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

Art therapy is a form of psychotherapy. Art therapy uses the creative process of art making to improve and enhance the physical, mental and emotional well-being of patients. Art therapy program may be help to stimulate patient's interaction and communicate with others and help them be socially interaction and independent. The aim of this study was to assess, plan, implement, and evaluate the effect of art therapy on social and communication skills among psychiatric patient at Assiut university hospital. Research design: quasi-experimental design (pre- and post test) was used. The setting: this study was carried out at inpatient psychiatric unit for males and females, at Assiut University Hospital. Subject & Method: the subjects include in the study & control group comprised of 100 schizophrenic and mood disorder(depressive) patients who were attending to psychiatric unit within a Period of 4 months. Study tools, Three tools; were used to collect the study data (I) Sociodemographic data (2) Social Skills Assessment Scale (SSAS),& (3) Communication skills assessment scale (CSAS). SSAS and CSAS Scales were used before and after implement of art therapy sessions .Results: revealed significant improvement in social and communication skills after application of the sessions of art therapy program especially social interaction and expression of feelings among studied group while control group no significant before and after program . Conclusion: It can be concluded that art therapy sessions are effective in improving communication and social interaction as well as social interest and cooperation. The study recommended: nurses must be implement and apply art therapy as a treatment and part of nursing care plan.

Drugs intake during pregnancy may adversely affect developing embryo or fetus. These drugs are known as teratogen. So to be safe, only drugs that are absolutely necessary should be used with permission of knowledgeable practitioner. Aim: to assess level of women's knowledge about teratogenicity of drugs used during pregnancy. Research design: a cross sectional study. Material & methods: this study was conducted in Maternal and Child Health care Centers at Minia city. The study included 300 pregnant women, an interview sheet was used by the researcher to assess socio-demographic characteristics, obstetrical characteristics, and knowledge about drug intake during pregnancy. Results: the main finding of the study were exploring that more than half of the study sample had inadequate and poor knowledge regarding drug intake during pregnancy and only 28.7% of sample had adequate knowledge especially in relation to the risk time for taking drugs. The most common reasons for taking drugs was common cold 26.9%, drugs,18.3%to relieve headache and 45.2% of sample take drugs for heartburn. in this study, it was also found that certain factors seemed to affect women's knowledge regarding drug intake during pregnancy such as illiteracy, being housewife, and young age. Conclusion: women lack essential knowledge regarding drugs intake during pregnancy. These findings indicate need to inform pregnant women about dangers of drugs use during pregnancy especially during the first 12 weeks of pregnancy. Physician and nurses should play a key role in communicating theses risks.

Adolescents around 17 million in Egypt (2005) have different needs and require different counseling approaches and more information. Adolescence is a critical stage for risk-taking because adolescents are moving toward independence and tend to experiment and test limits. Aim of this study: was to determine the problems of female adolescents, and provide information about reproductive health. Subject and methods: Cross-sectional analytic study was conducted in nursing secondary schools and technical institutes in Assiut city in Upper Egypt with total number of 514 adolescent female students which are recruited. The data were collected through a self-administered questionnaire sheet and a physical assessment sheet. Results: The study revealed that 94.6% of the girls were circumcised, and 98.2% had their menarche. Overall, 65.5% had satisfactory knowledge, and 81.5% had positive attitude. The main sources of information were classroom whereas parents, newspapers, and magazines were less reported. There was a statistical significance difference between knowledge and had circumcision (p=0.002), also, between knowledge about reproduction and their related attitudes and beliefs (p0.001). Conclusion: unmet information needs were related to female genital mutilation, family planning, pregnancy and labor, and the preferred sources are school book, media, and parents. Recommendations: It is recommended that the unmet needs identified should be used for development of educational programs for adolescents. The role of the parents, as well as health care providers needs to be fostered through using of multimedia as television and radio