Abstract: Objectives: To test if combining positive results of sequential magnified naked-eye examination (MNEE) and visual inspection of cervix after application of acetic acid (VIA) would increase diagnostic indices for precancerous and cancerous cervical lesions in comparison to the gold standard positive Pap test in a developing country set up. A secondary objective was to evaluate the effectiveness of nurse training and patient acceptance of this screening approach. Design: An analytic cross-sectional research design Setting: Gynecology and infertility out-patient clinics of the departments of Obstetrics and Gynecology, Woman’s Health University hospital, Assiut University, Egypt. Materials and methods: A total of 445 non-pregnant women aged between 17 and 44 years were counseled and entered this study. They were subjected to MNEE after cleaning of the cervix with 0.9% saline, exfoliative cytology and lastly VIA. Positive results were evaluated and managed accordingly. Colposcopy with or without subsequent cervical biopsy were done in all positive cases of MNEE, VIA and Pap smear. Main outcome measures included diagnostic accuracy of VIA alone versus VIA and MNEE as compared to cytology. Results: This study comprised 445 non pregnant women in the reproductive age. The main complaint was abnormal vaginal discharge in 403 cases (89.6%) . MNEE of the cervix indicated that 338 women (75.1%) and 112 women (24.9%) had healthy and unhealthy-looking cervices respectively. Pap smear sampling was negative for premalignant or malignancy in 377 cases (83.8%).VIA test findings were positive in 77 cases ( 17.3% ) and negative in 368 cases (82.6% ) All diagnostic indices increased significantly after combing MNEE and VIA positive results except negative predicative value if compared to VIA positive results alone as an alternative to the standard Pap smear. Nurses proved high level of skill in performing cervical cytology, MNEE and VIA as proved by lower rate of unsatisfactory results. Patient acceptability was very high after proper counseling. Conclusions: Sequential MNEE and VIA would improve most of diagnostic indices as an alternative diagnostic tool to the gold standard Pap smearing for detection of abnormal precancerous and cancerous cervical lesions. This simplified cheap approach with high percentage of patient acceptability would help expanding screening programs in countries were Pap smear is poorly available. Being performed by doctors as well as trained nurses on one-stop base is a clear advantage. More large sample sized studies on the cost-effectiveness of this approach versus colposcopically-guided positive histopathology are recommended before its universal spread

Abstract: Objectives: To test if combining positive results of sequential magnified naked-eye examination (MNEE) and visual inspection of cervix after application of acetic acid (VIA) would increase diagnostic indices for precancerous and cancerous cervical lesions in comparison to the gold standard positive Pap test in a developing country set up. A secondary objective was to evaluate the effectiveness of nurse training and patient acceptance of this screening approach. Design: An analytic cross-sectional research design Setting: Gynecology and infertility out-patient clinics of the departments of Obstetrics and Gynecology, Woman’s Health University hospital, Assiut University, Egypt. Materials and methods: A total of 445 non-pregnant women aged between 17 and 44 years were counseled and entered this study. They were subjected to MNEE after cleaning of the cervix with 0.9% saline, exfoliative cytology and lastly VIA. Positive results were evaluated and managed accordingly. Colposcopy with or without subsequent cervical biopsy were done in all positive cases of MNEE, VIA and Pap smear. Main outcome measures included diagnostic accuracy of VIA alone versus VIA and MNEE as compared to cytology. Results: This study comprised 445 non pregnant women in the reproductive age. The main complaint was abnormal vaginal discharge in 403 cases (89.6%) . MNEE of the cervix indicated that 338 women (75.1%) and 112 women (24.9%) had healthy and unhealthy-looking cervices respectively. Pap smear sampling was negative for premalignant or malignancy in 377 cases (83.8%).VIA test findings were positive in 77 cases ( 17.3% ) and negative in 368 cases (82.6% ) All diagnostic indices increased significantly after combing MNEE and VIA positive results except negative predicative value if compared to VIA positive results alone as an alternative to the standard Pap smear. Nurses proved high level of skill in performing cervical cytology, MNEE and VIA as proved by lower rate of unsatisfactory results. Patient acceptability was very high after proper counseling. Conclusions: Sequential MNEE and VIA would improve most of diagnostic indices as an alternative diagnostic tool to the gold standard Pap smearing for detection of abnormal precancerous and cancerous cervical lesions. This simplified cheap approach with high percentage of patient acceptability would help expanding screening programs in countries were Pap smear is poorly available. Being performed by doctors as well as trained nurses on one-stop base is a clear advantage. More large sample sized studies on the cost-effectiveness of this approach versus colposcopically-guided positive histopathology are recommended before its universal spread

