Objective This study was designed to evaluate the role of music therapy on the level of stress in children undergoing repair of congenital heart disease. Design Prospective, randomized double blind controlled clinical trial Setting of the study Children University Hospital Patients 50 children in the age of 4 to 12 years undergoing repair of congenital heart disease Methods Patients were randomized into two equal groups (control group and music group); in control group patients listened to a blank CD, while in music group patients listened to a recorded CD by music and songs preferred by the child. Demographic data clinical data and preoperative vital signs were recorded. A baseline stress markers (blood glucose and cortisol levels) were sampled. Patients were assessed intra-operatively till extubation for vital signs, stress markers and after extubation for pain and sedation scales. An interview conducted within the first postoperative week with the patients and their parents for assessment of posttraumatic stress disorder and negative postoperative behavior changes. Measurements and Main Results No significant difference in demographic, clinical data, vital signs, preoperative and at extubation blood glucose levels and preoperative blood cortisol level between both groups. Significant difference in blood glucose and cortisol levels at all intraoperative times, while only in cortisol blood level at extubation. Significant differences in pain score, sedation score, occurrence of child posttraumatic stress disorder and occurrence of negative postoperative behavior. Conclusion listening to favourable music in children undergoing repair for congenital heart disease resulted in less stress and more relaxation.

Critically ill patients with acute renal failure who are receiving dialysis therapy may suffer from many complications that can be decreased by using bicarbonate dialysate during dialysis sessions. Aim: this study was carried out to compare between the hemodialized acute renal failure patientsusing bicarbonate versus acetate dialysate ondeveloping complications. Design: descriptive comparative designutilized in this study. Setting: This study was carried out at the kidney dialysisunit, Assiut University Hospital. Subjects Sixty adult male and female critically ill patients with acute renal failure who are admitted to the kidney dialysis unit (how many using bicarbonate and how many using acetate and how you selected them).Tool:“hemodialysis patient observational and monitoring tool” was used to monitor and record the personal and medical data needed for this study by the researcher.Methods: Interview, observation and reviewing patient`s records were utilized to collect data pertinent to the study. Each patient was monitored closely ten minutes before connection to the dialysis machine, during the dialysis session and ten minutes after disconnection, three times per week for two successive weeks. Results: The patients on the acetate group had experienced many problems (tachycardia, hypotension and dyspnea). There was a significant statistical difference between both groups with (p value=0.001). Conclusion: the group of patients on bicarbonate dialysate during dialysis sessions was found to experience lesser problems than acetate dialysis group.

Critically ill patients with acute renal failure who receiving the dialysis therapy were suffered from many complication: dialysate during hemodialysis session. Aim: this study was carried out to investigate the effect of nursing guidelines for Complications of acetate and bicarbonate Solutions during hemodialysis among acute renal failure patients, Assuit University Hospital. Design: Quasi experimental design. Setting: This study was carried out at hemodialysis unit, ICUs Assuit University Hospital. Subjects: Sixty adult male and female critically ill patients with acute renal failure who are admitted to hemodialysis unit. Tools: Two tools were developed by the researcher and used in this study which are; tool I: Personal and medical data sheet and hemodialysis, tool II: Hemodialysis complications assessment sheet. Methods: Interview, observation and reviewing patient`s records where utilized to collect data pertinent to the study. Each patient was monitored closely and give nursing care for ten minutes before connection, during the dialysis session and ten minutes after disconnection from dialysis machine three times per week for two successive weeks. Results: The acetate groups had experienced many complications rather than bicarbonate. There was a significant statistical difference between both groups with (p value=0.001). The complications developed where, hypotension, chest pain, dysrhythmia, muscle cramps, nausea, vomiting, headache, pruritus. Conclusion: Nursing care reduces complications for both groups acetate and bicarbonate dialysis documented lesser complications in bicarbonate than acetate group. Recommendation: Replication of this research on a larger probability sample acquired from different geographical areas in the Arab republic of Egypt. [Naglaa Elrashedy, Warda Mohammed, Mona Mohammed, Mervat Abdel-Aziz and Maher Abd El Naser. Effect of Nursing guidelines to reduce Complications of Acetate and Bicarbonate Solutions during Hemodialysis among Acute Renal Failure Patients, Assuit University Hospital.

