 Td
(WHO)Tj
2.6986 0 Td
(definition)Tj
4.1669 0 Td
(of)Tj
1.0148 0 Td
(leprosy)Tj
3.1011 0 Td
(classi-)Tj
-34.8999 -1.304 Td
(fication)Tj
3.2541 0 Td
(is)Tj
0.8447 0 Td
(based)Tj
2.4718 0 Td
(on)Tj
1.2756 0 Td
(the)Tj
1.474 0 Td
(number)Tj
3.4186 0 Td
(of)Tj
1.0148 0 Td
(skin)Tj
1.8878 0 Td
(lesions)Tj
2.9367 0 Td
(and)Tj
1.7291 0 Td
(skin)Tj
1.8936 0 Td
(smear)Tj
2.6305 0 Td
(findings.)Tj
3.719 0 Td
(Paucibacillary)Tj
5.8167 0 Td
(\(PB\))Tj
-34.367 -1.2982 Td
(leprosy)Tj
3.101 0 Td
(is)Tj
0.8448 0 Td
(diagnosed)Tj
4.2859 0 Td
(in)Tj
1.0318 0 Td
(patients)Tj
3.3676 0 Td
(with)Tj
2.0012 0 Td
(five)Tj
1.6498 0 Td
(or)Tj
1.0998 0 Td
(fewer)Tj
2.4094 0 Td
(skin)Tj
1.8936 0 Td
(lesions.)Tj
3.1577 0 Td
(Multibacillary)Tj
5.8394 0 Td
(\(MB\))Tj
2.3697 0 Td
(leprosy)Tj
3.1011 0 Td
(is)Tj
-36.1528 -1.2983 Td
(diagnosed)Tj
4.2802 0 Td
(in)Tj
1.0375 0 Td
(patients)Tj
3.3675 0 Td
(with)Tj
1.9956 0 Td
(six)Tj
1.3153 0 Td
(or)Tj
1.0942 0 Td
(more)Tj
2.3414 0 Td
(skin)Tj
1.8935 0 Td
(lesions)Tj
2.9367 0 Td
(or)Tj
1.0998 0 Td
(positive)Tj
3.3165 0 Td
(skin)Tj
1.8879 0 Td
(smear.)Tj
2.8573 0 Td
(The)Tj
1.7801 0 Td
(results)Tj
2.812 0 Td
(of)Tj
1.0148 0 Td
(histo-)Tj
-35.0303 -1.3039 Td
(pathologic)Tj
4.4106 0 Td
(finding)Tj
3.1351 0 Td
(and)Tj
1.7292 0 Td
(Ridley-Jopling)Tj
5.9924 0 Td
(classification)Tj
5.3461 0 Td
(were)Tj
2.1203 0 Td
(also)Tj
1.7688 0 Td
(collected)Tj
3.7417 0 Td
(for)Tj
1.3833 0 Td
(further)Tj
3.0274 0 Td
(analyses.)Tj
-32.6549 -1.2983 Td
(Similarly,)Tj
4.0251 0 Td
(chart)Tj
2.2734 0 Td
(reviews)Tj
3.2088 0 Td
(were)Tj
2.1203 0 Td
(used)Tj
2.0636 0 Td
(to)Tj
1.0205 0 Td
(identify)Tj
3.2995 0 Td
(leprosy)Tj
3.1011 0 Td
(reactions)Tj
3.8494 0 Td
(which)Tj
2.6532 0 Td
(had)Tj
1.7064 0 Td
(been)Tj
2.126 0 Td
(diagnosed)Tj
4.2803 0 Td
(clin-)Tj
-35.7276 -1.2982 Td
(ically)Tj
2.2903 0 Td
(by)Tj
1.1792 0 Td
(a)Tj
0.6577 0 Td
(dermatologist,)Tj
5.9697 0 Td
(with)Tj
1.9956 0 Td
(a)Tj
0.6576 0 Td
(record)Tj
2.8403 0 Td
(of)Tj
1.0148 0 Td
(new)Tj
1.8765 0 Td
(skin)Tj
1.8936 0 Td
(lesions)Tj
2.9366 0 Td
(or)Tj
1.0999 0 Td
(nerve)Tj
2.4377 0 Td
(symptoms)Tj
