Leprosy has been a major burden on humanity over thousands of years. Perhaps no other disease in the history of mankind has been associated with such a strong social stigma as leprosy. Failure in early detection often leads to severe disability in spite of eradication of mycobacteria at a later date. Untreated the disease is progressive and results in permanent damage to the skin, nerves, limbs and eyes. Objectives: To study the pattern of neurological manifestations among adult Sudanese leprosy patients seen in Khartoum Dermatology Hospital in the period from March 2006 to August 2006. Methodology: This is a prospective cross-sectional hospital-based study. Seventy adult Sudanese leprosy patients were studied using simple, direct, standardized questionnaire including history and neurological examination, during the period from March to August 2006. Results:The most common age group affected was 18-27 years. Male to female ratio was 3:1. Numbness was the most common neurological symptom seen in 77.14%. Each of visual disturbance, headache and bilateral ulnar sensory impairment was detected in 7.14%. Half of the patients had upper limbs sensory nerve dysfunction while 42.86% exhibited sensory nerve dysfunction in the lower limbs. "Gloves and stoking" sensory impairment was the most common finding (30%) while bilateral lateral popliteal sensory impairment was seen with the same percentage. Bilateral median and unilateral posterior tibial sensory impairment were found in 1.43% each. Unilateral radial cutaneous sensory impairment was seen in 2.86%. Approximately half (48.57%) of the patients had upper limbs motor dysfunction. Bilateral ulnar distribution motor affection was seen in 40%. A significant number (41.43%) had upper limbs muscle wasting. Impaired olfaction was the most common cranial nerve sign seen in 12.86%. Leprosy reactions were detected in 21.43%; type 2 reaction in 14.29% while type 1 reaction in 7.14%. Conclusion: Numbness and limbs weakness were the most common neurological symptoms in leprosy patients. Peripheral nerve sensory impairment was found in half of the patients with "Gloves and stokes" peripheral sensory neuropathy being the most common sensory disturbance. Motor dysfunction was found in 48.57%. Ulnar and median nerves motor affection was the most common motor dysfunctions. Signs related to cranial nerves involvement were less common. Leprosy reactions were present in one-fifth of the patients.

Introduction: Worldwide, an estimated 1.4 million children are blind, of whom approximately 190,000 (14%) are blind owing to bilateral un-operated cataract, complications of surgery, amblyopia due to delayed surgery, or the presence of other associated anomalies. Pediatric cataract blindness presents an enormous problem to developing countries in terms of human morbidity, economic loss, and social burden. Managing cataracts in children remains a challenge, even in the industrialized world. Treatment is often difficult and tedious and requires a dedicated team effort. Aim of the work: To evaluate the experience with the surgical management of various types of pediatric cataract, managed at the Ophthalmology department, Sohag University Hospital during the period of the study Patients and Methods: A prospective, randomized study, patients were divided into 3 groups based on the surgical technique they had undergone. Group A "25 patients" : patients who have undergone Lensectomy anterior vitrectomy (LAV). GroupB"24patients": patients who have undergone Extracapsular cataract extraction, primary posterior capsulorhexis or capsulotomy, anterior vitrectomy, and IOL implantation (ECCE/PPC/AV/IOL). Group C"26patients": patients who have undergone Extracapsular Cataract Extraction and IOL Implantation (ECCE/IOL) Results: Uncorrected visual acuity was better than 6/60 in 27 eyes (27.8%); 13 (13.4%) in group B and 14 (14.4%) in group C. Acuity of 1/60 to 6/60 was measured in 5 eyes (5.1%); 3 (3.1%) in group B and 2 (2%) in group C. The remaining 5 eyes had visual acuity less than 1/60 and this was attributed to amblyopia. Conclusion: IOL implantation at primary cataract surgery helps to prevent development of secondry glaucoma, but increases the number of interventions for VAO in infants.

