[Maternal health care indicators, causes of maternal mortality and quality of medical records; at Women's Health Hospital, Assiut University, 2012]

Introduction: Maternal mortality is a preventable tragedy; measuring maternal mortality and identifying its causes is essential, and should be calculated regularly for the purpose of planning, monitoring, and evaluation of provided maternal health care

Objectives: To calculate maternal morality ratio, identify causes of maternal mortality, quality of care indicators such as maternal mortality index, case fatality rate and direct obstetric case fatality rate and to identify the main its in medical records

Methodology: A descriptive study was done through reviewing the records maternal mortality cases in the hospital using validated specific criteria published in WHO bulletin [2000] and data of cases that were admitted to the hospital's intensive care unit was collected for one [2012], followed by performing dissemination meetings

Results: In year 2012, there were 479 vaginal deliveries and 9, 908 caesarean sections, and 20,887 live births. The Maternal morality ratio was [225/100,000]. The Leading causes of maternal death were obstetric hemorrhage [38.3%], complications after caesarean sections, [27.7%] and pre-eclampsia/ eclampsia [23.4%].The age of maternal mortality was 29.3 +/- 8.5. Nearly half [42%] of the deaths occurred during vacation days. Quality indicators revealed poor quality of health care. The main deficits in the medical records included no recording of time of informing staff members and start of management, observational chart and management plan

Conclusions and recommendations: Maternal mortality is alarmingly high. Obstetric hemorrhage and complications after caesarean section were the two main causes of death that require strict and quick management protocols

Prevalence and risk factors of nocturnal enuresis in a rural area of Assiut governorate

Nocturnal enuresis is a common problem that can be troubling for children and their families. Nocturnal enuresis is the involuntary and undesirable wetting that occurs during sleep beyond the age of anticipated bladder control. Children are not considered enuretic until they have reached five years of age. Although comparison of studies are difficult because of variation in the definition of enuresis and in the age range of population studied, true geographical differences in prevalence and in natural history of enuresis seem to exist, arising from racial, cultural, or environmental factors. The literatures about the prevalence of enuresis in rural areas of Assiut governorate are limited. The aim of the study is to evaluate the prevalence of nocturnal enuresis among children aged 5-12 years old in a rural area of Assiut governorate, this is in addition to study risk factors associated with nocturnal enuresis among enuretic children in this rural area. A cross-sectional community- based study was carried out in mankabad village. A total of 592 houses were visited. All eligible children [5-12 years] in the selected houses were included. The first house was selected randomly, and then every third house of the village was included. A well-designed questionnaire was used for data collection. The questionnaire sheet was developed to assess the prevalence and risk factors of nocturnal enuresis among children. This study included 1148 children distributed in 592 houses in mankabad village. The prevalence of enuresis was found to be 17.8%. diurnal as well as nocturnal enuresis occurs in 19.6% of the enuretic group. The most frequent cause of nocturnal enuresis expected by the mother was deep sleep [24.5%], followed by urinary tract infection [13.7%]. As regards the dealing of the families with problem of nocturnal enuresis, 15.7% mentioned that they consult others and about 29.4% consult a physician, 30.4% punish their children, while 24.4% do nothing. The prevalence of enuresis was insignificantly higher in males [51.9%] than females [48.1%] [p=0.209]. The mean age of enuretic children [5.9 +/- 2.1] years is significantly lower than that of non-enuretic children [8.7 +/- 2.2] years [P<0.001]. Birth order has no significant effect on the prevalence of enuresis. The prevalence of enuresis was significantly higher among children of illiterate fathers than among those of educated fathers [p