Abstract: Extra-cranial metastases of malignant gliomas such as glioblastoma (GBM) are rare. 3 Cases were reported in this evaluation with spinal leptomeningeal metastasis in patients suffering from cerebral glioma / glioblastoma multiforme with radicular pain in the extremities.
Patients and Methods: The first patient (male, 34 years old) suffered from hemiparesis 2 years after the craniotomy and micro-neurosurgical extirpation of astrocytoma WHO II° then anaplastic astrocytoma WHO III° right frontotemporal. The second patient (female, 43 years old) developed a spinal channel metastases of a brain stem GBM approximately 9 months after surgical resection and radio-chemo-therapy. In the third case (male, 21 years old), initially a thoracic spinal intramedullary GBM was operatively excised with a postoperative paraplegia. In the following period of time the diagnosis of a cerebral GBM was performed by a stereotactic biopsy method. All specimens in the 3 cases were confirmed histopathologically.
Results: In the first patient, who was initially operated for astrocytoma WHO II° and then later the recurrence was diagnosed after excision as anaplastic astrocytoma WHO III°, for him a lumbar spine hemilaminectomy was performed after a concomitant radio-chemotharapy and stereotactic irradiation, whereas after the surgery a further irradiation therapy was necessary. A significant regression / improvement of the neurological symptoms was registered. Intraspinal metastases of the second patient were treated by irradiation therapy with significantly withdrawal of the symptoms, which was necessary due to reduced clinical and deterioration of the neurological state of the patient. A Partial improvement of the neurological symptoms was observed in the third patient during and after the chemotherapy.
Discussion: Reported cases of intraspinal dissemination from the primary intracerebral glioma tumor have varied and as in the presented cases in this series, intraspinal metastases have also been observed in patients with stable intracerebral disease. Typically, the incidence of symptomatic intraspinal metastasis has been lower than the incidence observed post mortem because patients do not survive long enough for small tumor implants to develop into symptomatic lesions. However, with improved outcome observed from newer treatments and improved diagnostics the incidence is likely to increase in the future.
The management of the three patients in this series was optimized through the modern diagnostic measures leading to improve the clinical condition despite the bad overall prognosis.
Conclusions: Spinal spread of malignant glioma should be considered during care and follow-up investigations in patients with this diagnosis and with spinal symptoms. The surgical therapy seems to offer benefits for these patients. The radio-chemotherapy can be helpful in this cases as well. Further examinations and studies are necessary to be performed in order to understand more about the etiology, clinical course, interrelationship and coherence of these findings.
Keywords: Cerebral glioma, glioblastoma multiforme, anaplastic astrocytoma, intraspinal dissemination, malignant brain tumors, extra-cranial metastases, cerebrospinal fluid (CSF), intracranial pressure (ICP), symptomatic intraspinal space occupying lesion (SOL).
Title: A Series of 3 Cases of Cerebral Glioma with Intraspinal Dissemination: Evaluation and Review of the Literature
Author: Dr. Munthir J. M. Al-Zabin, Professor Dr. Hartmut Krieg
ISSN 2394-7330
International Journal of Novel Research in Healthcare and Nursing
Novelty Journals

Abstract: As nursing technology advances, nurses are faced with numerous moral, professional, and ethical dilemmas for which they must make decisions based on their knowledge and personal beliefs. Nursing professional values facilitate working through ethical dilemmas.
Aim: To explores the values held by nursing students at the faculty of Nursing, Menoufia University.
Methods: Using a descriptive design, a convenience sample of 971 nursing students enrolled from first, second, third and fourth year at Faculty of Nursing, Menoufia University. The Nursing Professional Values Scale-Revised (NPVS-R) was used.
Results: The mean scores of the NPVS-R for participants ranged from 2.91 to 4.08 with the total mean score of 3.56 (SD = 0.30). The three statements rated by participants as the most important were “Maintain confidentiality of patients”; protect health and safety of the public”; and “safeguard patients’ right to privacy”. Whiles the least important items were “participate in public policy decisions affecting distribution of resources”; “participate in peer review” and “Engage in on-going Self- evaluation”.
Conclusion:   Awareness of nursing faculty of the need for strong professional values is important in preparation of nurses capable of managing patient in an ethical and professional manner.         

