Abstract: A decrease in pulmonary function is well known after open heart surgery. Roentgenological signs of atelectasis are common, reduced lung volumes and oxygenation in the post-operative period. Post-operative treatment includes early mobilization, change of position, breathing exercises and coughing techniques. Various mechanical devices have been used in order to improve post-operative pulmonary function, for example incentive spirometry, continuous positive airway pressure and intermittent positive pressure breathing and blow bottle device. The blow bottle is another technique to produce expiratory resistance and the initial rationale for the technique was to expand the lungs. Design A quasi –experimental design. Setting, The study was conducted in postoperative intensive care unit of Assiut university hospitals. Subject,a convenience sample of 50 adult open heart patients of both sexes. Group1 (conservative therapy), and group2 (blow bottle)] 25 patients for each. Tools, Two tools were developed in this study, tool one (Patient's socio demographic characteristics and health status tool among open heart patients),tool two (Observation checklist for post-operative pulmonary complications among open heart surgical patients). Result of this study revealed that a statistical significant difference was found between the two groups regarding to atalectasis p (0.044). As regard pulmonary secretion it was noticed that percent 72% of patients in group 1(incentive spirometer), while 60% of patients having pulmonary secretion in group 2(blow bottle). Conclusion of this study illustrated that a positive effects of PEP (blow bottle)than conservative therapy on occurrence of pulmonary complications among open heart patients postoperatively. Patients who performed deep breathing exercises with a blow bottle device postoperatively showed a significantly smaller amount of secretions and atelectasis, improved oxygenation and had less reduction in FVC and FEV1 on the fourth postoperative day compared to conservative therapy . Recommendations, Explain to the nurse the deference between deep breathing exercise alone and deep breathing exercise with anther maneuver such as blow bottle device, and the effectiveness on respiratory system for preventing respiratory complications.

Abstract: A decrease in pulmonary function is well known after open heart surgery. Roentgenological signs of atelectasis are common, reduced lung volumes and oxygenation in the post-operative period. Post-operative treatment includes early mobilization, change of position, breathing exercises and coughing techniques. Various mechanical devices have been used in order to improve post-operative pulmonary function, for example incentive spirometry, continuous positive airway pressure and intermittent positive pressure breathing and blow bottle device. The blow bottle is another technique to produce expiratory resistance and the initial rationale for the technique was to expand the lungs. Design A quasi –experimental design. Setting, The study was conducted in postoperative intensive care unit of Assiut university hospitals. Subject,a convenience sample of 50 adult open heart patients of both sexes. Group1 (conservative therapy), and group2 (blow bottle)] 25 patients for each. Tools, Two tools were developed in this study, tool one (Patient's socio demographic characteristics and health status tool among open heart patients),tool two (Observation checklist for post-operative pulmonary complications among open heart surgical patients). Result of this study revealed that a statistical significant difference was found between the two groups regarding to atalectasis p (0.044). As regard pulmonary secretion it was noticed that percent 72% of patients in group 1(incentive spirometer), while 60% of patients having pulmonary secretion in group 2(blow bottle). Conclusion of this study illustrated that a positive effects of PEP (blow bottle)than conservative therapy on occurrence of pulmonary complications among open heart patients postoperatively. Patients who performed deep breathing exercises with a blow bottle device postoperatively showed a significantly smaller amount of secretions and atelectasis, improved oxygenation and had less reduction in FVC and FEV1 on the fourth postoperative day compared to conservative therapy . Recommendations, Explain to the nurse the deference between deep breathing exercise alone and deep breathing exercise with anther maneuver such as blow bottle device, and the effectiveness on respiratory system for preventing respiratory complications.

