Transient Leukoerythroblastic Reaction in a Newborn with Rh-Incompatibility and Hemolysis: Case Report and Literature Review.

Leukoerythroblastosis is rarely encountered in clinical practice and is characterized by the presence of leukocytosis and erythroid and myeloid blast cells in peripheral blood. The most common causes of leukoerythroblastosis in early childhood are viral infection, juvenile myelomonocytic leukemia, and osteopetrosis. To the best of our knowledge, leukoerythroblastic reactions associated with hemolysis have not been previously reported in newborns. Here, we report a 24-hour-old female term newborn diagnosed with a leukoerythroblastic reaction, severe anemia, and neonatal hyperbilirubinemia secondary to Rh incompatibility based on presentation, laboratory determination, and peripheral morphology. A high index of clinical suspicion is required to avoid life-threatening complications among health professionals in the neonatal care unit.

Temporoparietal Brain Hydatid Cyst in an Eight-Year-Old Child: A Rare Case Report.

Hydatidosis is a parasitic disease caused by Echinococcus granulosus, which affects children in many different parts of the world. It commonly affects the lungs and the liver of the children. Brain hydatidosis is an extremely rare clinical condition in the pediatric population, presenting with non-specific symptoms and signs. The diagnosis of intracranial hydatid cysts can be established by brain magnetic resonance imaging and histopathological examination of the specimen. Here, we report an 8-year-old female child diagnosed with a temporoparietal brain hydatid cyst. Brain magnetic resonance imaging showed a thin-walled cystic lesion located in the right temporoparietal lobe with significant mass effect and midline shift, with no abnormal wall or solid enhancement, and no surrounding edema. The diagnosis of brain temporoparietal hydatid cyst was made radiologically. The patient was operated on and the cyst was completely removed without rupture. The removed cyst was sent for histopathological examination; the histological sections showed a laminated acellular cyst wall with a nucleated germinal layer and no protoscolices, and the diagnosis of temporoparietal brain hydatid cyst was confirmed. The patient had a smooth postoperative course, started albendazole therapy, and was discharged with improvement.

Case Report: Disseminated Strongloides stercoralis Presenting as an Ulcerated Gastric Mass in an HIV-1-infected Patient.

Disseminated Strongloides stercoralis is a common phenomenon among patients with immunosuppression. In this report, we present a case of disseminated Strongloides stercoralis presenting as a gastric mass in a 42-year-old male patient with a known history of HIV-1 infection and type 2 diabetes mellitus (T2DM). The patient presented with symptoms and signs suggestive of acute on chronic erosive gastritis, which included persistent vomiting. Endoscopic examination revealed a gastric mass with no signs of malignancy or dysplasia. There was noted to be chronic inflammation along with morphologic features consistent with the larvae and eggs of Strongloides nematodes in a biopsied gastric mass tissue and duodenum. The disease subsequently resulted in death despite the administration of ivermectin.

The Developmental Toxicity of Thymus schimperi Essential Oil in Rat Embryos and Fetuses.

Background: In Ethiopian traditional medicine, the aerial parts of Thymus schimperi are widely used to treat diseases such as gonorrhea, cough, liver disease, kidney disease, hypertension, stomach pain, and fungal skin infections. In addition, they have been used as vegetables to flavor a broad variety of food products. However, there is an insufficient investigation of the toxic effect of Thymus schimperi essential oil. The aim of this study was, therefore, to evaluate the developmental toxicity of the essential oil of Thymus schimperi leaves on developing rat embryos and fetuses. Methods: Essential oil of the aerial parts of Thymus schimperi was extracted by hydrodistillation. Pregnant Wistar albino rats were randomly divided into five groups. The doses 65 mg/kg, 130 mg/kg, and 260 mg/kg of the essential of Thymus schimperi were administered by force feeding to the III-V groups, respectively. Groups I and II were negative and ad libitum control groups. The embryos and fetuses were revealed on days 12 and 20 of gestations, respectively. The embryos were examined for developmental delays or growth retardation. Gross external, skeletal, and visceral anomalies in the fetuses were examined. Results: In this study, the developmental scores of the number of implantation sites, crown-rump length, the number of somites, and morphological scores were significantly lower while the score of fetal resorptions was increased in a 12-day-old rat embryos treated with 260 mg/kg of the Thymus schimperi essential oil. There was also a significant delay in the development of the otic system, olfactory system, and a reduction in the number of branchial bars in 12-day-old embryos treated with 130 mg/kg and 260 mg/kg of the essential oil. However, external morphological examinations of rat fetuses revealed no detectable structural abnormalities. The fetal skull, vertebrae, hyoid, forelimb, and hindlimb ossification centers did not differ significantly across all the groups. Furthermore, there were no skeletal or soft-tissue malformations as a result of the essential oil treatment. Although the difference was not statistically significant, fetuses of the high-dose treatment group had a reduced number of ossification centers in the caudal vertebrae and hind limp phalanges. Conclusion: The essential oil of Thymus schimperi at high doses has a detrimental effect on the development of rat embryos and fetuses. Its developmental toxicity is evidenced by significant delays in fetal and embryonic development, a decrease in the number of implantation sites, and an increase in fetal resorption. Furthermore, administration of the essential oil in higher doses resulted in a significant decrease in placenta weight and litter weight. In addition, the present study provided evidence that using the Thymus schimperi essential oil in a high dose could affect the developing embryo and fetus. Thus, it is recommended to discourage the use of Thymus schimperi essential oil in high doses.