Abstract: Patients with cervicobrachialgia and cervical spine stenosis can be treated by a ventral discectomy and implantation of prosthesis. Retrospectively, a study of the cases between 2003 and 2013 was performed with an evaluation of the clinical course and follow-up.
Materials and Methods: Between May 2002 and August 2003, 50 cases were treated, in 2008 there were 248 cases, whereas a ventral discectomy was performed with implantation of a Bryan cervical prosthesis. Only 50 operated cases were followed up until January 2013. The mean age was 45 years (range 31 – 64 years), 25 males, and 25 females.
Results: Prior to surgery 20 Patients had pain > 50 on VAS, 5 years later about 4 patients. Motor deficits were in 11 patients prior and in 5 patients after the surgery, but in all cases there was a significant improvement. 8 Patients had sensory deficits prior and 8 after the surgery. No myelopathy has been occurred after 5 years, prior to surgery in 3 cases this was observed. Ability to work: 11 full time, 4 part time, 1 unable to work and 4 retired. Back to work ratio 85%. About 20 out of 50 patients were available for reexamination and interview after the implantation of the prostheses. 18 were very satisfied with the outcome, 19 would do the surgery again and 19 would recommend this operation to a friend. Radiological findings: ratio of motion > 2° in 33 patients, < 2° in 11 patients and in 6 patients heterotopic ossification had occurred. There is no statistical correlation between clinical outcome and rate of motion. Correlation after Pearson: ODOM p= 0.27 and 0.247 respectively. Complications: Voice: One permanent paralysis of recurrent nerve. Bleeding: In 2 patients with re-bleeding a surgical evacuation was required on the day of surgery with uneventful further recovery. Dislocation of prosthesis: one patient with uneventful complete recovery after surgical replacement. So far there was no single case of infection or removal of prosthesis.
Conclusions: Implantation of cervical disc prostheses is not associated with an increased risk for the patient as compared to conventional fusion. A preservation of motion for several years in 70% to 80% may be expected. Cervical disc prosthesis appears to be particularly practicable in younger age groups up to the age of 65 years. The long term effect of the prosthesis on adjacent level disease in comparison to fusion is unclear as of yet.
Keywords: Cervicalgia, cervical disc prosthesis, cervical spinal canal stenosis.
Title: A Five Year Experience with Cervical Disc Prosthesis and Review of the Literature
Author: Munthir Al-Zabin, Dieter Hoffmann
ISSN 2394-7330
International Journal of Novel Research in Healthcare and Nursing
Novelty Journals

Abstract: Adrenal insufficiency is common but underdiagnosed. It develops in critically ill patients. Hypotension is a frequent observation caused by adrenal insufficiency in severely cerebro-cranial traumatic and brain-injured patients.  This type of hypotension is refractory to fluid substitution, and the application of vasopressors is often required. The investigation of adrenal insufficiency seems to be essential, whereas current data suggest that treatment with glucocorticoids are necessary to improve clinical outcome.
Objectives: Determination of the role of the hypothalamic-pituitary-adrenocortical system (HPAS) after brain injury. Investigation of the relationships between adrenocorticotropic hormone (ACTH), cortisol levels, and clinical condition of the patients.
Materials and Methods: Patients with traumatic brain injury (TBI, n=19), subarachnoid haemorrhage (SAH, n=8), intracerebral haemorrhage (ICH, n=5), cerebral hypoxia (Hypoxia, n=5), other neurological diseases (Others, n= 5). Measurement of ACTH and Cortisol values basal and after stimulation with CRH (100 µg i.v.): -15, 0, 15, 30, 45, 60, 90, 120 min.
Statistical Evaluations: Areas under the curve (AUC) were calculated and ANOVA test was performed for statistical evaluations. P values less than 0.05 were considered as significant.
Results: The evaluation of the measurements of ACTH and Cortisol values basal and after stimulation with CRH has mainly depended on the clinical conditions of the patients.  The calculations of the statistical results have been considered, whereas it was ensured, that the patients have passed the eventually complication of brain oedema.
Conclusions: Brain injuries mainly exercise influence over the above-mentioned hypothalamic-pituitary-adrenocortical system (HPAS) depending on the severity of the trauma. The results of this study indicate that investigation of HPAS hormones might be useful as an additional method in the common complex of ordinary examinations in establishing an early prognosis and improving the treatment of patients with brain injury.

