A 15-year-old girl presented with progressive abdominal distention for four months duration. An initial assessment by primary care and gynaecological teams concluded that the ascites as the cause based on the clinical and initial ultra sonographic findings. However, an abdominal radiography revealed that a huge mature cystic teratoma as the actual cause of the presenting issue. Despite being a rare incidence, this case report highlighted why a high index of suspicion of ovarian pathology in large abdominal fluid accumulation in the paediatric population should be raised. The case report also highlighted the value of abdominal radiography, particularly in a primary care setting facility in differentiating intra-abdominal mass and ascites, especially when the massive volume of ovarian mass hampered the ultrasound findings. Though it is not specific, it may improve accuracy of initial diagnosis leading to an appropriate investigation with timely referral to the appropriate department. The unusual component of this case was the ‘pseudoascites' presentation and the literature on the detail of distinction between the two conditions from the primary aspect point.

INTRODUCTION: Tuberculosis (TB) related stigma is one of the significant barriers in the global TB control programme and it may lead to depression. This study aims to assess the level of stigma among TB patients and its associated factors, as well as to ascertain the correlation between stigma and depression in Kedah, Malaysia. MATERIALS AND METHODS: This was a cross-sectional study using the proportionate sampling method. TB patients were recruited from respiratory clinics in three government hospitals in Kedah. Case report form, Malay version of TB stigma scale (TSS) and Beck Depression Inventory (BDI-Malay) were used for data collection. Data were then analyzed using the linear regression and correlation analysis. RESULTS: A total of 200 respondents were enrolled and the mean score of TB stigma from patient’s perspective was 13.3 (6.87). Younger patient, currently married, higher education, unemployment, and HIV co-infection were significantly associated with the stigma experienced. 27.5% (n=55) of the TB patients were found to be depressed, with the majority categorized into mild severity (20%, n=40), followed by moderate (5.5%, n = 11) and severe depression (2%; n = 4). There was a moderate, positive correlation between stigma and depression which was statistically significant (r = 0.345, p<0.001). CONCLUSION: Although the stigma score among TB patients was not as high as has been postulated, there was a moderate, positive correlation between stigma and depression. Thus, the intervention to reduce the stigma among TB patients may be helpful as it may reduce the depression level.