Application of stereology in liver volume measurements using computed tomography scan / Aplicación de la estereología en mediciones de volumen hepático mediante tomografía computarizada

SUMMARY: The application of stereology in hepatobiliary conditions is essential in liver volume estimation. Computerized topographic scan with contrast is a reliable method in liver scanning for precise boundaries demarcation. Liver volumetry varies in relation to different factors. Reports showed a correlation of liver volume with sex and body mass index. Steady relation between age and ethnicity is not established. This study aimed to design a protocol for liver volume measurement and apply it in the estimation of volume among the Sudanese population use stereology. Recruitment of the study population was obtained in the royal scan clinic in Khartoum by making an announcement for participation in the study. Patients with a history of hepatobiliary diseases were excluded. CT abdomen with contrast was obtained in DICOM format and transferred to computer-based software for image analysis. A protocol was designed and validated and then applied in volume estimation using software MRIcro for image display, ImageJ for volume estimation, and Onis 2.6 as image viewer. 300 apparently healthy volunteers were recruited. The protocol reliability result was 0.805. Absolute mean liver volume was 3261.32 ± 1365.313 cm3. High liver volume among females was detected than among males. A positive correlation was detected between volume and body mass index (p-value 0.001) regardless of sex. Relation with age showed a rough steady rise till the age of 50 years then it started to decline steadily. The relationship was detected in liver volume with sex and body mass index. More studies are needed to investigate the relationship between ethnicity and age groups.

RESUMEN: La aplicación de la estereología en condiciones hepatobiliares es fundamental en la estimación del volumen hepático. El escaneo topográfico computarizado con contraste es un método confiable en el escaneo del hígado para la demarcación precisa de sus límites. La volumetría hepática varía en función de diferentes factores. Los informes mostraron una correlación del volumen del hígado con el sexo y el índice de masa corporal. No se establece una relación estable entre la edad y la etnia. Este estudio tuvo como objetivo diseñar un protocolo para la medición del volumen hepático de la población sudanesa usando la estereología. El reclutamiento de la población de estudio fue realizado en la clínica de exploración real en Jartum mediante un anuncio de participación. Se excluyeron los pacientes con antecedentes de enfermedades hepatobiliares. Se obtuvo TC de abdomen con contraste en formato DICOM y se transfirió a un software informático para el análisis de imágenes. Se diseñó y validó un protocolo y luego se aplicó en la estimación de volumen utilizando el software MRIcro para la visualización de imágenes, ImageJ para la estimación de volumen y Onis 2.6 como visor de imágenes. Se reclutaron 300 voluntarios sanos. El resultado de la fiabilidad del protocolo fue 0,805. El volumen hepático medio absoluto fue 3261,32 ± 1365,313 cm3. Se detectó un volumen más elevado de hígado en las mujeres que en los hombres. Se detectó una correlación positiva entre el volumen y el índice de masa corporal (valor de p 0,001) independientemente del sexo. La relación con la edad mostró un aumento continuo y brusco hasta los 50 años, luego comenzó a disminuir de manera constante. Se detectó la relación del volumen hepático con el sexo y el índice de masa corporal. Se necesitan más estudios para investigar la relación entre la etnia y los grupos etarios.

Variations of Arterial Supply of the Liver: C.T. Angiographic Study Among Sudanese Adults

Hepatobiliary surgery through laparoscopic approach is becoming a routine. Knowledge of extrahepatic arterial tree is essential for surgical and imaging procedures. Anatomical complexity is expected since the liver is developed by mergingof lobules with its separate blood supply. This makes a wide range of variations in the pattern of vascular arrangement and so reinforces the need for an accurate understanding of full spectrum of variations. This study aimed to investigate the variations in origin and distribution of extrahepatic arterial supply. Fifty volunteers (32 males and 18 females) aged 20­70 years were randomly recruited from the department of CT scan in Al Amal Hospital, Khartoum North, Sudan. The patients were already candidates for CT angiography with contrast for conditions other than hepatobiliary diseases. The reported data is related to those who accepted to participate in the study. Patients with history of hepatobiliary disease were excluded. 3D views of the scans were treated and the extrahepatic arterial tree was traced in a computer-based software. Key findings suggest that Michel's classification was considered the standard template for description ­ 76% of them showed Michel's type I classification. Types III and V constituted about 2%. About 4% of the cases were represented by types VI and IX. Other types of variations constituted about 12%. To conclude, although type I classification which describes the textbook pattern of hepatic artery distribution was significantly detected among the Sudanese population, other variants were to be considered since they are related to major arteries like aorta and superior mesenteric.