Abstract: Degradation of extracellular matrix (ECM) is an essential prerequisite for invasive growth of brain tumours. There is evidence from investigations of CNS-neoplasmas that secreted proteolytic enzymes may facilitate tumour invasion by partial degradation of ECM. Among the enzymes which may be involved are cysteine proteinases, especially cathepsin B (CB) .
Cathepsin B is a lysosomal tissue proteine, which in cooperation with other enzymes is responsible for degradation of ECM and basement membrane (BM) components in gliomas. CB participates in the proteolysis and decomposition of laminin which is part of the basement membrane. Furthermore, CB probably can also degrade fibronectin and type IV-collagen, which are important components of ECM.
In the present investigations 78 oligodendrogliomas were examined immunohisto-chemically for CB-expression and increased levels of CB-expression were found in high grade oligodendroglial tumours.
Upregulation of CB-expression correlated in the present study with tumour dedifferentiation and in high-grade oligodendrogliomas the expression of CB correlated negatively with survival.

Abstract: Emotional intelligence has a great effect on the quality of learning  and application of the learned knowledge in practice. The aim of the current study is to compare the nursing students, emotional intelligence skills between Riyadh (Saudi Arabia) and Tanta (Egypt), A comparative study design was used for   the current study ,Data was collected from two settings Namely King Saud University (Riyadh) and Tanta University (Egypt)  ,The subject of this study was composed of 400 students who chosen by a convenience sample from previous mentioned settings to ensure representativeness ,One  tool was used to collect data for the current study, It consisted of two parts : part one A Socio-demographic and Academic Data Questionnaire: Part two ,Emotional intelligence scale   to assess the students’ emotional inelegance  which is a 33‐item scale. The results of this study revealed that there was a high statistical significant difference between Tanta and Riyadh students regarding their emotional intelligent mean score in several items. In addition to statistically significant positive relationship between total emotional intelligence and scores mother’s education and family incomes (p = 0.004 and p = 0.034 respectively) for Tanta students.  The study concluded:  the Riyadh student got high total emotional intelligence scores compared to Tanta students. Recommendation: Based on the results of this study we recommend that emotional intelligence concept should be incorporated into the nursing curriculum in order to promote growth of the student’ emotional intelligence abilities needed to work with patients in different clinical settings.

Abstract: Lesions of the third ventricle can have a variety of clinical manifestations. Masses related to the anterior recesses or floor of the third ventricle may manifest as dysfunction of the hypothalamic–pituitary hormonal axis. Masses of the posterior wall of the third ventricle, foramen of Monro masses, and intraventricular masses often manifest as hydrocephalus and headaches. Some congenital cysts or acquired abnormalities, such as cavum veli interpositi cyst and ectatic basilar artery, respectively, may be incidental imaging findings but distort the normal anatomy of the third ventricle or mimic more serious disease.
Objective: 33 Patients (18 female, 15 male, age 13-82 years) with occlusive hydrocephalus due to intraventricular processes were treated with endoscopic technique with the aid of neuronavigation.
Methods: In these cases the endoscopical cystoventriculostomy and biopsy has been selected as operation method. The neuronavigation has been used for the optimisation of the operation approach. For diseases in the area of the 3rd ventricle there are threee possiblilities: microsurgery, stereotaxy, and endoscopic method. In patients with unclear diagnosis and other clinically limiting conditions the endoscopic guided method as a minimally invasive method should be selected.
Results: With the endoscopical method the intraventricular processes could be visualized. A necessary haemostasis could be performed under direct vision in case of eventually occuring bleeding. In addition to the biopsy extraction the occlusive hydrocephalus could be also treated with this method in approximately 64% of the patients. There were no complications or bleedings postoperatively. There was in 70-90% of the cases a reliability of histopathological diagnosis. In comparison with the stereotactic method it has the same grade of accuracy. (Mennel HD et al, 1994, Zentralblatt für Neurochirurgie). There has been no morbidity or mortality postoperatively in consequence of this treatment.
Conclusions: This method of neurovavigation-assisted, endoscopical biopsy and cystoventriculostomy has in comparison with the stereotactic method the same grade of accuracy and reliability. It has also more advantages, such as visualization of the operation area and avoiding of complications postoperatively. The hydrocephalus can also be treated concurrently in the most cases.