4.3597 0 Td
(at)Tj
0.9524 0 Td
(the)Tj
1.4684 0 Td
(time)Tj
2.0296 0 Td
(of)Tj
-35.6596 -1.2983 Td
(presentation)Tj
5.2157 0 Td
(along)Tj
2.4207 0 Td
(with)Tj
2.0013 0 Td
(respective)Tj
4.1839 0 Td
(treatment)Tj
4.1329 0 Td
(regimen)Tj
3.5376 0 Td
(and)Tj
1.7291 0 Td
(duration.)Tj
3.9288 0 Td
(T1R)Tj
1.9276 0 Td
(was)Tj
1.7007 0 Td
(diagnosed)Tj
4.2803 0 Td
(in)Tj
-35.0586 -1.3039 Td
(patients)Tj
3.3675 0 Td
(with)Tj
1.9956 0 Td
(acute)Tj
2.33 0 Td
(inflammation)Tj
5.6976 0 Td
(in)Tj
1.0318 0 Td
(existing)Tj
3.3166 0 Td
(skin)Tj
1.8935 0 Td
(lesions,)Tj
3.1634 0 Td
(the)Tj
1.4684 0 Td
(development)Tj
5.4084 0 Td
(of)Tj
1.0148 0 Td
(nerve)Tj
2.4435 0 Td
(tenderness)Tj
-33.1311 -1.2983 Td
(or)Tj
1.0941 0 Td
(new)Tj
1.8765 0 Td
(nerve)Tj
2.4435 0 Td
(function)Tj
3.6283 0 Td
(impairment.)Tj
5.2157 0 Td
(T2R)Tj
1.9276 0 Td
(was)Tj
1.6951 0 Td
(diagnosed)Tj
4.2859 0 Td
(in)Tj
1.0318 0 Td
(patients)Tj
3.3676 0 Td
(who)Tj
1.9389 0 Td
(developed)Tj
4.2746 0 Td
(erythema-)Tj
-32.7796 -1.2982 Td
(tous)Tj
1.9105 0 Td
(tender)Tj
2.8176 0 Td
(skin)Tj
1.8935 0 Td
(papular)Tj
3.2655 0 Td
(or)Tj
1.0999 0 Td
(nodular)Tj
3.3788 0 Td
(lesions)Tj
2.9367 0 Td
(associated)Tj
4.2576 0 Td
(with)Tj
1.9956 0 Td
(systemic)Tj
3.6283 0 Td
(symptoms)Tj
4.3597 0 Td
(including)Tj
-31.5437 -1.304 Td
(fever.)Tj
2.4037 0 Td
(Neuritis)Tj
3.4753 0 Td
(was)Tj
1.6951 0 Td
(diagnosed)Tj
4.2859 0 Td
(in)Tj
1.0318 0 Td
(patients)Tj
3.3676 0 Td
(with)Tj
2.0012 0 Td
(reaction)Tj
3.4923 0 Td
(who)Tj
1.9389 0 Td
(developed)Tj
4.2689 0 Td
(nerve)Tj
2.4435 0 Td
(tenderness)Tj
4.507 0 Td
(or)Tj
-34.9112 -1.2982 Td
(pain.)Tj
2.211 0 Td
(EHF)Tj
2.0862 0 Td
(score)Tj
2.3074 0 Td
(and)Tj
1.7292 0 Td
(WHO)Tj
2.6985 0 Td
(disability)Tj
3.8494 0 Td
(grade)Tj
2.4435 0 Td
(were)Tj
2.1203 0 Td
(recorded)Tj
3.7984 0 Td
(according)Tj
4.1839 0 Td
(to)Tj
1.0261 0 Td
(the)Tj
1.4684 0 Td
(WHO)Tj
2.7042 0 Td
(operational)Tj
-32.6265 -1.2983 Td
(definitions)Tj
4.524 0 Td
([)Tj
0.83 0.64 0.02 0 k
(25)Tj
0 g
(].)Tj
2.075 0 Td
(Both)Tj
2.1316 0 Td
(eyes,)Tj
2.109 0 Td
(hands)Tj
2.6192 0 Td
(and)Tj
1.7291 0 Td
(feet)Tj
