Tropical Doctor

The observation of the predominance of scabies and streptococcal skin infection in the skin diseases occurring in the outpatient department of the Komfo Anokye Teaching Hospital, Kumasi, Ghana, led to a survey being conducted. It began with an exploratory survey in two well-defined communities, a medium security prison with a population of 1063 and a village with a population of 3000. This was later followed by an epidemiological survey in the village. The results showed that the most common skin disease in middle Ghana (a tropical rainforest area) was scabies with about 17.6% of the population having the disease.

Pancreatic pseudocysts are uncommon and very few cases have been reported in Nigeria. Six cases of pancreatic pseudocysts were treated at Ife University Teaching Hospitals Complex from 1984 to 1986. The striking presenting symptoms were abdominal pain, nausea, vomiting and weight loss. Investigative procedures of serum amylase, barium studies and ultrasonography were performed. One resolved spontaneously, 5 patients had internal drainage and one of these died. The surviving patients are still being followed up.

A noma is an acute, necrotizing ulcerative mucositis, also known as cancrum oris, which occurs commonly in children, 2–5 years of age, having a debilitating illness or severe malnourishment. This gangrene lives up to the meaning of its Greek name, by rapidly devouring all adjacent soft tissues, and in some cases even bone. It generally affects the mouth and genitalia and infrequently involves the lid and other extraocular tissues^1–3. A noma spreads painlessly and has been reported to leave extensive and complex facial defects^2,4,5.

Surprisingly, the nomas seen at the Lady Hardinge Medical College and Smt. Kalawati Saran Children's Hospital have been noted to heal without any disfiguring defects when maintained on supportive nutritional therapy and antibiotics without any surgical manipulation during the active or healing phases of the disease.

We detail the history and findings in one such case to emphasize the excellent cosmetic and functional results obtained by this purely conservative management.

A new destructive instrument for the delivery of the dead impacted fetus is presented. The efficiency of the instrument is demonstrated in three cases and the diminished risk of maternal trauma highlighted. The instrument consists of a perforator, an introducer, a screw holder and a fetal bone screw.

In the 1940s Anopheles mosquitoes were abundant about the wells and marshy areas in Saudi Arabia. Nearly 100% of the population in many villages and oases had suffered from malaria at one time or another. However, the progress made in the malaria program in Saudi Arabia from the time of its inception in 1948 is possibly one of the most significant achievements in public health in the Kingdom over the last 40 years. The challenge which the country now faces is to control malaria in the Southern Province and in the residual foci in the Western Province, while maintaining the rest of the country malaria free.