Hearing impairment is common among older adults. The study aimed to assess the quality of life among hearing impaired elderly patients attending audiology unit at Assiut University Hospital. Descriptive research design was used in this study. Total coverage of all elderly patient with hearing impairment and agreed to participate in the study during six months from 1st of November/2014 to the end of April/2015) were included in the study, their number were 227 patients. Two tools were used in data collection, tool I: Structured interview questionnaire sheet: include two parts, part I: include personal data as, age, sex, residence, part II: include onset type and degree of hearing impairment. Tool II: Quality of life scale. The main results showed that the majority of the participants (80.6%) aged (60-¬74) years. The mean age was 68.4± 7.4, more than two-third of the studied sample were male. There was a statistically significant difference between hearing impairment among elderly and quality of life. It concluded that age related hearing impairment (presbycusis) had adverse effects on physical, self-dependence, psychological, social relationships, and environmental features. Also, it recommended that increasing elderly awareness about the importance of regular ear examinations for early detection, treatment, and prevent complications.

Background: The aim of the study was : To assess nurses' knowledge and practice regarding patients undergoing coronary artery bypass graft surgery, to design nursing care protocol for nurses, and to evaluate the effect of implementing the designed nursing protocol on nurse's knowledge and practice. Three hypotheses were formulated: (1) the post mean knowledge scores of nurses who will expose to designed nursing protocol will be higher than their pre mean knowledge scores. (2) The post mean practice score of nurses who will expose to designed nursing protocol will be higher than their pre mean practice scores. (3) A positive relationship will exist between knowledge and practice score obtained by nurses receiving the designed nursing protocol. Research design: Quasiexperimental research design was utilized in this study. Tools: Three tools were utilized for data collection were a) structured interview sheet. b) Observation checklist sheet. c) Construction of designed nursing protocol. Results The first and the second hypotheses were supported as a good improvement in the mean knowledge & practice scores. Conclusion: implementing of designed nursing protocol showed a significant improvement in nurses` knowledge and practice. Recommendations: Nurses are in need for in-service training programs and refreshing courses to improve their knowledge.

Abstract: Coronary artery bypass grafting (CABG) is a common surgery to treat coronary artery disease. It involves a section of a vein or an artery to create a connection (or bypass) between the aorta and the coronary artery beyond the obstruction. Aim: This study aimed to assess nurses' knowledge and practice regarding patients undergoing coronary artery bypass grafting, to develop nursing care standards for coronary artery bypass grafting on patient's outcome, and to evaluate the effect of implementing nursing care standards on nurse's knowledge, practice as well as on patient's outcome. Methods: Quasi-experimental research design was utilized to conduct this study, the study was carried out cardiothoracic surgery department, post operative intensive care unit, and operating room at Assiut University Hospital. Sample: A convenient sample included (38) nurses and (40) patients who had CABG (20) patients pre and (20) patients post implementing nursing care standards aged from 18-65 years from both sexes. Tools: a) pre/post structured interview sheet. b) pre/post observation checklist sheet. c) Cardiac surgery patient's assessment sheet. d) Construction of nursing care standards booklet. Results: The first and second hypotheses were supported as a good improvement in the mean knowledge and practice scores were found post implementation of nursing care standards. The third hypotheses were supported as postoperative complications were reduced post nursing care standards implementation. The fourth hypotheses were supported as a positive relationship was found between nurses` knowledge and practice scores immediately post nursing care standards implementation. Conclusion: Improving nurses` knowledge and practice can favorable affect the incidence of coronary artery bypass graft surgery patient's complications. Recommendations: in-service training programs and refreshing courses must be applied to improve nurse's knowledge which will reflect into their practice while working with patients.

