Installing oncofertility programs for common cancers in limited resource settings (Repro-Can-OPEN Study): An extrapolation during the global crisis of Coronavirus (COVID-19) pandemic.

PURPOSE: The state of limited resource settings that Coronavirus (COVID-19) pandemic has created globally should be taken seriously into account especially in healthcare sector. In oncofertility, patients should receive their fertility preservation treatments urgently even in limited resource settings before initiation of anticancer therapy. Therefore, it is very crucial to learn more about oncofertility practice in limited resource settings such as in developing countries that suffer often from shortage of healthcare services provided to young patients with cancer. METHODS: As an extrapolation during the global crisis of COVID-19 pandemic, we surveyed oncofertility centers from 14 developing countries (Egypt, Tunisia, Brazil, Peru, Panama, Mexico, Colombia, Guatemala, Argentina, Chile, Nigeria, South Africa, Saudi Arabia, and India). Survey questionnaire included questions on the availability and degree of utilization of fertility preservation options in case of childhood cancer, breast cancer, and blood cancer. RESULTS: All surveyed centers responded to all questions. Responses and their calculated oncofertility scores showed different domestic standards for oncofertility practice in case of childhood cancer, breast cancer, and blood cancer in the developing countries under limited resource settings. CONCLUSIONS: Medical practice in limited resource settings has become a critical topic especially after the global crisis of COVID-19 pandemic. Understanding the resources necessary to provide oncofertility treatments is important until the current COVID-19 pandemic resolves. Lessons learned will be valuable to future potential worldwide disruptions due to infectious diseases or other global crises.

Retained surgical needle post myomectomy, an uncommon mishap.

BACKGROUND: Retained foreign bodies are relatively uncommon and probably underreported in the tropics. Largely preventable errors, they cause harm to both the patient and the medical practitioner. CASE PRESENTATION AND MANAGEMENT: A 32 year old primigravida with recurrent lower abdominal pain in pregnancy. She had myomectomy a year earlier at a private hospital in which the endometrium was inadvertently breached. She subsequently had an elective caesarean section at 38 weeks and 2 days gestational age. Intra-operative findings were adhesive bands between the uterus and loops of bowel and a round bodied surgical needle attached by adhesions anteriorly to the lower segment. Her post operative care was uneventful and she was discharged home on the 3rd day post operation. CONCLUSION: Retained surgical foreign body (RSFB) could pose a diagnostic dilemma as in the case of this patient with recurrent lower abdominal pain in pregnancy. Meticulous instrument count should include sutures and needles.

Ovarian dysgerminoma in an adolescent: a case report.

INTRODUCTION: Ovarian cancer is the second most frequent gynaecological cancer in Nigeria ranking next after carcinoma of the cervix. It has the highest case-fatality rate worldwide because of insidious onset, lack of effective screening methods and late presentation. This case of a sixteen-year old girl with a three-week history of abdominal pain which was later accompanied by abdominal swelling is a classic example of how dysgerminomas present. METHOD: The presumptive diagnosis of an ovarian tumour was made after physical examination and this was later confirmed by ultrasound scan. Urgent laparotomy was carried out based on a suspicion of torsion of the pedicle of the cyst. RESULT: At laparotomy, torsion of the pedicle with an intact capsule and imminent gangrene were found. The histology report revealed a malignant germ cell neoplasm (Dysgerminoma) with focal areas of necrosis without infiltration of the attached omentum. CONCLUSION: She had conservative surgery (left oophorectomy) done. She, however, defaulted from further follow-up.