[Burn out in health care providers: a Tunisian study about 142 nurses]

Burnout is a syndrome which affects preferentially help professions, having a strong emotional interpersonal implication. To assess the prevalence of burn out in a sample of Tunisian nurses, and to determine its causes and perceived repercussions. In a first step, we assessed the work conditions, the perceived burn out and its possible consequences in 142 nurses from 12 different wards. In a second step, we used the Malasch Burn Inventory to assess the burn out symptoms in ours ample. More than two thirds [69%] of our sample had a burn out. Forty five point eight percent of the affected professionals had a high level of emotional distress, 36.6% had a high level of depersonalization and 22.5% had a low level of professional fulfillment. The high caseload was the first cause of burn out [72.5% of professionals] and was associated to a moderate level of burn out [OR=3.80; 95%IC: 1.079-13.420 ; p = 0.038]. Role ambiguity and undefined responsibilities were associated to a high level of emotional distress [p=0.04] and depersonalization [p=0.03], and a low level of professional fulfillment [p=0.0001]. High scores of emotional distress were associated to a high number of work hours [p=0.006] and less than 10 years in carrier duration [p=0.008]. In our study, feelings of uselessness were associated to high levels of emotional distress [p=0.05] and depersonalization [p=0.002] on the one hand, and to a lower level of personal fulfillment on the other hand [p=0.04]. Moreover, we found that cases with suicide ideations had a higher level of burn out [p=0.04]. Concerning physical symptoms, emotional distress was associated to multiples somatic complains. Our results corroborate partially with those of the literature and illustrate some parameters that can be the cause of burnout, such as working conditions, role ambiguity, and lack of experience among the young nurse. Therefore, it is important to take into consideration this various factors had their impact on quality of life of caregivers

[Comparative study of appendical mucocela and pseudomyxoma peritonei. About 25 cases]

Aim: to study the clinicopathological features of the different types of appendical mucocele and to compare them with those of pseudomyxoma peritonei

Methods: 25 cases of appendical mucocele were operated in the Cap-Bon region in Tunisia during a period of 13 years from 1994 to 2006

Results: 9 retentionnal cysts, 13 mucinous cystadenomas, one serrated adenoma, one hyperplasia of the mucosa and one cystadenocarcinoma were diagnosed. Five cystadenomas as well as the only case of cystadenocarcinoma were associated with pseudomyxoma peritonei. Pseudomyxoma peritonei occurred 20 years later than in simple appendiceal mucocele and complicated 5 cases of cystadenoma with low grade dysplasia and 1 case of cystadenocarcinoma

Conclusion: Preoperative diagnosis of appendical mucocele and pseudomyxoma peritonei should be made on scannographic features in order to assess the adequate surgical management