Background: Hemorrhoid is considered one of the biggest problems all over the world. Hemorrhoidectomy is the most effective treatment method for advanced stages hemorrhoids. Aim of the study: To evaluate the effects of warm water sitz bath on post-hemorrhoidectomy symptoms. Patients and Methods: Research design: Prospective randomized controlled trial. Setting: General Surgery Wards and Outpatient Clinics of General Surgery at Assiut University Hospital. Sample: A random sample of 60 adult patients with hemorrhoids (grade III or IV) that did not respond to conservative treatment and consequently had undergone hemorrhoidectomy. Patients were randomly assigned to study group and control group, 30 patients for each group. Tools: Tool I: Patient assessment sheet: Tool II: Symptoms assessment sheet. Results: A significant improvement in the level of pain and anal burning during the 4 weeks follow-up period that was more apparent in the study group than in the control group (p0.01). A noticeable improvement of anal itching was found in both groups but it was higher in the study group more than the control one; however, it reached a statistically significant level at the third and fourth week. Wound healing was higher among the study group when compared with the control group. Conclusion: Warm water sitz bath had a statistically significant effect on improvement of posthemorrhoidectomy pain, anal burning, and anal irritation. Also, wound healing was improved but it did not reach a statistically significant level. Recommendation: Using sitz bath as a safe method to promote hygiene and comfort after hemorrhoidectomy.

Background: Hemorrhoid is considered one of the biggest problems all over the world. Hemorrhoidectomy is the most effective treatment method for advanced stages hemorrhoids. Aim of the study: To evaluate the effects of warm water sitz bath on post-hemorrhoidectomy symptoms. Patients and Methods: Research design: Prospective randomized controlled trial. Setting: General Surgery Wards and Outpatient Clinics of General Surgery at Assiut University Hospital. Sample: A random sample of 60 adult patients with hemorrhoids (grade III or IV) that did not respond to conservative treatment and consequently had undergone hemorrhoidectomy. Patients were randomly assigned to study group and control group, 30 patients for each group. Tools: Tool I: Patient assessment sheet: Tool II: Symptoms assessment sheet. Results: A significant improvement in the level of pain and anal burning during the 4 weeks follow-up period that was more apparent in the study group than in the control group (p0.01). A noticeable improvement of anal itching was found in both groups but it was higher in the study group more than the control one; however, it reached a statistically significant level at the third and fourth week. Wound healing was higher among the study group when compared with the control group. Conclusion: Warm water sitz bath had a statistically significant effect on improvement of posthemorrhoidectomy pain, anal burning, and anal irritation. Also, wound healing was improved but it did not reach a statistically significant level. Recommendation: Using sitz bath as a safe method to promote hygiene and comfort after hemorrhoidectomy.

Background and objective: Nursing role delivered at all levels of care is critical to eliminate surgical wound infection after neurosurgery. Aim: Evaluate the effect of implementing infection control guidelines on minimizing surgical wound infection for patients undergoing neurosurgery. Methods: Pretest/posttest was used to assess and evaluate nurses’ practices pre and post implementation of infection control guidelines while posttest only was used for patients to evaluate the effect of implementing infection control guidelines on minimizing surgical wound infection. Thirty-six nurses in neurosurgery department at Assiut Neurological, Psychiatric and Neurosurgery University Hospital, also 443 patients undergoing neurosurgery were included. Nurses’ practices were assessed pre and post implementation of infection control guidelines. Tools: Nurses’ observation checklist, patients’ assessment sheet, patients’ follow up sheet and neurosurgery infection control guidelines (teaching booklet) for nurses. Results: Nurses’ practices were improved, infection in neurosurgery was eradicated according to results of environmental swabs and surgical wound infection was reduced post implementation of infection control guidelines. Conclusion and recommendation: Proper implementation of disinfection and sterilization enhance safe and effective care. Infection control policy should be developed in neurosurgery department and all healthcare team should be responsible to adhere and implement it.

