Abstract: nur ses play a crucial role in post operative care. Therefore, assessing nurses’ clinical competence is essential to achieve qualified and safe care. Aims; assess postoperative nurses' competency regarding cholecystectomy care and compare the difference between university and non - university hospitals. R esearch questions; what are the postoperative nurses' competency regarding cholecystectomy?And what are the differences betweenuniversity and non - university hospitals? Descriptive correlation research design was utilized. The study was conducted at general surgery departments of university and non - university hospitals of A ssiut city. The sample consisted of all available nurses (55nurses) who were currently assigned for giving post cholecystectomy nursing care in the above mentioned hospitals. The instruments employed for data collection were; tool one” nurses' assessment sheet", tool two “nursescompetence advanced self - assessment tool ". Results showed that; all nurses exceeded the competent level &there were significant differences between two settings regarding to their post cholecystectomy nurses’ performance competency. Conclusion: nurses have adequate knowledge, skills to adequately meet all the requirements for postoperative competency. Recommendation; the research results can be used for the educational needs assessment of nurses and for modifying the quality of care in hospitals.

Purpose/Background: Many investigators reported that pharmacological treatment of female sexual dysfunction (FSD) has been a promising field yet to be explored. The purpose of this pilot study was to investigate the efficacy and safety of a topical cream containing small concentrations of three vasodilators with different mechanisms of action in treating FSD. Methods: In this randomized, controlled pilot trial, premenopausal (n = 30) and postmenopausal (n = 30) cases of 21- to 62-year age range with FSDwere allocated randomly into 15 given placebo or 15 given active cream in each group. The women included had FSD for more than a 6-month duration and a total score of Female Sexual Distress Scale- Revised of at least 15. Assessing sexual function by measuring female sexual function index (FSFI) during five clinic visits, one at the end of baseline week and at the end of each week of the 4-week treatment period. The primary end point was changed from baseline FSFI total scores to week 4 treatment. Secondary end point included the changes from baseline arousal, desire, orgasm, and satisfaction scores to week 4 treatment. Findings/Results: The sexual problem reported by patients was orgasmic or/and arousal disorders. In premenopausal cases, active cream led to a high significant increase inmean change FSFI total score fromthe baseline to week 4 compared with placebo (1.7 ± 1.886 vs 13.35 ± 4.646, respectively; P 0.0001). Greater improvement of mean change of orgasm and arousal domain score was also observed (0.3 ± 0.45 and 0.35 ± 0.39 vs. 2.66 ± 0.63 and 1.87 ± 0.168, respectively; P 0.0001). In postmenopausal cases, there were significantly greater improvements with active cream in all sexual functions compared with placebo cream (P 0.0001). In triple cream, mean change of FSFI total score, orgasm domain score, and arousal score domain were 14.85 ± 6.33, 1.87 ± 0.168 and 2.66 ± 1.182,whereas in the placebo cream, they were 1.54 ± 2.1,0.7 ± 0.76 and 0.22 ± 0.44, respectively. Meanwhile, orgasm scores increased significantly after the use of placebo cream. No serious adverse effects were reported during treatment. Implications/Conclusions: The results of the pilot trial suggest that topical cream containing small concentrations of three vasodilators may act synergistically, and was effective in improving arousal, orgasmic, and satisfaction disorder with a safer profile for premenopausal and postmenopausal women with FSD. Further studies are recommended to be conducted using a large number of nondepressive and depressive patients.

ABSTRACT INTRODUCTION The aim of this study was to investigate the effect of a lower dose subcutaneous sterile water injection technique versus subcutaneous saline injection, on the relief of low-back pain for women during childbirth, and to explore the lasting effects of pain relief after administration (followed at 15, 30, 45, 90 and 120 minutes). METHODS A prospective randomized controlled single-blinded study was conducted, with trial registration (NCT02813330). Women received one-time injections (sterile water or saline) and the effectiveness was observed at 15, 30, 45, 90 and 120 minutes after the intervention. RESULTS The intervention group had statistically significant pain reduction. Assessment of subsequent pain, followed at 30, 45, 90 and 120 minutes, reflected an increasing change with a statistically significant difference. The intervention group had more burning sensations than the control group with a statistically significant difference. CONCLUSIONS The modified technique of double injections of subcutaneous ‘water/ saline’ resulted in significant relief of low-back pain during childbirth.

