Prophylactic antibiotics have been shown to be effective in reducing the incidence of febrile morbidity associated with cesarean section after labor. However, the relative effectiveness of different single antibiotics has been studied infrequently. Several new broad spectrum antibiotics are now available, and any further benefit from more traditional antibiotics for surgical prophylaxis remains untested. A randomized clinical trial for testing the efficacy of cephalosporin versus Amoxicillin in preventing post cesarean section infection, and to identify the role of health education about wound care in reducing post cesarean section wound infection. This study conducted at emergency unit of the Obstetrics &Gynecological department, Woman's Health Center, Assuit University Hospital, between 2008 to 2009. Women's undergoing emergency and elective cesarean section were recruited into the study and given either drug as prophylaxis. The sample comprised 200 pregnant women. 100 pregnant women received Amoxicillin and the other 100 pregnant women received Cephalosporin as a prophylactic antibiotic. For each group, 50 women received routine hospital wound care and the other 50 women received health education about wound care. Random assignment was done by computer generated tables. Concealed envelopes containing the random number made to be opened after deciding to include the case in the study. the -present study reported that the percent of surgical site infection (SSI) of elective cesarean section was 2.5% (0.5% in Amoxicillin group and 2% in cephalosporin group) with no significant difference between both groups. We can concluded that use of Amoxicillin as a prophylactic antibiotic as effective as Cephalosporin in preventing post cesarean section wound infection. And women that received health education about wound care are less likely to expose to wound infection than those who receive only routine hospital care, in spite that the comparative results are not significant.

Exposure to pesticides may result in abnormal glucose metabolism, increasing risk of diabetes. The study was to investigate the relationship between maternal and infants residential pesticides exposure and the onset of diabetes in these infants. Both the diabetic infants and the control groups were recruited from the Outpatient Clinic for Diabetic children and Well Baby Clinic, Assiut University Children Hospital. The study included 72 infants divided into 2 groups study group (40 diabetic infants) and the control group included (32 infants). A structured questionnaire sheet was designed to collect data about mothers and their infants. The study showed that there was statistically significant difference considering the items of no consanguinity among parents of infants in the study group compared to those in the control group (52.5 % Vs. 40.6%, respectively P ≤ 0.02.).The percentage frequency of maternal exposure to residential pesticides was significantly higher for the patients group in comparison to the control group. (65% Vs. 31.2%, respectively, P- value 0.0001).Similarly, the percentage frequency of the diabetic infants exposed to residential pesticides was significantly higher than that for the control group. (47% Vs. 28.1%, respectively, P – ≤ 0.01). Moreover, the percentage frequency of exposure of infants to residential pesticides per week was significantly higher among the study group in comparison to their partners in the control group. P- ≤ 0.0001. In conclusion: Exposure of infants to residential pesticides both during pregnancy and after birth may be considered as a risk factor for developing diabetes mellitus in these infants. The study recommended that, further studies are needed to study the relationship of exposure to residential pesticides for developing diabetes by using the biochemical markers to detect the level of metabolites of these pesticides in these populations.

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Background: Children and adolescents with diabetes are at a greater risk for emotional and behavioral problems. Aim of the study was to assess behavioral, emotional and social difficulties of diabetic children and examine the association of these difficulties with demographic and disease related variables. Subjects and method: A cross sectional study of 423 diabetic children attended Sidy Galal health insurance outpatient clinic in Assuit city – Egypt was conducted. A similar number of healthy children matched for age, sex and socioeconomic status were included in the study as a control group used for comparison. Strength and Difficulty Questionnaire (SDQ) was used as a screening tool. The SDQ is a screening instrument consisting of five separate 5-item subscales for emotional symptoms, conduct problems, hyperactivity-inattention, peer problems, and prosocial behavior. Results: Most of diabetic children (92.9%) were in the abnormal group of the total score compared to 20.6% of the controls. In all SDQ subscales except prosocial, diabetic children had significantly higher percentages of abnormal indices than in controls (p value 0.001). Emotional, hyperactivity and conduct problems were significantly associated with age and sex of the child. Prolonged duration of illness was significantly associated with peer relationship problems. Glycemic control was not a significant risk factor for any problem. Conclusion: Many of diabetic children had behavioral and psychosocial problems. Age and sex of the child and duration of the disease were important determinants for these problems. Recommendation: Diabetic children need to be screened by psychologist and social worker to identify and manage any behavioral or emotional problems.

Quality of life as an individuals, perception of his/ her position in life in the context of the culture and value systems in which he /she lives and in relations to their goals expectations standards and concerns. This study was the first geographical location which helps such group of patients to describe changes in quality of life of patients with chronic heart failure undergoing permanent artificial pacemaker. Descriptive re- search design was adapted to conduit the study on 80 patients whit pacemaker implantation in coronary catheterization lab., at Assiut university Hospital. A structural interview sheet was developed for data collection to assess the quality of life among patients with permanent pacemaker. The tool content modified was done and translated into Arabic by researchers. Descriptive statistics calculated were frequency, percentage, chi-square and p-value. In the present study the patients characteristics, regarding age the majority of patients were in the age between 40-65 years although the majority of them were female and unskilled. 93.75% of total study patients were living in the rural areas 53.75% of them reported it as less them 6 months but 46.25% of them as more than 6 months. No significant relation was observed between patients education and self-concepts, although between patients psycho-logical assessment and duration of pacemaker implantation but there was a significant difference between patients occupation and physical activity.