Abstract: This is a 7-year retrospective analysis with the primary objective of noting the incidence of pituitary tumor recurrence after transnasal trans-sphenoidal approach using neuronavigation and operating microscope under a single operating unit. The secondary objective was to identify the type of tumor with highest secretory over activity and operative complications. The follow up period ranged between one to seven years. The result of this analysis indicates that the tumor size ranged between 5.7 X 5.7 mm to 42 X 24.5 mm. Headache was the commonest presenting symptom in 84.7% cases. The incidence of functioning adenomas in this series was 64.4% with prolactin being the dominant over secretory hormone in 47.4% cases. We noted an overall recurrence rate of 20.3%. The most important complication was a CSF leak noted in 13 patients (22.0%). CSF leak was fully cured in all patients by using a lumbar drainage catheter and/or placement of fat at the leakage site. There was only one mortality is this series.
Keywords: Pituitary tumors, neuro-navigation, trans-nasal trans-sphenoid excision of pituitary tumor.
Title: Pituitary Tumors: A 7-Year Retrospective Analysis of Outcome Following Neuronavigation Guided Trans-Nasal, Trans-Sphenoidal Microscope Aided Excision
Author: Ali M Al-Mashani, Munthir Al-Zabin, Maimuna Al Saadi, Neeraj Salhotra, Azmat Ali
ISSN 2394-7330
International Journal of Novel Research in Healthcare and Nursing
Novelty Journals

Abstract: Capacity development is about strengthening the abilities needed for successfully performing tasks, achieving results, identifying problems, finding solutions and taking sound decisions in the respective professional and living environments. Every citizen shares a responsibility of having basic first aid knowledge in case of emergency as we have to undergo such situations in our day today life. Aim: This study aims to enhance awareness of female rural leaders about first aid activities using capacity development approach. A Quasi experimental design was utilized. Setting: This study was conducted at Care of Menoufia Students' Association hall, which used for teaching. This association follows the Ministry of Social Affairs Shebin El kom, Menoufia governorate. Sample: A convenience sample of 200 female rural leaders who chosen by the Ministry of Social Affairs Shebin El kom, Menoufia governorate. They participated in the training at their request. Tools: 1. Self-administered structured questionnaire which involved socio-demographic data and knowledge of female rural leaders about first aid. 2. Observational checklist of subjects about first aid activities. The main result of this study showed that there was significant improvement in the knowledge and practice of female rural leaders' about first aid throughout the stages of capacity development. Additionally, there was statistically significant relation between knowledge of studied samples and their level of education.  Conclusion: capacity development approach was effective in improving knowledge and practice of female rural leaders about first aid activities. Recommendation: Use capacity development approach in teaching and learning the entire first aid skills to all individuals, aggregate and the entire population.

Abstract: Medical conditions, including ulcerative colitis or colon cancer, may necessitate a colectomy. The impact of a colectomy on patient's diet depends on how much of the colon remains after surgery. Total colectomy requires significant adjustment of eating habits and fluid intake. Nutrient deficiencies may occur after intestinal surgery due to mal-absorption, poor dietary intake, intestinal losses Aim: to determine the effect of nutritional educational intervention on improving dietary habits among recovering colorectal cancer patients. Hypothesis: Patients who will receive the nutritional educational intervention are more likely to have better dietary habits than before the nutritional educational intervention. Design:  Quasi experimental research design was utilized.  Setting: Surgical departments “male and female “at King Abdul Aziz University Hospital, Jeddah, KSA. Sample: purposive sample consists of all patients admitted to King Abdulaziz University Hospital was selected "30 patients"; 17 males and 13 females who diagnosed as colorectal cancer. Tools: 1) a structured questionnaire to assess socio-demographic data, medical information and types of intervention for studied patients. 2) Bio-physiological measurement tool to examine the anthropometric measurement and bio-chemical Values before & after nutritional educational intervention. 3) 24 hours’ Dietary recall was used to determine food history and dietary habits before & after nutritional educational intervention. Results: The total mean age was 51.96±1.02. A colon cancer represents 83.33% of cases whereas 16.66% had rectal cancer. A largest percent of the studied sample undergoing intervention with Surgery + chemotherapy and surgery was 43.33%, 26.66% respectively. A statistical significant difference was found between CEA, WBC, RBC, HCT, MCV, Platelet count, and Albumin for female of colorectal cancer patients. Conclusion: The nutritional educational intervention had better effect on improving dietary habits among recovering colorectal cancer patients. Recommendations: Developing strict written guidelines with colored pictures about prohibited, allowed nutrition and self-care for colorectal cancer patients.
Keywords: Nutritional Educational Intervention-Dietary Habits- Colorectal Cancer.
Title: Effect of Nutritional Educational Intervention on Improving Dietary Habits among Recovering Colorectal Cancer patients
Author: Magda M. Mohsen, Wafaa H. Abdullah, Thanaa A.  El Kholy, Hatim Al-Abbadi
ISSN 2394-7330
International Journal of Novel Research in Healthcare and Nursing
Novelty Journals