Abstract: Objectives: To test if combining positive results of sequential magnified naked-eye examination (MNEE) and visual inspection of cervix after application of acetic acid (VIA) would increase diagnostic indices for precancerous and cancerous cervical lesions in comparison to the gold standard positive Pap test in a developing country set up. A secondary objective was to evaluate the effectiveness of nurse training and patient acceptance of this screening approach. Design: An analytic cross-sectional research design Setting: Gynecology and infertility out-patient clinics of the departments of Obstetrics and Gynecology, Woman’s Health University hospital, Assiut University, Egypt. Materials and methods: A total of 445 non-pregnant women aged between 17 and 44 years were counseled and entered this study. They were subjected to MNEE after cleaning of the cervix with 0.9% saline, exfoliative cytology and lastly VIA. Positive results were evaluated and managed accordingly. Colposcopy with or without subsequent cervical biopsy were done in all positive cases of MNEE, VIA and Pap smear. Main outcome measures included diagnostic accuracy of VIA alone versus VIA and MNEE as compared to cytology. Results: This study comprised 445 non pregnant women in the reproductive age. The main complaint was abnormal vaginal discharge in 403 cases (89.6%) . MNEE of the cervix indicated that 338 women (75.1%) and 112 women (24.9%) had healthy and unhealthy-looking cervices respectively. Pap smear sampling was negative for premalignant or malignancy in 377 cases (83.8%).VIA test findings were positive in 77 cases ( 17.3% ) and negative in 368 cases (82.6% ) All diagnostic indices increased significantly after combing MNEE and VIA positive results except negative predicative value if compared to VIA positive results alone as an alternative to the standard Pap smear. Nurses proved high level of skill in performing cervical cytology, MNEE and VIA as proved by lower rate of unsatisfactory results. Patient acceptability was very high after proper counseling. Conclusions: Sequential MNEE and VIA would improve most of diagnostic indices as an alternative diagnostic tool to the gold standard Pap smearing for detection of abnormal precancerous and cancerous cervical lesions. This simplified cheap approach with high percentage of patient acceptability would help expanding screening programs in countries were Pap smear is poorly available. Being performed by doctors as well as trained nurses on one-stop base is a clear advantage. More large sample sized studies on the cost-effectiveness of this approach versus colposcopically-guided positive histopathology are recommended before its universal spread

Abstract: Objectives: To test if combining positive results of sequential magnified naked-eye examination (MNEE) and visual inspection of cervix after application of acetic acid (VIA) would increase diagnostic indices for precancerous and cancerous cervical lesions in comparison to the gold standard positive Pap test in a developing country set up. A secondary objective was to evaluate the effectiveness of nurse training and patient acceptance of this screening approach. Design: An analytic cross-sectional research design Setting: Gynecology and infertility out-patient clinics of the departments of Obstetrics and Gynecology, Woman’s Health University hospital, Assiut University, Egypt. Materials and methods: A total of 445 non-pregnant women aged between 17 and 44 years were counseled and entered this study. They were subjected to MNEE after cleaning of the cervix with 0.9% saline, exfoliative cytology and lastly VIA. Positive results were evaluated and managed accordingly. Colposcopy with or without subsequent cervical biopsy were done in all positive cases of MNEE, VIA and Pap smear. Main outcome measures included diagnostic accuracy of VIA alone versus VIA and MNEE as compared to cytology. Results: This study comprised 445 non pregnant women in the reproductive age. The main complaint was abnormal vaginal discharge in 403 cases (89.6%) . MNEE of the cervix indicated that 338 women (75.1%) and 112 women (24.9%) had healthy and unhealthy-looking cervices respectively. Pap smear sampling was negative for premalignant or malignancy in 377 cases (83.8%).VIA test findings were positive in 77 cases ( 17.3% ) and negative in 368 cases (82.6% ) All diagnostic indices increased significantly after combing MNEE and VIA positive results except negative predicative value if compared to VIA positive results alone as an alternative to the standard Pap smear. Nurses proved high level of skill in performing cervical cytology, MNEE and VIA as proved by lower rate of unsatisfactory results. Patient acceptability was very high after proper counseling. Conclusions: Sequential MNEE and VIA would improve most of diagnostic indices as an alternative diagnostic tool to the gold standard Pap smearing for detection of abnormal precancerous and cancerous cervical lesions. This simplified cheap approach with high percentage of patient acceptability would help expanding screening programs in countries were Pap smear is poorly available. Being performed by doctors as well as trained nurses on one-stop base is a clear advantage. More large sample sized studies on the cost-effectiveness of this approach versus colposcopically-guided positive histopathology are recommended before its universal spread

Abstract : Death rate of liver cirrhosis is 41.6% in Egypt. It is important to assess the nutritional status of this group of patients and design nutritional regimen because these patients suffer from protein calorie malnutrition. The aim of this study was assessment of the impact of a designed nutritional regimen on patients with liver cirrhosis. Patient and Methods: 60 adult patients with liver cirrhosis as a study group and 20 patients as a control group, the study were conducted at Tropical Medicine and Gastroenterology Department at Asyut University hospital. Tools utilized for data collection were :( I) patient assessment sheet (II) nutritional assessment sheet, and (III) Construction of nutritional regimen. Results: The most common malnutrition risk factors were dry mouth, taste alteration, food intolerance, multiple medications and the presence of ascites. Number of patients who didn't suffer from malnutrition increased post implication of the nutritional regimen one and three months later. Conclusions: the application of the nutritional regimen for patients with liver cirrhosis showed an improvement in patient's nutritional status. Recommendations: Nutritional support and regimen, advice and guidelines by dietitian should be undertaken for all cirrhotic patients to prevent occurrence of complications of malnutrition and improve clinical outcome.

