The aim of this study is to assess unsafe abortion and its effects in Menoufyia and Assiut governorates. A cross-sectional analytic design. The study was conducted in general hospitals, MCH centers, and households in Menoufyia and Assiut governorates. Subjects: The sample has included all the cases of unsafe abortion recorded in the general hospitals in the two governorates for a whole year, 138 in Menoufyia, and 304 in Assiut. Records of MCH centers in the study settings were used to identify subjects to be interviewed in households to fulfill the required sample of 1000 in each governorate. Data collection tools: Three tools were used. A personal interview sheet was used for the community-based sample of women. It contained queries about reproductive history, and details of the aborted pregnancy. The second tool was a checklist designed for recording data abstracted [Tom medical files of the record-based sample of women. The third tool was a psycho-social scale for assessment of psychological and social effects of unsafe abortion on woman. Statistical analysis: Data entry and analysis done on Epi-info 6.04 statistical software package, using Student t-test, chi-square, and Fisher tests, with statistical significance set at p-value 0.05.:Women' illiteracy in Assiut was 60.3%, and 46.3% in Menoufiya, the majority, were housewives. The mean age was 31.03±8.15 years in Assiut and 32.42±8.22 in Menoufiya. Economic status was the main reason for terminating pregnancy. The most frequently adopted method was carrying heavy loads (25.4% and 36.3%) jumping [Tom height (16.5% and 24.2%), and drinking boiled onion peels (19.4% and 23.4%) in Assiut and Menoufiya, respectively. However, it was practiced by 13.6% and 15% of cases, respectively. The majority of women agreed that family planning was better than unsafe abortion to get rid of unwanted pregnancy. From the record-based sample, the crude and estimated rates of unsafe abortion based were estimated, and were statistically significantly higher in Assiut. The majority of women in both governorates suffered from complications, mainly bleeding, followed by gastrointestinal disturbances. One patient from Assiut and three from Menoufiya died.It is recommended to integrate patient education and counseling at all levels of woman's care; premarital, antenatal, postnatal and family planning. Involving husband and mother-in-law is important. A family planning follow-up schedule is suggested. Lastly, there is a need for specialized related population-based studies in sociology, anthropology, behavioral sciences, as well as in pharmacology and toxicology.

The study was conducted in 18 villages and 5 cities in Assiut Govemorate to compare the knowledge of trained traditional birth attendants (TBAs) and untrained (TBAs) concerning labour. The study included 58 traditional birth attendants divided to 38 TBAs trained and 20 TBAs were not attending training program. Data- were collected through a questionnaire sheet during the period from February 1999 to May 1999 through the interview of the TBAs during the home visits for TBA on two days per week. The result of this study indicated that 87.9% of the sample were from rural areas and 12.1 % from urban. Statistical significant differences were found between trained TBAs and untrained (TBAs) in relation to their knowledge about the time of enema X = 10.30 , P = 0.05 and their knowledge about care during the preparation for labour X/· =10.3Q, P= 0.05. There is no statistical significant difference between the two groups in their knowledge related to most items. The present study recommended that Particular at attention should be given to help the traditional birth attendants how to read and write, this will help to improve their knowledge, refresher courses should be provided periodically for TBAs so that their knowledge are up-graded regularly.

Purpose: To evaluate the intra-operative course (including pain scores) of transcervical procedures under paracervical block, with or without vaginal misoprostol as a cervical ripening agent. Study design: This is a randomized double-blind placebo-controlled study, conducted during the period from the I st October 2002 till the end of August 2003. Patients were randomly allocated, by means of computer-generated numbers, to receive either placebo or 200 flg of misoprostol 24 and 12 hours before surgery. Setting Department of Obstetrics and Gynecology, Assiut University Hospital, Assiut, Egypt. Subjects: One hundred forty five cases with any indications for cervical dilatation up to 8-mm or more were considered eligible for the trial, 23 refused to be operated under paracervical block and 20 cases didn't completed the protocol. The remaining 102 cases were randomly allocated either for misoprostol (51 cases) or placebo (51 cases). Outcome measures: The primary outcome measure was intraoperative pain scores as measured by visual analog scale (V AS). The secondary outcome measure in this study was the ease of cervical dilatation. To avoid SUbjective bias, the ease of cervical dilatation was converted to an objectively measurable and statistically manageable variable by development of a simplified 7-points scale for scoring the ease of cervical dilatation. Also the needs for conversion to general anesthesia and side effects were also reported. Results: Pain scores were significantly lower in misoprostol group compared to placebo group during cervical dilatation (P= 0.027, CI -10.5: - 0.6). However the difference was less obvious during the definitive transcervical procedure. Also cervical dilatation scores were significantly lower (1.7±1 vs. 4.9±0.9) in misoprostol group than they were in the placebo group (CI -2.4: -1.7 P= · " .) Dilatation time as well as the number of cases needed conversion to general anesthesia were significantly less in the study group, however there were no differences in the complication rates .Conclusions: The use of vaginal misoprostol as a cervical ripening agent was found to be associated with lower pain scores in cases undergone transcervical procedures under paracervical block than was the use of placebo. Also it was found to be associated with lower cervical dilatation scores (easier cervical dilatation), consequently, fewer cases needed conversion to general anesthesia. Key words: misoprostol, cervical ripening, paracervical block, pain scores.

