Profile of Multidrug Resistant Bacteria in Bukavu Hospitals and Antimicrobial Susceptibility to Escherichia coli, Pseudomonas aeruginosa, Proteus mirabilis and Staphylococcus aureus

Objective: To evaluate the spread of Multidrug-Resistant (MDR) bacterial infections in Bukavu hospitals and test antimicrobial susceptibility patterns of some isolates to usual marketed antibiotics. Methods: The prevalence of MDR strains was determined by using general antimicrobial susceptibility data collected from 3 hospital laboratories. The susceptibility of some isolates to usual antibiotics was processed by agar diffusion method with standard E. coli ATCC8739 and standard antibiotics discs as controls. The tested antibiotics were ampicillin, ceftriaxone, gentamicin, chloramphenicol and ciprofloxacin. Results: At the 3 hospitals, 758 tests were realized in urine, pus, stool, FCV, blood, LCR, split and FU specimens;46 strains were unidentified and 712 strains were identified. Of 712 identified strains, 223 (31.4%) were MDR or XDR strains including Escherichia coli, Klebsiella pneumoniae, Enterobacter, Proteus mirabilis, Salmonella enterica, Pseudomonas aeruginosa, Citrobacter freundii, Morganella morganii, Enterococcus faecalis and E. faecium, Neisseria gonorrohoae, Staphylococcus aureus, coagulase-negative, staphylococci, Streptococcus pneumoniae and Streptococcus pyogenes. Of the infected patients, 36 (21.5%) children were under 16 years and 188 (78.5%) adults were predominately women (58.5%). The susceptibility test showed that all strains but S. aureus were resistant to ampicillin and amoxicillin and ciprofloxacin. Gentamicin, ceftriaxone, and chloramphenicol remain partially active (27% - 80%) against P. mirabilis, E. coli and P. aeruginosa. The resistance is more likely related to strain mutation than to pharmaceutical quality of the antibiotics prescribed. Conclusion: Both data from hospital laboratories and in vitro post-testing findings confirmed the ongoing elevated prevalence of MDR strains in Bukavu. The causes of antibiotic misuse and socio-economic determinants of the phenomenon of resistance should be scrutinized in order to take adequate strategies in the prospective of establishing an effective control system against this threat to overall health. The results of this work on MDR profiles have various implications for the management of infectious diseases. It provides indicators for the surveillance of antimicrobial resistance, practical guidelines for antibiotic susceptibility testing in biomedical laboratories, and guidance for antibiotic therapy.

Complete Hydatidiform Mole at Menopause: A Case Report from Panzi Hospital, Bukavu, Democratic Republic of Congo

Gestational trophoblastic disease is an abnormal proliferation of trophoblastic tissue during pregnancy. It occurs in women of childbearing age, although a few cases have also been observed in post-menopausal women, although it is extremely rare in the latter. Here we describe a rare case of complete hydatidiform mole in a 56-year-old female patient who presented with genital bleeding combined with nausea and vomiting and a gravid uterus 16 cm in height. The ultrasound findings and the increase in serum β-HCG to 182566.00 mIU/ml suggested a diagnosis of complete hydatidiform mole. Given the post-menopausal state and the future risk of post-molar gestational trophoblastic neoplasia, we opted for total hysterectomy without preservation of the adnexa via a transabdominal approach, followed by antimitotic treatment with methotrexate. The uterus measured 18.45 cm × 11.18 cm with intra cavitary vesicles. Microscopic examination showed chorionic villi of variable size and shape, most of which were dilated and oedematous, associated with trophoblastic cell proliferation and haemorrhage suggestive of complete benign hydatidiform mole. Follow-up showed a consistent decrease in serum β-HCG levels and no evidence of residual disease. A suspicion of gestational trophoblastic disease should be borne in mind when evaluating a patient with peri- or post-menopausal bleeding to avoid delay in diagnosis and treatment.

