Giant ovarian mucinous cystadenoma in Derna, Libya

Giant mucinous cystadenomas of the ovary are seldom documented in literature within developed countries, primarily due to the widespread availability of diagnostic technologies. However, in developing nations, such situations pose a challenge owing to limited access to diagnostic tools and constrained resources. Herein, we present the case of 35-year-old women, who reported a three-year history of a progressively enlarging giant mucinous cystadenoma which was initially mistaken for obesity, accompanied by abdominal distension and pain, and was not diagnosed during the cesarean section performed three weeks prior to the significant increase in size. Cystectomy performed, the resected cyst measured 25x23x17 cm, with no evidence of ascites. Subsequent histopathological analysis confirmed the diagnosis of mucinous cystadenoma. The patient experienced a complete postoperative recovery without any complications. Notably, the presence of vague gastrointestinal symptoms unrelated to the actual diagnosis underscores the importance of considering giant ovarian cysts as a potential differential diagnosis for ambiguous abdominal symptoms, given the varied clinical presentations they may manifest. This case underscores the necessity for multidisciplinary collaboration among various specialists to facilitate early diagnosis. Furthermore, it emphasizes the indispensable role of histopathological examination in ensuring accurate diagnosis and appropriate management of ovarian cysts

Incidence and risk factors of post dural puncture headache after spinal anesthesia in Tripoli Hospitals

Post Dural Puncture Headache (PDPH) remains a prominent clinical concern to the present day and common complication seen in the field of anesthesiology and pain medicine. Identification of such risk factors is a crucial step in the rational modification of anesthetic practice and evaluation of therapeutic interventions. This study was conducted to demonstrate the incidence and risk factors of PDPH in patients after spinal Anesthesia during three days' post operations at general hospital in Tripoli, Libya. In this study certain factors related to patient history, baseline clinical state or anesthetic technique might be associated with an increased risk for this side effect, so it was collected historical, physiologic, and technical data to determine their association with PDPH. Out of total of 100 patients distributed over 5 different hospitals admitted over a period (from November 2020 to April 2021) 27% of them have a PDPH, while 92.5% of cases with PDPH are females, that 55.6% of PDPH cases are between 20 and 25 years old, and this percentage getting smaller as patients get older, most of the operations were caesarean section, at a rate of 58%, followed by lower abdominal surgeries with 19% of cases, and orthopedic surgeries with 17% of cases, while the lowest percentage was for the Urologic surgeries. 55% of cases with PDPH are classified as (case I), and 44% of them are classified as (case II), 81.5% of PDPH cases used noncutting needles. In this study the PDPH remains the most problem in hospitalized patients after spinal Anesthesia at Tripoli hospitals can be caused by variety of risk factors, associated with ASA physical states, nonprofessional technique, the females are more common than males and the percentage increasing in early age group