This study aimed to shed light on the various alternative therapies for infertility used among women, in addition to identifY the factors that might be related to use of alternative therapies among women attending Assiut University Hospital, Obstetrics and Gynecology Clinics. The study had been conducted at outpatient clinics of Obstetrics and Gynecology in Assiut University Hospital. Any woman attending the clinic with the inclusion criterion of having infertility, primary or secondary was eligible for inclusion in the study sample. A convenience sample of 81 women fulfilling these criteria was consecutively recruited. An interview questionnaire sheet was developed by the investigators to collect data. The sheet included four sections divided to: first section for the socio demographic characteristics of women, second section on menstrual history of women, third section for the obstetric history for secondary infertility cases and the last section was concerned with infertility and alternative therapies. Data were collected during the period from the beginning of October 2006 to the end of January 2007. The study showed that the age of studied women ranged between 16 and 58 years, (85.2%) were housewives and (56.8%) were illiterate. Also the study revealed that (77.8%) had primary infertility while (22.2%) had secondary infertility. In (79.0%) of the sample, the wife was the cause of infertility. It was clear that (43.2%) of the study sample have consulted physician but (65.4%) of them have reported using alternative therapies as visiting holy shrines as a religious practice, going to cemeteries, using "hegab" and medicinal herbs. As the results show, neighbors were the main source of advice about the alternative therapies (56.6%). The study recommended that successful infertility programs should include health education about the causes of infertility in both men and women and where best to seek care. Alternative therapies must be provided with proper training, facilities backup for referral to any health resource for the common goal of improving the community health.

Quality of life as an individuals, perception of his/ her position in life in the context of the culture and value systems in which he /she lives and in relations to their goals expectations standards and concerns. This study was the first geographical location which helps such group of patients to describe changes in quality of life of patients with chronic heart failure undergoing permanent artificial pacemaker. Descriptive re- search design was adapted to conduit the study on 80 patients whit pacemaker implantation in coronary catheterization lab., at Assiut university Hospital. A structural interview sheet was developed for data collection to assess the quality of life among patients with permanent pacemaker. The tool content modified was done and translated into Arabic by researchers. Descriptive statistics calculated were frequency, percentage, chi-square and p-value. In the present study the patients characteristics, regarding age the majority of patients were in the age between 40-65 years although the majority of them were female and unskilled. 93.75% of total study patients were living in the rural areas 53.75% of them reported it as less them 6 months but 46.25% of them as more than 6 months. No significant relation was observed between patients education and self-concepts, although between patients psycho-logical assessment and duration of pacemaker implantation but there was a significant difference between patients occupation and physical activity.

Quality of life as an individuals, perception of his/ her position in life in the context of the culture and value systems in which he /she lives and in relations to their goals expectations standards and concerns. This study was the first geographical location which helps such group of patients to describe changes in quality of life of patients with chronic heart failure undergoing permanent artificial pacemaker. Descriptive re- search design was adapted to conduit the study on 80 patients whit pacemaker implantation in coronary catheterization lab., at Assiut university Hospital. A structural interview sheet was developed for data collection to assess the quality of life among patients with permanent pacemaker. The tool content modified was done and translated into Arabic by researchers. Descriptive statistics calculated were frequency, percentage, chi-square and p-value. In the present study the patients characteristics, regarding age the majority of patients were in the age between 40-65 years although the majority of them were female and unskilled. 93.75% of total study patients were living in the rural areas 53.75% of them reported it as less them 6 months but 46.25% of them as more than 6 months. No significant relation was observed between patients education and self-concepts, although between patients psycho-logical assessment and duration of pacemaker implantation but there was a significant difference between patients occupation and physical activity.

