BackgroundSince December 2009, Médecins Sans Frontières has diagnosed and treated patients with visceral leishmaniasis (VL) in Tabarak Allah Hospital, eastern Gedaref State, one of the main endemic foci of VL in Sudan. A survey was conducted to estimate the VL incidence in villages around Tabarak Allah.MethodsBetween the 5th of May and the 17th of June 2011, we conducted an exhaustive door-to-door survey in 45 villages of Al-Gureisha locality. Deaths were investigated by verbal autopsies. All individuals with (i) fever of at least two weeks, (ii) VL diagnosed and treated in the previous year, and (iii) clinical suspicion of post-kala-azar dermal leishmaniasis (PKDL) were referred to medical teams for case ascertainment. A new case of VL was a clinical suspect with a positive rk39 rapid test or direct agglutination test (DAT).ResultsIn the 45 villages screened, 17,702 households were interviewed, for a population of 94,369 inhabitants. The crude mortality rate over the mean recall period of 409 days was 0.13/10'000 people per day. VL was a possible or probable cause for 19% of all deaths. The VL-specific mortality rate was estimated at 0.9/1000 per year.The medical teams examined 551 individuals referred for a history of fever of at least two weeks. Out of these, 16 were diagnosed with primary VL. The overall incidence of VL over the past year was 7.0/1000 persons per year, or 7.9/1000 per year when deaths possibly or probably due to VL were included. Overall, 12.5% (11,943/95,609) of the population reported a past VL treatment episode.Discussion and ConclusionVL represents a significant health burden in eastern Gedaref State. Active VL case detection had a very low yield in this specific setting with adequate access to care and may not be the priority intervention to enhance control in similar contexts.

Intra-parenchymal sialolithiasis and subsequent fibrosis of the submandibular salivary glands is a rare disorder. The resulting swelling, pain, and infection derives affected patients to seek treatment. We present the case of an 85-years-old Saudi male patient who suffered from repeated swelling and infection in the left submandibular region which was misdiagnosed and treated for over 60 years as dental infection, infected skin sebaceous gland or lipoma. The presented case represents the largest intra-glandular submandibular stone with the longest duration ever reported in the medical literature.

The creation and characterization of laser-generated plasma are affected by laser irradiance, representing significant phenomena in many applications.  The present work studied the spectroscopy diagnostic of laser irradiance effect on Zn plasma features created in the air by a Q-switched Nd: YAG laser at the fundamental wavelength (1064nm).  The major plasma parameters (electron temperature and electron density) have been measured using the Boltzmann plot and the Stark broadening methods.  The value of electrons temperature ranged from 6138–6067 K, and the electron density in the range of 1.4×1018 to 2×1018 cm-3, for laser irradiance range from 2.1 to 4.8×108 (W/cm2).  The McWhirter criterion for preserving a local thermodynamic equilibrium (LTE) condition is confirmed in this study.  Furthermore, other fundamental plasma parameters, such as Debye length (λD), number of particles in Debye sphere (ND), and plasma frequency (ωp), were measured. We found that all plasma parameters are affected by laser intensity.

Odontomas are odontogenic tumors formed of various dental tissues.They are classified into: central odontomas that are common, eruption odontomas that are rare with only 23 cases reported to date, and peripheral odontomas that are also rare. We present a case of a large complex eruption odontome in a 24-year-old Saudi male.

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Objective: The objective of this study was to find out whether Lateral Internal Sphincterotomy (LIS) can be carried out using Local Anaesthesia (LA) hence, lowering down the cost and anaesthesia related complications in patients without compromising operative easiness or final result.Methods: One hundred patients who were diagnosed clinically as anal fissure patients and were scheduled for LIS were randomly distributed into two treatment arms. Non-probability consecutive sampling approach was employed. In the first group, LIS was carried out using LA while in the second group LIS was performed in spinal anaesthesia (SA). Age, gender, BMI, procedure time, post-operative complications like pain, post-operative nausea and vomiting (PONV), bleeding, headache, incontinence, urinary retention and patient satisfaction were the main outcome variables which were studied.Results: Out of 100 patients who were treated with LIS, 50 of these patients had SA whereas, the rests of the 50 patients were given LA. We found no statistically significant difference in the post-operative pain, PONV, bleeding, incontinence, and overall patient satisfaction but duration of surgery and post-operative complications like headache and retention of urine were considerably less in the LA group. The difference between the two groups dictated that LIS under local anaesthesia (Group A) took 13.46 minutes (SEM 0.808) lesser than Group B which was statistically significant. But the Mean postoperative pain scores of patients in both groups were not significantly different on statistical analysis nor pain scores at 12 hours from surgery and 24 hours from surgery separately i-e 'p-value>0.05'Conclusions: LIS under LA is less time-intensive, safe and has a comparable patient satisfaction rate to SA. Besides, the advantage of significant cost benefit, duration of surgery, exemption of the requirement of an anaesthetist, and less post-operative headache and PONV, LA also shows no noteworthy difference in the post-operative complications in comparison with SA.

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