Assessment of the risk factors associated with multidrug-resistant tuberculosis in Sudan: a case-control study / 한국역학회지

OBJECTIVES: The emergence of multidrug-resistant tuberculosis (MDR-TB) is a major challenge for the global control of tuberculosis (TB). The aim of this study was to determine the risk factors associated with MDR-TB in Sudan. METHODS: This case-control study was conducted from May 2017 to February 2019. Patients newly diagnosed with MDR-TB were selected as cases, and controls were selected from TB patients who responded to first-line anti-TB drugs. A questionnaire was designed and used to collect data from study participants. Logistic regression was used to evaluate associations between risk factors and MDR-TB infection. The best multivariate model was selected based on the likelihood ratio test. RESULTS: A total of 430 cases and 860 controls were selected for this study. A history of previous TB treatment (adjusted odds ratio [aOR], 54.85; 95% confidence interval [CI], 30.48 to 98.69) was strongly associated with MDR-TB infection. We identified interruption of TB treatment (aOR, 7.62; 95% CI, 3.16 to 18.34), contact with MDR-TB patients (aOR, 5.40; 95% CI, 2.69 to 10.74), lower body weight (aOR, 0.89; 95% CI, 0.87 to 0.91), and water pipe smoking (aOR, 3.23; 95% CI, 1.73 to 6.04) as factors associated with MDR-TB infection. CONCLUSIONS: Previous TB treatment and interruption of TB treatment were found to be the main predictors of MDR-TB. Additionally, this study found that contact with MDR-TB patients and water pipe smoking were associated with MDR-TB infection in Sudan. More efforts are required to decrease the rate of treatment interruption, to strengthen patients’ adherence to treatment, and to reduce contact with MDR-TB patients.

Assessment of the risk factors associated with multidrug-resistant tuberculosis in Sudan: a case-control study / 한국역학회지

OBJECTIVES@#The emergence of multidrug-resistant tuberculosis (MDR-TB) is a major challenge for the global control of tuberculosis (TB). The aim of this study was to determine the risk factors associated with MDR-TB in Sudan.@*METHODS@#This case-control study was conducted from May 2017 to February 2019. Patients newly diagnosed with MDR-TB were selected as cases, and controls were selected from TB patients who responded to first-line anti-TB drugs. A questionnaire was designed and used to collect data from study participants. Logistic regression was used to evaluate associations between risk factors and MDR-TB infection. The best multivariate model was selected based on the likelihood ratio test.@*RESULTS@#A total of 430 cases and 860 controls were selected for this study. A history of previous TB treatment (adjusted odds ratio [aOR], 54.85; 95% confidence interval [CI], 30.48 to 98.69) was strongly associated with MDR-TB infection. We identified interruption of TB treatment (aOR, 7.62; 95% CI, 3.16 to 18.34), contact with MDR-TB patients (aOR, 5.40; 95% CI, 2.69 to 10.74), lower body weight (aOR, 0.89; 95% CI, 0.87 to 0.91), and water pipe smoking (aOR, 3.23; 95% CI, 1.73 to 6.04) as factors associated with MDR-TB infection.@*CONCLUSIONS@#Previous TB treatment and interruption of TB treatment were found to be the main predictors of MDR-TB. Additionally, this study found that contact with MDR-TB patients and water pipe smoking were associated with MDR-TB infection in Sudan. More efforts are required to decrease the rate of treatment interruption, to strengthen patients' adherence to treatment, and to reduce contact with MDR-TB patients.

Assessment of the risk factors associated with multidrug-resistant tuberculosis in Sudan: a case-control study / 한국역학회지

OBJECTIVES: The emergence of multidrug-resistant tuberculosis (MDR-TB) is a major challenge for the global control of tuberculosis (TB). The aim of this study was to determine the risk factors associated with MDR-TB in Sudan.METHODS: This case-control study was conducted from May 2017 to February 2019. Patients newly diagnosed with MDR-TB were selected as cases, and controls were selected from TB patients who responded to first-line anti-TB drugs. A questionnaire was designed and used to collect data from study participants. Logistic regression was used to evaluate associations between risk factors and MDR-TB infection. The best multivariate model was selected based on the likelihood ratio test.RESULTS: A total of 430 cases and 860 controls were selected for this study. A history of previous TB treatment (adjusted odds ratio [aOR], 54.85; 95% confidence interval [CI], 30.48 to 98.69) was strongly associated with MDR-TB infection. We identified interruption of TB treatment (aOR, 7.62; 95% CI, 3.16 to 18.34), contact with MDR-TB patients (aOR, 5.40; 95% CI, 2.69 to 10.74), lower body weight (aOR, 0.89; 95% CI, 0.87 to 0.91), and water pipe smoking (aOR, 3.23; 95% CI, 1.73 to 6.04) as factors associated with MDR-TB infection.CONCLUSIONS: Previous TB treatment and interruption of TB treatment were found to be the main predictors of MDR-TB. Additionally, this study found that contact with MDR-TB patients and water pipe smoking were associated with MDR-TB infection in Sudan. More efforts are required to decrease the rate of treatment interruption, to strengthen patients' adherence to treatment, and to reduce contact with MDR-TB patients.