BACKGROUND: This study aimed to compare the gastric fluid volume (GFV) in children who fasted 1 versus 2 hours using ultrasound, after ingestion of a defined volume of clear fluid. METHODS: Children scheduled for elective surgery were enrolled in this randomized, double-blinded, controlled trial. After receiving 3 mL kg–1 clear fluid, participants were randomized to have a gastric ultrasound after fasting for either 1 hour (1-hour group, n = 116) or 2 hours (2-hour group, n = 111). Our primary outcome was the GFV. Other outcomes included the antral cross-sectional area, frequency of high risk and low risk of aspiration, and qualitative grading for the gastric antrum. RESULTS: Two hundred and twenty-seven children were available for final analysis. The median (Q1–Q3) GFV was higher in the 1-hour group versus the 2-hour group (0.61 [0.41–0.9] mL kg–1 vs 0.32 [0.23–0.47] mL kg–1; P value = .001). None of the study groups had GFV ≥1.5 mL kg–1. The frequency (%) of GFV ≥1.25 mL kg–1 was comparable between both groups (2 [1.7%] vs 0 [0%], P value = .165). However, the frequency of GFV ≥0.8 mL kg–1 was higher in 1-hour group than in 2-hour group (34.5% vs 4.5%), and grade 2 antral grading score was 56.9% in 1-hour group vs 0.9% in 2-hour group (P value <.001). CONCLUSIONS: In healthy children scheduled for elective surgery receiving 3 mL kg–1 clear fluid, the median GFV after 1-hour fasting was double the volume after conventional 2-hour fasting. These findings should be considered whether weighting the risk/benefit of a liberal approach to preoperative fasting versus the risk of pulmonary aspiration.

Introduction: Glaucoma is a recognized complication of pediatric cataract surgery. Despite improved surgical techniques, the incidence of glaucoma following successful cataract removal remains high. A significant number of surgeons regard aphakia as a cause of glaucoma. This glaucoma, however, may be better described as 'glaucoma in aphakia and pseudophakia'. Other complications, retinal detachment. It was found that retinal detachment is infrequent following aphakia in pediatric cataract surgery, at least at short term follow-up. Corneal astigmatism is recognized as a problem arising from cataract surgery. Aim of the work: To evaluate postoperative complications (early and late) after pediatric cataract surgery in Sohag University Hospital Patients and Methods: A prospective, randomized study, patients were divided into 3 groups based on the surgical technique they had undergone. Group A "25 patients" : patients who have undergone Lensectomy anterior vitrectomy (LAV). GroupB"24patients": patients who have undergone Extracapsular cataract extraction, primary posterior capsulorhexis or capsulotomy, anterior vitrectomy, and IOL implantation (ECCE/PPC/AV/IOL). Group C"26patients": patients who have undergone Extracapsular Cataract Extraction and IOL Implantation (ECCE/IOL) Results: Early postoperative complications were diagnosed in 34 eyes (35.1%). Postoperative iritis occurred in 7 eyes (7.2%) with mild inflammatory reaction. Striate keratopathy was found in 4 eyes (4.12 %) and cleared after frequent topical steroid application. Postoperative endophthalmitis: occurred in one eye in group A in the second postoperative day. Twenty-four hours later, 3 ports pars plana vitrectomy was done but unfortunately the eye passed into atrophia. Early IOL capture occurred in 2 eyes (2.1%) with PMMA IOL. Both patients belonged to group C. Both occurred in the second postoperative day. Postoperative retinal detachment (RD) occurred in one eye (1%) in group B, Posterior capsule opacification (PCO) occurred in 30 eyes (31%) during the first 3 months of follow up. Seven eyes (7.2%) belonged to group A. In group B, 5 eyes (5.1%) had PCO, Late IOL capture occurred in 9 eyes (9.3%). These included 5 eyes (5.2%) in group B; among them 4 eyes (4.1%) had been implanted PMMA IOL. Conclusion: Complications after cataract surgery in children are often associated with a robust inflammatory reaction or secondary opacity and, in infants, glaucoma.