Maternal deaths remain high, numbers at the facility level are relatively low. Aim: To evaluate the effect of management guidelines on occurrence of maternal near miss in Women's Health Hospital. Design: A cross-sectional study. Setting: ICU of Women's Health Hospital's at Assiut Main University Hospital and Al-fayoum University Hospital. Subjects: Convenient sample of 93 maternal near-miss cases including (Pregnancy or postpartum complications). Tool: audit the applied critical care for severe condition related to obstetric complications and consist of three parts: Patient's demographic data, Audit of critical care and “Maternal near-miss” Fate. Data collected during a period of 1/3/2015 to 30/8/2015 for management guidelines and maternal outcomes. Results: A statistical significant differences between the medical management and occurrence of severe maternal complications such as (severe postpartum hemorrhage, severe pre-eclampsia, Sepsis or severe systemic infection, uterine hemorrhage, ruptured uterus) (P=0.000, P=0.031, P= 0.036, P =0.052, P=0.012 respectively). Conclusions: The maternal management guidelines was a successful tool in recording the gap between the current received management and standards management guidelines in ICU. Also, they measure the effectiveness of current management in ICU on maternal mortality and morbidity.

Background: Iron deficiency anemia (IDA) is one of the most common medical disorder disturbing pregnancies particularly in low resources countries, and contributes significantly to morbidities and mortalities. Thus, early diagnosis and prompt management of IDA is highly recommended. Aim: To Test the efficacy and safety of oral lactoferrin plus health education provided by a nurse versus total dose infusion (TDI) of low-molecular weight (LMW) iron dextran for treating IDA in the second and third trimester of pregnancy. Design: A prospective interventional, randomized, parallel-group, single-center longitudinal study. Setting: Woman’s Health Assiut University Hospital, Assiut, Egypt, at the outpatient clinic and inpatient unit. It comprised 120 cases divided into two groups as pineapple flavored lactoferrin oral sachets 100mg twice daily with health education (group A) and TDI of LMW iron dextran (group B). Main outcome measures: The primary efficacy parameter was clinical improvement and the amount of increase in hemoglobin concentration by 4 weeks after therapy, secondary outcome measures included measurement of the rest of RBC, and iron indices, the adverse effects related to iron therapy and the patient compliance to the treatment. Results: There was insignificant difference between both groups regarding sociodemographic data, parity and mean gestational age. Both groups showed a significant clinical improvement of anemia 4 weeks post-therapy. There was no statistically significant difference in mean Hb level improvement in both groups after 1 month of therapy. However, mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH) improved significantly more in group B than A while iron indices (serum iron and serum ferritin) were significantly more in group A than group B. Conclusions: Pineapple flavored lactoferrin oral sachets plus health education can be widely used as an alternative to TDI iron dextran supplementation due to clinical as well as laboratory improvement of IDA during pregnancy after 1 month of treatment. Proper health education of the pregnant women with nurse recommendations of balanced diet containing good sources of iron would increase awareness of pregnant women and help eradicate IDA with its serious sequel during pregnancy.

