A 30-year-old G(2) P(1+0+0+1) was referred at 30 weeks of pregnancy with an ultrasound diagnosis of a large multicystic ovarian cyst with no solid areas, ascites or evidence of metastasis. Antenatal corticosteroid was administered and she was advised to follow-up with reports of tumor markers. She presented a week later with acute pain abdomen and breathlessness. Clinical

examination revealed a relaxed uterus and ultrasound was suggestive of rupture of the ovarian cyst. Exploratory laparotomy revealed a ruptured left mucinous ovarian cyst with no evidence of solid areas or metastasis. Left ovariotomy with infracolic omentectomy and concurrent cesarean section was done. A healthy male baby of weight 1.880 kg was delivered. Belnacasan clinical trial Histopathology revealed stage-1c mucinous cyst adenocarcinoma of left ovary. This was followed-up, with a complete surgery done after a month. She is now receiving postoperative chemotherapy.

This is the first reported case of a ruptured malignant ovarian tumor in pregnancy. Torsion or rupture of ovarian masses is an important differential diagnosis of abdominal or pelvic pain during pregnancy.”
“Background: Malaria is the leading cause of

morbidity and mortality in post-conflict Burundi. To counter the increasing challenge of anti-malarial drug resistance and improve highly effective treatment Burundi adopted artesunate-amodiaquine (AS-AQ) as first-line treatment for uncomplicated Plasmodium falciparum malaria and oral quinine as second-line treatment in its national treatment policy in 2003. Uptake of this policy in the public, private Bucladesine supplier and non-governmental (NGO) retail selleck screening library market sectors of Burundi is relatively unknown. This study was conducted

to evaluate access to national policy recommended anti-malarials.

Methods: Adapting a standardized methodology developed by Health Action International/World Health Organization (HAI/WHO), a cross-sectional survey of 70 (24 public, 36 private, and 10 NGO) medicine outlets was conducted in three regions of Burundi, representing different levels of transmission of malaria. The availability on day of the survey, the median prices, and affordability (in terms of number of days’ wages to purchase treatment) of AS-AQ, quinine and other anti-malarials were calculated.

Results: Anti-malarials were stocked in all outlets surveyed. AS-AQ was available in 87.5%, 33.3%, and 90% of public, private, and NGO retail outlets, respectively. Quinine was the most common anti-malarial found in all outlet types. Non-policy recommended anti-malarials were mainly found in the private outlets (38.9%) compared to public (4.2%) and NGO (0%) outlets. The median price of a course of AS-AQ was US$0.16 (200 Burundi Francs, FBu) for the public and NGO markets, and 3.5-fold higher in the private sector (US$0.56 or 700 FBu). Quinine tablets were similarly priced in the public (US$1.