Background: Of the life-threatening conditions for critically ill patients are to have intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS). Teaching of nurses is the first line of defense that benefits patients and prevent access to complications. Aim: This paper was aimed to evaluate the effect of teaching program about ACS on (1) nurses’ knowledge and skills and (2) development of ACS among critically ill patients. Design and methods: A quasi experimental research design was used. Convenience sampling of 32 nurses working in General and Trauma ICUs and two groups of patients (pre-teaching patients =20) and (post teaching patients=25) were included in the study. All nurses were evaluated pre and post teach program for their knowledge and skills. Along with, all patients were evaluated for development of acute compartment syndrome for two consecutive months. The study took approximately eight months. Results: nurses’ knowledge and skills about ACS improved significantly after implementing teaching program (p= 0.001). Development of ACS was identified in 20% of preteaching patients versus none of post teaching patients. Mean score of IAP was significantly higher among preteaching than post teaching patients on fifth day (p=0.003**). Conclusion: teaching is important to clarify, remind, and master nurses' knowledge and skills. Highlighting the importance of monitoring IAP of most vulnerable patients help to early detection of IAH and prevent access to ACS.

Background: Of the life-threatening conditions for critically ill patients are to have intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS). Teaching of nurses is the first line of defense that benefits patients and prevent access to complications. Aim: This paper was aimed to evaluate the effect of teaching program about ACS on (1) nurses’ knowledge and skills and (2) development of ACS among critically ill patients. Design and methods: A quasi experimental research design was used. Convenience sampling of 32 nurses working in General and Trauma ICUs and two groups of patients (pre-teaching patients =20) and (post teaching patients=25) were included in the study. All nurses were evaluated pre and post teach program for their knowledge and skills. Along with, all patients were evaluated for development of acute compartment syndrome for two consecutive months. The study took approximately eight months. Results: nurses’ knowledge and skills about ACS improved significantly after implementing teaching program (p= 0.001). Development of ACS was identified in 20% of preteaching patients versus none of post teaching patients. Mean score of IAP was significantly higher among preteaching than post teaching patients on fifth day (p=0.003**). Conclusion: teaching is important to clarify, remind, and master nurses' knowledge and skills. Highlighting the importance of monitoring IAP of most vulnerable patients help to early detection of IAH and prevent access to ACS.

Background: The technique of monitoring patient’s blood glucose using a glucose meter is most useful as an adjunct therapy with pharmacological treatments against diabetes mellitus. The value and effectiveness of selfmonitoring of blood glucose (SMBG) is affected by the patient’s SMBG knowledge and skill. This paper aimed to quantify the impact of washing hands on accuracy result of capillary blood glucose measurements among diabetic patients. Patients and method: Quasi-experimental research design was conducted to meet the study's objective. In the internal medicine department at Assiut university hospital, Egypt. Sixty adult patients were eligible according to the inclusion criteria were enrolled. An interview questionnaire involved patients' demographic characteristics, clinical data, and knowledge regarding self-monitoring of blood glucose. Results: the mean blood glucose readings before washing hands were74.37± 86.594 mg / dl, 225.66± 85.973 mg / dl respectively after washing hands, and after peeling an orange followed by no washing hands were 349.03±90.084 mg / dl. Conclusion: The results of this study indicated that there was a statistically significant difference between washing hands and accuracy results of capillary blood glucose measurements. Recommendations: All patients should be advised to wash their hands with water and soap before performing the test.

