ABSTRACT Objective: Anal fissure is a common problem through the world, it causes considerable morbidity. The aim of the study was to evaluate the effect of designed nursing guidelines on acute anal fissure treatment outcomes. Methods: Research design: Quasi-experimental design. Setting: General Surgery Wards and Outpatient Clinics of General Surgery at Assiut University Hospital. Sample: A purposive sample of 60 male and female adult patients diagnosed of having acute anal fissure. Patients were equally divided on random basis into two equal groups (study and control) 30 patients for each. Tools: Tool I-Patient assessment sheet. Tool II-Numeric Pain Rating Scale. Tool III-Bates-Jensen Wound Assessment Tool. Results: No statistically significant difference was found between the study and the control groups as regard demographic data. There was a statistically significant improvement in the pain level and wound healing among the study group (1.63 ± 2.08 and 11.93 ± 4.5 respectively) than in the control group (2.87 ± 2.33 and 14.43 ± 4.29 respectively). Also, there was a high statistically significant improvement in the level of knowledge of the study group than their level before applying the guidelines (p .001). Conclusions: Designed nursing guidelines had a statistically significant effect on improving patients’ knowledge, pain level, and wound healing among the study group patients than among the control group ones with acute anal fissure. Recommendations: Patients teaching should be an integral part of the nurses’ duty in all hospitals. Further studies on larger sample from different geographical areas in Egypt to generalize the results.

ABSTRACT Objective: Anal fissure is a common problem through the world, it causes considerable morbidity. The aim of the study was to evaluate the effect of designed nursing guidelines on acute anal fissure treatment outcomes. Methods: Research design: Quasi-experimental design. Setting: General Surgery Wards and Outpatient Clinics of General Surgery at Assiut University Hospital. Sample: A purposive sample of 60 male and female adult patients diagnosed of having acute anal fissure. Patients were equally divided on random basis into two equal groups (study and control) 30 patients for each. Tools: Tool I-Patient assessment sheet. Tool II-Numeric Pain Rating Scale. Tool III-Bates-Jensen Wound Assessment Tool. Results: No statistically significant difference was found between the study and the control groups as regard demographic data. There was a statistically significant improvement in the pain level and wound healing among the study group (1.63 ± 2.08 and 11.93 ± 4.5 respectively) than in the control group (2.87 ± 2.33 and 14.43 ± 4.29 respectively). Also, there was a high statistically significant improvement in the level of knowledge of the study group than their level before applying the guidelines (p .001). Conclusions: Designed nursing guidelines had a statistically significant effect on improving patients’ knowledge, pain level, and wound healing among the study group patients than among the control group ones with acute anal fissure. Recommendations: Patients teaching should be an integral part of the nurses’ duty in all hospitals. Further studies on larger sample from different geographical areas in Egypt to generalize the results.

ABSTRACT Objective: Anal fissure is a common problem through the world, it causes considerable morbidity. The aim of the study was to evaluate the effect of designed nursing guidelines on acute anal fissure treatment outcomes. Methods: Research design: Quasi-experimental design. Setting: General Surgery Wards and Outpatient Clinics of General Surgery at Assiut University Hospital. Sample: A purposive sample of 60 male and female adult patients diagnosed of having acute anal fissure. Patients were equally divided on random basis into two equal groups (study and control) 30 patients for each. Tools: Tool I-Patient assessment sheet. Tool II-Numeric Pain Rating Scale. Tool III-Bates-Jensen Wound Assessment Tool. Results: No statistically significant difference was found between the study and the control groups as regard demographic data. There was a statistically significant improvement in the pain level and wound healing among the study group (1.63 ± 2.08 and 11.93 ± 4.5 respectively) than in the control group (2.87 ± 2.33 and 14.43 ± 4.29 respectively). Also, there was a high statistically significant improvement in the level of knowledge of the study group than their level before applying the guidelines (p .001). Conclusions: Designed nursing guidelines had a statistically significant effect on improving patients’ knowledge, pain level, and wound healing among the study group patients than among the control group ones with acute anal fissure. Recommendations: Patients teaching should be an integral part of the nurses’ duty in all hospitals. Further studies on larger sample from different geographical areas in Egypt to generalize the results.