Therapeutic use of hyperbaric oxygen therapy for children with autism spectrum disorder

Autism spectrum disorder [ASD] is neurodevelopment disorder, characterized by impairment in social interaction, verbal and non-verbal communication and the presence of restricted and repetitive stereotyped behaviors. The condition manifests within the first 3 years of life and persists till adulthood. At present, the etiology of ASD is largely unknown, but genetic, environmental, immunological, and neurological factors are thought to play a role in the development of ASD. The prevalence of ASD has increased dramatically in the past few decades. According to current estimates from the United States Centers for Disease Control and Prevention [CDC] as many as 1 in 91 children have ASD in USA. Studies from the Middle East on this topic are limited. Autism in Saudi Arabia is slightly higher than reported in the developed countries. Hyperbaric oxygen therapy [HBOT] has been growing in popularity for the treatment of ASD over recent years. However, few studies of its effectiveness have been reported. This article reviews important publications regarding the physiologic and clinical influence of HBO on ASD. Several case series and randomized trials have all proposed that low pressure/ low oxygen concentration hyperbaric treatment can improve the clinical manifestations of autism

Physical, mental, emotional and social health status of adolescents and youths in Benghazi, Libya

Adolescence and youth are stages of life that offer great opportunities for reduction of future health needs. A cross-sectional study was carried out to assess the physical, mental, emotional and social health status of adolescents and youths attending 2 large universities in Benghazi city, Libya, and to determine variables associated with their health status. Stratified sampling was used to select 383 students aged 17-24 years and data were collected by face-to-face interview and self-administered questionnaires. Major health problems were depression/anxiety and pain/discomfort, and these were suffered by significantly more females than males. Mental health was at the transitional stage in Dabrowski's emotional development theory [spontaneous multilevel disintegration]. Females had higher levels of emotional development. Regular physical activity was practised by 34.7% overall [25.8% of women] and 17.2% were smokers. The main social activity was visiting family members

Analysis of surgical emergencies in Benghazi, Libyan Arab Jamahiriya

The increasing incidence of trauma due to road crashes and violence has increased the need for an efficient emergency medical service. This cross-sectional study was based in a surgical emergency care facility in Benghazi city, Libyan Arab Jamahiriya. A representative sample of 391 admissions and 492 deaths was drawn from hospital medical records over a 6-year period [2000-05]. A higher proportion of patients were males among both deaths and admissions. Surgical emergencies for females were less serious and less likely to be fatal. The most vulnerable age for admissions was 25-49 years [37.6%] and for deaths was 60+ years [37.0%]. Noncommunicable diseases were responsible for 50.0% of deaths and 61.6% of admissions; the remainder were classified as injuries. The causes of surgical emergencies not only highlight priority areas for hospital management but also have relevance for community health management

