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Al-Azahar Assiut Medical Journal September 2010, Vol.8 N.(3) Impact of child labor on psychosocial development of under fourteen years in Assiut city, Egypt. Eman S. Masoud,1 Salwa A. Marzouk2 and Safaa R. Mahmoud3 1Pediatric Nursing department, faculty of Nursing, Minia University and 2Pediatric Nursing department,3 Community health, faculty of Nursing, Assiut University. Abstract: Child labor is a pervasive problem in Egypt. For the last two decades there has been growing concern for child labor across the globe and several efforts are being made by the governments and civil society organizations to eliminate child labor. It has a great impact on child health whether psychosocially or physically. Objectives: this study aimed to assess the impact of child labor on the psychosocial development of under fourteen years in Assiut. Design: A descriptive research design was used in this study. Subjects and Methods: The study was conducted on 248 children divided equally into two groups (working children and school children). Data are collected using an interview questionnaire sheet. Results: the present results revealed that children work because the family is in need of financial support or children fail in school. Also, the results revealed that working children had lower score of anger control and had elevated scores regarding excessive suffering and weak ego strength. Conclusion: Even work has negative effect on their Psychosocial condition, but it also has positive effect as the children become independent. From the study results the researcher recommended that the ministry of manpower must have strict enforcement and real application of existing law against all forms of child labor.

Hearing impairment is common among older adults. The study aimed to assess the quality of life among hearing impaired elderly patients attending audiology unit at Assiut University Hospital. Descriptive research design was used in this study. Total coverage of all elderly patient with hearing impairment and agreed to participate in the study during six months from 1st of November/2014 to the end of April/2015) were included in the study, their number were 227 patients. Two tools were used in data collection, tool I: Structured interview questionnaire sheet: include two parts, part I: include personal data as, age, sex, residence, part II: include onset type and degree of hearing impairment. Tool II: Quality of life scale. The main results showed that the majority of the participants (80.6%) aged (60-¬74) years. The mean age was 68.4± 7.4, more than two-third of the studied sample were male. There was a statistically significant difference between hearing impairment among elderly and quality of life. It concluded that age related hearing impairment (presbycusis) had adverse effects on physical, self-dependence, psychological, social relationships, and environmental features. Also, it recommended that increasing elderly awareness about the importance of regular ear examinations for early detection, treatment, and prevent complications.

Background: The aim of the study was : To assess nurses' knowledge and practice regarding patients undergoing coronary artery bypass graft surgery, to design nursing care protocol for nurses, and to evaluate the effect of implementing the designed nursing protocol on nurse's knowledge and practice. Three hypotheses were formulated: (1) the post mean knowledge scores of nurses who will expose to designed nursing protocol will be higher than their pre mean knowledge scores. (2) The post mean practice score of nurses who will expose to designed nursing protocol will be higher than their pre mean practice scores. (3) A positive relationship will exist between knowledge and practice score obtained by nurses receiving the designed nursing protocol. Research design: Quasiexperimental research design was utilized in this study. Tools: Three tools were utilized for data collection were a) structured interview sheet. b) Observation checklist sheet. c) Construction of designed nursing protocol. Results The first and the second hypotheses were supported as a good improvement in the mean knowledge & practice scores. Conclusion: implementing of designed nursing protocol showed a significant improvement in nurses` knowledge and practice. Recommendations: Nurses are in need for in-service training programs and refreshing courses to improve their knowledge.

Abstract: Coronary artery bypass grafting (CABG) is a common surgery to treat coronary artery disease. It involves a section of a vein or an artery to create a connection (or bypass) between the aorta and the coronary artery beyond the obstruction. Aim: This study aimed to assess nurses' knowledge and practice regarding patients undergoing coronary artery bypass grafting, to develop nursing care standards for coronary artery bypass grafting on patient's outcome, and to evaluate the effect of implementing nursing care standards on nurse's knowledge, practice as well as on patient's outcome. Methods: Quasi-experimental research design was utilized to conduct this study, the study was carried out cardiothoracic surgery department, post operative intensive care unit, and operating room at Assiut University Hospital. Sample: A convenient sample included (38) nurses and (40) patients who had CABG (20) patients pre and (20) patients post implementing nursing care standards aged from 18-65 years from both sexes. Tools: a) pre/post structured interview sheet. b) pre/post observation checklist sheet. c) Cardiac surgery patient's assessment sheet. d) Construction of nursing care standards booklet. Results: The first and second hypotheses were supported as a good improvement in the mean knowledge and practice scores were found post implementation of nursing care standards. The third hypotheses were supported as postoperative complications were reduced post nursing care standards implementation. The fourth hypotheses were supported as a positive relationship was found between nurses` knowledge and practice scores immediately post nursing care standards implementation. Conclusion: Improving nurses` knowledge and practice can favorable affect the incidence of coronary artery bypass graft surgery patient's complications. Recommendations: in-service training programs and refreshing courses must be applied to improve nurse's knowledge which will reflect into their practice while working with patients.

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 : 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.