Assessment of Acute Poisoning Cases in Emergency Department of the Provincial General Reference Hospital in Bukavu, DR-Congo

Background: Acute intoxications result from intentionally or accidentally taking a relatively significant amount of a chemical substance which triggers disturbances in the level of psychophysiological functions, the complications of which may lead to mental disorders, physical causalities, and death. Any acute intoxication mostly requires emergency care. Objective: To highlight the prevalence, history, clinical features, emergency treatment, and prediction of acute intoxication cases referred to the emergency services at the Provincial General Reference Hospital in Bukavu, DR-Congo. Methods: A retrospective cross-sectional study was conducted from January 2021 to October 2022 based on an analysis of patients’ medical files. Triage was performed among all-type of patient files recorded in the computerized hospital database Ebale-Sante to sort cases of intoxication. Results: During the observational period, 3966 emergency admissions were counted, of which 321 (8.09%) patients were identified as having acute intoxication. Among these, 100 files that containing sufficient information fit the quality criteria for this study’s analysis. The victims were infants, adolescents and adults aged 1 - 45 years, and 52% were female and 48% were male. Most cases were accidental and, occurred at home, and the victims were driven to the hospital within 2 - 24 hours. The substances consumed included household products, drugs, and herbs. Resuscitation care, antidotes and supportive symptomatic medications ensured that 85% were healed and 10% experienced sequelae;however, 5% died. Conclusion: Acute intoxication occurs in infants mostly accidentally though the ingestion of household products and medicines. Furthermore, suicide cases may occur in traumatized adolescents and discordant couples. People should be informed about how to store hazardous products (e.g.: drugs, household products and pesticides), which should not be available to children, to avoid unintentional poisoning. Special training in clinical toxicology is required to reduce treatment failure.

Serum Calcium Ionised Rate and Materno-Perinatal Prognosis in Arterial Hypertension in Pregnancy at the Reference General Hospital of Panzi

Hypertensive disorders of pregnancy are among the leading causes of severe maternal morbidity and mortality, particularly in developing countries. Hypertensive disorders of pregnancy are among the leading causes of severe maternal morbidity and mortality, particularly in developing countries, maternal hypocalcaemia being a factor favouring the onset of arterial hypertension during pregnancy. The aim was to determine the maternal and perinatal prognosis of patients with hypertensive disorders of pregnancy as a function of serum ionised calcium levels. Material and Methods: A cross-sectional analytical study of 114 patients with arterial hypertension during pregnancy or during pregnancy or in the postpartum period at the HGR/Panzi from 1 January 2021 to 30 June 2022, text was entered using Microsoft Office Word 2010 and the tables were analysed using Excel 2010. The data was analysed using SPSS version 20.0 and Stata 14.0. The associations of the variables were calculated using Pearson's chi-square test, with a significance threshold set at a value of p < 0.05. Study of risk factors, Odds ratios and their confidence intervals were estimated in a univariate analysis. The most determining factors were identified by multivariate analysis using the Forward conditional logistic regression model. Results: The mean gestational age was 34.43 ± 4.327 amenorheas weeks, 46.6% of patients had a vaginal delivery, 66.65% of which were indicated for maternal prognosis, maternal complications were associated with maternal hypocalcaemia in 81, 82% (P = 0.043) and an OR = 3.255 (P = 0.0158) threefold risk that the patient presenting with a complication is likely to be in a state of hypocalcaemia at 95% confidence index, and fetal prognosis was not significantly related to maternal calcaemia. Conclusion: Maternal hypocalcaemia is one of the factors that can influence maternal-foetal complications maternal-fetal complications, early management and prevention of this pathology is pathology is important to reduce maternal-fetal morbidity and mortality.

Assessment of antidiabetic activity and acute toxicity of leaf extracts from Physalis peruviana L.in guinea-pig

