BackgroundGiant ovarian cysts are tumours of the ovary presenting with diameters greater than 10 cm. Giant ovarian cysts have become rare in recent days as they are diagnosed and managed early due to the availability of good imaging modalities. The aim of this case report is to show how a huge cystic ovarian mass can mislead the diagnosis of ascites in a postmenopausal woman. Factors associated with late presentation of giant ovarian cysts in sub-Saharan Africa have also been discussed.Case presentationWe present the case of a 65-year-old grand multiparous woman who was referred to our centre with a grossly distended abdomen misdiagnosed as a massive ascites. Abdominopelvic ultrasound scan revealed a right giant multiloculated ovarian cyst. She benefited from a cystectomy with an uneventful postoperative stay. Histopathology revealed mucinous cystadenoma.ConclusionLarge cystic ovarian tumours can present masquerading as massive ascites and misleading diagnosis as in this case report. We report this case to increase the suspicion index of a large ovarian cyst in all women presenting with massive ascites.
ObjectiveMedical and nursing students in Cameroon are likely to have mental health problems given the stressful nature of their studies. Paucity of mental health institutions in the country implies they hardly get access to professional help when needed and are obliged to develop coping strategies such as recreational drug use. This study aims to determine the prevalence and predictors of recreational drug use among a group of Cameroonian medical and nursing students.ResultsCross-sectional analysis of 852 medical and nursing students (mean age 21.78 ± 3.14, 31.49% males) recruited by convenience sampling from three state-owned medical schools; and from two state-owned and two private nursing schools in Cameroon over a four-month period (January–April 2018). Information was collected via a printed self-administered and structured questionnaire from consenting students. Multivariable logistic regression analysis was used to identify independent predictors of recreational drug use. The overall prevalence of recreational drug use was 1.64% with tramadol and marijuana noted as the drugs used by these students. Independent predictors of recreational drug use were: presence of a chronic illness (OR 5.26; 95% CI 1.32, 20.97; p = 0.019), alcohol consumption (OR 5.08; 95% CI 1.54, 16.73; p = 0.008) and Total Oldenburg Burnout Inventory score (OR 1.11; 95% CI 1.02, 1.21; p = 0.021). The use of recreational drugs by medical and nursing students in Cameroon remains worrisome despite its very low prevalence, as it may negatively impact their performance and health.Electronic supplementary materialThe online version of this article (10.1186/s13104-018-3631-z) contains supplementary material, which is available to authorized users.
BackgroundTropical diabetic hand syndrome describes a complex hand sepsis affecting patients with diabetes across the tropics and often results from a trivial hand trauma. The clinical presentation of this syndrome is variable and ranges from localised swelling and cellulitis, with or without ulceration of the hand to progressive fulminant hand sepsis, and gangrene affecting the entire limb which may be fatal. Tropical diabetic hand syndrome could lead to permanent disability and death as a result of delay in presentation, late diagnosis and late medical and surgical intervention. This indexed case acts as an eye opener for physicians to the existence of this hand sepsis.Case presentationWe report the case of a 57 year-old black African female diabetic who was referred to our centre for the management of a suppurating ulcer and swelling of the left hand of two weeks duration. On examination and work-up, the patient was found to have Lawal Group III left diabetic hand syndrome and was managed with parenteral antibiotics, radical debridement and the hand was eventually amputated. She died 7 days following amputation from overwhelming sepsis.ConclusionThough tropical diabetic hand syndrome is a relatively rare complication of diabetes, it can be fatal as in this case report. Early diagnosis and proper management would yield better outcome. Initial management should include aggressive intravenous broad-spectrum antibiotics with anaerobic coverage. Classification of tropical diabetic hand syndrome will assist physicians and surgeons in decision making, proper management and easy communication.
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