1.6554 0 Td
(were)Tj
2.1203 0 Td
(evaluated)Tj
3.9912 0 Td
(and)Tj
1.7291 0 Td
(graded)Tj
2.9707 0 Td
(for)Tj
1.3889 0 Td
(severity)Tj
3.2712 0 Td
(of)Tj
1.0148 0 Td
(disability,)Tj
-33.3295 -1.3039 Td
(and)Tj
1.7291 0 Td
(the)Tj
1.4683 0 Td
(EHF)Tj
2.0863 0 Td
(score)Tj
2.3074 0 Td
(was)Tj
1.6951 0 Td
(calculated)Tj
4.2066 0 Td
(with)Tj
1.9956 0 Td
(the)Tj
1.474 0 Td
(sum)Tj
1.9275 0 Td
(of)Tj
1.0148 0 Td
(the)Tj
1.4683 0 Td
(gradings.)Tj
3.8835 0 Td
(The)Tj
1.7858 0 Td
(flow-chart)Tj
4.3483 0 Td
(of)Tj
1.0148 0 Td
(patient)Tj
-32.4054 -1.2983 Td
(enrolment)Tj
4.405 0 Td
(and)Tj
1.7291 0 Td
(data)Tj
1.9162 0 Td
(collection)Tj
4.1102 0 Td
(is)Tj
0.8504 0 Td
(depicted)Tj
3.6283 0 Td
(in)Tj
0.83 0.64 0.02 0 k
1.0318 0 Td
(Fig)Tj
1.4797 0 Td
(1)Tj
0 g
(.)Tj
ET
Q
q
1 j
1 J
0 w
11.9999 0 0 11.9999 200.0125 289.0204 cm
BT
/F13 1 Tf
1 TL
-0.0033 Tc
0 0 Td
(Evaluation)Tj
4.7244 0 Td
(of)Tj
1.0677 0 Td
(pain)Tj
ET
Q
q
1 j
1 J
0 w
10 0 0 10 200.0125 272.0125 cm
BT
/F6 1 Tf
1 TL
-0.004 Tc
0 0 Td
(All)Tj
1.3946 0 Td
(patients)Tj
3.3675 0 Td
(were)Tj
2.126 0 Td
(asked)Tj
2.4605 0 Td
(about)Tj
2.4944 0 Td
(a)Tj
0.652 0 Td
(history)Tj
3.0104 0 Td
(of)Tj
1.0148 0 Td
(leprosy-related)Tj
6.1738 0 Td
(pain.)Tj
2.211 0 Td
(However,)Tj
4.0762 0 Td
(only)Tj
1.9786 0 Td
(the)Tj
1.4683 0 Td
(patients)Tj
3.3675 0 Td
(who)Tj
-35.7956 -1.2982 Td
(reported)Tj
3.6566 0 Td
(current)Tj
3.1861 0 Td
(pain)Tj
1.99 0 Td
(were)Tj
2.1203 0 Td
(assessed)Tj
3.4695 0 Td
(by)Tj
1.1849 0 Td
(the)Tj
1.4683 0 Td
(DN4)Tj
2.1714 0 Td
(questionnaire)Tj
5.7032 0 Td
(for)Tj
1.3833 0 Td
(NP)Tj
1.5194 0 Td
(and)Tj
1.7291 0 Td
(required)Tj
3.6397 0 Td
(to)Tj
1.0205 0 Td
(com-)Tj
-34.2423 -1.2983 Td
(plete)Tj
2.1259 0 Td
(BPI-short)Tj
4.1159 0 Td
(for)Tj
1.389 0 Td
(the)Tj
1.4683 0 Td
(evaluation)Tj
4.3597 0 Td
(of)Tj
1.0148 0 Td
(pain)Tj
1.9899 0 Td
(severity)Tj
3.2711 0 Td
(and)Tj
1.7292 0 Td
(inventory)Tj
4.0932 0 Td
(of)Tj
1.0148 0 Td
(medications)Tj
5.1023 0 Td
(taken)Tj
2.4208 0 Td
(for)Tj
1.3833 0 Td
(pain)Tj
-35.4782 -1.3039 Td
(control.)Tj
3.3448 0 Td
(BPI-short)Tj
4.1159 0 Td
(includes)Tj
3.5433 0 Td
