Nabil Younis

A community study of gynecological and related morbidities in rural Egypt.

This study assesses the prevalence of gynecological and related morbidity conditions in a rural Egyptian community. A medical examination was conducted on a sample of 509 ever-married, nonpregnant women. For gynecological morbidities, genital prolapse was diagnosed in 56 percent, reproductive tract infections in 52 percent, and abnormal cervical cell changes in 11 percent of the women. For related morbidities, anemia was present in 63 percent of the women, followed by obesity (43 percent), hypertension (18 percent), and urinary tract infection (14 percent). Regression analysis of risk factors demonstrated the contribution of social conditions and medical factors to these diseases. Reproductive tract infections were shown to occur more frequently with uterovaginal prolapse, IUD use, presence of husband (regular sexual activity), and unhygienic behavior. Genital prolapse increased with age and number of deliveries. Age, recent pregnancy, education, socioeconomic class, and workload showed significant associations with related morbidity conditions. This evidence challenges national health programs to go beyond safe motherhood, child survival, and family planning in its services to women, and to consider the social context of health as well.

Women's health problems in the Arab World: a holistic policy perspective

The paper reviews key health problems of women in the Arab World. It relies on data and information from international yearbooks, regional data bases, and small scale field studies. The relevant context in which women live; of lingering illiteracy rates, lack of access to cash income, and increasing poverty is described. Reproductive health is reviewed within this context pointing to trends of delayed marriage and declining fertility in some countries while other countries maintain high levels. Similar variability is observed in contraceptive use rates and the interaction of contraception and health is discussed. Evidence points to high levels of reproductive morbidity. The socio‐cultural context is found particularly relevant to pregnancy and childbirth, seen as natural processes by women, to experiences of menopause, and to violence against women, particularly female circumcision. A holistic policy perspective is suggested to address these problems.

Laparoscopic ventrosuspension: A new technique

During 42 months of study, 150 cases of laparoscopic ventrosuspension were performed at Al‐Azhar University hospitals. In 98 patients (65.33%), the primary complaint was infertility. Retroversion of the uterus was the only abnormality detected during laparoscopic examinations. The remaining 52 patients (34.66%) had retroversion of the uterus concomitant with other conditions requiring surgery. Ventrosuspension was performed via the laparoscope by applying Falope® rings (KLI, Newtown, Pennsylvania USA) to the round ligaments. These patients were followed up for 6–30 months. Pregnancy occurred in 29 infertile patients and improvement of backache, deep dyspareunia, congestive dysmenorrhea and leukorrhea occurred in 81.25%, 89.25%, 68.18% and 56.66%, respectively. The technique is simple and safe; it reduces the length of hospitalization and can be performed concomitant with other surgical procedures.

Laparoscopy on patients with previous lower abdominal surgery: A new technique

During the period June 1979–May 1981, 1582 diagnostic and operative laparoscopic procedures were performed at Al‐Azhar University Endoscopy Unit and during field visits to several hospitals in Egypt, Sudan and Mauritania. Ninety‐nine of these had had previous lower abdominal surgery. Laparoscopy was performed on 93 of these patients using a modified technique of laparoscopy. The modified technique involves direct visualization of the previous peritoneal scar with the scope before its careful puncturing with the trocar and cannula. The paper describes the technique, findings, complications, limitations of the procedure and its application.

Perinatal mortality in an Egyptian maternity hospital

The factors affecting perinatal mortality during a period of 21 months were studied at Al‐Galaa Teaching Hospital, using the International Fertility Research Programs Maternity Record 903 to collect the data. There were 6990 deliveries during the 21 months and 580 hospital perinatal deaths. Certain high‐risk factors associated with perinatal mortality were identified including both biosocial and biomedical factors. The biosocial factors affecting perinatal mortality in this study are discussed, including maternal education, marital status, residence, hospital status as paying or non‐paying patient, maternal age, registration status, outcome of last pregnancy, parity/family size, antenatal care, maternal hemoglobin, and the weight and sex of the baby.