Objective: To assess impact of tactile stimulation on neurobehavioral development of premature infants in Assiut City. Design: Quasi-experimental research design. Setting: The study was conducted in the Neonatal Intensive Care Unit at Assiut University Children Hospital, Assiut General Hospital, Health Insurance Hospital (El- Mabarah Hospital) and El-Eyman for Gynecology and Obstetric Hospital. Subjects: The study subjects included a convenient sample of 50 premature infants divided into study or control groups and they were matched with gestational age and birth weight. Tool: Brazelton Neonatal Behavioral Assessment Scale is used to assess neurobehavioral development of infants from birth to two months of age. Method: Premature infants divided into two groups; (a) study group who receiving tactile stimulation (b) control group who receiving routine hospital care only. Neurobehavioral development using Brazelton’s Neonatal Behavior Assessment Scale (NBAS) was assessed at initial contact and after 5 days of intervention and on discharge. Results: showed that the premature infants of the study had better neurobehavioral development than those in the control group with statistical significant differences were found between the study and the control groups Conclusion: It was concluded from the findings of the current study that premature infants who received tactile stimulation had better neurobehavioral development than those who didn’t receive it and had only the hospital routine care.

The aim of the study is to develop nursing care standards for cancer patients undergoing chemotherapy. A study was conducted in oncology unit and outpatient clinic of oncology at Assiut university hospitals. To accomplish the purpose of this study data were collected from all head nurses and nurses works in oncology unit and out patient clinic of oncology (30), physician (24) who had an experience in the field of the study for determining the basic competencies. Tool utilize for data collection were Health team opinionnaire sheet, Nurses knowledge standards level test for cancer patient undergoing chemotherapy, and Nurses performance observation standards level checklist for cancer patient undergoing chemotherapy. The results show that the majority of physician and nurses agreed about all competencies to be performed by physician and nurses whom works at oncology field as these competencies required for cancer patients undergoing chemotherapy, as regard nurse's knowledge about cancer there was a highly significant statistical difference between four stages (Pre, Immediate, after one month, and after three months) application of standards. On pre standards application 53.3% of study group were Poor in knowledge, on immediate standards application 100% of study group were good in knowledge, after 1 month of standards application 80% of study group were good in knowledge, and after 3 months 60% of study group were satisfied in knowledge, and regarding to nurse's performance the results show that the level of performance improved in all procedures immediately, after one month and after three months than pre- standards application.

Background: Breast milk has antimicrobial and healing properties that actually can help the wound healing. Surgical neonates are at a much higher risk for malnutrition as a result of increased metabolic demands from surgery, nutrient losses, and sepsis. Many methods of feeding are used postoperatively for neonates; oral feeding (breast milk or formula milk), enteral, or parenteral feeding. Aim of this work was to assess the relation between feeding types and surgical wound healing of neonates after. Methods and materials: Comparative descriptive research design was used to carry out this study. It comprised 100 neonates aged less than one month, they were divided into two equal groups as the following: Group 1: received breast milk feeding, Group 2: received formula milk feeding. Tools were developed by the researcher, after that the researcher fulfill assessment sheet and took the photographs were taken by the researcher on the 7th postoperative day and reassessed for second time on the 14th day. Results: Out of the included neonates received breast milk feeding, 78 % were boys, while 22% were girls. Also in the formula-feeding neonates, the majority (58%) of formula feeding neonates' wounds were inflamed, while less than one third (30%) of breast milk feeding neonates' wounds were inflamed during the 7th day. On the other hand 38% of formula fed neonates' wounds were inflamed, while only 8% of breast milk feeding neonates' wounds were inflamed during the 14th day. Conclusion, neonates received breast milk feeding have rapid sound healing, less wound inflammation and receiving more number of daily feeding than formula feeding neonates.

Breast milk has antimicrobial and healing properties that actually can help the wound healing. Surgical infants are at a much higher risk for malnutrition as a result of increased metabolic demands from surgery, nutrient losses, and sepsis. Many methods of feeding are used postoperatively for infants; oral feeding (breast or formula milk), enteral, or parenteral feeding. Aim of this work was to assess the effect of breast-feeding versus formula feeding on surgical wound healing in infant during the first three months. Methods and materials: Comparative descriptive research design was used to carry out this study. It comprised 100 infants aged less than 3 months, they were divided into two equal groups as the following: Group 1: received breast milk feeding, Group 2: received formula milk feeding. Tools were developed by the researcher, after that the researcher fulfill assessment sheet and took anthropometric measurements for each infant then the photographs were taken by the researcher on the 7th postoperative day and reassessed for second time on the 14th day. Results: Out of the included breast-fed infants, 78 % were boys, while 22% were girls. Also in the formula-fed infants, the males were 64%, while the females were 36 %. As a general statistically significant difference was found between anthropometric measurements. The majority (58%) of artificially fed infants' wounds were inflamed, while less than one third (30%) of breast-fed infants' wounds were inflamed during the 7th day. on the other hand 38% of artificially fed infants' wounds were inflamed, while only 8% of breast-fed infants' wounds were inflamed during the 14th day. Conclusion, breast-fed infants have rapid sound healing, less wound inflammation, higher anthropometric measurements, receiving more number of daily feeding, fewer disturbances in urinary tract and gastrointestinal tract and had normal laboratory results than artificially fed infants.