Evaluation of diagnostic accuracy of different biomarkers for prostate cancer

Serum total prostate specific antigen [PSA], free fraction of total prostate specific antigen percent [fPSA%] and prostate specific antigen density [PSAD] have all been considered as valuable non-invasive tumor markers for prostate cancer. This study was carried out to evaluate and compare the performances of serum total PSA, fPSA% and PSAD in terms of their sensitivity, specificity and overall diagnostic accuracy for prostate cancer. Fifty [50] DRE [digital rectal examination]-positive patients admitted in Rajshahi Medical College Hospital [RMCH], Bangladesh during January, 2006 to January, 2008 were included. Estimation of serum total PSA and fPSA% were done by ELISA [Enzyme linked immunosorbent assay] using commercially available kits. Data pertaining to volume of prostate as determined by transabdominal ultrasonography were used to calculate PSAD and histology of the surgically resected prostatic tissue was done for laboratory confirmation of prostate cancer for all patients. Diagnostic sensitivity, specificity and accuracy of serum total PSA, fPSA% and PSAD were calculated using standard formulae against histopathological diagnosis. Prostate cancer was revealed in 41 of 50 patients by histopathological examination with mean age of 71.2 +/- 10.1 years. There were 9 cases detected as Nodular Hyperplasia of Prostate [NHP] with prostate-specific biomarkers mostly within their normal range. The sensitivity, specificity and overall diagnostic accuracy for prostate cancer of serum total PSA [at cut off value of >10 ng/ml] were 80.48%, 88.90% and 82.00%, for serum fPSA [at cut off value of <25%], were 92.68%, 77.80% and 90.00% and for PSAD [at a cut off value of > 0.15 ng/ ml/cm[3]], were found to be 90.00%, 88.90% and 90.00% respectively. Histologically, 27 [65.85%], 13 [31.71%] and 01 [2.44%] cases were labeled as poorly differenntiated, moderately differentiated and well differentiated carcinoma respectively and overwhelming majority had excellent correlation with all prostate-specific biomarkers. These results reinforce that different prostate-specific biomarkers have good diagnostic prediction with free PSA percent and PSAD have slightly better diagnostic accuracy over serum total PSA for prostate cancer

Pattern of semen fluid abnormalities in male partners of infertile couples in Khartoum, Sudan

Normal semen is a mixture of spermatozoa suspended in secretions from the testis and epididymis, which at the time of ejaculation, are combined with secretions from the prostate, seminal vesicles, and pulbourethral glands. Many factors affect the quantity and quality of semen parameters such as cigarette smoking, excessive exercise and alcohol consumption. The objectives of the study were to determine the pattern of semen fluid abnormalities [volume of the ejaculate, sperm concentration, sperm motility, sperm morphology] in male partners of infertile couples in Khartoum, Sudan. This was a descriptive study, 100 records of couples who attended Sudan Assisted Reproduction Centre in Khartoum seeking fertility treatment from July - December 2008 were reviewed for the volume of the ejaculate, the concentration of the sperms, the motility and the morphology. Semen production was obtained in the centre or at home after 3-7 days of abstinence from intercourse. Production of semen was by masturbation in a sterile container. Evaluation of samples was made by a qualified andrology technician. Statistics was done by the computer using SPSS soft ware. Results showed that 41.5%, 53.9%, 3.1%, and 1.5% of men had a volume of < 2, 2-4, 5-7 and >8 ml respectively. 25%, 37% and 38% had normal, oligozoospermia and azoospermia respectively. As regards motility, 27.4% had normal motility 62.9% had sluggish motility and 9.7% their sperms were immotile. There were only 1.8% of men who had normal morphology. The study concluded that, few men had sperm profile that was consistent with reference values with regard to volume, concentration, motility and morphology. Morphology showed the least normality. Results showed that no subject in the cohort fulfilled the full criteria of normozoospermia

Particle associated polycyclic aromatic hydrocarbons in the atmospheric environment of urban and suburban residential area

Ten polycyclic aromatic hydrocarbons associated with suspended particulate matter in the ambient air were collected at two sampling sites: urban and suburban residential areas of Yokohama, Japan from 1999 to 2005. The concentrations of target compounds were determined using gas chromatography-mass spectrometry. The total concentrations were higher in urban residential area than suburban residential area. They ranged from 0.31 to 6.16 ng/m3 with a mean of 2.07 ng/m3 and 0.33 to 2.87 ng/m3 with a mean of 1.02 ng/m3 in the urban and suburban residential areas, respectively. The predominant compounds determined both in the urban and suburban residential areas were benzo[b]fluoranthene, benzo[ghi]perylene, indeno[1,2,3-cd]pyrene and benzo[e]pyrene. The concentrations of 5- and 6-ring polycyclic aromatic hydrocarbons were higher in the urban than the suburban residential area, accounting for 77.3% and 72.1% of total polycyclic aromatic hydrocarbons, respectively. Source identification was performed by principal component analysis. Two principal components were identified for each study area and these accounted for 95.9% and 83.3% of total variance, respectively. The results revealed that stationary source and vehicle emissions were the major pollution sources in the studied areas. The impact of emission regulations for automobiles in large Japanese cities, which were enacted during 2002 and 2003, was also studied. Based on the average total concentration, emission reduction was 47.8% and 18.6% in urban residential and suburban residential areas, respectively

Detection of ESBL producing nosocomial gram negative bacteria from a tertiary care hospital in Bangladesh