Composition of the Essential Oil Thymus schimperi and Evaluation of Its Acute and Subacute Toxicity in Wistar Albino Rats: In Silico Toxicity Studies.

BACKGROUND: In Ethiopian traditional medicine, the aerial part of Thymus schimperi is widely used to treat diseases such as gonorrhea, cough, liver disease, kidney disease, hypertension, stomach pain, and fungal skin infections. However, there is insufficient investigation on the toxic effect of the essential oil of T. schimperi. The aim of this study was, therefore, to evaluate the acute, subacute, and in silico toxicity of Thymus schimperi essential oil in the Wistar albino rats. METHOD: Essential oil of the aerial part of T. schimperi extracted by hydrodistillation was analyzed by GC-MS. The oil was subjected to toxicity studies. In the acute toxicity study, rats were randomly divided into seven groups (n = 5). The control group received only distilled water with 2% of tween 80, whereas the experimental groups received single doses of 300, 600, 900, 1200, 1500, and 2 000 mg/kg of the oil. In the subacute toxicity study, rats were randomly divided into four groups (n = 10). The control group received distilled water with 2% of tween 80, whereas the experimental groups received 65 mg/kg, 130 mg/kg, and 260 mg/kg of the oil orally for 28 days. At the end of the experiment, blood samples were collected for hematology and clinical chemistry evaluation. Gross pathology and histopathology of the liver and the kidneys were also evaluated. For the in silico toxicity study, PubChem CID numbers of GC-MS identified bioactive compounds in the essential oil of T. schimperi obtained from PubChem. Chemdraw (8.0) was used to construct two-dimensional structures of the compounds. The Swiss ADMET web tool was used to convert the two-dimensional structures into a simplified molecular-input line input system (SMILES). In addition, the toxicity parameters were predicted via vNN and ADMET servers. RESULTS: In this study, the LD50 of the essential oil of T. schimperi was found to be 1284.2 mg/kg. According to the World Health Organization, the oil is classified as moderately hazardous in its oral administration. In the subacute toxicity study, rats showed no significant changes in behavioral indices, gross pathology, body weight, biochemical, and most hematological parameters. However, hematological profiles showed a significant decrement in WBC counts and a significant increment of MCV in high dose (260 mg/kg) groups as compared to the control group. Furthermore, no significant differences were observed between the control and essential oil-treated groups, observed in the gross histopathology of the liver and the kidneys. In the in silico toxicity study, all compounds derived from the essential oil showed no cardiac toxicity (h-ERG Blocker), AMES (Ames Mutagenicity), and cytotoxicity via ADMET and vNN-ADMET toxicity predictors. However, by using these servers, about 8.6% of the compounds showed hepatotoxicity, only 3.45% caused drug-induced liver injury, and only 1.75% were potentially toxic to the mitochondrial membrane. CONCLUSION: From the results of this study, oral administration of the essential oil T. schimperi up to a dose of 130 mg/kg is not harmful. However, in the high-dose (260 mg/kg) group, the WBC count was significantly decreased and the MCV was significantly increased. In the in silico toxicity study, most of the components of the oil were found to be nontoxic, although a few of the compounds showed hepatotoxicity and mitochondrial membrane potential toxicity. It is, therefore, essential to conduct chronic toxicity of the essential oil as well as its components, which showed toxicity in the in silico study before using preparations containing the essential oil of T. schimperi.