Abstract: Self-efficacy could be a key part of a nurse's competency or ability, therefore, a nurse who lacks a precise understanding of these competencies puts self and others in danger and without self-awareness, nurses are unable to display empathy with others. The aim of the study was to promote self-awareness and self-efficacy for psychiatric nurses. Design: A quasi-experimental design was used to conduct the current study (pretest -posttest). The study was completed in Outpatient Clinics and inpatient department Psychiatric Hospital in Mit-Khalaf at Menoufia, Egypt. A non-probability sampling of fifty psychiatric nurses from the previously mentioned setting was recruited. Tools of the study comprise a Nurses Characteristics Data Form, Self- Efficacy Scale and Self-awareness Scale. Results of the study: nurses' self- efficacy was 50.2±4.88 pre- intervention but increased to 68.1±2.78 post- intervention, nurses 'awareness was 62.2±4.71 pre intervention but increased to 69.4±2.01 post intervention .Conclusion: the intervention has a positive effect on self -awareness and self –efficacy among psychiatric nurses. Recommendations: self awareness and self –efficacy education should be applied for psychiatric nurses and nursing students to be able to take care of psychiatric patients.             

Abstract: Sleep is a vital part of a healthy lifestyle, but with technological advances, there are number of growing factors that can inhibit this vital function and causing poor sleep quality. The aim of this study was to examine relationship between nighttime technology devices use, stimulant drinks intake and sleep quality among adolescents students. Design: Descriptive correlation design was used. Setting: The study was conducted at four preparatory and secondary governmental schools from both rural and urban schools in Menouf District, Menoufia Governorate, Egypt. Sample: A multistage stratified random sampling technique was used to select the sample composed of 352 adolescent students including 161 boys and 191 girls aged between 12-17 years. Tools of the study: 1. Self-administered structured questionnaire included socio demographic data, nighttime technology devices usage and stimulant drinks intake questionnaire.  2. Pittsburgh Sleep Quality Index for assessing sleep quality.  Results: The main results showed that more than two thirds (68.2%) of studied students had poor sleep quality, it was significant higher (74.3%) among females than among males (60.9%). There was significant difference between males and females as regarding to sleep duration, sleep latency and sleep disturbance, however, there was no significant difference between males and females as regarding sleep efficiency, daytime dysfunction, and sleeping medication. In addition, it was revealed that age, gender, place of residence and family income had significant relation with poor sleep quality among students. Additionally, most of the studied students (88.1%) using different forms of technology devices at night and more than half of them had reported presence of technology devices in their bed room and used at night before sleep and  the most common devices used and affected sleep were mobile phone and television. Moreover, three fourths of the studied students (75.3%) reported intake of stimulant drinks, and there was a statistically significant relation between intake of stimulant drinks and poor sleep quality. Conclusion: Poor sleep quality among studied adolescent students was high (68.2%), most of the studied students (88.1%) using different forms of technology devices at night before bed time and three fourths of students were consumed stimulant drinks. Moreover, poor sleep quality was associated with age, gender, place of residence, family income, nighttime technology media usage and intake of stimulant drinks. Recommendations: Educational and awareness programs should be implemented in schools by the ministry of health in collaboration with the ministry of education to raise awareness of adolescent students about harmful health effects of night time technology devices usage and intake of stimulant drinks.
Keywords: Sleep quality, Adolescents students, Nighttime, Technology usage, Stimulant drinks.
Title: Relation between Nighttime Technology Devices Use, Stimulant Drinks Intake and Sleep Quality among Adolescent Students
Author: Samia Ali El-Nagar
ISSN 2394-7330
International Journal of Novel Research in Healthcare and Nursing
Novelty Journals

