Hanna Kaspar

Prevalence of reproductive tract infections, genital prolapse, and obesity in a rural community in Lebanon

OBJECTIVE To determine the prevalence of reproduction-related illnesses in a rural community in Lebanon. METHODS Data were collected through interviews with women in their homes, physical examinations and history taking by physicians in a clinic in the community, and laboratory tests. A total of 557 ever-married women aged 15-60 years were selected randomly. FINDINGS Just over half of the sample (268, 50.6%) had five or more children, and (320, 78.9%) of women aged < 45 years were using contraception. The prevalence of reproductive tract infections was very low: six (1.2%) women had sexually transmitted diseases and 47 (9.3%) had endogenous reproductive tract infections. None had chlamydial infection or a positive serological finding of syphilis. None had invasive cervical cancer, and only one had cervical dysplasia. In contrast, genital prolapse and gynaecological morbidity were elevated. Half of the women studied (251, 49.6%) had genital prolapse, and 153 (30.2%) were obese. CONCLUSION The prevalence of reproductive tract infections in this conservative rural community in east Lebanon was low. Possible explanations include the conservative nature of the community, the high rate of utilization of health care services, and the liberal use of antibiotics without a prescription. More importantly, the study showed an unexpectedly high prevalence of genital prolapse and obesity--a finding that has clear implications for primary health care priorities in such rural communities.

Spontaneous uterine rupture following intercourse

Endres LK, 2000, OBSTET GYNECOL, V96, P806, DOI 10.1016-S0029-7844(00)01028-0; Imseis HM, 1998, J REPROD MED, V43, P233; Kavanagh JK, 2001, COCHRANE DB SYST REV, DOI DOI 10.1002-14651858.CD003093; Levrant SG, 1996, J REPROD MED, V41, P186; Shipp TD, 2001, OBSTET GYNECOL, V97, P175, DOI 10.1016-S0029-7844(00)01129-7

DNA ploidy by image cytometry and karyotype in spontaneous abortion.

We compared the DNA content (DI) by cell image analysis with the karyotype and morphological phenotype of paraffin-embedded tissues from 51 spontaneous abortions. The study included 21 cases with triploid, 19 cases with diploid, and 11 cases with aneuploid (monosomic, trisomic, or mosaic) karyotype. Measurements were performed by image analysis on the trophoblastic and stromal cells of chorionic villi using 5-microm-thick, Feulgen-stained sections. At least 200 cells were analyzed. Results were interpreted using DI ranges of 1.3 to 1.7 for triploid and 0.9 to 1.1 for a diploid profile. All 21 cases with a cytogenetically confirmed triploid karyotype had DI values within the triploid range, and all 19 cases with a diploid karyotype had DI values within the diploid range. All of the trisomies and monosomies also had a DNA mass within the diploid range. However, eight cases with a triploid karyotype also had a peak in the diploid range: one case with a diploid karyotype and one case with a trisomic karyotype each had an additional peak in the triploid range. We did not find a morphological correlation either with image analysis or with karyotype. We conclude that cell image analysis is a reliable method for detection of triploidy in spontaneous abortions. This relatively rapid method allows visual discrimination of the areas to be analyzed, avoids the problem of maternal cell contamination, and may unmask mosaic karyotypes that would go unrecognized by cytogenetic studies alone.

Premenarchal ovarian serous borderline tumor: A case report and review of the literature

Epithelial ovarian tumors commonly occur after menopause. They are uncommon before 20 years of age and rarely occur before puberty. While Norris and Jensen (1) found no epithelial tumors among 54 patients with ovarian tumors aged less than nine years and one among 82 patients aged 10 to 14 years, there are few individual case reports of ovarian cystadenocarcinoma in very young patients (2-5). Smith et al. (6) in a review of 22 ovarian tumors in children less than 13 years, found only one patient with poorly differentiated adenocarcinoma. There is only one report of a 12 year old premenarchal girl with mucinous ovarian tumor of borderline malignancy (7). There are no previous reports of serous borderline tumors in premenarchal females(3-11).Serous ovarian tumors of low malignant potential are the most common borderline epithelial ovarian tumors. Prolonged survival of over 10 years is expected even in advanced stages. However 25-30% of patients with advanced stages (III and IV) will eventually succumb to th...