High tibial osteotomy is preferential treatment for patients with knee osteoarthritis. Strengthening exercise program helps post (HTO) patients achieve greater functioning during sport, recreation, and activities of daily living after surgery. To examine the effect of postoperative exercise program on knee physical function among high tibial osteotomy patients. Method: quasi experimental research design. Department of Orthopedic Surgery and orthopedic Outpatient Clinic at Assiut University Hospital.A purposive sample of 60 adult patients undergoing high tibial osteotomy were included in our study. Knee Outcome Survey Activities of Daily Living Scale and Lysholm knee scoring scale were used.  A highly statistically significant improvement of knee Function score and Lysholm knee score (<0.001**) among patients with high tibial osteotomy.!Application of exercise program had a statistically significant effect on improvement physical function of knee among the study group than among the control group.  Successful postoperative exercises should be practiced for each patient undergoing high tibial osteotomy in order to improving physical function of the knee. 

Education has a vital role in decreasing stroke recurrence and facilitating successful self-management of this chronic disease. Aims were to; Evaluate the effect of implementing pre discharge nursing education on recurrence of stroke among studied patients. Research design; (Pre/posttest) quazi experimental research design was utilized in this study. Setting; Neurology department at Assuit University Hospital. Sample; (150) adult patients with stroke (males & females). Tools; Patient’s assessment sheet and National Institutes of Health Stroke Scale (NIHSS) were used (pre & post) the implementation of pre discharge nursing education. Results; Mean age of patients in control group was ( 9.25 ±2 4.44 ) years old and study group was (51.6±12.8) years old and there was a statistical significance difference between the control and the study groups as regarding recurrence of the stroke (p< 0.005). Conclusion; Stroke recurrence was significantly decreased among the studied patients who received pre discharge nursing education than patients who received routine hospital care (control group). Recommendation; Instruction hand book about modifiable risk factors that lead to stroke recurrence and methods to deal with it should be available for all patients with stroke

Abstract: Despite technological advances contrast induced nephropathy (CIN) remains responsible for a third of all hospital-acquired acute kidney injury, but considered the agent of choice in cardiac interventional procedures. The aims of this study were to; identify associated risk factors for contrast induced nephropathy and assess patients' knowledge as regard preventative measures for CIN , and  evaluate  the effect of nursing instructions on minimizing CIN, Methods: Research design: a quasi- experimental research design. Setting: The study was conducted in cardiac catheterization unit at El -Orman Heart Hospital of Assiut University. Sample: A purposive sample of hundred male and female adult patients who underwent cardiac catheterization. Tools:  tool (I): Structured Interview Questionnaire Sheet: This included four parts (demographic data, physiologic reactions to contrast, risk factors for development of CIN, and serum creatinine follow-up), Tool (II): Patients' knowledge assessment sheet. Results: showed statistical significant differences between pre and post nursing instruction as regarding patient preventive measures for minimizing CIN after contrast injection. Conclusion: Nursing instructions had a good effect on reducing CIN among patients who underwent cardiac catheterization. Recommendation:  Provide evidence-based prevention strategies to allow nurses assist in the prevention of CIN 

Adherencetomedicationsisthebackbonetoeffectivenessofatreatment. Adherencetoantiepileptic drugs (AEDs) is essential to prevent the risk of seizures recurrence. The aims were to study the effect of teaching strategies on adherence to antiepileptic drugs, recurrence of seizures, and identify factors affecting the adherence level among epileptic patients. Methods: Research design: Quasi-experimental design. Setting: Neurology Department at Neurological and Psychiatric Assiut University Hospital. Sample: A purposive sample of sixty male and female adult patients diagnosed with epilepsy. Tools: Tool I-Patient assessment sheet. Tool II-Morisky Medication Adherence Scale. Tool III-Liverpool Seizure Severity Scale. Results: There was a statistically significant difference between pre and post applying of teaching strategies as regard drug adherence and recurrence of seizures among epileptic patients (p < .001). Also, forgetfulness, side effects of medications, and absence of family or friend were the main factors of non- adherence to AEDs. Conclusionsandrecommendations: Teaching strategies had statistical significant effects on adherence to antiepileptic drugs and on reducing recurrence of seizures among epileptic patients. Simple educational pamphlet for epileptic patients and their family members to improve adherence to AEDs should be available in Neurology Department and Outpatient Neurology Clinics. 

Pulmonary complications after stroke contribute significantly to a poor stroke outcome. Early in hospital pulmonary complications of stroke patients can be reduced by chest physiotherapy exercises .The aim of this study was to evaluate the effect of chest physiotherapy on reducing pulmonary complications among stroke patients. Methodology: A quasi-experimental research design was used in this study. The study was conducted in the neurological departments at Assiut University Hospital. The study included 60 adult stroke patients from the acute stage (2 Days) of admission to the hospital until discharge time. The sample was divided into two equal groups. Study and control group (30 patients each). Two tools used to collect data include, patient assessment sheet, pulmonary complication assessment sheet. Results: In the control group was 66.7% while pneumonia in the study group was 23.3% after the application of physical therapy exercises to the chest. Conclusion: Applying chest physiotherapy exercises had a statistically significant effect on reducing pulmonary complications among study group than the control group. Recommendations: Successful chest-program physiotherapy exercises should be implemented as early as the time of hospitalization for each stroke patient. 