Abstract Pilon fractures often involving a lengthy, sometimes painful recovery time. Aim; to evaluate the effect of rehabilitation exercises program on Pilon fracture outcome. Research hypothesis; the outcome of study group patients will be better than the outcome of control group. Patients and Methods: A quasi – experimental research design was utilized. Setting; the study was conducted in Traumatology Department of Assuit University Hospital. A convenience sample of sixty patients diagnosed with Pilon fracture divided into study and control group (thirty for each). Tools; tool I "Patient assessment sheet", tool II “Modified Mazur scale [1]". The control group exposed to routine hospital care while study group patients received the rehabilitation exercises program. Results revealed better outcome among study group patients than control group; Mazur score (85.27 ± 8.69 vs. 72.57 ± 13.43), and marked reduction in postoperative complications rate. Conclusion: This study proved that; application of rehabilitation exercises program had a statistically significant improvement on Pilon fracture outcome that was apparent in fewer postoperative complications rate and raised level of Mazur score among study group. Recommendation: Rehabilitation exercises program for Pilon fracture should be carried out on an individual basis from beginning of this fracture to prevent postoperative complications and achieve better outcome.

Abstract Pilon fractures often involving a lengthy, sometimes painful recovery time. Aim; to evaluate the effect of rehabilitation exercises program on Pilon fracture outcome. Research hypothesis; the outcome of study group patients will be better than the outcome of control group. Patients and Methods: A quasi – experimental research design was utilized. Setting; the study was conducted in Traumatology Department of Assuit University Hospital. A convenience sample of sixty patients diagnosed with Pilon fracture divided into study and control group (thirty for each). Tools; tool I "Patient assessment sheet", tool II “Modified Mazur scale [1]". The control group exposed to routine hospital care while study group patients received the rehabilitation exercises program. Results revealed better outcome among study group patients than control group; Mazur score (85.27 ± 8.69 vs. 72.57 ± 13.43), and marked reduction in postoperative complications rate. Conclusion: This study proved that; application of rehabilitation exercises program had a statistically significant improvement on Pilon fracture outcome that was apparent in fewer postoperative complications rate and raised level of Mazur score among study group. Recommendation: Rehabilitation exercises program for Pilon fracture should be carried out on an individual basis from beginning of this fracture to prevent postoperative complications and achieve better outcome.

Abstract Pilon fractures often involving a lengthy, sometimes painful recovery time. Aim; to evaluate the effect of rehabilitation exercises program on Pilon fracture outcome. Research hypothesis; the outcome of study group patients will be better than the outcome of control group. Patients and Methods: A quasi – experimental research design was utilized. Setting; the study was conducted in Traumatology Department of Assuit University Hospital. A convenience sample of sixty patients diagnosed with Pilon fracture divided into study and control group (thirty for each). Tools; tool I "Patient assessment sheet", tool II “Modified Mazur scale [1]". The control group exposed to routine hospital care while study group patients received the rehabilitation exercises program. Results revealed better outcome among study group patients than control group; Mazur score (85.27 ± 8.69 vs. 72.57 ± 13.43), and marked reduction in postoperative complications rate. Conclusion: This study proved that; application of rehabilitation exercises program had a statistically significant improvement on Pilon fracture outcome that was apparent in fewer postoperative complications rate and raised level of Mazur score among study group. Recommendation: Rehabilitation exercises program for Pilon fracture should be carried out on an individual basis from beginning of this fracture to prevent postoperative complications and achieve better outcome.

Abstract: nur ses play a crucial role in post operative care. Therefore, assessing nurses’ clinical competence is essential to achieve qualified and safe care. Aims; assess postoperative nurses' competency regarding cholecystectomy care and compare the difference between university and non - university hospitals. R esearch questions; what are the postoperative nurses' competency regarding cholecystectomy?And what are the differences betweenuniversity and non - university hospitals? Descriptive correlation research design was utilized. The study was conducted at general surgery departments of university and non - university hospitals of A ssiut city. The sample consisted of all available nurses (55nurses) who were currently assigned for giving post cholecystectomy nursing care in the above mentioned hospitals. The instruments employed for data collection were; tool one” nurses' assessment sheet", tool two “nursescompetence advanced self - assessment tool ". Results showed that; all nurses exceeded the competent level &there were significant differences between two settings regarding to their post cholecystectomy nurses’ performance competency. Conclusion: nurses have adequate knowledge, skills to adequately meet all the requirements for postoperative competency. Recommendation; the research results can be used for the educational needs assessment of nurses and for modifying the quality of care in hospitals.

