Challenges of Management of Ruptured Second Trimester Ovarian Pregnancy in Low-and Middle-Income Settings: A Case Report.

Background: Ovarian ectopic pregnancy is a rare form of non-tubal ectopic pregnancy. It can rupture before the end of the first trimester, causing hemoperitoneum, and present with signs and symptoms similar to other commoner abdominal emergencies or the pregnancy can continue intraperitoneally. Therefore, they are not often diagnosed preoperatively. Ultrasound can assist in diagnosis of ovarian ectopic pregnancy but the findings could be ambiguous or inconclusive. We present a case of ruptured ovarian ectopic pregnancy at the second trimester causing massive hemoperitoneum that was suspected as an intrabdominal malignancy co-existing with intrabdominal pregnancy. Case presentation: She was a 34 year-old Nigerian unbooked G4P3+0, (3 alive), who presented to the labor ward on 21st January, 2021 with a complaint of a 6-week history of abdominal pain and swelling. Pain was insidious in onset, generalized, non-colicky, non-radiating, constant, no known aggravating or relieving factor, but it was of moderate intensity. She had amenorrhea with a positive serum pregnancy test without prior early ultrasound. At presentation, initial abdominopelvic ultrasound revealed intra-uterine viable pregnancy but repeat ultrasound done showed a left adnexal ectopic gestation and an echo-rich intraperitoneal fluid collection. Laparotomy was done and ovarian pregnancy was accurately diagnosed intra-operatively. Tissue samples from the ovary confirmed normal products of conception, namely chorionic villi, trophoblastic cells and ovarian stroma at histology. Conclusion: Despite advances in imaging techniques, the diagnosis of ovarian ectopic gestation is still very difficult. When premenopausal women present with amenorrhea, generalized non-colicky abdominal pain and swelling in combination with ambiguous findings of pregnancy on ultrasound in the absence of trauma, differential diagnoses should include ruptured ovarian pregnancy. Obstetricians should maintain a high index of suspicion to forestall delayed diagnosis and the potential maternal morbidity and mortality. However, the need for high-index of suspicion should be for any ectopic, not just ovarian pregnancy.

Primary Carcinosarcoma of the Skin in an African Albino: Case Report and Review of Literature.

Albinism results from a deficiency of the protein responsible for melanin production in melanocytes. Albinos are at an increased risk of dermatoses and malignancies. Primary carcinosarcoma of the skin is an exceedingly rare biphasic tumor composed of malignant epithelial and mesenchymal elements with an unclear histogenesis. To our knowledge, this has not been reported in an African albino. Here, we report the index case of this rare tumor in an albino of African descent.

A retrospective survey of death care practices and procedures in handling suspected and confirmed COVID-19 deceased bodies in the mortuary of a resource-poor tertiary healthcare facility in Uyo, South-South Nigeria.

Introduction: the death care of deceased bodies of confirmed COVID-19 cases is a critical component of holistic healthcare provision for COVID-19 cases particularly from the public health perspective of infection prevention/control. Regrettably, there is a dearth of research-based information on the management (death care) of COVID-19 deceased bodies. Thus, we aimed to determine the preservation/storage death care practices and procedures in accordance with infection prevention/control measures used for deceased bodies of suspected/confirmed COVID-19 cases deposited in our mortuary and explore their antemortem age/sex distribution. Methods: a retrospective hospital-based cross-sectional survey done at the mortuary unit of Department of Histopathology, University of Uyo Teaching Hospital (UUTH), Uyo, Akwa Ibom State (covering January 2020 to September 2021). Our study participants were all deceased bodies of suspected/confirmed COVID-19 cases deposited in/cared for at UUTH mortuary within this period. Results: we found 28 suspected/confirmed COVID-19 deceased bodies, of which 51.86% were within the 6th and 7t hdecade of life and 71.43% were males (M/F = 2.5/1). They constituted 5.93% of the deceased bodies deposited in UUTH mortuary within this period. All (100%) were embalmed, and 75% were embalmed by immersion. The peak periods of their deposition were within the first halves of the two years affected by the COVID-19 pandemic. Conclusion: we provided death care (mainly through embalmment) for deceased bodies of suspected/confirmed COVID-19 cases in our resource poor setting using locally derived innovative means while still adhering to infection prevention/control measures to protect our death care workers in the mortuary.