The 1952 Revolution and Democracy

Thjs monograph is the outcome of a symposium on the theme of Problems and Prospects of Democracy in Egypt , which was organized by the Centre for Political and Strategic Studies of AI-Ahram Foundation, and the Department of Political Science of the American University jn Cairo. The symposium was held from 8 - 11 December 1976, and was attended by a number of university professors and scholars representing different intel 1- ectual and ideological persuasions. It took place at a time when Egyptian democracy was in the ascendent: thus papers and discussions radiated a general feeling of optimism. The pages that fol low represent, in a sense, the testimony of a number of Egyptian Intellectuals and a summation of their perceptions of the problems that democracy faces in their country. This volume could not have been possible without the active support and encouragement of a number of people. I would like to express my deep­est gratitude to Dr Thomas Lamont, Dean of the Faculties at AUC, who was of untold help in making into reality the idea of the symposium and the project of this monograph. I would also like to thank Dr Boutros Boutros­ Ghali and Dr Earl Sullivan for their vital help. Mr Bahgat Badei made an initial translation of most of the papers which were originally delivered in Arabic. Responsibility for verification of the translations is my own. My sincere thanks go also to Mr Michel Le Gal I, who spent considerable time reading the manuscript, and who suggested various stylistic improvements

Accuracy of the Manipal Cervical Scoring System for predicting successful induction of labour

The Manipal Cervical Scoring System is an accurate and objective sonographic score that predicts the outcome of induced labour. The aim of the current study was to compare the performance of the Manipal Cervical Scoring System against the Bishop Score. A prospective study was conducted on 105 women underwent labour induction in Ain Shams University Hospital, Cairo, Egypt. Both scores were assessed pre-induction. Successful induction occurred in 78.09% of the cases. The area under the ROC curve (AUC) was of 0.940 (95% CI = 0.876 to 0.977; p value 5 had a sensitivity of 91.5% and a specificity of 91.3%. While the Bishop score >4 had a sensitivity of 98.8% and specificity of 69.6% to predict the outcome of induced labour. The Manipal Cervical Scoring system is a better objective tool to predict the outcome of labour induction compared to the Bishop Score. However, other female and fetal characteristics, including body mass index (BMI) at gestation, gestational weight gain, occiput position and parity should be taken into consideration when performing labour induction.Impact statement What is already known on this subject? The ultimate fate of 20% of women having an induction of labour (IOL) is a Caesarean delivery. Thus, predicting the possible response to IOL before starting induction could guide clinicians to determine the efficacy of starting and/or continuing the induction process and in counselling women regarding the possible response to IOL. The main predictor for IOL outcome is based on the pre-induction cervical status which has been traditionally assessed by the Bishop Score. However, the Bishop Score remains subjective, thereby, associated with high rates of bias and several studies have demonstrated its poor predictive value for the outcome of induction. What do the results of this study add? Proposed use of ultrasound parameters that are equivalent to Bishop Score will be objective, reliable and reproducible method. It allows for patient re-evaluation by other obstetricians without the need for re-examination (thus decreasing exposing the patient to pain and anxiety). What are the implications of these findings for clinical practice and/or further research? According to WHO and FIGO, oral misoprostol (25 μg, 2-hourly) is recommended for induction of labour. This helps to decrease the discomfort of repeated vaginal examination and increases the women satisfaction with labour process, especially in women at higher risk of infection. Thus evaluating cervical status using an ultrasound cervical scoring system can similarly increase women's satisfaction with labour process. Our goal in the upcoming trial is to perform RCT comparing ultrasound versus Bishop in women undergoing IOL using oral misopristol regarding measures of satisfaction during labour in the parturient women

Role of hysteroscopy in the evaluation of tubal patency in infertile women

Study objective: To evaluate the effectiveness of hysteroscopy as a method for the diagnosis of tubal patency using saline distention media. Design: Prospective cohort study. Setting: Infertility clinic of the Ain-shams University maternity hospital. Materials & methods: Sixty-four infertile women underwent hysteroscopy (HSC) and hysterosalpingography (HSG) on two consecutive days. Transvaginal ultrasonography (TVS) was carried out before and after hysteroscopy in order to measure the fluid in the cul-de-sac. The difference between the two methods in the diagnosis of tubal patency was compared using laparoscopy/chromotubation as a gold standard. Main outcome measures: Fluid volume measurements were used to determine a cut off value for tubal patency. Pain was recorded at the end of the process. Results: According to the laparoscopy, the sensitivity and specificity of HSC and HSG in detecting tubal patency were 94.6% and 100% vs. 92.8% and 50%, respectively. The best cut off point of the fluid volume in the cul-de-sac at which both tubes are patent is 6 ml. All of the patients reported significantly less pain during hysteroscopy in response to HSG. Conclusions: Office hysteroscopy combined with TVS may be used as an alternative to HSG, as an effective, easy, safe and minimal invasive office procedure that can be offered as a first line method for the evaluation of the uterine cavity along with the tubes in infertile women

Psychiatric morbidity in Egyptian children with acute lymphoblastic leukemia and their care providers

Aim of the study: To evaluate the psychological morbidity of acute lymphoblastic leukemia (ALL) on children and their parents at different stages of illness and to assess the crucial contribution of the psychologist in the pediatric oncology team. Methods: We recruited 103 children with ALL and their 96 parents, and divided them into five groups according to disease phase: diagnosis, initial remission, active treatment, survival and relapsing. We compared these to 22 healthy controls and their parents. Patients and controls were subjected to clinical assessments, the symptoms checklist of the International Classification of Disease ICD (ICD-10), and the Wechsler Intelligence Scale for Children The parents of patients and controls underwent a general health questionnaire, the ICD-10 symptoms checklist, rating scales for anxiety and depression, post-traumatic stress disorder (PTSD) assessment scale, and the physical cognitive affective social economic ego problems (PCASEE) questionnaire for quality of life (QOL) rating. Results: Psychiatric morbidity was evident in nearly 60% of leukemic children and their parents and was significantly increased in comparison to controls. Children mostly suffered from adjustment and oppositional defiant disorders. The most common discriminators between patient groups were conduct and attention problems being lowest in newly diagnosed patients, and social aggression being lowest in patients in remission. The three parameters were highest in relapsed patients whose parents mostly had adjustment and depressive disorders. Risk factors for child psychopathology were older age, female gender, and parental psychopathology. Mothers and parents with lower education and professional level were found to be vulnerable. Performance and total intelligence quotient (IQ) were significantly lower in leukemic children, and these were most pronounced in the survivor group. Risk factors for cognitive dysfunction were younger age, longer chemotherapy duration, and lower parental education level. Conclusion: Most patients and their caregivers suffered from significant psychiatric morbidity, highlighting the need for routine screening to improve psychological outcomes in such cases. Keywords: Psychiatric morbidity, ALL, Stress reaction, Children, Parent