Is mastectomy an option in treatment of breast abscesses?

Three cases of severe breast infection are presented. The first patient was admitted with a gangrenous left breast and was in septic shock. She died soon after admission. Thc second case had bilateral breast abscesses and was toxic. She also died after treatment with antibiotics and multiple debridments. The third patient with bilateral severe breast infection had right mastectomy. She made a rapid improvement. It is proposed that mastectomy may be a reasonable option for management of advanced or neglected breast infection or necrotising fasciitis of the breast.Key words: hlastectomj; option, treatment and breast absces

Évaluation comparée de la pollution des rivières Kahuwa et Mpungwe par l'utilisation des macroinvertébrés benthiques

Les perturbations environnementales dues aux activités anthropogéniques se multiplient dans de nombreuses régions du globe et entraînent diverses pollutions des eaux. Ces pollutions sont importantes et causent un grand problème régional et local de santé publique. Dans la ville de Bukavu et ses environs, il y a suffisamment des systèmes aquatiques qui présentent des signes de pollution résultant des activités humaines. En vue d’estimer l’impact des activités anthropogéniques sur l’environnement des rivières, cette étude a été menée sur les rivières Kahuwa, située en milieu urbain, la ville de Bukavu et Mpungwe, située en milieu rural, à 20 km de la même ville. Des analyses physico-chimiques et biologiques réalisées in situ et au laboratoire du Centre de recherche en sciences naturelles de Lwiro, République Démocratique du Congo dans 7 sites des deux rivières (4 dans la rivière Kahuwa et 3 dans la rivière Mpungwe). Les résultats obtenus ont montré que la rivière Kahuwa est plus polluée que la rivière Mpungwe durant la période d’étude. Les paramètres physico-chimiques étudiés varient de l’amont en aval dans les deux rivières. Les concentrations en nutriments (phosphore et azote) sont en générales très élevées dans les sites où les activités anthropogéniques sont intenses (Kibonge, Cheche et SNCC pour la rivière Kahuwa et Usine Murhesa pour la rivière Mpungwe). Ces concentrations montrent bien que la pollution organique est intensifiée par les apports anthropogéniques. En général, la différence des concentrations des paramètres physico-chimiques dans les deux rivières est significative (p < 0,05). Les sources de ces nutriments sont généralement les effluents domestiques, les fosses septiques, les érosions provenant de l’agriculture, les rejets des industries et rejets des déchets divers qui ne sont pas réglementés. Les sites de la rivière Kahuwa ont moins d’espèces (14) que les sites de la rivière Mpungwe (31). La différence est significative entre les deux rivières (p < 0,001) en ce qui concerne la richesse spécifique. Cette faible richesse spécifique de la rivière Kahuwa serait due à la dégradation de la qualité des eaux comme déjà observée dans les facteurs physico-chimiques. En effet, il a été remarqué que l’utilisation des terres dans le bassin versant avait un impact significatif sur la distribution des macroinvertébrés. L’indice de Shannon et Weaver H’, l’indice biotique de pollution des macroinvertébrés l’indice de Hilsenhof, l’indice de Simpson et l’indice de Margalef montrent des variations entre les sites de prélèvement et les rivières. Des mesures de lutte antiérosive dans le bassin versant de la rivière Kahuwa et de mesures d’éco-sanitation (utilisation des toilettes VIP) sont recommandées pour diminuer la quantité des matières organiques apportées par la rivière Kahuwa dans le Lac Kivu.The environmental disturbances due to human activities increase in many countries and draw away various types of water pollutions. These pollutions are important and cause a serious regional and local problem in public health. In Bukavu and the surrounding areas, there are enough aquatic systems which shown signs of pollution resulting from human activities. In order to estimate the impact of human activities on the water quality within rivers, this study was carried out in the Kahuwa river, located in Bukavu, urban area, and Mpungwe river, located in rural area, so far at 20 Km of Bukavu. The physico-chemical and biological parameters from 7 sampling sites of both rivers (4 in the Kahuwa river and 3 in the Mpungwe river) was assessed in-situ and in the laboratory of the Lwiro Research Centre in Natural Sciences, Democratic Republic of Congo. According to the results obtained, Kahuwa river is more polluted than Mpungwe river during the period of this study. The physico-chemical parameters reach from upstream to downstream in both rivers Kahuwa and Mpungwe. The nutrients (phosphorus and nitrogen) increased in the sites which is intensively anthropogenic activities (Kibonge, Cheche and SNCC for the Kahuwa river and Murhesa factory for the Mpungwe river). The organic pollution is intensified by anthropogenic used. In general the physico-chemical water quality parameters show a significant difference (p <0,05). The major sources of the high levels of nutrients are in general the waste dumping, the mechanical erosion of rocks and soil particles due to agriculture blocks, the septic hole, the domestic sewers and industrial effluents in the water bodies, which are not regulated. The taxanomic diversity presents fewer species in Kahuwa river (14) than Mpungwe river (31). The difference is significant between both rivers (p <0,001) as regards species richness. The water quality was found to be the major factor contributing to the species richness of Kahuwa river and the impact of agriculture land use in the catchment on benthic macroinvertebrates distribution is significant. The several diversity (Shannon-Weaver, Hilsenhof, Simpson and Maragelf Indices) and pollution biotic macroinvertebrates indices show variations of the population diversity between the samples sites and rivers. In order to reduce the organic materials loading from Kahuwa micro catchment and Lake Kivu, there is need of erosion prevention and sanitation program (VIP toilet)

Évaluation comparée de la pollution des rivières Kahuwa et Mpungwe par l'utilisation des macroinvertébrés benthiques

The environmental disturbances due to human activities increase in many countries and draw away various types of water pollutions. These pollutions are important and cause a serious regional and local problem in public health. In Bukavu and the surrounding areas, there are enough aquatic systems which shown signs of pollution resulting from human activities. In order to estimate the impact of human activities on the water quality within rivers, this study was carried out in the Kahuwa river, located in Bukavu, urban area, and Mpungwe river, located in rural area, so far at 20 Km of Bukavu. The physico-chemical and biological parameters from 7 sampling sites of both rivers (4 in the Kahuwa river and 3 in the Mpungwe river) was assessed in-situ and in the laboratory of the Lwiro Research Centre in Natural Sciences, Democratic Republic of Congo. According to the results obtained, Kahuwa river is more polluted than Mpungwe river during the period of this study. The physico-chemical parameters reach from upstream to downstream in both rivers Kahuwa and Mpungwe. The nutrients (phosphorus and nitrogen) increased in the sites which is intensively anthropogenic activities (Kibonge, Cheche and SNCC for the Kahuwa river and Murhesa factory for the Mpungwe river). The organic pollution is intensified by anthropogenic used. In general the physico-chemical water quality parameters show a significant difference (p &#60;0,05). The major sources of the high levels of nutrients are in general the waste dumping, the mechanical erosion of rocks and soil particles due to agriculture blocks, the septic hole, the domestic sewers and industrial effluents in the water bodies, which are not regulated. The taxanomic diversity presents fewer species in Kahuwa river (14) than Mpungwe river (31). The difference is significant between both rivers (p &#60;0,001) as regards species richness. The water quality was found to be the major factor contributing to the species richness of Kahuwa river and the impact of agriculture land use in the catchment on benthic macroinvertebrates distribution is significant. The several diversity (Shannon-Weaver, Hilsenhof, Simpson and Maragelf Indices) and pollution biotic macroinvertebrates indices show variations of the population diversity between the samples sites and rivers. In order to reduce the organic materials loading from Kahuwa micro catchment and Lake Kivu, there is need of erosion prevention and sanitation program (VIP toilet)