Background and objective: Nursing role delivered at all levels of care is critical to eliminate surgical wound infection after neurosurgery. Aim: Evaluate the effect of implementing infection control guidelines on minimizing surgical wound infection for patients undergoing neurosurgery. Methods: Pretest/posttest was used to assess and evaluate nurses’ practices pre and post implementation of infection control guidelines while posttest only was used for patients to evaluate the effect of implementing infection control guidelines on minimizing surgical wound infection. Thirty-six nurses in neurosurgery department at Assiut Neurological, Psychiatric and Neurosurgery University Hospital, also 443 patients undergoing neurosurgery were included. Nurses’ practices were assessed pre and post implementation of infection control guidelines. Tools: Nurses’ observation checklist, patients’ assessment sheet, patients’ follow up sheet and neurosurgery infection control guidelines (teaching booklet) for nurses. Results: Nurses’ practices were improved, infection in neurosurgery was eradicated according to results of environmental swabs and surgical wound infection was reduced post implementation of infection control guidelines. Conclusion and recommendation: Proper implementation of disinfection and sterilization enhance safe and effective care. Infection control policy should be developed in neurosurgery department and all healthcare team should be responsible to adhere and implement it.

Background and aims: Low back pain is mostly due to disc herniation and has a burden upon economy and social aspects of life. Failure to improve after open lumbar discectomy is frustrating. Therefore, identifying predictors of improvement is of great clinical benefit. Aims: This research was conducted to evaluate whether an early exercises rehabilitation program using educational booklet would provide benefit to patients following open lumbar discectomy and determine potential factors of improvement. Patients and methods: Design: Single blind randomized controlled trial. Eighty-eight patients scheduled for open lumbar discectomy from January 2017 to January 2019 at Assiut and Ain Shams Universities hospitals in Egypt were randomly assigned to two groups. Control group (n = 44) received routine postoperative instructions while intervention group (n = 44) received routine instructions in addition to early exercises rehabilitation program and were also provided with a specifically designed educational booklet. Patients were followed up after six months using Oswestry disability index. Results: There was significant improvement among intervention group as compared to control group in several domains of Oswestry disability index (walking, sitting, standing, sleeping, travelling and sexual and social life). Better pre-operative Oswestry disability index score and early application of exercises rehabilitation program using an educational booklet predicted better postoperative Oswestry disability index score after six months. Conclusion: Application of an early exercise rehabilitation program and providing patients with a specifically designed educational booklet would be helpful for patients following open lumbar discectomy. Clinical Relevance: Early exercises rehabilitation program can be used by nursing staff as a reference in management of patients following open lumbar discectomy.

Background and aims: Low back pain is mostly due to disc herniation and has a burden upon economy and social aspects of life. Failure to improve after open lumbar discectomy is frustrating. Therefore, identifying predictors of improvement is of great clinical benefit. Aims: This research was conducted to evaluate whether an early exercises rehabilitation program using educational booklet would provide benefit to patients following open lumbar discectomy and determine potential factors of improvement. Patients and methods: Design: Single blind randomized controlled trial. Eighty-eight patients scheduled for open lumbar discectomy from January 2017 to January 2019 at Assiut and Ain Shams Universities hospitals in Egypt were randomly assigned to two groups. Control group (n = 44) received routine postoperative instructions while intervention group (n = 44) received routine instructions in addition to early exercises rehabilitation program and were also provided with a specifically designed educational booklet. Patients were followed up after six months using Oswestry disability index. Results: There was significant improvement among intervention group as compared to control group in several domains of Oswestry disability index (walking, sitting, standing, sleeping, travelling and sexual and social life). Better pre-operative Oswestry disability index score and early application of exercises rehabilitation program using an educational booklet predicted better postoperative Oswestry disability index score after six months. Conclusion: Application of an early exercise rehabilitation program and providing patients with a specifically designed educational booklet would be helpful for patients following open lumbar discectomy. Clinical Relevance: Early exercises rehabilitation program can be used by nursing staff as a reference in management of patients following open lumbar discectomy.

Background and aims: Low back pain is mostly due to disc herniation and has a burden upon economy and social aspects of life. Failure to improve after open lumbar discectomy is frustrating. Therefore, identifying predictors of improvement is of great clinical benefit. Aims: This research was conducted to evaluate whether an early exercises rehabilitation program using educational booklet would provide benefit to patients following open lumbar discectomy and determine potential factors of improvement. Patients and methods: Design: Single blind randomized controlled trial. Eighty-eight patients scheduled for open lumbar discectomy from January 2017 to January 2019 at Assiut and Ain Shams Universities hospitals in Egypt were randomly assigned to two groups. Control group (n = 44) received routine postoperative instructions while intervention group (n = 44) received routine instructions in addition to early exercises rehabilitation program and were also provided with a specifically designed educational booklet. Patients were followed up after six months using Oswestry disability index. Results: There was significant improvement among intervention group as compared to control group in several domains of Oswestry disability index (walking, sitting, standing, sleeping, travelling and sexual and social life). Better pre-operative Oswestry disability index score and early application of exercises rehabilitation program using an educational booklet predicted better postoperative Oswestry disability index score after six months. Conclusion: Application of an early exercise rehabilitation program and providing patients with a specifically designed educational booklet would be helpful for patients following open lumbar discectomy. Clinical Relevance: Early exercises rehabilitation program can be used by nursing staff as a reference in management of patients following open lumbar discectomy.