Effect of Chronic Administration of Aqueous Leaves Extract of Moringa Stenopetala on Blood Parameters and Histology of Liver and Kidney in Rats.

BACKGROUND: Moringa stenopetala is used as nourishments, and treatment of various diseases. However, there is no much information on its safety. Hence, this study aimed to investigate the chronic administration of aqueous leaves extract of the plant. MATERIALS AND METHODS: Twenty-four rats were divided into: a control group administered with distilled water and three experimental groups, respectively, administered with the extract at doses of 500, 1000, and 2000 mg/kg orally for six months were investigated. Various hematological and biochemical parameters followed by histopathological analysis were evaluated. RESULTS: Treatment with the extract did not significantly affect most of the hematological parameters. However, there were a significant decrease of MCH at doses of 1000 mg/kg and 2000 mg/kg in male rats and increase of MCV at all doses in female rats. Levels of ALP at 2000 mg/kg and those of AST and ALT at 1000 and 2000 mg/kg were significantly increased in male rats. Furthermore, significant decrease in urea and increase in creatinine levels at the dose of 2000 mg/kg occurred in female rats. Mild histopathological changes were also observed in the liver of male rats and kidney of female rats treated with the extract, respectively at doses of 1000 and 2000 mg/kg, and 2000 mg/kg. CONCLUSION: Findings from the present study suggest that prolonged administration of extract of Moringa stenopetala at therapeutic doses is safe, but shows sign of mild toxicity as dose increases, with differential effect on male verses female rats.

Evaluation of Acute and Sub-Acute Toxicity of Aqueous Extracts of Artemisia afra Leaves on Brain, Heart and Suprarenal Glands in Swiss Albino Mice.

BACKGROUND: The majority of population rely on traditional medicine as a source of healthcare. Artemisia afra is a plant traditionally used for its medicinal values, including treatment of malaria in many parts of the world. Currently, it is also attracting attention because of a claim that a related species, Artemisia annua, is a remedy for the COVD-19 pandemic. The aim of the present study was to investigate toxic effects of A. afra on brain, heart and suprarenal glands in mice aged 8-12 weeks and weighing 25-30g. METHODS: Leaves of A.afra were collected from Bale National Park, dried under shade, crushed into powder and soaked in distilled water to yield aqueous extract for oral administration. For acute toxicity study, seven treated and one control groups, with 3 female mice each, were used. They were given a single dose of 200mg/kg, 700mg/kg, 1200mg/kg, 2200mg/kg, 3200mg/kg, 4200mg/kg or 5000mg/kg b/wt of the extract. For the sub-acute toxicity study, two treated and one control groups, with 5 female and 5 male mice each, were used. They were daily treated with 600mg/kg or 1800mg/kg b/wt of extract. RESULTS: LD50 was found to be greater than 5000mg/kg indicating that the plant is relatively safe. In the sub-acute study, no signs of toxicity were observed in all treatment groups. On microscopic examination of the brain, heart and suprarenal glands no sign of cellular injury was observed. CONCLUSION: The findings of this study suggest that the leaves extract of A. afra is relatively safe in mice.

Histopathological Changes of Placenta Associated with Maternal Anaemia in Northeast Ethiopia: A Comparative Study.

BACKGROUND: Anaemia during pregnancy affects about half of all pregnant mothers in developing countries; it is the major causes of indirect maternal mortality. Anaemia can directly cause poor growth of fetus in utero due to inadequate oxygen flow to the placental tissue or it is indirect indicator of maternal nutritional deficiency. Mal-development of placenta is the leading cause of maternal and perinatal mortality and an important factor of fetal growth retardation. The aim of this study was to compare histopathological changes of placenta associated with maternal anaemia. METHODS: A comparative cross-sectional study was conducted from May-June, 2018 in Dessie Referral Hospital. A total of 66 placentas (33 anaemic and 33 non-anaemic) were collected after delivery. EPI data version 4.2.0 was used to enter the data while the data were analyzed by using SPSS version 22. Chi-square and one-way ANOVA were used to analyze the data. RESULTS: In pregnancies with maternal anaemia, 75.7% of anaemic placentas terminal villi vessels were increased in number, compared to 15.1% in non-anaemic (p=0.001). Placental calcification was 72.7% in anaemic groups compared to 54% in non-anaemic groups. However, it was insignificant (p=0.12). Intervillous space was wider in anaemic compared to non-anaemic groups (p<0.001). CONCLUSIONS: Chorionic villi capillaries were increased in number, and it was dilated in anaemic placenta, compared to non-anaemic. Intervillous space was significantly wider in anaemic placenta.