Sleep disturbance is very common in patient with end stage renal disease (ESRD) on dialysis. ESRD patients reports a significantly poor subjectively quality of sleep in comparison to the general population.(ll the most frequently reported complaints are insomnia, restlessness syndrome, sleep disordered breathing and excessive daytime sleeplessness (EDSi2 ) The aim of this study was to assess the quality of sleep among patients with end stage renal disease (ESRD) undergoing hemodialysis unit of Assiut University hospital. The sample of study include 108 patients with end stage renal disease (ESRD) undergoing hemodialysis both male and females. A structural interview questionnaire sheet was used, it include sociodemographic, Pittsburgh sleep quality index (PSQI) (Buysse et aI, 1989) was translated into Arabic in order to assess the quality of sleep among patient with ESRD undergoing hemodialysis. The PSQI is useful in identifYing good and poor sleepers. A global PSQI score 75 indicate that a person is (poor sleeper). The results. The mean total and subtotal good and poor scores of PSQI, the mean total score were (34.3%) were good sleepers and (65.7%) were poor sleepers. Various strategies should be recommended to improve sleep. Sleep medication, anemia correction more frequent dialysis and assessment sleep.

Sleep disturbance is very common in patient with end stage renal disease (ESRD) on dialysis. ESRD patients reports a significantly poor subjectively quality of sleep in comparison to the general population.(ll the most frequently reported complaints are insomnia, restlessness syndrome, sleep disordered breathing and excessive daytime sleeplessness (EDSi2 ) The aim of this study was to assess the quality of sleep among patients with end stage renal disease (ESRD) undergoing hemodialysis unit of Assiut University hospital. The sample of study include 108 patients with end stage renal disease (ESRD) undergoing hemodialysis both male and females. A structural interview questionnaire sheet was used, it include sociodemographic, Pittsburgh sleep quality index (PSQI) (Buysse et aI, 1989) was translated into Arabic in order to assess the quality of sleep among patient with ESRD undergoing hemodialysis. The PSQI is useful in identifYing good and poor sleepers. A global PSQI score 75 indicate that a person is (poor sleeper). The results. The mean total and subtotal good and poor scores of PSQI, the mean total score were (34.3%) were good sleepers and (65.7%) were poor sleepers. Various strategies should be recommended to improve sleep. Sleep medication, anemia correction more frequent dialysis and assessment sleep.

Sleep disturbance is very common in patient with end stage renal disease (ESRD) on dialysis. ESRD patients reports a significantly poor subjectively quality of sleep in comparison to the general population.(ll the most frequently reported complaints are insomnia, restlessness syndrome, sleep disordered breathing and excessive daytime sleeplessness (EDSi2 ) The aim of this study was to assess the quality of sleep among patients with end stage renal disease (ESRD) undergoing hemodialysis unit of Assiut University hospital. The sample of study include 108 patients with end stage renal disease (ESRD) undergoing hemodialysis both male and females. A structural interview questionnaire sheet was used, it include sociodemographic, Pittsburgh sleep quality index (PSQI) (Buysse et aI, 1989) was translated into Arabic in order to assess the quality of sleep among patient with ESRD undergoing hemodialysis. The PSQI is useful in identifYing good and poor sleepers. A global PSQI score 75 indicate that a person is (poor sleeper). The results. The mean total and subtotal good and poor scores of PSQI, the mean total score were (34.3%) were good sleepers and (65.7%) were poor sleepers. Various strategies should be recommended to improve sleep. Sleep medication, anemia correction more frequent dialysis and assessment sleep.

Back ground and purpose: Hemodialysis patient are susceptible to muscle cramps, both during dialysis sessions as well as in the interdialytic interval, these cramps are often very painful disruptive to dialysis management & adversely affect quality of life there no well defined mean of preventing or treating these cramps. Exercises have been used with apparent success in some patient. Exercises is very important element in the overall health of people at any age stretching exercises may be the best measure to reduce or prevent cramps from occurring. So the present study was designed to determine the effect of stretching exercises protocols on reduction of leg cramp during hemodialysis among patient with renal failure. Quasi- experiment ( research design was applied. This study was conducted in kidney dialysis department of Assiut university hospitals. The subjects of this study consists of 60 patient with muscle cramps during hemodialysis. three tools included in the study, tools of soci - demographic data ,tools of patient information about muscle cramps & management & tool of evaluated patient knowledge & skills after performance exercises. Results: there was lack of knowledge & skills related to muscle cramps before nursing instruction protocol but there was statistical significant difference after performance of exercises. It was found also that high significance difference between before & after performance of exercises. Conclusions: the importance of performance exercises for patient undergoing dialysis to prevent cramps. there is clearly a need for effective education regarding recognition ,individual patient need & appropriate intervention strategies in muscle cramps in dialysis patient & nurses, in partnership with patient, relatives & careers & other health professional can help to empower the individual to mange their cramps.