(a)Tj
0.6576 0 Td
(body)Tj
2.2167 0 Td
(chart)Tj
2.2734 0 Td
(for)Tj
1.3833 0 Td
(the)Tj
1.474 0 Td
(localization)Tj
4.8075 0 Td
(of)Tj
1.0148 0 Td
(the)Tj
1.474 0 Td
(area)Tj
1.8822 0 Td
(with)Tj
1.9956 0 Td
(pain,)Tj
2.211 0 Td
(four)Tj
1.9162 0 Td
(severity)Tj
-34.3103 -1.2983 Td
(items)Tj
2.3867 0 Td
(with)Tj
2.0013 0 Td
(numerical)Tj
4.2802 0 Td
(pain)Tj
1.9843 0 Td
(rating)Tj
2.6078 0 Td
(scale,)Tj
2.3301 0 Td
(a)Tj
0.6576 0 Td
(measure)Tj
3.5773 0 Td
(of)Tj
1.0148 0 Td
(response)Tj
3.7361 0 Td
(to)Tj
1.0261 0 Td
(medications)Tj
5.0967 0 Td
(and)Tj
1.7291 0 Td
(an)Tj
1.2019 0 Td
(evalua-)Tj
-33.63 -1.2982 Td
(tion)Tj
1.8425 0 Td
(of)Tj
1.0148 0 Td
(pain)Tj
1.9842 0 Td
(interference)Tj
5.0286 0 Td
(with)Tj
2.0013 0 Td
(seven)Tj
2.4321 0 Td
(items.)Tj
2.6135 0 Td
(Regarding)Tj
4.3427 0 Td
(the)Tj
1.4683 0 Td
(DN4)Tj
2.1713 0 Td
(criteria,)Tj
3.2995 0 Td
(light)Tj
2.024 0 Td
(finger)Tj
2.5851 0 Td
(touch)Tj
2.5058 0 Td
(and)Tj
-35.3137 -1.3039 Td
(Semmes-Weinstein)Tj
7.9936 0 Td
(monofilaments)Tj
6.2929 0 Td
(were)Tj
2.1203 0 Td
(applied)Tj
3.1521 0 Td
(to)Tj
1.0261 0 Td
(the)Tj
1.4684 0 Td
(area)Tj
1.8821 0 Td
(of)Tj
1.0148 0 Td
(pain)Tj
1.99 0 Td
(to)Tj
1.0261 0 Td
(determine)Tj
4.32 0 Td
(touch)Tj
-32.2864 -1.2983 Td
(hypoesthesia)Tj
5.3234 0 Td
(and)Tj
1.7291 0 Td
(pinprick)Tj
3.6283 0 Td
(hypoesthesia)Tj
5.3235 0 Td
(respectively)Tj
4.8812 0 Td
([)Tj
0.83 0.64 0.02 0 k
(26)Tj
0 g
(].)Tj
2.0806 0 Td
(Cotton)Tj
3.0387 0 Td
(wool)Tj
2.1657 0 Td
(was)Tj
1.7008 0 Td
(used)Tj
2.0579 0 Td
(to)Tj
1.0261 0 Td
(check)Tj
2.5172 0 Td
(for)Tj
-35.4725 -1.2983 Td
(the)Tj
1.4683 0 Td
(presence)Tj
3.7133 0 Td
(of)Tj
1.0148 0 Td
(allodynia)Tj
3.8835 0 Td
(due)Tj
1.7008 0 Td
(to)Tj
1.0261 0 Td
(brushing.)Tj
ET
Q
q
1 j
1 J
0 w
11.9999 0 0 11.9999 200.0125 139.011 cm
BT
/F13 1 Tf
1 TL
-0.0033 Tc
0 0 Td
(Evaluation)Tj
4.7244 0 Td
(of)Tj
1.0677 0 Td
(life)Tj
1.5449 0 Td
(impact)Tj
ET
Q
q
1 j
1 J
0 w
10 0 0 10 200.0125 122.0031 cm
BT
/F6 1 Tf
1 TL
-0.004 Tc
0 0 Td
(All)Tj
1.3946 0 Td
(patients,)Tj
3.5943 0 Td
(with)Tj
1.9956 0 Td
(or)Tj
1.0998 0 Td
(without)Tj
