From the Editor
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Ahmad Husari
Editor, Middle-East Journal of Internal Medicine
Director, American University of Beirut Sleep Disorders Center
Director, American University of Beirut outpatient clinical care services
Assistant Professor
Division of Pulmonary and Critical Care Medicine
American University of Beirut Medical Center
Beirut Lebanon
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This is the last issue this year andhas a number of research papers and community care papers from the region.

A paper from Turkey compared results of the two methods of port catheter application and evaluation of patient comfort with visual analogue scale. Forty-six patients were port-catheterized. Group 1 (n=21) consisted of non-aided catheter procedures and Group 2 (n=25) consisted of ultrasonography aided catheter application procedures. The patients were asked to evaluate the in-procedural pain, the duration of the procedure, their comfort in the procedure and mark on a visual analogue scale. The mean age of the patient population was 53.85 years. A statistically significant difference was found in the operation length, puncture count, pain score and comfort score data of the groups. Operation length, puncture count and pain score were lower and comfort score was higher in Group 2 (p values respectively 0.001; 0.003; 0.031; 0.047). The authors concluded that visually aided port catheterization is less risky and more comfortable for both the surgeon and the patient.

A paper from Iraq reported a case of undiagnosed Left Renal Artery Aneurysm causing maternal and fetal death in late pregnancy. The authors stressed that rupture of a renal artery aneurysm during pregnancy is a rare event, and associated with high mortality and morbidity not only for the mother but also for the fetus. The diagnosis was made during caesarean section and confirms by pelvic CT scan in spite of massive blood transfusion. Unfortunately the mother and her baby died due to severe retroperitoneal hemorrhage. The authors concluded that the possibility of a ruptured renal artery aneurysm should be considered in pregnant women with evidence of retroperitoneal hemorrhage.

A second paper from Iraq looked at the effect of membrane Sweeping, on enhancement of the onset of labour. 120 pregnancies at gestational age of 39 weeks, who were followed up antenatal at our clinic, were recruited. All women were allowed until 41weeks gestation until they were admitted if not delivered spontaneously to induce their labour. Group one were pregnant women of 40 weeks' gestation completed, put in for cervical sweeping at 40+2, 40+4 and 40+6 weeks. Group two were women at 40 weeks who were put in for prospective follow up awaiting spontaneous onset of labour. In group one, a total of 23 women (30%) ended by caesarean delivery and total of 10 (16%) had their membranes ruptured before the onset of labour. Group two (n=60) included 18 primipara women and 42 multiparous. 39 women (68%) went into labour before completed 41 weeks of gestation, 13 of them ended by caesarean delivery. The rest 21 (32%) women were induced, 8 of them ended by caesarean section. In group two, total of 21 women (36%) ended by caesarean delivery. The authors concluded that membrane sweeping increases the rate of spontaneous labour, it reduces the caesarean section rate, and nevertheless, there is marginal increase in the rate of spontaneous rupture of membranes before the onset of labour.

A paper from Lebanon discussed the way to motivate people toward better family planning in the Region. The various methods of family planning were discussed.