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.
Objective To evaluate and compare the prevalence, reasons, sources and factors associated with self‐medication with antibiotics (SMA) within Africa. Methods Systematic review and meta‐analysis. An electronic search of PubMed and Google Scholar databases was performed for observational studies conducted between January 2005 and February 2020. Two reviewers independently screened abstracts and full texts using the PRISMA flowchart and performed quality assessment of eligible studies. Both qualitative and quantitative syntheses were carried out. Results Forty studies from 19 countries were eligible for qualitative synthesis. The prevalence of SMA in Africa ranged from 12.1% to 93.9% with a median prevalence of 55.7% (IQR 41–75%). Western Africa was the sub‐region with the highest reported prevalence of 70.1% (IQR 48.3–82.1%), followed by Northern Africa with 48.1% (IQR 41.1–64.3%). We identified 27 antibiotics used for self‐medication from 13 different antibiotic classes. Most frequently used antibiotics were penicillins (31 studies), tetracyclines (25 studies) and fluoroquinolones (23 studies). 41% of these antibiotics belong to the WHO Watch Group. The most frequent indications for SMA were upper respiratory tract infections (27 studies), gastrointestinal tract symptoms (25 studies) and febrile illnesses (18 studies). Common sources of antibiotics used for self‐medication were community pharmacies (31 studies), family/friends (20 studies), leftover antibiotics (19 studies) and patent medicine stores (18 studies). The most frequently reported factor associated with SMA was no education/low educational status (nine studies). Conclusions The prevalence of SMA is high in Africa and varies across sub‐regions with the highest prevalence reported in Western Africa. Drivers of SMA are complex, comprising of socio‐economic factors and insufficient access to health care coupled with poorly implemented policies regulating antibiotic sales.
ObjectiveStillbirth measures provide means to assess adequacy of maternal and perinatal care in a given population. The aim of this study was to describe the determinants of stillbirth in Douala general hospital, Cameroon.ResultsDeterminants of stillbirth in this hospital are: maternal age ≥35 years (OR 1.79, 95% CI 1.26–2.54, p = 0.001), pre-eclampsia/eclampsia (OR 2.97, 95% CI 0.87–8.89, p value of 0.03), diabetes in pregnancy (OR 9.97, 95% CI 1.15–86.86, p = 0.03), stillbirth in previous pregnancies (OR 3.94, CI 2.02–7.7, p < 0.0001), inter-pregnancy interval >2 years (OR 2, 06 CI 1.22–3.49; p = 0,006), referral from another hospital (OR 14.16, 95% CI 7.08–28.3, p < 0.0001), gestational age <37 (OR 19.9, 95% CI 12.3–32.2, p < 0.0001) and >42 (OR 6.27, 95% CI = 0.86–45.2, p = 0.096), congenital malformation (OR 11.09, 95% CI 3.2–38,5, p < 0.0001) and birth weight <2500 g (p < 0.0001).Electronic supplementary materialThe online version of this article (doi:10.1186/s13104-017-2787-2) contains supplementary material, which is available to authorized users.
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