Background: The technique of monitoring patient’s blood glucose using a glucose meter is most useful as an adjunct therapy with pharmacological treatments against diabetes mellitus. The value and effectiveness of selfmonitoring of blood glucose (SMBG) is affected by the patient’s SMBG knowledge and skill. This paper aimed to quantify the impact of washing hands on accuracy result of capillary blood glucose measurements among diabetic patients. Patients and method: Quasi-experimental research design was conducted to meet the study's objective. In the internal medicine department at Assiut university hospital, Egypt. Sixty adult patients were eligible according to the inclusion criteria were enrolled. An interview questionnaire involved patients' demographic characteristics, clinical data, and knowledge regarding self-monitoring of blood glucose. Results: the mean blood glucose readings before washing hands were74.37± 86.594 mg / dl, 225.66± 85.973 mg / dl respectively after washing hands, and after peeling an orange followed by no washing hands were 349.03±90.084 mg / dl. Conclusion: The results of this study indicated that there was a statistically significant difference between washing hands and accuracy results of capillary blood glucose measurements. Recommendations: All patients should be advised to wash their hands with water and soap before performing the test.

Aims: Was to evaluate the effect of applying nursing guidelines on patients' awareness about HBOT. Research design: auasi experimental design has been used to carry out this study on a sample of 200 adult diabetic patients both sex since two years ago within 6 months. Study was conducted at internal medicine department and diabetic outpatient clinic at Assiut University Hospitals. Tools: Three tools used; A structured interview questionnaire sheet, Designed Nursing guidelines and Patient evaluation sheet. Results: Out of 200 patients, the highest percent of studied sample were male (53.3%), their age 50- 65 years (39.5%) married and living in rural area (80.5), read and write (59.0%), not working (59.0%) , (84.0%) had family history from other relatives, and (33.0%) of patients were having hypertension with diabetes mellitus and the majority (ninety five percent and(hundred percent) had poor level of knowledge about diabetic foot and HBOT during pre-test followed by (hundred percent), (ninety percent) had good knowledge level about diabetic foot and HBOT after implementation nursing guidelines. Conclusion: Diabetic foot patients exposed to several complications, improving patient's awareness about HBOT can favorable affect the incidence of these complications. Recommendation: Organize regular counseling sessions for meeting the patients' information about diabetic foot and HBOT.

Aims: Was to evaluate the effect of applying nursing guidelines on patients' awareness about HBOT. Research design: auasi experimental design has been used to carry out this study on a sample of 200 adult diabetic patients both sex since two years ago within 6 months. Study was conducted at internal medicine department and diabetic outpatient clinic at Assiut University Hospitals. Tools: Three tools used; A structured interview questionnaire sheet, Designed Nursing guidelines and Patient evaluation sheet. Results: Out of 200 patients, the highest percent of studied sample were male (53.3%), their age 50- 65 years (39.5%) married and living in rural area (80.5), read and write (59.0%), not working (59.0%) , (84.0%) had family history from other relatives, and (33.0%) of patients were having hypertension with diabetes mellitus and the majority (ninety five percent and(hundred percent) had poor level of knowledge about diabetic foot and HBOT during pre-test followed by (hundred percent), (ninety percent) had good knowledge level about diabetic foot and HBOT after implementation nursing guidelines. Conclusion: Diabetic foot patients exposed to several complications, improving patient's awareness about HBOT can favorable affect the incidence of these complications. Recommendation: Organize regular counseling sessions for meeting the patients' information about diabetic foot and HBOT.

Aims: Was to evaluate the effect of applying nursing guidelines on patients' awareness about HBOT. Research design: auasi experimental design has been used to carry out this study on a sample of 200 adult diabetic patients both sex since two years ago within 6 months. Study was conducted at internal medicine department and diabetic outpatient clinic at Assiut University Hospitals. Tools: Three tools used; A structured interview questionnaire sheet, Designed Nursing guidelines and Patient evaluation sheet. Results: Out of 200 patients, the highest percent of studied sample were male (53.3%), their age 50- 65 years (39.5%) married and living in rural area (80.5), read and write (59.0%), not working (59.0%) , (84.0%) had family history from other relatives, and (33.0%) of patients were having hypertension with diabetes mellitus and the majority (ninety five percent and(hundred percent) had poor level of knowledge about diabetic foot and HBOT during pre-test followed by (hundred percent), (ninety percent) had good knowledge level about diabetic foot and HBOT after implementation nursing guidelines. Conclusion: Diabetic foot patients exposed to several complications, improving patient's awareness about HBOT can favorable affect the incidence of these complications. Recommendation: Organize regular counseling sessions for meeting the patients' information about diabetic foot and HBOT.