Acute and Subacute Toxicity of Methanol Extract of Syzygium guineense Leaves on the Histology of the Liver and Kidney and Biochemical Compositions of Blood in Rats.

Plant medicine is the oldest form of health care known to mankind. Syzygium guineense is one of the many species of Ethiopian medicinal plants which has a long history of use as remedies for various ailments such as dysentery, diarrhea, and hypertension. In many countries, herbal medicines and related products are introduced into the market without safety or toxicological evaluation. The aim of this study was to investigate the histopathological effect of 80% methanol extract of S. guineense on liver and kidney and blood parameters of rats. For acute toxicity study, rats were randomly divided into three groups (n=4). The control group received distilled water, while the experimental groups received a single dose of 2000 mg/kg and 5000 mg/kg 80% methanolic extract of S. guineense leaves per oral. For subacute toxicity study, the rats were randomly divided into three groups (n=6). The control group received distilled water, while the experimental groups received 500 mg/kg and 1500 mg/kg 80% methanol extract of S. guineense leaves orally for 28 days. At the end of the experiment, blood samples were collected for hematology and clinical chemistry evaluations. Gross pathology and histopathology of liver and kidneys were assessed. In the acute toxicity study, rats treated with 2000 mg/kg and 5000 mg/kg showed no toxicological signs observed on behavior, gross pathology, and body weight of rats. In the subacute toxicity study rats have showed no significant changes on behavior, gross pathology, body weight, and hematological and biochemical parameters, whereas both experimental groups had a lower blood glucose level compared with the control group (p < 0.05). There were no significant differences in the gross and histopathology of the liver and kidneys of experimental animals in extract exposed groups and their counterpart control. The 80% methanol extract of S. guineense does not produce adverse effects in rats after acute and subacute treatment. Before marketing a S. guineense leaf based remedy, subchronic and chronic toxicity evaluations need to be done.

HPV genotype distribution among women with normal and abnormal cervical cytology presenting in a tertiary gynecology referral Clinic in Ethiopia.

BACKGROUND: Cervical cancer is the second most prevalent cancer among women of child-bearing age in Ethiopia. The aim of this study was to determine human papilloma virus (HPV) genotype distribution among HIV-negative women with normal and abnormal cervical cytology results. METHODS: We investigated a consecutive of 233 HIV-negative women between December 2008 and March 2009 presenting in a Tertiary Gynecology Referral Clinic in Ethiopia. Screening was done by Pap cytology and HPV detection and genotyping method was nested PCR (direct amplification with MY09/MY11 primers, followed by nested amplification with GP5/GP6 primers) and sequencing of the nested products. Sequencing of the non-purified nested PCR products was performed following re-amplification with Big dye terminator, using the GP6 primer. RESULTS: Of the 233 study participants, 92 (39.5%) had abnormal cytology. All women with abnormal cervical cytology had positive HPV DNA compared to only 48.9% of those presenting with normal cytology. Of these women, the frequency of high-risk (HR)-HPV was 83.2% and its prevalence in women with abnormal cervical cytology was significantly higher than those with normal cytology (92.4% vs. 71%, p < 0.0001). The most frequent genotypes identified were HPV16 (44.1%), followed by HPV35 and HPV45 (each 6.2%), HPV31 (4.4%), HPV56 (3.7%), HPV18 and HPV59 (each 3.1%), HPV58 (2.5%) and HPV39 (1.9%). While the most common HR-HPV infections among women with normal cytology were HPV16 (20.3%), followed by HPV35 (8.7%), HPV56 and HPV58 (each 5.8%), HPV18, HPV31 and HPV39 (each 4.4%), HPV45 (2.9%) and HPV59 and HPV68 (each 1.5%), the most common HR-HPV infections in women with abnormal cytology included HPV16 (62%), followed by HPV45 (8.7%), HPV 31, HPV35 and HPV59 (each 4.4%), and HPV18, HPV52 and HPV56 (each 2.2%). We also noted low prevalence of multiple HPV infections in women with normal or abnormal cytology. Multivariable logistic analysis showed that residing in rural area (OR 3.24, 95% CI: 1.13-9.30), being multipara (OR 7.35, 95% CI: 1.78-30.38) and having abnormal cervical cytology results (OR 6.75, 95% CI: 1.78-25.57) were all independently associated with HPV16 genotype. CONCLUSIONS: Our study revealed a significant risk of infection with HR-HPV, in particular with HPV16 genotype, in women attending a referral center in Ethiopian women presenting with or without abnormal cervical cytology. Moreover, Pap smear cytology missed a significant proportion of women compared to those who were identified by PCR for HR-HPV infections. In addition, the PCR method we used was not suitable for sensitive detection of co-existent multiple infections. Data from the present study indicate that currently available HPV vaccines could prevent nearly 67% of all cervical cancer cases in women in Ethiopia.