Abstract:Social websites addiction is a rising problem that affects Egyptian students physically, psychologically, socially and mentally. The purpose of the present study was to examine the effect of the psychiatric nursing intervention in prevention social websites communication addiction among university students. AQuasi- experimental research design (pre-post-test) was utilized to achieve the purpose of the study. This Study was carried out at the faculty of art and faculty of nursing menoufia university. A purposive sample of (n= 140) first-year students was selected from the above mention setting who have the scores of 50 to 79 on social networking sites addiction scale (high- risk groups).Three instruments for data collection as an interview questionnaire composed of two parts to assess; socio-demographic characteristics and social websites use data; Internet use motives scale and social networking addiction scale were used. The results revealed that all studied students use social websites for 3-5 h pre-intervention reduced to one - third post-intervention, regarding social websites motives, there were a highly statistically significant reduction on escape from stress, a lack of assertiveness, control, fun and entertainment, self esteem, social integration, sexual behavior as a social websites motives post-intervention than pre-intervention while there were a highly statistically significant increase in gaining information and personal integration as a social websites motives post- intervention than pre- intervention, there was a high reduction on the potential social websites addiction post-intervention than pre-intervention. Conclusion : The psychiatric nursing intervention has a positive impact in preventing social websites communication addiction among studies students. Recommendation: Provide cognitive behavior program on reducing social networking addiction among elementary and secondary school students.
Keywords:  Social Websites Communication Addiction.
Title: Psychiatric Nursing Intervention to Prevent Social Web Sites Communication Addiction among University Students
Author: Hanaa Abd El Hameed El kotb, Sorayia Ramadan Abd El Fattah, Maaly Ibrahim El Malky, Gehan Ahmed Abed, Lamiaa Hassanien Eita
ISSN 2394-7330
International Journal of Novel Research in Healthcare and Nursing
Novelty Journals
Manuscript Amendment Date: 8 November 2017

Abstract: Chlamydia trachomatis is a deadly silent killer and most prevalent bacterial sexually transmitted disease. The efficacy of Azithromycin in the treatment of Chlamydia trachomatis was assessed among male fertility subjects as well as other associated factors associated in Nnewi. Five hundred (500) males were randomly enrolled in the study. Four hundred (400) male subjects had infertility as their main complaint while the remaining 100 had no complaint and so were recruited as control group. Blood sample collected from the subjects was analyzed using immunocomb Chlamydia trachomatis IgG kit (ORGENICS, Israel). Single dose of Azithromycin (one gram) was administered for all subjects positive for Chlamydia trachomatis antibody and re-examined after two weeks to confirm the efficacy of Azithromycin.  Majority of the subjects (including control group) had a sharp increase titer level (53.8%) from 1:32 to 1:128 and reached its peak at 1:256 (38.5%) with another sharp decline on titer level greater than 1:256 (7.7%). Fifty-two (80.0%) out of 65 subjects positive for Chlamydia trachomatis antibody were negative after the post treatment with Azithromycin. Subjects with secondary infertility had more Chlamydia infection (11.2%) than primary infertility (17.3%). However, the difference was not significant (p = 0.129). Males who are staying apart  accounted for more Chlamydia infection (19.5%) than subjects who are residing together (14.6%), although there was no significant difference (p = 0.709). Finally, majority of subjects had previously treated Chlamydia infection more with herbal mixtures (38.8%) when compared to other methods of treatment. Therefore, this study has confirmed that azithromycin has high efficacy in the treatment of Chlamydia trachomatis antibodies among couples attending fertility clinics in Nnewi.

Abstract: Optic tract gliomas are a well known entity mainly in pediatric age group.  Patient’ s presentation is mainly visual deterioration.  MRI is the gold standard for diagnosis and treatment planning. Treatment varies from observation to biopsy to complete excision.  Outcome to the visual improvement is guarded.  We present here our experience of optic tract gliomas in Dept of Neurosurgery Khoula hospital Muscat Oman with various treatment strategies adopted by different units and outcome thereof.

Abstract: Critically ill patients need to constant assessment, monitoring, observing and adequate nursing care. When oral care is ignored and improperly performed; patients may become colonized by bacterial species which lead to nosocomial respiratory tract infections. Miswak contains numerous natural chemical compounds necessary for good quality oral and dental hygiene together with bactericidal and antiseptic effects, these chemical elements do not have any adverse effects.  Aim of the study: to determine the effect of miswak on oral health among critically ill patients. Subjects & method: Research design; A quasi experimental research design was utilized to achieve the aim of the study. Setting: The study was conducted at intensive care units in Menoufia University Hospital. Subjects: A purposive sample of fifty six   patients who had critically ill assigned randomly and alternatively into two equal groups, 28 patients for each group study group (1): receive oral care by Sewak. Control group (2) exposed only to routine hospital care. Tool: tool 1, Questionnaire  include :Scio demographic as age, sex and medical data as diagnosis, level of consciousness, mechanical ventilation ,chest infection. Tool 2 , Oral Health Assessment Tool (OHAT) for Dental Screening by Chalmers (2004) . Results: there was statistically significant difference between study and control group regarding oral health post intervention. Conclusion: Based on these researches and the current study results, the researchers supported miswak in oral hygiene because it has a strong effect on a general health which reflected by healthy oral status; miswak composition has an effective role in oral health by its properties. Recommendation: Nurse should be  used  Miswak for oral care for critically ill patients  in intensive care unit.