Death rate of patients with liver cirrhosis is 41.6% in Egypt. It is important to assess the nutritional status of this group of patients because these patients suffer from protein-calorie malnutrition. Aim: Assessment of nutritional status in patients with liver cirrhosis in Assiut university hospital.Patient and Methods: 60 adult patients with liver cirrhosis as a study group were conducted at Tropical Medicine and Gastroenterology Department at Assiut University hospital. Tools utilized for data collection were :( I) patient assessment and (II) nutritional assessment. Results: The main causes of patients with liver cirrhotic were HCV and HBV infection. Malnutrition was prevalent in 85% of patients. The most common malnutrition risk factors were dry mouth, taste alteration, food intolerance, multiple medications and the presence of ascites. Conclusions: the majority of patients with decompensated liver cirrhosis were malnourished regardless the etiology of liver cirrhosis. Identifying the patients that are approaching the state of malnutrition by simple and easily applied methods is necessary in order to provide nutritional support. Recommendations: Nutritional support and regimen, advice and guidelines by dietitian should be undertaken for all cirrhotic patients to prevent the occurrence of complications of malnutrition and improve clinical outcome.

Death rate of patients with liver cirrhosis is 41.6% in Egypt. It is important to assess the nutritional status of this group of patients because these patients suffer from protein-calorie malnutrition. Aim: Assessment of nutritional status in patients with liver cirrhosis in Assiut university hospital.Patient and Methods: 60 adult patients with liver cirrhosis as a study group were conducted at Tropical Medicine and Gastroenterology Department at Assiut University hospital. Tools utilized for data collection were :( I) patient assessment and (II) nutritional assessment. Results: The main causes of patients with liver cirrhotic were HCV and HBV infection. Malnutrition was prevalent in 85% of patients. The most common malnutrition risk factors were dry mouth, taste alteration, food intolerance, multiple medications and the presence of ascites. Conclusions: the majority of patients with decompensated liver cirrhosis were malnourished regardless the etiology of liver cirrhosis. Identifying the patients that are approaching the state of malnutrition by simple and easily applied methods is necessary in order to provide nutritional support. Recommendations: Nutritional support and regimen, advice and guidelines by dietitian should be undertaken for all cirrhotic patients to prevent the occurrence of complications of malnutrition and improve clinical outcome.

Death rate of patients with liver cirrhosis is 41.6% in Egypt. It is important to assess the nutritional status of this group of patients because these patients suffer from protein-calorie malnutrition. Aim: Assessment of nutritional status in patients with liver cirrhosis in Assiut university hospital.Patient and Methods: 60 adult patients with liver cirrhosis as a study group were conducted at Tropical Medicine and Gastroenterology Department at Assiut University hospital. Tools utilized for data collection were :( I) patient assessment and (II) nutritional assessment. Results: The main causes of patients with liver cirrhotic were HCV and HBV infection. Malnutrition was prevalent in 85% of patients. The most common malnutrition risk factors were dry mouth, taste alteration, food intolerance, multiple medications and the presence of ascites. Conclusions: the majority of patients with decompensated liver cirrhosis were malnourished regardless the etiology of liver cirrhosis. Identifying the patients that are approaching the state of malnutrition by simple and easily applied methods is necessary in order to provide nutritional support. Recommendations: Nutritional support and regimen, advice and guidelines by dietitian should be undertaken for all cirrhotic patients to prevent the occurrence of complications of malnutrition and improve clinical outcome.

Death rate of patients with liver cirrhosis is 41.6% in Egypt. It is important to assess the nutritional status of this group of patients because these patients suffer from protein-calorie malnutrition. Aim: Assessment of nutritional status in patients with liver cirrhosis in Assiut university hospital.Patient and Methods: 60 adult patients with liver cirrhosis as a study group were conducted at Tropical Medicine and Gastroenterology Department at Assiut University hospital. Tools utilized for data collection were :( I) patient assessment and (II) nutritional assessment. Results: The main causes of patients with liver cirrhotic were HCV and HBV infection. Malnutrition was prevalent in 85% of patients. The most common malnutrition risk factors were dry mouth, taste alteration, food intolerance, multiple medications and the presence of ascites. Conclusions: the majority of patients with decompensated liver cirrhosis were malnourished regardless the etiology of liver cirrhosis. Identifying the patients that are approaching the state of malnutrition by simple and easily applied methods is necessary in order to provide nutritional support. Recommendations: Nutritional support and regimen, advice and guidelines by dietitian should be undertaken for all cirrhotic patients to prevent the occurrence of complications of malnutrition and improve clinical outcome.