Adequacy of Pathologic Reports of Invasive Breast Cancer From Mastectomy Specimens at Tikur Anbessa Specialized Hospital Oncology Center in Ethiopia.

Purpose Although information from pathology reports is essential to the care of individuals with cancer and to population-level cancer control, no systematic evidence exists regarding the adequacy of breast pathology reporting in Ethiopia. This study audited pathology reports of mastectomy specimens from patients evaluated at the Tikur Anbessa Specialized Hospital Oncology Center in Addis Ababa, Ethiopia. Methods Mastectomy pathology reports from February 2014 through January 2016 were assessed for gross and microscopic information considered by the Breast Cancer Initiative 2.5 (BCI 2.5; formerly the Breast Health Global Initiative) guideline to be necessary for care of patients with breast cancer stratified according to basic, limited, and enhanced resource settings. Results Fewer than two thirds (61.6%) of the 417 reports we reviewed included all four of the BCI 2.5 basic pathology data elements we could evaluate with available data (tumor category, lymph node category, histologic type, and histologic grade). Only 1.0% of reports included all three pathology data elements recommended for limited resource settings (estrogen receptor status, margin status, and lymphovascular invasion). Several elements were significantly more likely to be noted in reports from nonpublic hospitals than from public hospitals. Although only three of 417 reports included checklists or templates, all three of these reports included all of the basic pathology information, and they all included at least two of the three limited pathology elements not already on the basic list. Conclusion More than one third (38.4%) of mastectomy pathology reports did not meet BCI 2.5 standards for basic resource settings. Quality measurement and improvement programs and capacity-building interventions by national pathology and oncology organizations, collaboration with medical and public health organizations in neighboring countries, adoption of synoptic reporting templates, use of electronic pathology reporting, and histotechnology and histopathology training collaborations with laboratories in high-resource regions are recommended.

Toxicological investigation of acute and chronic treatment with Gnidia stenophylla Gilg root extract on some blood parameters and histopathology of spleen, liver and kidney in mice.

BACKGROUND: In southeast Ethiopia, people locally use the roots of Gnidia stenophylla Gilg (Thymelaeaceae) to cure malaria and other diseases with no literature evidence substantiating its safety. The aim of this study was, therefore, to investigate the safety of the aqueous root extract of G. stenophylla after acute (single dose) and repeated sub chronic oral administration in mice. RESULTS: A single oral administration of the extract at 500, 1000, 2000 and 4000 mg/kg body weight did not induce any behavioral change and mortality in both sexes. The oral LD50 of the extract was found to be above 6000 mg/kg body weight in mice. Chronic treatment with the extract for 13 weeks did not induce any sign of illness and/or death and had no adverse effect on the body weight. Dose-related elevations of erythrocytes, hematocrit, hemoglobin, platelets and neutrophils differential and significant decrease in the number of lymphocyte were observed. Liver sections of mice treated with 800 mg/kg body weight, revealed mild inflammations around the portal triads and central veins; whereas the spleen and kidneys appeared normal with no detectable gross morphological and histopathological alteration at both doses. CONCLUSIONS: The results of this study revealed that aqueous root extract of G. stenophylla Gilg at antimalarial dose is safe even when taken for a longer period. At a higher dose, the extract may have a potential to increase some hematological indices but may induce mild hepatotoxicity as a side effect.

Effect of Oral Administration of Gnidia Stenophylla Gilg Aqueous Root Extract on Food Intake and Histology of Gastrointestinal Tract in Mice.