Objective:To verify the antidiabetic activity of leaf extracts from Physalis peruviana L.popularly used in the Eastern part of the Democratic Republic of the Congo and to point out the possible toxicity.Method:Aqueous decoctions prepared from dried leaves powder were administrated to guinea pigs at the dose range of 100 mg/kg to 3.2 g/kg of body weight.The hypoglycemic activity was evaluated by glucose tolerance test,loading animals with glucose 4 g/kg and measuring blood glucose concentrations at various times.The effect was compared to the control and glibenclamide as antidiabetic reference drug.Acute toxicity was evaluated by recording mortality rate,changes on blood biomarkers and damage caused to vital organs.Results:At a dose of 100 mg/kg,the aqueous extract induced a significant reduction of peak concentration at 30 min after glucose loading as compared with control or reference(P<0.05).At doses greater than 400 mg,some alterations on blood,kidney and liver markers were observed.Upper 800 mg/kg,mortality was observed with LD_(50)estimated at about 1280 mg/kg.At the autopsy,vital organs were in haemorrhage and swelling state.Conclusion:The crude aqueous extracts from the leaves of Physalis peruviana L.present hypoglycemic aclivily in animal model,but at high doses the plant may cause severe intoxication.

Development and Validation of a Spectrofluorimetric Method for the Assay of Tetracycline in Capsules

The purpose of this study is to develop and validate a method for the analysis of tetracycline capsules by spectrofluorimetry. A pH 9 borate buffer was used as diluent of tetracycline after reaction with magnesium salt at the excitation wavelength of 372 nm and 516 nm of emission. A linear response was observed between 0.25 μg/mL and 1.5 μg/mL with a correlation coefficient (R) of 0.9998. The detection and quantification limits found are 0.0125 μg/mL and 0.0412 μg/mL respectively. The proposed method proved trueness with a recovery between 99.88% and 101.10%. The relative standard deviations of repeatability and intermediate precision found ≤2.88% reflected a good precision of the method. The proposed method is therefore valid within the limits of 90% to 110%. The proposed method was applied to the quality control of 9 tetracycline samples from market and gave results in accordance with the pharmacopoeia standards.

Epidemiological and Cytopathological Profile of Dysplastic Lesions of the Cervix in South-Kivu/Dr Congo

Background: Cervical cancer is one of the most common cancers in women in the world. The recrudescence of dysplastic lesions is increasing, especially in developing countries, because of the absence of screening. The objective of this work is to determine the prevalence of dysplastic lesions of the cervix in women who are sexually active in South Kivu province. Methods: It was a cross-sectional, descriptive and analytical study of 625 women who came for gynecological consultation, all of whom had cervical-uterine Pap smears, during the period from January 1st, 2017 to December 31st, 2018 at Panzi General Referral Hospital (South Kivu, DR Congo). Data analysis was done using Epi Info software version 7. Results: The median age of the respondents was 34 years, 47.0% of them were married, and 59.0% had a low socio-economic level. The majority had first sexual intercourse between the ages of 15 and 20 (67.5%), a number of former sexual partners estimated at 1 - 5 (87.8%), did not use tobacco (97.4%) and did not use contraception (78.1%). Pap smear was normal in 82.88% of cases, inflammatory in 2.4% of cases and with cytologic abnormalities in 14.72% of cases. Rates of dysplastic lesions were significantly higher among women aged ≥35 years (p = 0.0245), brides (p = 0.0183) and nulliparas (p = 0.0042). Multivariate analysis revealed the adjusted OR (95% CI) statistically insignificant (p < 0.05) for the age group, marital status and parity respondents. Conclusion: Cervical cancer remains a real scourge in the world, especially in sub-Saharan Africa, where the diagnosis is often made when the pathology is at its stage almost incurable. Early detection of dysplastic lesions by Pap smear is therefore imperative in the eradication of this pathology.

Quality Control of Quinine in Pharmaceutical Forms Tablets Find East of the Democratic Republic of Congo

The present study focuses on the quality control of quinine in the compressed pharmaceutical forms circulating in eastern Democratic Republic of Congo. The analyses performed on the collected samples included disintegration of the tablets, identification of quinine in the formulations by color reaction methods and thin-layer chromatography. The quantitative analysis was performed by spectrophotometric and volumetric methods. The most significantly observed findings were abnormalities of release;underdosing, overdosing and absence of the active ingredient, Which brings us to the conclusion that more than 30% of the samples analyzed are of inferior quality and adulterated.

