Cutaneous leishmaniasis

This may be encountered in travellers and servicemen and servicewomen returning from the Middle East, especially the Persian Gulf. The protozoa is transmitted by a sandfly and has an average incubation period of 9 weeks. The key clinical finding is an erythematous papule. Diagnosis is made by performing a punch biopsy and culturing tissue in a special medium. Treatment for extensive lesions is with high dosage ketoconazole for 1 month. Smaller lesions should be treated topically with 15% paromomycin and 12% methyl benzethonium chloride ointment applied bd for 10 days. 8 A special vaccine is available in some Middle Eastern countries, e.g. Israel.

Dealing With Back Pain

Dealing With Back Pain

Deal With Your Pain, Lead A Wonderful Life An Live Like A 'Normal' Person. Before I really start telling you anything about me or finding out anything about you, I want you to know that I sympathize with you. Not only is it one of the most painful experiences to have backpain. Not only is it the number one excuse for employees not coming into work. But perhaps just as significantly, it is something that I suffered from for years.

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