Extended spectrum beta-lactamases [ESBLs] represent a major group of lactamases currently being identified in large number worldwide mostly produced by gram-negative bacteria. The present study was done to see the frequency of ESBLs in gram-negative bacterial isolates causing nosocomial wound infections from a tertiary care hospital in Bangladesh. A total of 125 wound swabs were collected from surgical site infections and burn cases, admitted in Rajshahi Medical College Hospital [RMCH], during January to June, 2008. Swabs were cultured for aerobic bacteria and antimicrobial susceptibility testing was carried out using the Kirby-Bauer agar diffusion method. Gram-negative isolates were tested for ESBLs on Mueller Hinton agar by both modified double disc and phenotypic confirmatory methods. Culture yielded 71 [56.8%] bacterial growths with 60 [84.51%] gram-negative and 11 [15.49%] gram-positive bacteria [Staph aureus]. Gram-negative isolates included 23 [32.39%] E. coli, 19 [26.76%] Klebsiella spp., 16 [22.54%] Pseudomonas spp., and 02 [2.82%] Proteus spp. The number of ESBL producing bacteria in modified double disc and phenotypic confirmatory methods were 28 [46.67%] and 25 [41.66%] respectively. Highest rate of ESBLs was observed in Klebsiella spp. [57.89%] followed by Proteus spp. [50.0%], E. coli [47.83%] and Pseudomonas spp. [31.25%], which showed significantly increasing resistance to 3rd generation cephalosporins, aminoglycoside, quinolone and trimethoprim-sulfamethoxazole. Significant number of nosocomial wound infections is caused by ESBL bacteria; those are not detected by routine antimicrobial susceptibility testing. It is recommended that clinical microbiology laboratory should take urgent measure for ESBLs detection as routine to enhance hospital infection control programme

Colorectal cancer during pregnancy in a Sudanese female

We report a new case of uncommon but not rare condition of colorectal cancer during pregnancy in 33 years old Sudanese female at her 16th weeks of gestation presented with bloody diarrhea and intermittent left side abdominal pain. Initially she was diagnosed as a case of dysentery which was treated by antibiotics. Condition was diagnosed by colonoscopy and histopathology as colonic cancer, located in the sigmoid colon 50 cm from anal verge. A review of literature found that 276 cases of colon cancer associated with pregnancy have been reported. Pregnancy affects the clinical presentation, evaluation, therapy, and prognosis of colon cancer. Patients usually present with misdiagnosed symptoms. Diagnostic delays often lead to the tragic demise of a young woman from a potentially curable disease and of an otherwise viable fetus. This delay in diagnosis is a major contributing factor to the poor prognosis associated with this disease. Synchronous colon cancer during pregnancy presents a diagnostic and therapeutic challenge for clinicians because there are no generally accepted guideline regarding diagnosis or treatment. This article reviews this uncommon condition with a focus on the features of colon cancer in pregnancy to facilitate earlier diagnosis, to modify investigations, to optimize the therapy, and to improve the maternal and fetal outcomes

Congenital visceral leishmaniasis

Visceral leishmaniasis [kala-azar] is caused by the protozoan parasite Leishmania donovani and transmitted by the bite of infected sand fly Phlebotomus argentipes. Only a few cases of congenital transmission have been reported. We are reporting a 15 days old baby with congenital visceral leishmaniasis and then the literature is reviewed

Blunt non-perforating ocular trauma patterns of ocular damage and final visual outcome

To study the causes of blunt ocular trauma in a closed-globe, its various clinical signs on presentation and final visual outcome. A prospective analytic study of one hundred cases of the blunt ocular trauma conducted in the Department of Ophthalmology, Ayub Teaching Hospital, Abbottabad. In one hundred cases. Seventy-nine [79%] were males and twenty-one [21%] were females. Hyphacma occurred in sixty-two cases [93.9%], mydriasis in twenty-nine cases [43.9%], traumatic iritis/uveitis fifty three [80.3%], and seventeen [25.8%] patients developed traumatic cataract. Traumatic Glaucoma occurred in 3% cases. Vitreous haemorrhage occurred in nineteen [63.3%] and seventeen [56.7%] cases were with retinal heamorrhages, commotio retinae was seen in ten [33.3%] post-traumatic optic atrophy occurred in eight [26.7%] and retinal detachment in six cases. Anterior segment involvement have better visual prognoses 89.4%, compared to posterior segment trauma which is 26.7%. A high percentage of youth and children suffered eye injuries, home setting and sports-related injuries were more common. Hyphaemas and lens injuries have relative little affect on the final visual outcome as compared to the posterior segments injuries

