Splenic aspiration in childhood visceral leishmaniasis: an experience from Assir region of Saudi Arabia

To study the role of diagnostic splenic aspiration in Arabian childhood visceral leishmaniasis, in a situation where many children with possible visceral leishmaniasis remained undiagnosed by bone marrow aspiration alone. Prospective study of the safety and reliability of diagnostic splenic aspiration. Asir Central hospital, the regional referral hospital for Asir Province, an area endemic for visceral leishmaniasis. Hospitalized bone-marrow negative children with suspected visceral leishmaniasis in whom parental consent was available and a coagulopathy had been excluded or corrected. Percutaneous splenic aspiration using a small-calibre [22-gauge] needle, rapid-aspiration technique, and examination of Giemsa-stained smears for amastigote leishman Donovan bodies. Close monitoring of patients post-aspiration for complications. Parasites were detected in 12 of 12 [100%] children with visceral leishmaniasis and absent in two children with other illnesses. There were no failed taps or complications. Splenic aspiration is a safe and reliable alternative diagnostic method in bone marrow negative children with suspected visceral leishmaniasis in the appropriate hospital setting. Further experience is required to confirm our findings

Clinical and laboratory features of childhood visceral leishmaniasis in south western Saudi Arabia

The clinical and laboratory features of visceral leishmaniasis [VL] were studied in 51 children at Abha in southwestern Saudi Arabia, an area endemic for the disease. The majority of patients came from the coastal Tihama Valley or had visited the Valley from the hills. There was a predilection for infants and young children [median age 18 months]. A double quotidian fever pattern was observed in half the patients. Splenomegaly was noted to be more common and more severe than hepatomegaly. Important hematological features were anemia, often severe, neutropenia and thrombocytopenia. Common biochemical abnormalities included hepatic dysfunction, hypoalbuminemia and hyperglobulinemia. The hematological and biochemical changes noted in VL are nonspecific. Our findings are compared with those from other endemic areas. Saudi Arabian VL resembles the Mediterranean form of the disease

Congenital hip instability in hospital born neonates in Abha

In a prospective screening of 2222 consecutive live hospital births over a ten-month period in Abha, there was an incidence of 3.6% for congenital hip instability by examination within 48 hours of delivery. This is a higher incidence than that reported from most parts of the world and is comparable to earlier Japanese figures. This suggests a regional variation in the incidence of hip instability within the Kingdom of Saudi Arabia. Bilateral instability was found in 32% and there was a left lateral dominance. There was a significantly higher incidence in female babies, in the local Saudi population and in first degree relatives of affected babies. Hip instability was noted in 8% of breech deliveries. No association was demonstrable with maternal age, birth order, size of the baby or gestation. Our findings are compared with other published data from Saudi Arabia and the West. The need for continued appropriate neonatal screening for early diagnosis of congenital hip instability is emphasized

Clinical and radiological features of chondroectodermal dysplasia

This report documents the presence of chondroectodermal dysplasia in southwestern Saudi Arabia by describing the clinical and radiological features in three patients from two families. Mesomelic dwarfism, characteristic orodental manifestations, small thorax, nail hypoplasia and polydactyly of the hands were seen in all cases. Two patients had atrial septal defect; the third patient, who died, had an undefined cardiac anomaly with congestive heart failure. In addition to the typical radiological features, variations such as anterior scalloping of dorsolumbar vertebrae, syntarsaly and polydactyly of feet with separate unfused metatarsals were seen in one patient each. The combination of ectodermal and mesodermal anomalies permits early recognition of the syndrome