Evaluation of the Vulnerability to Groundwater Pollution of the Makiso Municipality in Kisangani (DR Congo) Using the DRASTIC Parametric Method and GIS

The Makiso municipality is located in an urban area influenced by a very high rate of land occupation by houses. This land use has an impact on the quality of the groundwater exploited by wells and springs. This groundwater helps to make up for the deficit caused by the lack of a water distribution network. It is also threatened by pollution from human activities. In order to protect the groundwater in Makiso municipality from pollution, the study of the intrinsic vulnerability assessment in the aquifers was carried out by applying the DRASTIC method and the Geographic Information System (GIS). The results obtained using this method were grouped into two degrees of vulnerability (medium and high), with variations in DRASTIC indices of [141 - 145] for the medium degree and [146 - 175] for the high degree. The high vulnerability class is the most dominant, with a percentage of 96.5% of the study area. The medium vulnerability class, which represents 3.5% of the area of the Makiso municipality, is mainly located in the western (medical plateau district), central (Lualaba district) and southern (commercial district) sectors in the form of isolated pockets. A comparison of the nitrate distribution map with the final vulnerability map shows that the areas defined as highly vulnerable by the DRASTIC method and the areas with high nitrate concentrations (above 0.11 mg/l) are in agreement. On the other hand, there are other areas with low nitrate concentrations (below 0.05 mg/l) which correspond to the high vulnerability indices.

Development, Validation and Application of a Spectrofluorimetric Method for the Quantification of Nevirapine in Pharmaceutical Formulations Tablets and Suspensions

The development of the spectrofluorimetric method can be considered a promising alternative that is relatively less expensive and sufficiently reliable. In the current literature, no method for the analysis of nevirapine by spectro-fluorimetric has been reported. The proposed method is based on the transformation of naturally non-fluorescent nevirapine into a fluorescent derivative after chemical synthesis. Maximum excitation and emission wavelengths are 290 nm and 357 nm respectively. The analytical performance of the method demonstrates linearity in the concentration range 1.5 × 10-2 and 13.5 × 10-2 μg/mL with a correlation coefficient (r) greater than 0.999. The detection (LOD) and quantification (LOQ) limits found are 1.97 × 10-3 μg/mL and 5.48 × 10-3 μg/mL respectively. Recovery is achieved with 99.9% and 100.3% trueness, intra-day precision with a coefficient of variation of repeatability (CVr) of 0.99% and inter-day precision with a coefficient of variation of precision (CVR) of 1.7%. The method has been successfully applied in the analysis of 10 batches of nevirapine tablets and suspensions.

The Place of Human Papillomavirus Test in the Screening of Intraepithelial Lesions of Cervix in South-Kivu Province, DR Congo

Introduction: Human papillomavirus (HPV) infection remains the most common cause of cervical intraepithelial neoplasia. The objective of this study is to evaluate the sensitivity and predictive value of the HPV test associated with the cervico-uterine smear in the screening of cervical intraepithelial neoplasia in our environment. Methodology: This is a descriptive cross-sectional study of 625 women who consulted in the department of gynecology for cervical cancer screening, of whom 300 received an HPV test;during the period from January the 1st to December 31st, 2018 at Panzi general reference hospital (South-Kivu, DRC). Data analysis was done using Epi Info version 7 software. Results: For all respondents (n = 625), the cervico-uterine smear was normal in 82.88%, inflammatory in 2.4% of cases and with cellular atypia in 14.72%. The HPV test was positive in 87 respondents against 213 negatives cases, i.e. a prevalence of HPV of 29% [95% CI: 23.9% - 34.5%]. Among women with precancerous lesions, 27.6% had HPV infection;among those with normal smears, 29.3% of them had HPV infection;however, this difference was not statistically significant. Patients with dysplastic lesions, 31.3% had genotypes with very high carcinogenic potential;and for those with a normal Pap smear, 45.1% had genotypes with very high carcinogenic potential;however, this difference was also not statistically significant. Conclusion: The human papillomavirus test remains a very important indication cation in the detection of cervical intraepithelial neoplasia, its sensitivity remaining clearly superior to that of cytology, especially for high grade lesions.