BACKGROUND: Aqueous preparations of a medicinal plant, Gnidia stenophylla Gilg (Thymelaeaceae) are commonly used to cure malaria and other ailments in Ethiopia. This study evaluated the safety of the plant extract by determining its effects on food intake and histology of gastrointestinal tract (GIT) after oral administration for 13 weeks in albino mice. METHODS: Thirty mice were equally assigned to three groups. Group I served as control and received a vehicle while groups II and III were given 400 and 800 mg/kg body weight/day plant extract respectively, orally, for 13 weeks. At the end of the study, the mice were scarified and postmortem gross and histopathological evaluations were performed on their stomachs and intestines. RESULTS: Chronic oral treatment with the extract for 13 weeks did not induce any sign of illness and death and had no effect on food intake of the mice. Furthermore, extract treatment at both doses did not produce any detectable gross morphological change in GIT. Microscopic evaluation of sections of the stomach, duodenum and jejunum of the mice treated with 400 mg/kg body weight did not show any histopathological change. In the mice treated with 800 mg/kg body weight, however, the GIT sections revealed cytoplasmic vacuolation, hydropic degeneration and excessive erosion of the surface mucosal cells. CONCLUSION: The results of this study revealed that aqueous root extract of G. stenophylla at effective antimalarial dose is safe even when taken for a longer period in mice. At a higher dose, however, the extract may induce gastrointestinal irritation. Further studies on other vital organs and non-rodent species including humans are recommended.

Frontal Lobe Tuberculoma: A Clinical and Imaging Challenge.

BACKGROUND: Pediatric nervous system tuberculomas are usually infra-tentorial and multiple. A frontal lobe location is rare. CASE DETAILS: We report a 10 year-old boy who presented with a chronic headache and episodes of loss of consciousness. He had no signs of primary pulmonary tuberculosis and a diagnosis of frontal tuberculoma was made upon a post-operative biopsy. He improved following treatment with anti-tubercular drugs. CONCLUSION: Tuberculosis should be considered in children with a chronic headache or focal neurologic deficit and a supra-tentorial intracranial mass in endemic countries like Ethiopia.

Toxicological study of the butanol fractionated root extract of Asparagus africanus Lam., on some blood parameter and histopathology of liver and kidney in mice.

BACKGROUND: The butanol fractionated root extract of Asparagus africanus Lam., a traditional herb widely used to treat various ailments were analyzed for the presence of potential toxicity after single (acute) and repeated (subchronic) dose oral administration in adult swiss albino mice using gavages. METHODS: For the acute study, butanol fractionated extract of the plant was administered in single doses of 1000, 3000 and 5000 mg/kg body weight. In the sub-chronic dose study, the extract was administered at doses of 300 and 600 mg/kg body weight/day for 42 days. Selected hematological and biochemical parameters of the blood followed by histopathological analysis were investigated after 42 days of daily administrations. The results were expressed as M ± SE, and differences at P < 0.05 was considered significant. One way analysis of variance (ANOVA) and least significant difference tests were employed to check the significant differences between the various parameters of the experimental groups. RESULTS: In the acute study, the extract did not caused dose-dependent general behavioral adverse effects, body weight change and mortality. The single dose toxicity studies therefore showed that the butanol fraction of the extract has high safety profile when given orally. After 42 days of daily dosing, in the sub-chronic study, no clinically significant changes were observed for hematological and biochemical parameters. Except an occasional small number of focal mononuclear lymphocytic cells infiltrations around the central and portal triad of the liver of a few mice, the histopathological parameters do not show significant change. CONCLUSION: It is concluded that, the butanol fractionated extract from A. africanus at the given dose does not show significant toxicity. The presence of focal inflammation on the liver of a few mice may be associated to the presence of flavonoid glycoside in the butanol fractionated extract.

True hermaphrodite: very unusual type.

True hermaphrodite is one of the rare gonadal as well as genital abnormality due to a defect in sexual differentiation. Here, we are reporting the most unusual type of true hermaphrodite diagnosed at the age of 25 years during operation for undescended testis, presenting as a case of infertility and failure to ejaculate during sexual intercourse. The patient was found to have grossly as well as histologically proven left ovary, left fallopian tube and uterus as well as a well descended left testis, with totally absent either right fallopian tube and ovary or testis. Thus, this is unusual finding to ratify the occurrence of true hermaphrodite in the absence of ambiguous external genitalia.

An ovarian tumor larger than the patient's body weight.

Surface epithelial-stromal tumors constitute by far the most important group among all ovarian neoplasms. Sixty-four kilogram left ovarian serous cystadenoma was removed from a forty-nine kilogram weighing Ethiopian woman. She presented with twenty-five years history of abdominal swelling. She had extreme degree of difficulty in bearing her weight, which resulted in keeping her to the house. This unusually big tumor is discussed with clinicopathologic correlation and literature review.