Imaging features of fulminant cerebral malaria: A case report.

Cerebral malaria is associated with high mortality and morbidity in patients infected with Plasmodium Falciparum. The mechanisms of cerebral malaria include sequestration of parasitized red blood cells in brain capillaries, production of cytokines, immune cell/platelet accumulation, and release of microparticles, resulting in disruption of the blood-brain barrier, which caused brain injuries. The severity of this reflects on neurological findings ranging from simple delirium to profound coma. We herein present unique magnetic resonance imaging findings of a case of fulminant cerebral malaria as computed tomography studies usually underestimate the extent of cerebral involvement in malaria.

The risk of cancer in primary care patients with thrombocytosis: A retrospective observational study within a family medicine setting in Saudi Arabia.

Background: An elevated platelet count, or thrombocytosis, is a risk factor for cancer. This study will highlight the importance of primary health care providers' awareness of the potential for malignancy in patients with thrombocytosis. Aim: To evaluate the prevalence of cancer among patients aged above 40 years with elevated platelet counts. Objectives: The purpose of the study was to analyze the prevalence of cancer among patients aged above 40 years at King Faisal Specialist Hospital and Research Centre (KFSHRC) who had thrombocytosis and a platelet count above 450 × 109/L. A secondary objective was to examine whether primary care physicians were prompt in initiating investigation of these patients. This study's findings will help primary care physicians thoroughly investigate thrombocytosis and develop guidelines that can be applied in primary care settings. Materials and Methods: This study was an observational cohort study. The data used originated from the family medicine patient Records at KFSHRC. The data were collected from electronic records by searching all the patient consultations and laboratory results that were available. Results: In total, 338 patients aged above 40 years had a platelet count above 450 × 109/L. Of these patients, 68 were men (20%) and 270 were women (80%). Cancer was diagnosed within two years of thrombocytosis in 7.8% of patients (n = 26), of whom 8 were men and 18 were women. Conclusion: It is necessary to enhance primary health care professionals' awareness of the need to investigate the prevalence of cancer in patients with thrombocytosis.

Awareness of medical law among health care practitioners in Saudi Arabia.

OBJECTIVES: To determine the level of awareness of medical law among healthcare practitioners and to identify factors that influence that level of awareness in Saudi Arabia. METHODS: This cross-sectional study was carried out in Riyadh, Saudi Arabia in 2020-2021 via a survey including 750 healthcare practitioners, from different specialties including all regions in Saudi Arabia. Participants included consultants, senior registrars, interns, and residents. RESULTS: Majority of enrolled healthcare practitioners had poor awareness of medical law (approximately 97%). Only 1.5% had adequate awareness of medical law, and only 1.5% had moderate awareness. Factors associated with increased medical law awareness were the age group between 25 and 34, being from the central region, and having a clinical practice for less than 10 years p-value of <0.05. CONCLUSION: Awareness of medical law among healthcare practitioners is limited in Saudi Arabia. Professional medico-legal education should be part of required competencies for undergraduate and postgraduate levels of medical education. Health care practitioners must be educated with laws and regulations of practicing health professions in the country.

Relationship between the occlusal plane and three different levels of ala-tragus line in a sample of sudanese adults / Relación entre el plano oclusal y tres niveles diferentes de la línea ala-trago en una muestra de adultos sudaneses

Aim: Correct orientation of the occlusal plane plays a vital role in achieving the perfect occlusal balance and function of complete dentures. This study aimed to evaluate the most reliable posterior reference point of the ala-tragus line (ATL) concerning occlusal plane (OP) in a sample of the dentate Sudanese population. Materials and Methods: A total of 150 subjects with healthy and well-aligned permanent teeth were randomly selected. Right lateral profile photographs were taken with subjects having a fox plane placed intra-orally, contacting the occlusal plane. Reference points corresponding to inferior, middle, and superior borders of the tragus and inferior border of the ala of the nose were marked on photographs. The angles between the lines were measured using the Auto-CAD software program, and the most parallel relationship was determined. Descriptive statistics in terms of means and standard deviations were presented. Independent t-test and one-way ANOVA tests were used to compare as appropriate. A p-value < 0.05 was considered significant. Results: The mean angle formed by the OP and ATL was 8.5±3.69º for the superior level, 4.68±3.13º for the middle line, and 2.89±2.57º for the inferior line. A significant difference was found between the means of the three angles (p< 0.001), while no significant difference (p> 0.05) was found between both genders regarding the measured angles. Conclusions: The line joining the inferior border of the ala of the nose with the inferior border of the tragus of the ear was the most reliable line in terms of parallelism to determine the occlusal plane orientation.

