Intra- and interobserver reproducibility of grading of helicobacter pylori gastritis according to the updated sydney system

Aims. To study the intra- and interobserver reproducibility of Sydney System amongst pathologists in Cameroon as Sydney System gradation has not gained enough confidence in African pathologists. Methods. We performed a descriptive study including 100 patients who benefited from gastric biopsy by endoscopy. These biopsy specimens were stained with hematein and eosin and modified Giemsa; and read independently using the same microscope by two pathologists with four years experience and no experience with the updated Sydney System. Gastritis was graded according to the updated Sydney System. Levels of intra- and interobserver reproducibility were assessed using the unweighted kappa coefficient. Results. The intraobserver reproducibility of gradation of Helicobacter pylori density; activity; chronic inflammation; atrophy; and intestinal metaplasia showed respective values of kappa: 0.63; 0.34; 0.61; 0.48; and 0.82 for one observer against 0.42; 0.005; 0.41; 0.31; and 0.72 for the other. Interobserver reproducibility kappa values were; respectively; 0.41; 0.18; 0.57; 0.58; and 0.82. Conclusion. Results are encouraging but experience in the updated Sydney System should be improved. The later should be introduced as a means to grade and classify gastritis in Cameroon and African countries

Cornual molar ectopic pregnancy: a case report with difficult management in poor resources settings

Molar pregnancy is a rare entity and ectopic location of pregnancy in the uterine horn represents the least frequent site of implantation. This paper presents a rare case of molar cornual ectopic pregnancy at advanced gestational age with a particular difficulty in diagnosis and management. A 35-year-old woman; gravida 4 para 3 with a history of 12 weeks amenorrhea; was operated for presumed ruptured ectopic pregnancy. Per-operative findings showed swollen villi in clusters that looked like bunches of grapes; characteristic of a complete hydatiform mole; located at the left horn of the uterus. Histopathologic examination confirmed the diagnosis. Bleeding could not be controlled with suturing and hysterectomy was eventually done. Although rare; molar pregnancy can be ectopic. If it is located at the uterine horn; bleeding may be difficult to control if at a gestational age of 12 weeks or more