Abstract : Death rate of liver cirrhosis is 41.6% in Egypt. It is important to assess the nutritional status of this group of patients and design nutritional regimen because these patients suffer from protein calorie malnutrition. The aim of this study was assessment of the impact of a designed nutritional regimen on patients with liver cirrhosis. Patient and Methods: 60 adult patients with liver cirrhosis as a study group and 20 patients as a control group, the study were conducted at Tropical Medicine and Gastroenterology Department at Asyut University hospital. Tools utilized for data collection were :( I) patient assessment sheet (II) nutritional assessment sheet, and (III) Construction of nutritional regimen. Results: The most common malnutrition risk factors were dry mouth, taste alteration, food intolerance, multiple medications and the presence of ascites. Number of patients who didn't suffer from malnutrition increased post implication of the nutritional regimen one and three months later. Conclusions: the application of the nutritional regimen for patients with liver cirrhosis showed an improvement in patient's nutritional status. Recommendations: Nutritional support and regimen, advice and guidelines by dietitian should be undertaken for all cirrhotic patients to prevent occurrence of complications of malnutrition and improve clinical outcome.

Anterior Cruciate ligament (ACL) surgery is one of the most common clinical entities in daily orthopaedic practice. The Aim of the study is to assess nursrs knowledge and practice for patients with ACL surgery. Quasi experimental research design was utilized in this study .This study was conducted in arthroscopy and sports injuries unit at orthopaedic department at Assiut University Hospital. A convenient sample of all available nurses (44 nurses) was included in this study. Data collected by utilizing the designed interview questionnaire sheet consists of biosocial characteristics of nurses , assessment of nurses's knowledge, observation checklist sheet to assess nurses's practice. The results can be concluded that (93.2) of nurses had an poor level of knowledge regarding ACL, all of nurses (100%) had an inadequate level of practice regarding patients who had ACL surgery . It was found that there was a strong relationship (r =.838, P = .0001) between total knowledge and total practice. Conclusion: Nurses`s knowledge and practice regarding patient who had ACL surgery in orthopaedic department of Assiut University Hospitals are unsatisfactory and inadequate. Recommendation :All nurses need to develop nursing care standards for patients with ACL surgery to improve nurses` knowledge and practice

Anterior Cruciate ligament (ACL) surgery is one of the most common clinical entities in daily orthopaedic practice. The Aim of the study is to assess nursrs knowledge and practice for patients with ACL surgery. Quasi experimental research design was utilized in this study .This study was conducted in arthroscopy and sports injuries unit at orthopaedic department at Assiut University Hospital. A convenient sample of all available nurses (44 nurses) was included in this study. Data collected by utilizing the designed interview questionnaire sheet consists of biosocial characteristics of nurses , assessment of nurses's knowledge, observation checklist sheet to assess nurses's practice. The results can be concluded that (93.2) of nurses had an poor level of knowledge regarding ACL, all of nurses (100%) had an inadequate level of practice regarding patients who had ACL surgery . It was found that there was a strong relationship (r =.838, P = .0001) between total knowledge and total practice. Conclusion: Nurses`s knowledge and practice regarding patient who had ACL surgery in orthopaedic department of Assiut University Hospitals are unsatisfactory and inadequate. Recommendation :All nurses need to develop nursing care standards for patients with ACL surgery to improve nurses` knowledge and practice

Cognitive impairment is a frequent consequence of stroke. The study aimed to measure the effect of cognitive rehabilitation of elderly patients with stroke on their cognitive function and activities of daily living. Quasi experimental research design were used in this study. This study was conducted at neuropsychiatric, physical medicine and rehabilitation departments at Assiut University hospital, their number were 70 elderly stroke patients aged 60 years and above, (study group, 35, control group, 35) . Six tools were utilized ,tool 1: Socio- demographic characteristics and questions about stroke tool II: Mini-Mental State Examination tool III: Digit Span tool IV: Logical memory tool V: Geriatric Depression Scale. Tool VI: Barthel Index scale. The rehabilitation program: consist of five practical session about spatial memory, attention and concentration, visual attention, fish face task and N400 task and three theoretical session about health education for diabetes mellitus, hypertension and prevention of recurrent stroke. The main result of the present study revealed that a significant statistical difference was existed between both studied groups in relation to Min Mental State Examination (P-value = 0.000*). Conclusion: Application of training program about cognitive impairment of stroke elderly patients have significant therapeutic effect on cognitive function, and on activities of daily living. Recommendation: Routine use of screening assessment of cognitive impairment in every stroke patient for early detection, and Health education to the elderly patients and caregivers about the possible ways of prevention of recurrent stroke and ways for controlling of diabetes and hypertension