Background and aims: Low back pain is mostly due to disc herniation and has a burden upon economy and social aspects of life. Failure to improve after open lumbar discectomy is frustrating. Therefore, identifying predictors of improvement is of great clinical benefit. Aims: This research was conducted to evaluate whether an early exercises rehabilitation program using educational booklet would provide benefit to patients following open lumbar discectomy and determine potential factors of improvement. Patients and methods: Design: Single blind randomized controlled trial. Eighty-eight patients scheduled for open lumbar discectomy from January 2017 to January 2019 at Assiut and Ain Shams Universities hospitals in Egypt were randomly assigned to two groups. Control group (n = 44) received routine postoperative instructions while intervention group (n = 44) received routine instructions in addition to early exercises rehabilitation program and were also provided with a specifically designed educational booklet. Patients were followed up after six months using Oswestry disability index. Results: There was significant improvement among intervention group as compared to control group in several domains of Oswestry disability index (walking, sitting, standing, sleeping, travelling and sexual and social life). Better pre-operative Oswestry disability index score and early application of exercises rehabilitation program using an educational booklet predicted better postoperative Oswestry disability index score after six months. Conclusion: Application of an early exercise rehabilitation program and providing patients with a specifically designed educational booklet would be helpful for patients following open lumbar discectomy. Clinical Relevance: Early exercises rehabilitation program can be used by nursing staff as a reference in management of patients following open lumbar discectomy.

Background: Urodynamic procedure identifies how well bladder, sphincters, and urethra are storing and releasing urine. Aim: Evaluate the importance of verbal and written instructions in outcomes of patients undergoing pressureflow urodynamic studies. Research Design: Randomized controlled trial. Patients and Methods: A total of 130 adult patients with no previous experience with urodynamics were attended to urodynamic outpatient clinic at Assiut Urology and Nephrology University Hospital to perform pressure-flow urodynamic studies from April 2016 to April 2018. Patients were divided randomly into 2 groups; odd numbers = study group (65 patients received routine instructions, detailed explanation about the procedure and received pressure-flow urodynamic brochure) and even numbers = control group (65 patients received routine instructions only). Tools: Assessment sheet for patients undergoing pressure-flow urodynamic studies, Spielberger six-item short form state trait anxiety inventory, urodynamic – patient satisfaction questionnaire and pressure-flow urodynamic brochure. Results: Study group was significantly better regarding all outcome parameters; cooperation, satisfaction, less procedure time and repetition, and less state trait anxiety inventory score. Conclusion: Patients education and good communication skills significantly affect outcomes of patients undergoing pressure-flow urodynamic studies.

Background: Urodynamic procedure identifies how well bladder, sphincters, and urethra are storing and releasing urine. Aim: Evaluate the importance of verbal and written instructions in outcomes of patients undergoing pressureflow urodynamic studies. Research Design: Randomized controlled trial. Patients and Methods: A total of 130 adult patients with no previous experience with urodynamics were attended to urodynamic outpatient clinic at Assiut Urology and Nephrology University Hospital to perform pressure-flow urodynamic studies from April 2016 to April 2018. Patients were divided randomly into 2 groups; odd numbers = study group (65 patients received routine instructions, detailed explanation about the procedure and received pressure-flow urodynamic brochure) and even numbers = control group (65 patients received routine instructions only). Tools: Assessment sheet for patients undergoing pressure-flow urodynamic studies, Spielberger six-item short form state trait anxiety inventory, urodynamic – patient satisfaction questionnaire and pressure-flow urodynamic brochure. Results: Study group was significantly better regarding all outcome parameters; cooperation, satisfaction, less procedure time and repetition, and less state trait anxiety inventory score. Conclusion: Patients education and good communication skills significantly affect outcomes of patients undergoing pressure-flow urodynamic studies.