3.3279 0 Td
(current)Tj
3.1861 0 Td
(pain,)Tj
2.211 0 Td
(were)Tj
2.126 0 Td
(asked)Tj
2.4604 0 Td
(to)Tj
1.0262 0 Td
(complete)Tj
3.8777 0 Td
(the)Tj
1.4684 0 Td
(SALSA)Tj
3.0784 0 Td
(and)Tj
1.7348 0 Td
(the)Tj
1.4683 0 Td
(GHQ-12)Tj
-34.0495 -1.2982 Td
(questionnaires)Tj
6.0604 0 Td
(for)Tj
1.3833 0 Td
(the)Tj
1.4683 0 Td
(assessment)Tj
4.6091 0 Td
(of)Tj
1.0148 0 Td
(daily)Tj
2.1487 0 Td
(activity)Tj
3.1124 0 Td
(limitation)Tj
4.1726 0 Td
(and)Tj
1.7291 0 Td
(psychiatric)Tj
4.5637 0 Td
(morbidity,)Tj
4.4617 0 Td
(respec-)Tj
-34.7241 -1.3039 Td
(tively.)Tj
2.5908 0 Td
(Both)Tj
2.1316 0 Td
(questionnaires)Tj
6.0661 0 Td
(had)Tj
1.7065 0 Td
(Nepalese)Tj
3.7871 0 Td
(versions)Tj
3.5149 0 Td
(available)Tj
3.668 0 Td
(that)Tj
1.7745 0 Td
(had)Tj
1.7121 0 Td
(previously)Tj
4.3483 0 Td
(been)Tj
2.126 0 Td
(used)Tj
2.0579 0 Td
(in)Tj
-35.4838 -1.2983 Td
(leprosy)Tj
3.101 0 Td
(investigations)Tj
5.7203 0 Td
([)Tj
0.83 0.64 0.02 0 k
(27)Tj
0 g
()Tj
0.83 0.64 0.02 0 k
(29)Tj
0 g
(].)Tj
3.5433 0 Td
(The)Tj
1.7858 0 Td
(Likert-type)Tj
4.6601 0 Td
(method)Tj
3.3222 0 Td
(was)Tj
1.7008 0 Td
(used)Tj
2.0579 0 Td
(to)Tj
1.0262 0 Td
(calculate)Tj
3.6737 0 Td
(the)Tj
1.474 0 Td
(GHQ-12)Tj
ET
Q
q
1 j
1 J
0 w
576 737.1 m
36 737.1 l
36 737.6 l
576 737.6 l
f*
36 741.2598 183.2882 23.6976 re
W* n
q
183.2315 0 0 23.6409 36 741.3165 cm
q
/I0 Do
Q
Q
Q
q
0 0 612 792 re
W* n
1 j
1 J
0 w
7.9999 0 0 7.9999 482.1732 745.7952 cm
BT
/F0 1 Tf
1 TL
-0.005 Tc
0 0 Td
(Neuropa)Tj
3.763 0 Td
(thic)Tj
1.7504 0 Td
(pain)Tj
2.0693 0 Td
(in)Tj
0.9779 0 Td
(leprosy)Tj
ET
Q
q
1 j
1 J
0 w
36 48.0002 m
576 48.0002 l
576 47.5002 l
36 47.5002 l
f*
0.83 0.64 0.02 0 k
163.5591 34.9228 m
317.7071 34.9228 l
h
f*
0 g
7.9999 0 0 7.9999 36 36 cm
BT
/F0 1 Tf
1 TL
-0.005 Tc
0 0 Td
(PLOS)Tj
2.8559 0 Td
(Neglected)Tj
4.6417 0 Td
(Tropical)Tj
3.7135 0 Td
(Disease)Tj
3.5433 0 Td
(s)Tj
0.7158 0 Td
(|)Tj
0.83 0.64 0.02 0 k
0.4748 0 Td
(https://doi.or)Tj
5.4142 0 Td
(g/10.137)Tj
3.8197 0 Td
(1/journal.pn)Tj
5.1237 0 Td
(td.00066)Tj
3.8197 0 Td
(10)Tj
0 g
2.0905 0 Td
(July)Tj
1.9701 0 Td
(2,)Tj
1.0347 0 Td
(2018)Tj
