ABSTRACT
Background: The placenta facilitates vital nutrient exchange between fetus and mother, offering insights into fetal and maternal health. Despite its significance, research on placental histopathology in Tanzania is scarce. This study investigates placental features, maternal factors, and their impact on fetal outcomes at Bugando Medical Centre from January to May 2022. Methods: This 5-month cohort study included 205 mothers delivering at BMC. Fetal outcomes were evaluated at birth and after seven days, with maternal characteristics recorded at delivery. Participants were from the twenty-eighth week of gestation, excluding those with intrauterine fetal death or multiple pregnancies. Data on placental histology, maternal factors, and fetal outcomes were collected systematically, while statistical analysis employed STATA version 15, utilizing descriptive statistics. Results: In this study of 205 placentas, participants had a median age of 29 years and a mean gestational age of 38 weeks. Histopathological patterns were present in 61% of placentas, with acute inflammation (22%) and maternal vascular malperfusion (20.8%) being most common. Favorable outcomes were observed in 81% of newborns, while 19% experienced poor outcomes, including 1.9% early neonatal deaths. Most placental lesions were mild (53.6%), with severe pathology in 2.9% of cases. Acute inflammation correlated with various admission reasons, especially neonatal sepsis (60%). Maternal vascular lesions were associated with prematurity (63.6%) and birth asphyxia (40%). Chronic inflammation was more prevalent among low-birth-weight infants (18.8%), while very low birth weight was common in cases of maternal vascular lesions (68.8%). Conclusion: The majority of placentas showed normal or mild pathology, associated with positive fetal outcomes. Further research is needed to understand placental changes and their impact on maternal-fetal health.

ABSTRACT
Congenital eversion of the eyelid is defined as an externalization of the palpebral conjunctiva, most often seen at birth but can also be revealed late. It can be unilateral or bilateral and is a rare condition that can be associated with other anomalies or malformative syndromes. We present our experience in the management of three cases according to conservative treatment. Two isolated cases, one uni and the other bilateral, and one bilateral case associated with ichthyosis. Our three patients benefited from conservative treatment with application of Rifamycin antibiotic ointment and pressure dressing every 24 hours without puncture of the chemosis with a needle until resorption of the chemosis. Conservative treatment is an effective alternative and early management is a guarantee of success.

ABSTRACT
The organisation of the evacuation referral system is an important strategy for reducing maternal and perinatal mortality in Mali. Objective: To study obstetric evacuations received in the gynaecology and obstetrics department of the "Major Moussa DIAKITE" referral health centre in Kati. Method: We conducted a cross-sectional, descriptive and analytical study. Data were collected retrospectively and prospectively over a 12-month period (from 1 January to 31 December 2020). Sampling was exhaustive and included all cases of obstetric evacuation received and managed on site during the study period. Results: Out of a total of 3050 deliveries, we received and managed 352 cases of obstetric evacuation, representing a frequency of 11.5%. The average age of the patients was 25 years, with extremes of 15 and 44 years, although the 20-34 age group was dominant, accounting for 73.6% of cases. The majority of evacuees were housewives (86.4%), married (92%), nulliparous and primiparous (52%). Dystocic labour was the most common reason for evacuation (51.1%), followed by ante-partum haemorrhage (13.4%). Nearly nine out of ten women evacuated came from Community Health Centres (89.8%) and the most common means of evacuation was by ambulance (52.1%). The average time from admission to the start of care was 26.5 minutes, with extremes of 3 and 50 minutes. Delivery by the vaginal route was carried out in almost eight out of ten cases (79%). Newborns were resuscitated alive (7.9%); stillbirths were fresh (3.7%) and stillbirths were macerated (06%). We recorded 2 cases of maternal death (0.6%) and the causes of maternal death were haemorrhage due to uterine rupture and eclampsia. Conclusion: The improved organisation of the evacuation referral system in our facility has improved the maternal and, above all, foetal prognosis of obstetric evacuations, but more needs to be done.

ABSTRACT
Introduction: The demographic characteristics of cancer patients correlate with their awareness of diagnosis, prognosis, and the psychological distress associated with their condition. Objectives: The purpose of this study was to evaluate patients' knowledge of psychological distress, diagnosis, and prognosis who were presenting to the palliative medicine department of a tertiary hospital in Bangladesh. Methodology: This cross‐sectional study was conducted among 377 patients living with cancer attending the Department of Palliative Medicine, Bangabandhu Sheikh Mujib Medical University, Bangladesh from November 2021 and March 2022. Information on the clinical and sociodemographic aspects was gathered through a structured questionnaire and in-person interview, and the degree of distress was measured using a distress thermometer. After information was gathered, descriptive statistics were used to analyze it. Result: Approximately 16.2% of patients were unaware of their diagnosis, with two-thirds (68%) lacking awareness of prognosis. Over half (54.1%) reported significant distress. Gender, education, employment status, and head-and-neck cancer diagnosis were linked to diagnosis awareness, while educational level predicted prognosis awareness. Younger age, head-and-neck or hematological cancer diagnosis and lack of awareness regarding diagnosis and prognosis were associated with distress. Conclusions: Higher education and socioeconomic status correlate with patients' awareness of diagnosis and prognosis. However, distress remains higher among those unaware of prognosis.

ABSTRACT
Photodynamic treatment (PDT) has emerged as a promising therapeutic approach for immune system diseases due to its ability to selectively target abnormal cells while modulating the immune response. This review explores the mechanisms by which PDT activates the immune system to target diseased cells, including the induction of immunogenic cell death, activation of dendritic cells, release of tumor-associated antigens, modulation of immune checkpoints, and induction of cytokines and chemokines. Additionally, PDT can generate reactive oxygen species, induce apoptosis, and exhibit anti-inflammatory and vascular effects, all of which contribute to its therapeutic potential in immune system diseases [1]. Harnessing PDT for immune system diseases offers a unique opportunity to leverage the immune system's inherent ability to recognize and eliminate abnormal cells, providing a targeted and potentially less toxic treatment option. Further research and clinical studies are warranted to fully elucidate the potential of PDT in the management of immune system diseases and to optimize its clinical application.

ABSTRACT
Giant lipomas are voluminous benign mesenchymal tumors formed by fatty lobules from mature adipose tissue and whose exact etiological is not yet elucidated. We report the case of a 64-year-old patient with a giant lipoma at the hip with physical and psychological impact. Treatment was surgical and consisted of a wide excision of the mass. The surgical piece measured 378X303 mm and weighed 2600 grams. The surgical follow-ups were simple. The late management of lipomas can lead them to reach an inordinate size causing disabilities and increasing the possibility of neoplastic transformation. After excision, a pathological anatomopatological study is required to rule out a liposarcoma.