Abstract: Normal growth is a sign of good health. Screening for growth interruptions is essential to children’s health needs. Early detection and diagnosis of the causes of short stature allows management of underlying medical conditions, optimizing attainment of good health and normal adult height. The aim of this study was to assess mother' Knowledge and perception about short stature of their children. Design of this study was descriptive design. Sample of this study was convenient sample of 400 students aged between 6-10 years old and their mothers were selected to carry out this study. Instruments of this study included a questionnaire sheet that was used to assess mothers' knowledge and perception about short stature, and a chart for children's height was used to assess children's height. The settings this study conducted at health insurance outpatients' clinics for students' at Quessna district, Menoufia governorate. The main findings were, the prevalence of short stature in the studied sample was 8% with the prevalence appeared higher in rural than urban.  Three quarters (75%) of mothers had poor knowledge about short stature. The majority (87.5%) of mothers for short stature students felt that their children had normal height. This study concluded that short stature prevalent in the studied sample with low rate (eight percent). Short stature was more prevalent in rural areas.  Majority of mothers of short stature children perceived that their children had normal height. Recommendations According the findings of this study attention should be given to national strategies which aim to prevent and treat short stature by increasing mothers' awareness of short stature problems and its consequences. Screening campaign needed for more awareness about the importance of early detection of growth disorders.

Abstract: Deficits in cognitive functioning and learning styles characteristic of individuals with mental retardation include poor memory, slow learning rates, attention problems, difficulty generalizing what they have learned, and lack of motivation. Individuals with mental retardation who require extensive supports must often be taught basic self-care skills such as dressing, eating, and hygiene. The AIM of my study is to assess the effectiveness of cognitive skill training on performance of Self Help Skills among Mentally challenged Children. Material and Method: Pre experimental one group pre-test – post-test research design, and non-probability purposive sampling technique was adopted. The tool used for data collection was observation check list. Sample size was 50 mentally challenged children in school of mentally challenged children in Vadodara. Conclusion: The‘t’ value is significant. So it reveals that cognitive skill training is effective and improve the self help skill of mentally challenged children.
Keywords: Effectiveness, cognitive skill training, self help skill, mentally challenged children.
Title: Effectiveness of Cognitive Skill Training on Performance of Self Help Skills among Mentally Challenged Children in School of Mentally Challenged Children in Vadodara City
Author: Ms Bhavisha Patel, Mr Suresh V, Mrs Janki B Patel
ISSN 2394-7330
International Journal of Novel Research in Healthcare and Nursing
Novelty Journals

Abstract: Safety is a universal concept that encompasses efficiency, security of care, peaceful conduction of healthcare providers that lead to patients' satisfaction. One of the causes that threat patients and nurses is the infection. Transmission of infection is a major health problem in Egypt. Meanwhile, midwives and maternity nurses are more exposed to infections during clinical practice. Therefore, improvement in the performance of health care workers is an important aspect of infection control in the health care settings. Aim: The study aimed to: (1) Assess the nurses' knowledge regarding standard precautions for infection control. (2) Assess the nurses' practices regarding implementation of standard precautions for infection control, and (3) identify the factors influencing nurses' adherence to standard precautions for infection control. Design: A quasi-experimental research design was utilized in this study. Setting: The study was carried out in Maternity Teaching Hospital Fayoum University (General Hospital and University Hospital). Sample: A convenience sample was selected from the delivery room, which consist of 71 nurses. Tools: Data collected by using three tools. (1) A Self-administered Questionnaire Format to assess the demographic characteristics and nurses' knowledge about infection control standards (2) An Observational Checklist Format, adopted and adapted by the researchers from the Egyptian Infection Control Guideline, Ministry of Health (2009) to assess nurses' practices and (3) Staff Nurses' Opinionnaire Format developed by the researchers to assess barriers & factors hindering implementation of infection control standards. Results: A statistical significant improvement in nurses' knowledge and practice score level after program implementation.  While, in comparison with the pre program results and two months later there were a statistical significant difference regarding knowledge and practice total mean score level at p < 0.000. Non availability of supplies and heavy work load with no time were the strongest reasons hindering nurses' adherence to universal precaution standards. Conclusion: Application of the infection control standards precautions training program was effective for improving nurses' knowledge and practice mean score levels. Recommendation: In-service training programs should be provided to nursing staff in order to keep them updated in knowledge and practice regarding infection control standards.