Mercury[II] cystine complex as antineoplastic agent

Antineoplastic activity of mercury[II] cystine complex was studied against ehrlich ascites carcinoma [EAC] cells in Swiss Albino mice. Cell growth inhibition, increase of life span, haematological parameters, alkaline phosphatase activity of tumour bearing mice inoculated with EAC cells were studied with the test compound. It was found that this compound significantly inhibited the tumour cell growth, enhanced life span of the tumour bearing mice at dose 6 mg/kg i.p. Such treatment also restored the altered haematological parameters and serum alkaline phosphatase activity very closely towards normal. The compound can be considered as a potent antineoplastic agent

variation in the circulus arteriosus: a case report

This article described a variation detected in the cerebral arteries. In general the right arteries were found larger than the left. The left vertebral artery was found very small. Both anterior cerebral arteries originated from the right internal carotid and there was a small connecting branch from the left internal carotid to the left anterior cerebral artery

Frequency of cardiac defects among children at echocardiography centre in a teaching hospital

To assess frequency of cardiac defects among children from birth to 12 years of age on echocardiography basis. A cross sectional study was conducted at echocardiography centre in coronary care unit at Bahawal Victoria Hospital Bahawalpur for fifteen months from April 2007 to July 2008. A sample of 150 patients [<12 years age] were selected by non-probability convenience sampling technique. The cardiologists performed echocardiography by Paediatric Transthoracic echo probe; 2-D colour Doppler, Acuson CV-70 and Niemo-30 echocardiography machines. Mothers of children with cardiac defects were interviewed at the echocardiography centre. Variables included were A- Muscular plus Vascular defects; B- Valvular defects; C-Pericardial effusion; D- Dextrocardia and E- Congestive cardiac failure. History of children for sore throat followed by joint pains; history of mothers for drug intake [antihypertensive, antipyretic, anti-emetic, hypoglycaemic] as well as chronic diseases [diabetes mellitus, hypertension, anaemia] during pregnancy were surveyed. Parity of mothers, their cousin marriages, and family socio-economic status was also inquired. The results were tabulated, analyzed and finally subjected to suitable test of significant [SR of proportion] to find out statistical significant if any. It was found that out of 150 patients, 76 [50.66%] were suffering from Cardiac muscular and Vascular defects, 61 [40.66%] Valvular defects, 7 [4.66%] Pericardial effusion, 2 [1.33%] Dextrocardia and 4 [2.66%] from Congestive Cardiac Failure. According to age, 54 [36%] were from birth to 3 years of age and 51 [34%] from 10 to 12 years. There was history of Rheumatic fever among 45 [30%] children. There were 106 [70.6%] children from lower socio-economic class and 79 [52.6%] parents had history of cousin marriages. Frequency of cardiac defects was more in children of male sex, lower socio-economic group, from birth to three years age and children from primipara mothers in our specified locality. Rheumatic fever, cousin's marriage, and prescribed drugs intake during pregnancy [for metabolic and hormonal disorders] were other contributors to cardiac defects

overview of odontogenic infections. When to refer?

Dental and Medical practitioners as well as specialists in medicine and dentistry are often faced with the challenge of managing patients with infections. These infections can range in their severity from those that may only require antibiotic therapy to those that may require aggressive surgical intervention. Oral and maxillofacial infections, in particular, have the tendency to spread rapidly along fascial planes and if left untreated they may lead to highly morbid clinical conditions with severe complications that may ultimately lead to death. Careful diagnosis and sound clinical judgment have the potential to reduce morbidity associated with odontogenic infections. The success of these treatments are, in part, dependent on the virulence of the pathogen involved, the resistance of the host and strict adherence to sound medical, pharmacological and surgical principles. An overview of the principles of antibiotic therapy, diagnostic laboratory and imaging studies and the principles of surgical management will be presented

Epidemiology of Kawasaki disease in Qatar [an Arabian gulf country]

Case records were reviewed retrospectively of 49 patients admitted between January 1992 and December 2002 to evaluate the epidemiologic pattern of Kawasaki disease [KD] in Qatar. Ages ranged from three months to nine years with a median of 28 months and a male/female ratio of 2.3:1. During the eleven years, the annual incidence varied from 2.5/100,000 to 20/100,000 and appears to be increasing. Most cases occurred in the cooler season [January-May] affecting predominantly males and children under five years of age with no apparent predilection for any section of the ethnically varied population