Background:Cutaneous leishmaniasis (CL) is still a major health problem in many countries including Saudi Arabia. Patients with CL are seen, not only by dermatologists, but also by pediatricians and community physicians. Knowledge of available treatment options is essential. Design: A literature review utilizing PubMed and Cochrane evidence-based library was undertaken in the last five years. Results : Several medications and therapeutic modalities are currently in use, though the gold standard remains systemic antimonials. Drug resistance and serious side effects preclude the use of available medications. Newer therapies like liposomal amphotericin B, miltefosine and pentamidine are being used; while it is hoped that other drugs like imiquimod, tamoxifen, PDT and pentamidine structural analogs being tested would offer better efficacy, easier administration and lower toxicity. Conclusion : After decades of little advance in the treatment of leishmaniasis, there are now several options with newer compounds and combinations of these.

Background: Coronary heart disease (CHD) is the leading cause of death throughout the world. PHC doctors are in a unique position to prevent CHD and promote health in the population. However, the perception of PHC doctors on CHD prevention has not been well documented. Objectives : To explore and examine the perception of PHC doctors on the prevention of CHD. Subject and method: A questionnaire survey of all PHC doctors attending a continuing medical education (CME) activity in Riyadh city. The questionnaire was designed and piloted with local PHC doctors before being used in this survey. Results : All the 77 PHC doctors responded (100%) and almost all the them (97.4%) agreed that the primary prevention of CHD was an essential task. Fifty-two participants (67.53%) confirmed that little attention had been paid to the primary prevention of CHD. While the majority of respondents (71.43%) felt that the primary prevention of CHD was an easy task, a significant minority (23.37%) disagreed. Interestingly, 70 (90.91%) respondents were not aware of any local literature on how to achieve primary prevention of CHD and would like to have the literature made available to them. Finally, participants indicated that the percentage prevalence of CHD risk factors among their patients was high. Conclusion : the findings of this survey confirm a general feeling that the primary prevention of CHD is not being given enough attention. Participants accepted that the primary prevention of CHD was an essential part of their work, but the lack of local literature and research on this vital area was a major concern.

Background:Noise is recognized as a source of hazard to the patient's environment. Studies have also shown that it has a direct impact on mortality and morbidity as a result of sleep deprivation which affects the immunity of critically ill patients. Objectives: The aim of this study was to measure levels of environmental noise in a six- bed, open-plan general medical intensive care unit (MICU). Methods: Levels of exposure to environmental noise were assessed in the intensive care unit of King Fahad Hospital of the University (KFHU) where measurements of environmental noise were taken using calibrated sound level meter during shifts of working days and weekends. Results : Statistical analysis revealed that there were no significant differences between noise levels in the morning, evening and night shifts of working days and weekends in the ICU of KFHU (p value =0.155, 0.53 and 0.711) respectively . There was no significant difference between overall level of exposure to noise in the working days and weekends as well (p-value=0.71). However, the assessed levels of exposures to noise were still higher than stipulated international standards. Conclusion : Some sources of environmental noise, such as the use of oxygen, suction equipment or respirators are unavoidable. Nevertheless, hospital ICUs should have measures to minimize the level of exposure to noise in the ICU. Further research in this area might focus on the noise level and other modifiable environmental stress factors in the ICU that affect patients as well as the staff.

Toxoplasmosis drugs have the longest history and are still the first choice for most conditions. Alternative drugs such as Co-trimoxazole and Tetracycline have been tried and acclaimed successful. The lack of general acceptance, however, is an indication that the results are not very convincing. A wide range of antibiotics is urgently needed for patients with drug reaction or resistance problems. The anti-toxoplasmic activity of water and ethanol extracts as well as the oil of some home spices (Piper nigrum, Capsicum frutescens, Cinnamomum cassia and Curcuma longa), were evaluated in murine models of intraperitoneal infection using the RH strain of Toxoplasma gondii. Female mice were infected with 2x10 ^[2] tachyzoites/ml, and then treated intraperitoneally with the home spices at 100 and 200 mg/kg/day for seven days. The tested extracts reduced the mean number of tachyzoites present in the peritoneal fluid of the experimental mice. The most effective extract was Curcuma longa ethanol extract which showed a 98.6% and 99.2% inhibition of the growth of Toxoplasma tachyzoites in 100 and 200 doses respectively compared to the control infected untreated mice.

Medical education began in Saudi Arabia in 1969 when King Saud University, the first medical school was established. Since then globalization has brought numerous challenges. In this paper, we review the status of medical education and its expected future projects.

Pancytopeni,a as an initial manifestation of acute plasmodium vivax malaria is extremely rare and mainly reported with plasmodium falciparum. We report a 37- year old Nepali patient who recently came to Saudi Arabia and presented with a three-week history of intermittent fever, chills and rigor. She was found to have spleenomegaly, pancytopenia, hyperferrtinemia, and hypofibronogenemia with positive peripheral blood smear for plasmodium vivax. The patient had a full recovery from pancytopenia with oral chloroquine.