Sleep disturbance is very common in patient with end stage renal disease (ESRD) on dialysis. ESRD patients reports a significantly poor subjectively quality of sleep in comparison to the general population.(ll the most frequently reported complaints are insomnia, restlessness syndrome, sleep disordered breathing and excessive daytime sleeplessness (EDSi2 ) The aim of this study was to assess the quality of sleep among patients with end stage renal disease (ESRD) undergoing hemodialysis unit of Assiut University hospital. The sample of study include 108 patients with end stage renal disease (ESRD) undergoing hemodialysis both male and females. A structural interview questionnaire sheet was used, it include sociodemographic, Pittsburgh sleep quality index (PSQI) (Buysse et aI, 1989) was translated into Arabic in order to assess the quality of sleep among patient with ESRD undergoing hemodialysis. The PSQI is useful in identifYing good and poor sleepers. A global PSQI score 75 indicate that a person is (poor sleeper). The results. The mean total and subtotal good and poor scores of PSQI, the mean total score were (34.3%) were good sleepers and (65.7%) were poor sleepers. Various strategies should be recommended to improve sleep. Sleep medication, anemia correction more frequent dialysis and assessment sleep.

Back ground and purpose: Hemodialysis patient are susceptible to muscle cramps, both during dialysis sessions as well as in the interdialytic interval, these cramps are often very painful disruptive to dialysis management & adversely affect quality of life there no well defined mean of preventing or treating these cramps. Exercises have been used with apparent success in some patient. Exercises is very important element in the overall health of people at any age stretching exercises may be the best measure to reduce or prevent cramps from occurring. So the present study was designed to determine the effect of stretching exercises protocols on reduction of leg cramp during hemodialysis among patient with renal failure. Quasi- experiment ( research design was applied. This study was conducted in kidney dialysis department of Assiut university hospitals. The subjects of this study consists of 60 patient with muscle cramps during hemodialysis. three tools included in the study, tools of soci - demographic data ,tools of patient information about muscle cramps & management & tool of evaluated patient knowledge & skills after performance exercises. Results: there was lack of knowledge & skills related to muscle cramps before nursing instruction protocol but there was statistical significant difference after performance of exercises. It was found also that high significance difference between before & after performance of exercises. Conclusions: the importance of performance exercises for patient undergoing dialysis to prevent cramps. there is clearly a need for effective education regarding recognition ,individual patient need & appropriate intervention strategies in muscle cramps in dialysis patient & nurses, in partnership with patient, relatives & careers & other health professional can help to empower the individual to mange their cramps.

Urinary diversion operations (urostomy) patients require a great deal of emotional and physical adjustment. They usually face many problems such as loss of body function and relationship with others, and change in life style. They need to adapt to the external appliance, stoma alteration in toileting habits, skin irritation problems, infection and odor problems. Self care of these patients considered the most important factor that can minimize the complaints and complications. The aim of this study was to evaluate the impact of nursing intervention among urostomy patients, regarding practicing self care. The sample comprised 100 urostomy patients, divided into two groups: 50 study and 50 control. For both groups, patients knowledge about urostomy and related self care performance were assessed before intervention, immediately after, and after six months follow up at out patient clinic. Data were analyzed using Epi-info 6.04 computer software package. Findings revealed statistically significant improvements in knowledge and performance among patients in the study group. The rates of complaints and complications were found to be lower in the study group than in the control one. The study suggests that urostomy patients should receive self care training regarding urostomy during hospitalization. Follow up at out patient clinic is highly recommended as well.

Body position is known to influence respiratory function in normal subjects & those with respiratory pathology. Its effect on respiratory function after stroke has received little attention. It's generally thought that stroke morbidity is increased by appropriate decision early recovery phase. So the present study was designed to identify changes in arterial oxygen saturation (Sa02) associated with different four positions of the patient in order to detect proper position which maintain the optimal level of Sa02. Quasiexperiment research design was applied in this study. This study was conducted in stroke intensive care unit of neurological department of Assiut University Hospitals. The subjects of this study consist of 60 patients with acute ischemic stroke within 48 hours following mild to moderate and severe stroke. Three tools were included in the study, tool of sociodemographic data, tool of the positions, & tool of the Scandinavian stroke scale. The result of the present study revealed that there was statistical significant difference between Sa02 & blood pressure of the patient before & after the positions. It was found also that total mean of Sa02 during right side, supine & semi sitting positions was nearly equal and that there was statistical significant difference between left position and 3 other positions. So the study recommended the importance of changing patient's positions which improve ventilation & blood pressure. The importance of the use of positions tested CRt. Side, supine & semi sitting positions) in the clinical practice to maintain Sa02 in patients with ischemic stroke.