The Evolutionary Profile of Patients Operated for Peptic Ulcer Perforation in Bujumbura

Background: The evolutionary profile of patients operated for peptic ulcer perforation in Bujumbura. Perforated peptic ulcer is a serious complication of peptic ulcer with potential risk of grave complications. Aim: To study the early morbidity and mortality of surgery for peptic ulcer perforation in Bujumbura City Hall hospitals: Kamenge University Hospital Center (CHUK), Kamenge Military Hospital (HMK) and Prince Louis Rwagasore Clinic (CPLR). Patients and methods: This is a retrospective, descriptive and analytical study carried out in the three hospitals of Bujumbura over a period of three years from January 1, 2020 to December 31, 2022. It involved 57 cases (n = 57) of peptic ulcer perforation. Results: The frequency of surgery for peptic ulcer perforation was 2.7% with a mean age of 43.6 years +/- 15.3 years and a male predominance with a sex ratio of 3.7. Eight percent of patients presented with shock, 24.5% were smokers, and 67.9% had taken non steroidal anti-inflammatory drugs. The mean hospital stay was 15.2 days with a standard deviation of 12.1. The morbidity rate was 30.2%, 32% were classified in grade IIIb of the Clavien-Dindo Surgical Complications Scale. There were 9 deaths (17%). Seven patients who underwent surgery and received late consultations died. Conclusion: Surgery for peptic ulcer perforation remains an intervention associated with a high rate of morbidity and mortality in Bujumbura. Surgery for peptic ulcer perforation remains a procedure associated with a high morbidity and mortality rate in Bujumbura. The time before consultation was the only factor associated with early morbidity and mortality of Surgery for peptic ulcer’s perforations.

Assessment of Nurses’ Knowledge of the Management of Pre-Eclampsia in a Hospital Setting: The Case of the Van Norman Clinic. Bujumbura-Burundi

Background: Pre-eclampsia is one of the pathologies of pregnancy that causes serious maternal and fetal complications. Good nursing management of pre-eclampsia could stabilize and limit possible maternal and fetal complication. Aim: This study aims to assess nurses’ knowledge of the management of pre-eclampsia. This is a descriptive prospective study conducted at the Van Norman Clinic over three-month period from November 1st, 2020 to January 31st, 2021 to assess the knowledge of nurses assigned to the Patient reception service, Emergency service, Gynecological-Obstetrics service and Community Medicine department on the management of pre-eclampsia. Data were treated using Microsoft Word and analyzed by Statistical Package for Social Scientists version 16 (SPSS). During the period of our study, we collected 40 nurses out of 44 nurses, which represents 90.9% (n = 40) of the nurses assigned to the Patient reception service, Emergency service, Gynecological-Obstetrics service and Community Medicine department. Among the 40 cases collected, 30% respondents did not give the true definition of pre-eclampsia. Our study also showed that 70% of nurses had not been trained on the management of pre-eclampsia and 90% had not used nursing theories in their practice while the Inquiry-Based Practice (IBP) and Evidence-Based Practice (EBP) applications were known in 7.5% of cases. With regard to the nursing management of pre-eclampsia, 62.5% of cases knew the first gestures of management while 90% of cases did not know the overall nursing management of pre-eclampsia. Last of continuing education, use of nursing theories and lack of resuscitation were the main obstacles observed in the nursing management of pre-eclampsia. For better nursing management of pre-eclampsia, emphasis should be placed on building staff capacity and executing the care plan by applying nursing theories.

Morbidity and Mortality of Emergency Hernia Surgery in Adults in Bujumbura: Analysis of Favourable Factors

Background: Abdominal parietal hernia, a temporary or permanent exit of viscera through an anatomically pre-existing zone of weakness, is a frequent pathology in surgery. So, the management of emergency hernias surgery should include some complications most often up after 30 days of the operation. Aim: To analyze the factors contributing to morbidity and mortality after 30 days of emergency hernia surgery in adults in the surgical departments of Bujumbura hospitals. Methodology: This is a prospective study over a period of one year that included all hernias operated on in emergency from January 2022 to February 2023. Results: During the period, 251 patients were admitted to the operating room for abdominal parietal hernias, including 49 for emergency hernia surgery. There were 43 men (87.76%) and 6 women (12.24%), i.e. a sex ratio of 7.1. The average age was 49.6 years, with extremes of 18 and 84 years. The occupation of strength (farmer, labourer, mechanic, mason, mason’s helper) represented 75.51% of the cases. Inguino-scrotal hernia was preponderant (65.31%) followed by inguinal hernia (25.58%), umbilical hernia (4.08%);femoral hernia represented 4.08%. Hernial strangulation represented 89.80% and engorged hernia 10.20%. Morbidity was minor, 2.04% of complications (suppuration, hematoma, urinary retention). No deaths were found. Altemeir stage and occupation were statistically related to morbi-mortality of emergency hernia surgery in adults at 30 days postoperative (p = 0.0028 and p = 0.0284 respectively). Conclusion: Abdominal parietal hernias are frequent, dominated by groin hernias. The high frequency of strangulation calls for awareness of cold hernia cures.

Morbidity and Mortality of Emergency Hernia Surgery in Children in Bujumbura: Analysis of Favourable Factors

Background: Management of emergency hernias surgery should include certain complications most often up after 30 days of the operation. Aim: To analyze the factors contributing to morbidity and mortality after 30 days of emergency hernia surgery in children in the surgical departments of 8 Bujumbura hospitals. Patients and Methods: This is a prospective study over a period of one year which included all hernias operated on in emergency from January 1, 2022 to February 29, 2023. Results: During the period, 282 patients (children) were admitted to the operating theatre for abdominal parietal hernias, of which 46 were admitted for emergency hernia surgery. Males accounted for 86.96% (40), sex ratio 6.6. The average age was 3.4 years. The persistence of the peritoneo-vaginal canal represented 52.17% of cases. Inguino-scrotal hernia was prevalent (43.48%). The main complication was strangulation (80.43%). Morbidity accounted for 1.3% of complications (infection, residual pain, testicular atrophy, hernia recurrence). No deaths were found. Altemeier stage and gender were statistically related to morbi-mortality of emergency hernia surgery in adults at 30 days post-op (p = 0.0260 and p = 0.0212 respectively). Conclusion: Abdominal parietal hernias are common in children, dominated by groin hernias. The high frequency of strangulation calls for awareness of cold hernia repairs.