Nursing care standards of colostomy are significant action to ensure quality of care. The examination of nurses’ knowledge and practices regarding the nursing care standards of colostomy has not been conducted before at Assiut University Hospital. This descriptive study aimed at establishing the level of nurses’ knowledge and practice and to examine the relationship between nurses’ knowledge and practice for developing the nursing care standards of colostomy. The subjects were nurses working in the surgical wards of hospital. The Nurses’ Knowledge Questionnaire and Practice checklist were administered. Data were analyzed by descriptive statistics and Pearson product-moment correlation. The findings revealed that all of nurses (100%) had knowledge about the standards regarding colostomy at an unsatisfactory level (M ± SD = 29.8654 ± 8.34085) with the maximum mean scores (M = 0.8269)and minimum mean scores (M =2.2308). All of nurses (100%) scored the actual nurses' practice of the standards at an unsatisfactory level (M ± SD = 111.51 ± 25.706) with the maximum mean scores (M = 19.42) and minimum mean scores (M = 2.4615). It was found that there was a positive weak relationship between knowledge and practice regarding nursing care standards of colostomy(r = 0.15, p = .3).It was concluded that nurses' knowledge and practice in the nursing care standard of colostomy were unsatisfactory. It was needed to be improved through implementation of proposed nursing care standards of colostomy.

Aims: to assess patient caregiver's knowledge and practice toward safe handling chemotherapy, development of suggesting guidelines for patient caregivers toward safe handling chemotherapy. Methods: a study was conducted in oncology unit at Assiut University hospitals. To accomplish the purpose of this study data were collected from all patient caregiver in oncology a convenience sample of all available patient caregivers about (60) male and female working in oncology department who were participated in this study, who are currently assigned and provide care for adult patient with chemotherapy, in period from preparation until 72 hour post administration, it consist of (20) nurses, (20) worker and (20) patient family member. Tool utilize for data collection were an Arabic structured interview questionnaire sheet for patient caregivers and observation checklist for patient caregivers. Results: the result implies that there was lack of nurse's knowledge about chemotherapy with percentage (95%).In addition workers had low knowledge about chemotherapy with percentage (50%, 85%, 65%and 45% respectively).Family member had low knowledge regarding knowledge about cancer and chemotherapy at high percentage of score with percentage (85%, 100%and 80 respectively). And there is lack of practice related to there are some equipment are not applicable (use ducted bio-safety cabinet, a long sleeved gown, safety spectacles or goggles, spill kit).Conclusions: recommendation, further research studies are needed to focus on more training and education for patient caregivers toward safe handling chemotherapy and health monitoring for health care worker to prevent or reduce risk of exposure.

Careful and regular assessment of pain improves the perception of nurses concerning the impact of pain on their patients' lives to enhance the quality of its management. Monitoring pain as the fifth vital sign is currently practiced in many developed countries. Therefore, the present study aimed to apply of a proposed graphic chart for pain as fifth vital sign in nursing practice in Assiut University Hospitals- Egypt. An exploratory descriptive research design was carried out in five units including (medical, surgical, burn, trauma & orthopedic units). The study subjects consisted of 60 nurses available at the time of the study. An interview questionnaire, nurses’ opinionnaire scale, nurses’ audit and proposed five vital signs graphic chart were used for data collection. Results revealed that nurse’s mean age ± SD was (27.85±7.82) years, years of experience mean ± SD was (7.40±3.94) years. The majority of nurses agreed upon chart feasibility (81.7%) & quality of pain care (83.3%). Overall 83.3% of the nurses agreed upon the proposed graphic chart. Auditing of patients files revealed full application of the new change by 93.3%, 63.3% of nurses for graphic part &70 % for pain assessment part. It is concluded that the majority of the nurses had full application of the proposed change & it is recommended to be implemented in nursing practice in different health settings. Nurses need to be accountable to improve their knowledge and skills in assessing pain, which necessitates implementing educational programs through in-service training and continuing nursing education. It is also necessary for hospitals to require nurses’ notes on their charts for pain assessment and management.