25.923 0 Td
(4)Tj
0.7654 0 Td
(/)Tj
ET
endstream
endobj
93 0 obj
<>stream
endstream
endobj
94 0 obj
<>stream
endstream
endobj
95 0 obj
<>stream
endstream
endobj
96 0 obj
<>stream
endstream
endobj
97 0 obj
<>stream
endstream
endobj
98 0 obj
<>stream
endstream
endobj
99 0 obj
<>stream
endstream
endobj
100 0 obj
<>stream
endstream
endobj
101 0 obj
<>stream
endstream
endobj
102 0 obj
<>stream
BT
66.402 0 Td
(15)Tj
ET
Q
endstream
endobj
103 0 obj
<>/XObject<>>>/CropBox[0 0 612 792]/MediaBox[0 0 612 792]/Parent 10 0 R/Annots 107 0 R/Contents 108 0 R/TrimBox[0 0 612 792]>>
endobj
106 0 obj
<>stream
xwnGU>PD4
ALBPJQH'$ J R"H %J "H@L+|~{ϽsϹǾg֬Y>]^3}5@#4@#@ k^rQZTX12sJ>Ȕ|uyyXIh.\cғR%u'Qr>2D`Vf+
ѹZXQOcNIn+nD+1;-=kUjyf3XcݤVJ'GIcrHzbId2*d06yLn ,,UZ Ec=z4c:*''6J"jcjF=.11QuWQ1Qfժt%"\Dt*s.saB19_6Q03UR䞫213̱VrYJRJ@N6@#4@#4@#4@#4@#4@#4@#4@#4@#4@#?C?SN9N{ֻVUN%X={WbM-
fVG&pJL.܃Z{Pl؛Q =ZwX\RT
7"yyĞ]
L>7"sw]yuw~*:h5@#4@#4@#4@#lWL}iO{'<ص]k\]KeN 1gL.YXqa%k,`}Xm9mt#4@#4@#4@#7V啯||HzhH_Q:eVn=F~.\YQϘ(U2%Q$kUJ ʟK2H?uǢQxOtlW~ʜɗ9VetՊ|=&1ceVsj(Uc~)Y(S%V
Ifβ=%$]btrYu9>Js%X(y<_ΘtRۘИhSDJVS%'Q`rǪ%1ϔc%0bU{ J?Z_#4@#4@#4@#lc8OX߱*xFhF`ǪtzcFhFhFhF`["0aU^F{NXэ@#4";+hFhFhFh*l^hFhfU4@#4@#4@#4-aUg9ձ*HwFh5#0O_3x-4@#4@#4@#43_m ?yhFXcJ6Xf-4@#4@#4@#49ͪkFhv1VCYGk4@#4@#4@#4~@*vFh@`U4@#4@#4@#4 l4@#4{r^
FhFhFhF`@ ?>4@#4@ǪhFhFhFhUO4@#X>WemM@#4@#4@#4@#@#4 0gUzA6@#4@#4@#46C`ª5сub4@#+#r!ݿ
V4@#4@#4@#4l\4@#l0}FhFhFhF`!VYzVV-nFh6U\[k#4@#4@#4@#l{&*ض@#4@#U9}t\4@#4@#4@#4Uyk_Ww0݇FhF`OcU>`jUS,^#4@#4@#4@#WLXUٯF;4@#}^UFhFhFhF`D`߲*[ذڥ.J z̫c;+V}gNZߟ3 Uٟƴ4@#4@#4@#4 ?=~sZUZ/غ_*@[d;lYͪlZw6!(밡M*9WF|hFhFhFhF qI|k_ۿۧ>x3?x\|3<ӛ|%#-܌Gsqq +
Vg=O>&Ĥ~Ygl)Xޑ.|ĸ[Y۽;[Oޢ'>4lY}=>3
4// o|CsB뭕W0 got*uwP<;Άvvk*YskjFhFhFhF`'*qq?~bdys&Rfrы^7c.O>Y/}szRAxDp'?9Bd9|ޕ̌s/گB\WsŖ\@&/xLΌB\;y)US%4^n`<.u)}V~ڣzs㳟nGw[^7yk/7,yS¯~n{
6@#4@#4@#4E`9;ʼnFU??z\{]t8r1bW__3=fdi>X?گ!^W3oy["77Ǜ&>\W?VCuٓi'{<ۨcj''MW{.mycykҳc֣~1{??b?OTm EMnN7p'EWWmCaX2`OZǪlFhFhFhE`*}aUn|sU7|[*tEv%g=KJ!Όy=x6rhFhFhFh x6\
*4檺n
7iv%/yI<ҹQE|.]: 'UGQYU*>^ȪDk7uD#9I3&b?6'*>V10J#'Bflk[Ϊwr͵!JUUdIwqvDP(1Id\cI:M*eV#RmŪTJ,gjG38V
nU.15PKkip%I8WU"URZkR*%5D*/}iznvɯu:ʌSGI:?s?5*ZQ7)nj4inRT\%/ԄUڗe?