Background: Patients with newly placed arteriovenous fistula are generally advised to perform hand exercise because of its effects on fistula maturation. Aim of the study was to compare between two different hand exercises in improving hand grip strength for patients underwent arteriovenous fistula surgery. Setting: Vascular surgery department and outpatient clinics of the vascular surgery at Assiut University Hospital. Subjects 60 patients who had chronic kidney disease and had undergone arteriovenous fistula surgery for hemodialysis. After the surgery, subjects divided into two groups one group(30) used hand gripping GD grip squeezing exercise and the other one(30) used soft ball squeezing exercise. The subjects continued the exercises for 4 weeks. The hand strength of the subjects were assessed before and after the hand-squeezing exercises. Results: Showed that 25 patients of both groups had pain of the access arm, 6 patients had abnormal sensation of the access arm and both groups had normal access arm and had thrill on palpation and bruit on auscultation. Conclusion: The results showed that hand squeezing exercise with GD Grip was more effective in improving hand grip strength compared to hand squeezing exercise with soft ball. Recommendations: Further research to evaluate the effect of the improved hand strength on the activities of daily living, and replication of the study using a larger probability sample acquired from different geographical areas.

Background: Patients with newly placed arteriovenous fistula are generally advised to perform hand exercise because of its effects on fistula maturation. Aim of the study was to compare between two different hand exercises in improving hand grip strength for patients underwent arteriovenous fistula surgery. Setting: Vascular surgery department and outpatient clinics of the vascular surgery at Assiut University Hospital. Subjects 60 patients who had chronic kidney disease and had undergone arteriovenous fistula surgery for hemodialysis. After the surgery, subjects divided into two groups one group(30) used hand gripping GD grip squeezing exercise and the other one(30) used soft ball squeezing exercise. The subjects continued the exercises for 4 weeks. The hand strength of the subjects were assessed before and after the hand-squeezing exercises. Results: Showed that 25 patients of both groups had pain of the access arm, 6 patients had abnormal sensation of the access arm and both groups had normal access arm and had thrill on palpation and bruit on auscultation. Conclusion: The results showed that hand squeezing exercise with GD Grip was more effective in improving hand grip strength compared to hand squeezing exercise with soft ball. Recommendations: Further research to evaluate the effect of the improved hand strength on the activities of daily living, and replication of the study using a larger probability sample acquired from different geographical areas.

Background:Hyperphosphatemia is common among hemodialysis patients, and independently associated with high mortality risk in those patients. Aim: To examine the effect of sugar free chewing gum as a supplemental approach instructions to control serum phosphorus level among hemodialysis patients. Researchdesign: A quasi-experimental research design. Setting: Kidney Dialysis Unit at Assiut University Hospital, Egypt. Sample:120 patients were randomized in two groups, experimental and control and met the inclusion criteria. Patients in the experimental group were instructed to chew two pieces of gum, for 60 min, during fasting periods in the morning and the afternoon and to use of phosphate binder with meals for 4weeks. Tool: The interview questionnaire sheet involved two parts: Part I: Demographic characteristics for patients: Part II: Clinical data of patients: Results: Serum phosphorus level was significantly lower in the experimental group than in control after 4weeks of using sugar free chewing gum (8.200 ±1.34 to5.30 ±0.94 (p 0.0001). Conclusion: The use of sugar free chewing gum as a supplemental approach instructions was effective in controlling serum phosphorus level. Recommendation: The study was highly reinforced the need for sugar free chewing gum to be used by hemodialysis patients for its positive effect on controlling serum phosphorus level.