稀有金属伟晶岩的地球化学和岩石成因:以刚果(金)Karagwe-Ankole成矿带Kivu地区Lemera锡矿床为例

本文报道刚果(金)Karagwe-Ankole成矿带Kivu地区Lemera花岗伟晶岩型锡矿床的岩石成因和地球化学研究结果。从露头采集7个花岗岩伟晶岩样品,并采用ICP-MS和XRF光谱法对其进行全岩岩石地球化学分析。花岗伟晶岩具有较高的Al_(2)O_(3)、较低的Fe_(2)O_(3)(T)和MgO含量(平均值分别为12.95%、0.96%和0.16%,质量分数),岩石铝饱和指数范围为1.33~2.05。一些重要稀有金属的丰度以及相关关键参数计算结果如下:Sn((1~138)×10^(-6))、Ta((0.20~0.60)×10^(-6))、Nb((1~8)×10^(-6))、Cs((1.20~3.20)×10^(-6))、Rb((3~223)×10^(-6))、Zr((7~201)×10^(-6));w(K)/w(Rb)(150~272);w(K)/w(Cs)(9.06~23.3),w(Nb)/w(Ta)(3.33~14)。结果表明,Lemera花岗伟晶岩形成于碰撞后期至后碰撞的构造环境中,由过铝质S型花岗岩岩浆结晶而成,岩浆经历了强烈的分离结晶作用。该岩体具有锡和锆的矿化。

The Lie Group <i>S</i><i>U</i>(2) Hopf Fibration and the Fourier Equation

The Fourier equation explains the dynamics of heat transfer. But bringing this phenomenon closer to the notion of fibration seems difficult to achieve. This study then aims to find the solution of the one-dimensional Fourier equation and to interpret it in terms of bundle. And then apply the results obtained at the Kankule site in Katana in South Kivu. To do this work, we resorted to geometric or topological analysis of the Hopf fibration of the unit sphere S3 (identifiable in SU(2)). We had taken the temperatures of the thermal waters and the soil of Kankule, from 2010 to 2014, in situ. And laboratory analyses had allowed us to know the physical and chemical properties of the soil and water at each of our 14 study sites in Kankule. The data of the geomagnetic field of each site, were taken in on the site NOAA, for our period of study. We then determined the integral curve (geotherm) of the Fourier equation and wrote it as a unit quaternion which is a bundle. The constants intervened in the geotherm, for each site of Kankule, we had obtained them statistically. We have found that the geotherm of each Kankule site is a bundle. We have compared this model to the bundle model of the geomagnetic field. From there we realized that to determine the energy potential of Kankule, we should consider the thermal springs separately. We were able to find a connection between the fibration of the geomagnetic field and the heat field for the Kankule site.

Continuous Spinal Anesthesia in Precarious Patients: An Experience in Lubumbashi DR Congo

Background: Continuous spinal anesthesia (CSA) is an underused technique in modern anesthesia practice. Compared with other techniques of neuraxial anesthesia, CSA allows incremental dosing of an intrathecal local anesthetic for an indefinite duration, whereas traditional single-shot spinal anesthesia (SSA) usually involves larger doses, a finite, unpredictable duration, and greater potential for detrimental hemodynamic effects including hypotension, and epidural anesthesia via a catheter may produce lesser motor block and suboptimal anesthesia in sacral nerve root distributions. It is indicated in elderly patients undergoing lower limbs and sub umbilical surgery. Aim: This work aims to highlight the advantages of CSA on hemodynamic stability and as an alternative to heavy anesthetic procedures in already fragile patients. Case presentation: Our cases were two elderly patients, both of them with past stories of cardiac diseases. Both of them were undergoing amputation indicated for wet gangrene on lower limbs. They had unstable hemodynamics states due to inflammatory state. They were all rated ASA 3. CSA was performed with low doses of local anesthetics and maintenance by reinjections of mixture with the same doses. The interventions took place without major incidents and all patients survived. Conclusion: CSA is an underused technique in modern anesthesia. However, there is renewed interest due to the quality of the blocs and the hemodynamics stability. We report a case series of 2 elderly patients with past stories of cardiac diseases undergoing amputation for dry gangrene that had been operated under CSA.