Antecedentes: La orientación correcta del plano oclusal juega un papel vital para lograr el equilibrio oclusal perfecto y la función de las prótesis completas. Este estudio tuvo como objetivo evaluar el punto de referencia posterior más confiable de la línea ala-trago (ATL) con respecto al plano oclusal (OP) en una muestra de la población dentada de Sudán. Materiales y Métodos: Se seleccionaron aleatoriamente un total de 150 sujetos con dientes permanentes sanos y bien alineados. Se tomaron fotografías de perfil lateral derecho de sujetos a los que se les colocó un plano de zorro intraoralmente, en contacto con el plano oclusal. En las fotografías se marcaron los puntos de referencia correspondientes a los bordes inferior, medio y superior del trago y al borde inferior del ala de la nariz. Los ángulos entre las líneas se midieron utilizando el programa de software Auto-CAD y se determinó la relación más paralela. Se presentaron estadísticas descriptivas en términos de medias y desviaciones estándar. Se utilizaron prueba-t independiente y prueba ANOVA unidireccional para las comparaciones, según correspondiera. Se consideró significativo un valor de p<0,05. Resultados: El ángulo medio formado por OP y ATL fue de 8,5±3,69º para el nivel superior, 4,68±3,13º para la línea media y 2,89±2,57º para la línea inferior. Se encontró una diferencia significativa entre las medias de los tres ángulos (p< 0,001), mientras que no se encontró diferencia significativa (p>0,05) entre ambos sexos con respecto a los ángulos medidos. Conclusión: La línea que une el borde inferior del ala de la nariz con el borde inferior del trago de la oreja fue la línea más confiable en términos de paralelismo para determinar la orientación del plano oclusal.

A review of Meckel-Gruber syndrome--incidence and outcome in the state of Qatar.

Meckel-Gruber (MKS) syndrome is a lethal autosomal abnormality diagnosed most commonly from classical findings on ultrasound scan after the late first trimester. There are few reports of cases followed up antenatally until delivery. We report here one of the largest series of 19 cases diagnosed antenatally from as early as 11 weeks gestation with 5 born alive. Of the 12 cases followed up antenatally, 7 were stillbirths while 5 were live births. The absence of obvious polycystic kidneys and severe oligohydramnios were prognostic features consistent with a live birth; however, mortality was 100% within a few weeks of delivery. The incidence of 2/1000 live births in the local population is similar to that reported from similar groups where consanguinity is more than 40%. The recurrence rate was high with 50% of the parous patients having had an affected baby. We conclude that diagnosis in early pregnancy does not require the classical triad of encephalocele, polydactyly and polycystic kidneys as some of these features do not manifest on imaging until much later.

Contribution of noncommunicable diseases to medical admissions of elderly adults in Africa: a prospective, cross-sectional study in Nigeria, Sudan, and Tanzania.

OBJECTIVES: To describe the nature of geriatric medical admissions to teaching hospitals in three countries in Africa (Nigeria, Sudan, Tanzania) and compare them with data from the United Kingdom. DESIGN: Cross-sectional cohort study. SETTING: Federal Medical Centre, Idi-Aba, Abeokuta, Nigeria; Soba University Hospital, Khartoum, Sudan; Kilimanjaro Christian Medical Centre, Moshi, Tanzania; and North Tyneside General Hospital, North Shields, United Kingdom. PARTICIPANTS: All people aged 60 and older urgently medically admitted from March 1 to August 31, 2012. MEASUREMENTS: Data were collected regarding age, sex, date of admission, length of stay, diagnoses, medication, date of discharge or death, and discharge destination. RESULTS: In Africa, noncommunicable diseases (NCDs) accounted for 81.0% (n=708) of admissions (n=874), and tuberculosis, malaria, and the human immunodeficiency virus and acquired immunodeficiency syndrome accounted for 4.6% (n=40). Cerebrovascular accident (n=224, 25.6%) was the most common reason for admission, followed by cardiac or circulatory dysfunction (n=150, 17.2%). Rates of hypertension were remarkably similar in the United Kingdom (45.8%) and Africa (40.2%). CONCLUSIONS: In the elderly population, the predicted increased burden of NCDs on health services in Africa appears to have occurred. Greater awareness and some reallocation of resources toward NCDs may be required if the burden of such diseases is to be reduced.