Abstract Up to 50% of chronic heart failure patients suffer from lower urinary tract symptoms; urinary frequency, urgency, and incontinence are extremely bothersome, while nocturnal symptoms may disrupt sleep and quality of life. The medications are used to treat heart failure may also indirectly provoke or exacerbate urinary symptoms. Aim of the study: to determine the prevalence of Lower Urinary Tract Symptoms among chronic heart failure patients and its impact on their quality of life. Patients and methods: Cross-sectional research design was utilized in this study. The study sample was composed of two hundred adult patients attending cardiac outpatient clinics male and female; at Assuit University Hospital. Tools: Data collected by utilizing the designed interview questionnaire sheet that included demographic data, assessment of lower urinary tract symptoms and World health organization quality of life scale. The study was done in a period of sex months from November 2017 to April 2018. Results: The results revealed that 72% of the patients have nocturia and 70% of them suffering from frequency urination and urgency followed by 48%, 44%, & 41% of patients suffering from double voiding, intermittent flow of urine, and urinary incontinence respectively; While 38% & 27% of them have hesitancy, and a weak flow stream. In the relationship between quality of life and urinary tract symptoms, there was a strong correlation (r=0.89) and statistically significant difference at p. value <0.01. Conclusion: Lower Urinary Tract Symptoms have a great effect on the quality of life among patients with chronic heart failure. Recommendation: Chronic heart failure patients should be provided with sufficient information about lower Urinary Tract Symptoms and how to cope with it to improve their quality of life. Keywords: chronic heart failure, lower urinary tract symptoms, and quality of life

Background: Cancer patients undergoing radiotherapy experience a variety of physical and psychosocial side effects. Aim of the study: To evaluate the effect of educational nursing guidelines on minimizing side effects for cancer patients undergoing radiotherapy. Patients and Methods: Research design: A quiz–experimental (pretest / post-test) research design was utilized. Setting: The study was conducted in Clinical Oncology Department at Assiut University Hospital. Sample: A convenience sample of sixty male and female adult cancer patients undergoing radiotherapy. Tool: Interview questionnaire sheet which included Patient assessment and memorial symptom assessment scale. Results: Statistical significant differences were found between pre and post applying of the educational nursing guidelines as regard physical symptom subscale score, psychological symptom subscale score, global distress index score, and total memorial symptom assessment scale score. (p<0.01). Conclusion: The educational nursing guidelines had a statistical significant positive effect on minimizing the side effects for cancer patients undergoing radiotherapy. Recommendation: Each cancer patient undergoing radiotherapy should be given an educational booklet including guidelines to minimize side effects of radiotherapy. Key Words: Educational guidelines, Side effects, Radiotherapy.

Abstract: Background: The majority of dialysis patients complain from restless leg syndrome and how it negatively affects their sleep causing sleep disturbance and insomnia. Aim of the study: to evaluate the effect of sleep hygiene measures and home remedies on minimizing the insomnia and restless leg syndrome. Subjects and Methods: Design; A quasi - experimental (pre/post-test) research design was utilized. Setting: The study was carried out in the hemodialysis unit at Assiut University Hospitals. Sample: The total number of the hemodialysis patients was (356 patients) the assessment conducted on about 50% (180 patients) while sleep hygiene measures and home remedies applied on (90 patients). A purposive sampling technique was utilized. Tools: four tools have been utilized; Tool I: an interview questionnaire sheet to collect patients’ demographic characteristics. Tool II: Insomnia Severity Index. Tool III: Restless Leg Syndrome Screening Questionnaire and Tool IV: sleep hygiene measures and home remedies nursing instructions. Results: Nearly one-third of the studied sample their age ranged between 50 - 65 years old, with a mean of (44.21±11.21) years. The prevalence of insomnia and restless legs syndrome were 42.8 % & 51.7 respectively. The statistical significant difference was found between pre and post application of sleep hygiene measures and home remedies nursing instructions as regards the severity of both insomnia and restless leg syndrome. Conclusion: Giving written sleep hygiene measures and home remedies nursing instructions for patients have an obvious effect in reducing the prevalence and severity of insomnia and restless legs syndrome. Recommendations: Booklet and pamphlets with an Arabic language must be provided for each hemodialysis patient to help them manageing their insomnia and restless leg syndrome. Keywords: Incidence, Insomnia, Home Remedies, Hemodialysis, Sleep Hygiene Measures, and Restless Leg Syndrome

Background: Keratoplasty is a surgical procedure in which part or all of a damaged or diseased cornea is replaced by healthy corneal tissue from a donor. The study aimed to evaluate the effect of a multidisciplinary education course on the health literacy and satisfaction of patients undergoing keratoplasty. This study was carried out at the Ophthalmology department and outpatient clinics at Assiut University hospital. The sample of the study was a purposive sample of 60 adult and elderly patients (30 study group and 30 for the control group) undergoing corneal transplantation surgery. Tools of data collection included four tools,(1) patient’s interview questionnaire sheet,(2) patient's knowledge assessment & observation checklist,(3) health literacy questionnaire,(4) patient satisfaction with nursing care quality questionnaire. The main results of this study revealed the majority of patients in the two groups were diagnosed with keratoconus, performed Full-thickness (penetrating) keratoplasty for optical reasons. There was a highly statistically significant difference between both the study and control of patients regarding health literacy score. Half of the patients in the control group have poor satisfaction level while the majority of the study group patients (83.3%) have a very good satisfaction level post educational course application. There was a positive correlation between patients’ knowledge & health literacy and patient satisfaction (P.< 0.001). The main recommendation is to establish a patient education center in the ophthalmology department to provide patients with the needed information before performing the keratoplasty.