So, this is our second patient today, and he's called Emmanuel He's a Masai man, and he was admitted to us on the second of the fourth with, a history of, anemia. And, the referral actually said his hemoglobin was down to 4.5 grams. Now, this is typically what we see here. When you examine his abdomen, the first thing that strikes you is a large mass in his left side of his abdomen. And in the area which we know corresponds to the spleen. And when you look at him, [FOREIGN]. And you look for signs of anemia like we did with the last patient, here you see the, the, the, the pallor, but it's not as striking as the last patient, and his conjunctiva are pale, [FOREIGN]. And his tongue is, is has some racial hyperpigmentation, which makes it difficult to interpret. Just lie flat for a minute. [FOREIGN] Uh-huh. And then we come to his abdomen, and what you see here is a large mass in the left side of his abdomen. And clinically, this looks to us like a spleen. So, when I go to examine that, I just put a hand gently in the right lower quadrant, and then move in anticlockwise direction. And here I can feel the edge of the mass. And as I move up it, it's an edge and I can feel a notch. And then, and there's the liver, I do feel liver edge. And [FOREIGN] you see it moving down. Moving down. And, and that confirms that it's in his spleen. It's superficial. It's got a leading edge, a notch, and if I do percussion, dullness that extends across there. Down here we have the same looking for the liver and there's dullness there. We can feel the liver edge. I'm just presenting you that [FOREIGN] is another patient that comes into us with a large liver. Sorry, a large spleen. And also possibly some slight liver enlargement. >> Mm-hm. >> And he doesn't seem to have free fluid like the last patient. So in contrast to the last patient he's presenting with isolated organomegaly. And the cause of his large liver and spleen could in some ways overlap with schistosomiasis. There are some features here which might suggest that it's not schistosomiasis. He's under investigation for schistosomiasis. Now, the way we screen for schistosomiasis is by history, clinical examination and then by investigations. And I'll talk about those in a minute. To our knowledge [FOREIGN] is a traditional Masai man who has never been exposed to schistosomiasis according to his history.