Abstract Addiction is a social, health, economic and cultural harm and problem that have influenced the future sovereignty and security of countries. The interactions between anxiety, depression and drug addiction are complex, approximately 31% of depression and anxiety has been found among drug addict people in Egypt. Aim of the study: To assess levels of anxiety and depression, and assess the difference between levels of anxiety and depression among drug addict people. Subjects and method: Non experimental (case-control) research design used to conduct this study. The current study included 150 subjects, 100 were drug addict people & 50 were drug non- addict people. Tools of study included demographic and clinical data sheet, Drug Use Disorder Identification Test, Hamilton Anxiety Rating Scale, and Hamilton Depression Rating Scale Results: The majority of drug addict people had severe levels of anxiety and depression as compared to normal non- addict people. Using patterns and various drug related problems was positively and significantly correlated with anxiety (r=0.256&p=0.010*) and depression (r=0.330&p=0.001**). The present study can concluded that drug addict people had severe levels of anxiety and depression than drug non-addict people Recommendations: psychosocial counseling program for drug addict people to decrease depression and anxiety.

Abstract Addiction is a social, health, economic and cultural harm and problem that have influenced the future sovereignty and security of countries. The interactions between anxiety, depression and drug addiction are complex, approximately 31% of depression and anxiety has been found among drug addict people in Egypt. Aim of the study: To assess levels of anxiety and depression, and assess the difference between levels of anxiety and depression among drug addict people. Subjects and method: Non experimental (case-control) research design used to conduct this study. The current study included 150 subjects, 100 were drug addict people & 50 were drug non- addict people. Tools of study included demographic and clinical data sheet, Drug Use Disorder Identification Test, Hamilton Anxiety Rating Scale, and Hamilton Depression Rating Scale Results: The majority of drug addict people had severe levels of anxiety and depression as compared to normal non- addict people. Using patterns and various drug related problems was positively and significantly correlated with anxiety (r=0.256&p=0.010*) and depression (r=0.330&p=0.001**). The present study can concluded that drug addict people had severe levels of anxiety and depression than drug non-addict people Recommendations: psychosocial counseling program for drug addict people to decrease depression and anxiety.

Abstract Addiction is a social, health, economic and cultural harm and problem that have influenced the future sovereignty and security of countries. The interactions between anxiety, depression and drug addiction are complex, approximately 31% of depression and anxiety has been found among drug addict people in Egypt. Aim of the study: To assess levels of anxiety and depression, and assess the difference between levels of anxiety and depression among drug addict people. Subjects and method: Non experimental (case-control) research design used to conduct this study. The current study included 150 subjects, 100 were drug addict people & 50 were drug non- addict people. Tools of study included demographic and clinical data sheet, Drug Use Disorder Identification Test, Hamilton Anxiety Rating Scale, and Hamilton Depression Rating Scale Results: The majority of drug addict people had severe levels of anxiety and depression as compared to normal non- addict people. Using patterns and various drug related problems was positively and significantly correlated with anxiety (r=0.256&p=0.010*) and depression (r=0.330&p=0.001**). The present study can concluded that drug addict people had severe levels of anxiety and depression than drug non-addict people Recommendations: psychosocial counseling program for drug addict people to decrease depression and anxiety.

Abstract Addiction is a social, health, economic and cultural harm and problem that have influenced the future sovereignty and security of countries. The interactions between anxiety, depression and drug addiction are complex, approximately 31% of depression and anxiety has been found among drug addict people in Egypt. Aim of the study: To assess levels of anxiety and depression, and assess the difference between levels of anxiety and depression among drug addict people. Subjects and method: Non experimental (case-control) research design used to conduct this study. The current study included 150 subjects, 100 were drug addict people & 50 were drug non- addict people. Tools of study included demographic and clinical data sheet, Drug Use Disorder Identification Test, Hamilton Anxiety Rating Scale, and Hamilton Depression Rating Scale Results: The majority of drug addict people had severe levels of anxiety and depression as compared to normal non- addict people. Using patterns and various drug related problems was positively and significantly correlated with anxiety (r=0.256&p=0.010*) and depression (r=0.330&p=0.001**). The present study can concluded that drug addict people had severe levels of anxiety and depression than drug non-addict people Recommendations: psychosocial counseling program for drug addict people to decrease depression and anxiety.

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