Abstract: Background: Egypt has a population of 28.37 million women aged 15- 44 years and older who are at risk of developing cervical cancer. Current estimates indicate that every year 866 women are diagnosed with cervical cancer and 373 die from the disease. Cervical cancer in Egypt ranks as the 10th most frequent cancer among women between 15 and 44 years of age. The study aimed to assess knowledge of female nursing students regarding risk factors of cervical cancer and to explore the association between educational stage and knowledge level of the students about cervical cancer. Subjects and Methods: Systematic sampling was used and self-administered questionnaires were given to 230 1st grade students (Junior) and 174 from 4th grade (senior), (100%) and (99%) respectively of whom responded. Results: A total of Three hundred and eighty-nine (n=398) students completed the survey questionnaire for a 100% response rate. knowledge score (86.2%) of the participants had thought their knowledge about cervical cancer was inadequate according to their answers for question. Conclusion: The low knowledge level of participants reflected the urgent need for modification of nurses curricula to include the cervical cancer prevention which increase female awareness based on improving female nursing students knowledge.

Abstract: Background: Egypt has a population of 28.37 million women aged 15- 44 years and older who are at risk of developing cervical cancer. Current estimates indicate that every year 866 women are diagnosed with cervical cancer and 373 die from the disease. Cervical cancer in Egypt ranks as the 10th most frequent cancer among women between 15 and 44 years of age. The study aimed to assess knowledge of female nursing students regarding risk factors of cervical cancer and to explore the association between educational stage and knowledge level of the students about cervical cancer. Subjects and Methods: Systematic sampling was used and self-administered questionnaires were given to 230 1st grade students (Junior) and 174 from 4th grade (senior), (100%) and (99%) respectively of whom responded. Results: A total of Three hundred and eighty-nine (n=398) students completed the survey questionnaire for a 100% response rate. knowledge score (86.2%) of the participants had thought their knowledge about cervical cancer was inadequate according to their answers for question. Conclusion: The low knowledge level of participants reflected the urgent need for modification of nurses curricula to include the cervical cancer prevention which increase female awareness based on improving female nursing students knowledge.

Abstract: E-learning has been suggested as an alternative approach that can provide graduates with a wide range of academic and employability skills. This study aimed to identify the attitudes of students and teaching staff in Faculty of Nursing, Assiut University toward e-learning. The present study conducted at Faculty of Nursing, Assiut University using a descriptive study design. The subjects were all teaching staff who volunteered to participate in the study (n= 90) and 650 students from the four levels at Faculty of Nursing, Assiut University who were selected using systemic random sampling technique, they constitute 50 % from the total numbers of students recruited at (2014-2015) academic year. Two tools were used in this study, first tool is Attitude towards electronic learning scale for teaching staff, and the second tool is Student attitudes towards e-learning scale for data collection. Results: More than two-thirds of teaching staff members have positive attitude towards e. learning, also, the studied students have positive attitude towards e. learning. All of the e-learning domains among the studied nursing students had statistical significant differences at P=0.001. Recommendations: All teaching staff should be encouraged to adopt e. learning strategies in their teaching courses. Future research using qualitative techniques to identify problems which appear in the use of ICT for e-learning. Maximizing the use of e. learning strategy in other non-nursing subjects.

Abstract: E-learning has been suggested as an alternative approach that can provide graduates with a wide range of academic and employability skills. This study aimed to identify the attitudes of students and teaching staff in Faculty of Nursing, Assiut University toward e-learning. The present study conducted at Faculty of Nursing, Assiut University using a descriptive study design. The subjects were all teaching staff who volunteered to participate in the study (n= 90) and 650 students from the four levels at Faculty of Nursing, Assiut University who were selected using systemic random sampling technique, they constitute 50 % from the total numbers of students recruited at (2014-2015) academic year. Two tools were used in this study, first tool is Attitude towards electronic learning scale for teaching staff, and the second tool is Student attitudes towards e-learning scale for data collection. Results: More than two-thirds of teaching staff members have positive attitude towards e. learning, also, the studied students have positive attitude towards e. learning. All of the e-learning domains among the studied nursing students had statistical significant differences at P=0.001. Recommendations: All teaching staff should be encouraged to adopt e. learning strategies in their teaching courses. Future research using qualitative techniques to identify problems which appear in the use of ICT for e-learning. Maximizing the use of e. learning strategy in other non-nursing subjects.