L$zŹ഻jt9
"Kta\6f̕7'6Yö57@#4@#4@#46E`ªl`qv9*%*[/9wD&b,ΣŷsI'gt/wԚR=bUF;X,كϞ9FhBocU2[FVyWis`8$YPQgk-BR̅Ty631o.sN-s'4BdBU2W3ra~Ъʜ]zi'Fh[ª£XX WH V+- "()ַ҅UdNQi}ªueӣ
憍U6:5o-螶FhFhFhFhֈ@F̧/|JIsG{c>zЃnzӛtx{^]>?;η-yTL~4@2V~7yt;&URw5V%~_?Jr)O9#3sl+}_-V%FS>RؽǠ˿^?ϟxO)=6G|!148DI
f@|NRw^[ߪ+ 7%O/}闾%b-oy i$4T¼rz6UEn030ׅZ%ͪXwVo{b)@UIU
}|3? MƠo{T(HYz;`)jJJ%/q`SYYNyt`9=Ċe/%}{X5k>5.y{
U7-nq?f?O*Qk,3ԆqWCX$MHK}hQ0K"c.yXsMں6pf};ߑ_*<
~LV'? Т|=y=/ӐWsUvώU0@F<"{oֽtԒpR*mnsܛc+}0sTmBcU6nhFhFhFhqn27RŪ,gU1/9\ҢW=Pb>ag#AE.?6zz)эnM*]
pj_U!fCJï[zX-|k]
~eh1C^BR[)I3EGWH@@#9*WJ|Ū>yS8;Ǝa|yn7'dv N99$Kᇿ!G\?3?TnF4
Fic$Ip#n8Kt10Nlbg*|">fLi(::/sRie/_L´^9s(29;0!E/j*Uy'FCt#䒦͓]sXXejqM_z3%q+\A,_$Ml=epKUr9tG~+_Jˆ\2*@B-eV9'w {uի^m#4n}[#nz#2%4!PccW{a
è>;0mU~FwYDQu#/]K+^YŅ՛,a|Ya.$7"TDP*ALpծVo-˱h(ƶi/aK4%8/(EMU@8U)Y]Ȅ9JתWUJ4.d3CB3u+Q?[=X>IGֽV4@#4@#4@#4@ nMfUq6ŷUq'P>!%.Kun_Q"N\Rs!ӜL;&]ו5c1h_q'S0g}\tăgϟ%rkG7ES3s29gjQJafoL8?`8C[ZEifYBJu!;kk||kMGv%ulkf^"_®Q!rhxigFV%l5*|%EQ%gj4_0Y bv}540bݐ9*Uȫw P[y#4@#4@#4@#l/&末Orܰ*ɟ Gb6É'qwip=qoo69%(\F)̵}T-rL+ꆕ77Jo죪X:*#
{Oܣ7>+C/쉑4Qxw[*)^\v4*pl1b"Vz2cީ+
xS~].bLVt/~NS{϶ GSO[j N;X0! 9~OT:Y\yr
&cX.}(`\6LKEhEHL|/߅jwLD2+(Ja;~< UUD{`T|!nbr*YMJ(]^+uDNS,%
wHi<!Jc#)4'Vʅ~$Ȃvv=