Abstract: nur ses play a crucial role in post operative care. Therefore, assessing nurses’ clinical competence is essential to achieve qualified and safe care. Aims; assess postoperative nurses' competency regarding cholecystectomy care and compare the difference between university and non - university hospitals. R esearch questions; what are the postoperative nurses' competency regarding cholecystectomy?And what are the differences betweenuniversity and non - university hospitals? Descriptive correlation research design was utilized. The study was conducted at general surgery departments of university and non - university hospitals of A ssiut city. The sample consisted of all available nurses (55nurses) who were currently assigned for giving post cholecystectomy nursing care in the above mentioned hospitals. The instruments employed for data collection were; tool one” nurses' assessment sheet", tool two “nursescompetence advanced self - assessment tool ". Results showed that; all nurses exceeded the competent level &there were significant differences between two settings regarding to their post cholecystectomy nurses’ performance competency. Conclusion: nurses have adequate knowledge, skills to adequately meet all the requirements for postoperative competency. Recommendation; the research results can be used for the educational needs assessment of nurses and for modifying the quality of care in hospitals.

Purpose/Background: Many investigators reported that pharmacological treatment of female sexual dysfunction (FSD) has been a promising field yet to be explored. The purpose of this pilot study was to investigate the efficacy and safety of a topical cream containing small concentrations of three vasodilators with different mechanisms of action in treating FSD. Methods: In this randomized, controlled pilot trial, premenopausal (n = 30) and postmenopausal (n = 30) cases of 21- to 62-year age range with FSDwere allocated randomly into 15 given placebo or 15 given active cream in each group. The women included had FSD for more than a 6-month duration and a total score of Female Sexual Distress Scale- Revised of at least 15. Assessing sexual function by measuring female sexual function index (FSFI) during five clinic visits, one at the end of baseline week and at the end of each week of the 4-week treatment period. The primary end point was changed from baseline FSFI total scores to week 4 treatment. Secondary end point included the changes from baseline arousal, desire, orgasm, and satisfaction scores to week 4 treatment. Findings/Results: The sexual problem reported by patients was orgasmic or/and arousal disorders. In premenopausal cases, active cream led to a high significant increase inmean change FSFI total score fromthe baseline to week 4 compared with placebo (1.7 ± 1.886 vs 13.35 ± 4.646, respectively; P 0.0001). Greater improvement of mean change of orgasm and arousal domain score was also observed (0.3 ± 0.45 and 0.35 ± 0.39 vs. 2.66 ± 0.63 and 1.87 ± 0.168, respectively; P 0.0001). In postmenopausal cases, there were significantly greater improvements with active cream in all sexual functions compared with placebo cream (P 0.0001). In triple cream, mean change of FSFI total score, orgasm domain score, and arousal score domain were 14.85 ± 6.33, 1.87 ± 0.168 and 2.66 ± 1.182,whereas in the placebo cream, they were 1.54 ± 2.1,0.7 ± 0.76 and 0.22 ± 0.44, respectively. Meanwhile, orgasm scores increased significantly after the use of placebo cream. No serious adverse effects were reported during treatment. Implications/Conclusions: The results of the pilot trial suggest that topical cream containing small concentrations of three vasodilators may act synergistically, and was effective in improving arousal, orgasmic, and satisfaction disorder with a safer profile for premenopausal and postmenopausal women with FSD. Further studies are recommended to be conducted using a large number of nondepressive and depressive patients.

ABSTRACT INTRODUCTION The aim of this study was to investigate the effect of a lower dose subcutaneous sterile water injection technique versus subcutaneous saline injection, on the relief of low-back pain for women during childbirth, and to explore the lasting effects of pain relief after administration (followed at 15, 30, 45, 90 and 120 minutes). METHODS A prospective randomized controlled single-blinded study was conducted, with trial registration (NCT02813330). Women received one-time injections (sterile water or saline) and the effectiveness was observed at 15, 30, 45, 90 and 120 minutes after the intervention. RESULTS The intervention group had statistically significant pain reduction. Assessment of subsequent pain, followed at 30, 45, 90 and 120 minutes, reflected an increasing change with a statistically significant difference. The intervention group had more burning sensations than the control group with a statistically significant difference. CONCLUSIONS The modified technique of double injections of subcutaneous ‘water/ saline’ resulted in significant relief of low-back pain during childbirth.