Abstract: E-learning has been suggested as an alternative approach that can provide graduates with a wide range of academic and employability skills. This study aimed to identify the attitudes of students and teaching staff in Faculty of Nursing, Assiut University toward e-learning. The present study conducted at Faculty of Nursing, Assiut University using a descriptive study design. The subjects were all teaching staff who volunteered to participate in the study (n= 90) and 650 students from the four levels at Faculty of Nursing, Assiut University who were selected using systemic random sampling technique, they constitute 50 % from the total numbers of students recruited at (2014-2015) academic year. Two tools were used in this study, first tool is Attitude towards electronic learning scale for teaching staff, and the second tool is Student attitudes towards e-learning scale for data collection. Results: More than two-thirds of teaching staff members have positive attitude towards e. learning, also, the studied students have positive attitude towards e. learning. All of the e-learning domains among the studied nursing students had statistical significant differences at P=0.001. Recommendations: All teaching staff should be encouraged to adopt e. learning strategies in their teaching courses. Future research using qualitative techniques to identify problems which appear in the use of ICT for e-learning. Maximizing the use of e. learning strategy in other non-nursing subjects.

Abstract : Death rate of liver cirrhosis is 41.6% in Egypt. It is important to assess the nutritional status of this group of patients and design nutritional regimen because these patients suffer from protein calorie malnutrition. The aim of this study was assessment of the impact of a designed nutritional regimen on patients with liver cirrhosis. Patient and Methods: 60 adult patients with liver cirrhosis as a study group and 20 patients as a control group, the study were conducted at Tropical Medicine and Gastroenterology Department at Asyut University hospital. Tools utilized for data collection were :( I) patient assessment sheet (II) nutritional assessment sheet, and (III) Construction of nutritional regimen. Results: The most common malnutrition risk factors were dry mouth, taste alteration, food intolerance, multiple medications and the presence of ascites. Number of patients who didn't suffer from malnutrition increased post implication of the nutritional regimen one and three months later. Conclusions: the application of the nutritional regimen for patients with liver cirrhosis showed an improvement in patient's nutritional status. Recommendations: Nutritional support and regimen, advice and guidelines by dietitian should be undertaken for all cirrhotic patients to prevent occurrence of complications of malnutrition and improve clinical outcome.

Abstract : Death rate of liver cirrhosis is 41.6% in Egypt. It is important to assess the nutritional status of this group of patients and design nutritional regimen because these patients suffer from protein calorie malnutrition. The aim of this study was assessment of the impact of a designed nutritional regimen on patients with liver cirrhosis. Patient and Methods: 60 adult patients with liver cirrhosis as a study group and 20 patients as a control group, the study were conducted at Tropical Medicine and Gastroenterology Department at Asyut University hospital. Tools utilized for data collection were :( I) patient assessment sheet (II) nutritional assessment sheet, and (III) Construction of nutritional regimen. Results: The most common malnutrition risk factors were dry mouth, taste alteration, food intolerance, multiple medications and the presence of ascites. Number of patients who didn't suffer from malnutrition increased post implication of the nutritional regimen one and three months later. Conclusions: the application of the nutritional regimen for patients with liver cirrhosis showed an improvement in patient's nutritional status. Recommendations: Nutritional support and regimen, advice and guidelines by dietitian should be undertaken for all cirrhotic patients to prevent occurrence of complications of malnutrition and improve clinical outcome.

Abstract : Death rate of liver cirrhosis is 41.6% in Egypt. It is important to assess the nutritional status of this group of patients and design nutritional regimen because these patients suffer from protein calorie malnutrition. The aim of this study was assessment of the impact of a designed nutritional regimen on patients with liver cirrhosis. Patient and Methods: 60 adult patients with liver cirrhosis as a study group and 20 patients as a control group, the study were conducted at Tropical Medicine and Gastroenterology Department at Asyut University hospital. Tools utilized for data collection were :( I) patient assessment sheet (II) nutritional assessment sheet, and (III) Construction of nutritional regimen. Results: The most common malnutrition risk factors were dry mouth, taste alteration, food intolerance, multiple medications and the presence of ascites. Number of patients who didn't suffer from malnutrition increased post implication of the nutritional regimen one and three months later. Conclusions: the application of the nutritional regimen for patients with liver cirrhosis showed an improvement in patient's nutritional status. Recommendations: Nutritional support and regimen, advice and guidelines by dietitian should be undertaken for all cirrhotic patients to prevent occurrence of complications of malnutrition and improve clinical outcome.