Abstract:Stroke is a leading cause of disability. The study aimed to: assess musculoskeletal complications for immobilized stroke patients. Methods: Descriptive research design carried out in AssiutUniversityhospital.It included30 patientsconducted at neurological departmentsatAssiut University Hospital. Tools:Data collected by using three tools; Firsttool: part I;includedSociodemographic patient characteristics, part II;assessment of the past and present health history, second toolincluded: Assessment of patient's knowledge regarding stroke and musculoskeletal complications resulting from immobility,while the third toolincluded patient’s assessment for the musculoskeletal complications. The main results of present study The incidences of musculoskeletal complications in studied sample were higheramong the stroke immobilized patient and hadunsatisfactory knowledge regarding to stroke. It concluded that:The majority of store immobilized patients after prolonged immobilization suffer from sever musculoskeletal complications and had unsatisfactory knowledge. It was recommended that:the exercise programme should be applying early as possible as from at time of admission to the hospital.

Abstract:Stroke is a leading cause of disability. The study aimed to: assess musculoskeletal complications for immobilized stroke patients. Methods: Descriptive research design carried out in AssiutUniversityhospital.It included30 patientsconducted at neurological departmentsatAssiut University Hospital. Tools:Data collected by using three tools; Firsttool: part I;includedSociodemographic patient characteristics, part II;assessment of the past and present health history, second toolincluded: Assessment of patient's knowledge regarding stroke and musculoskeletal complications resulting from immobility,while the third toolincluded patient’s assessment for the musculoskeletal complications. The main results of present study The incidences of musculoskeletal complications in studied sample were higheramong the stroke immobilized patient and hadunsatisfactory knowledge regarding to stroke. It concluded that:The majority of store immobilized patients after prolonged immobilization suffer from sever musculoskeletal complications and had unsatisfactory knowledge. It was recommended that:the exercise programme should be applying early as possible as from at time of admission to the hospital.

Abstract:Stroke is a leading cause of disability. The study aimed to: assess musculoskeletal complications for immobilized stroke patients. Methods: Descriptive research design carried out in AssiutUniversityhospital.It included30 patientsconducted at neurological departmentsatAssiut University Hospital. Tools:Data collected by using three tools; Firsttool: part I;includedSociodemographic patient characteristics, part II;assessment of the past and present health history, second toolincluded: Assessment of patient's knowledge regarding stroke and musculoskeletal complications resulting from immobility,while the third toolincluded patient’s assessment for the musculoskeletal complications. The main results of present study The incidences of musculoskeletal complications in studied sample were higheramong the stroke immobilized patient and hadunsatisfactory knowledge regarding to stroke. It concluded that:The majority of store immobilized patients after prolonged immobilization suffer from sever musculoskeletal complications and had unsatisfactory knowledge. It was recommended that:the exercise programme should be applying early as possible as from at time of admission to the hospital.

Abstract:Stroke is a leading cause of disability. The study aimed to: assess musculoskeletal complications for immobilized stroke patients. Methods: Descriptive research design carried out in AssiutUniversityhospital.It included30 patientsconducted at neurological departmentsatAssiut University Hospital. Tools:Data collected by using three tools; Firsttool: part I;includedSociodemographic patient characteristics, part II;assessment of the past and present health history, second toolincluded: Assessment of patient's knowledge regarding stroke and musculoskeletal complications resulting from immobility,while the third toolincluded patient’s assessment for the musculoskeletal complications. The main results of present study The incidences of musculoskeletal complications in studied sample were higheramong the stroke immobilized patient and hadunsatisfactory knowledge regarding to stroke. It concluded that:The majority of store immobilized patients after prolonged immobilization suffer from sever musculoskeletal complications and had unsatisfactory knowledge. It was recommended that:the exercise programme should be applying early as possible as from at time of admission to the hospital.