Abstract: keeping patients safe while in the postoperative period is a topic of great concern for patients and nurses. Aim: To determine safety measures applied by nurses for surgical patients postoperatively and its relation to patients’ outcomes. Design: descriptive, correlational research designs was utilized. Setting: Surgical “Male & Female ‘departments’ at king abdulaziz university teaching affiliated hospital in Jeddah, Kingdom of Saudi Arabia. Subjects: a non-probability convenience sample was chosen and it consisted of all available nurses working from the above setting and their surgical postoperative patients. Total numbers included in the study were 31 nurses and 31 post-operative patients. Tools: 1. Sociodemographic questionnaire: to assess nurses Socio-demographic characteristics. 2. Safety Measures Observation Checklists: to investigate safety measures applied by nurses for surgical patients postoperatively. 3. Surgical Patient Clinical outcomes observational Checklist: was adopted from hospital chart to determine surgical patient clinical outcomes within the first 24 hours postoperatively. Results: The highest percentage of studied nurses were providing care for their patients equally without pay attention to religion, color or gender. Also it revealed that nurses were not explains to patients; the importance of knowing the signs of wound inflammation. Conclusions: There is a positive correlation but not significant between safety measures score and surgical patient clinical outcome score. Also the educational level among the studied nurses had a positive effect between safety measures dimension and patient outcomes postoperatively. Recommendations: There is a need to change in the educational system through creating patient safety courses in nursing faculties’ curriculums.

Abstract: Vanishing brain lesions are infrequently seen condition 1. Well known in multiple sclerosis, lymphomas with steroids etc 2,3, we herewith report a case of a young female presenting with headache and diplopia and imaging revealed cavernous sinus lesion .Surgery was attempted but due to vigorous venous channels was abandoned . However post of imaging revealed vanishing lesion ans patient completely improved.

Abstract: Rotavirus gastroenteritis is a major cause of morbidity and mortality among African infants and young children and is the most common cause of severe dehydration. Safe, effective, and affordable rotavirus vaccines are needed for developing countries. So recently the World Health Organization (WHO) has released a global recommendation that all countries include infant rotavirus vaccination in their national immunization programs. In Sudan rotavirus infection deaths represent 10-10.000 per 100.000 for this reason; in day17/7/2011 rotavirus vaccines are administered in all health settings in Sudan (Product: RotaRix; Manufacturer: GlaxoSmithKline; Year Licensed: 2008, suspended March 22, 2010) (Ministry of Health). So, the mother’s in Sudan must posses’ suitable knowledge regarding rotavirus vaccine. Aim of the study: To assess mother’s knowledge regarding the importance of rotavirus vaccine for their children. Method: The study is descriptive  enrolled mother's age between 20-45 years whom have children with an age less than 6 months, by convenience sample as a case finding (46) mother. Tool: Through structured interviewing questionnaire the data represent the level of mothers’ knowledge were collected.  Result:  The range of study; mother's age was between 20 to 45 years old, with a mean of 32.8 ±8. 4 years, less than half of study, mothers were 30 - 34 years old their number 18 (39.1%). The relation between level of education and level of knowledge regarding rotavirus vaccine among mothers; the majority were secondary school 14,  10 (71.4%) having poor knowledge and the others 4 (28.6%) having good knowledge; as presented there was a significant statistical relationship between mothers knowledge  and mothers' educational level;  p value 0.08. Recommendation: Community health nurse must be updated with their knowledge about new vaccines, and help in increasing awareness and knowledge regarding rotavirus vaccine and teach the mothers how to manage the adverse effect if it occur.

Abstract: "Cardiovascular diseases have the highest death rates and will remain the primary cause of death in the world until 2020. One of the most important aspects of the recovery period after cardiac surgery is the patient’s mental state, which has an indispensable role in the other aspects of social functioning and resumption of work and activities. Massage therapy is a safe, noninvasive therapy that has significant effects in reducing pain, anxiety and stress". The aim of study was to evaluate the effect of massage therapy on stress, anxiety, and pain among cardiac surgical patient Material & Methods: Research design Quasi-experimental design (the case group and control group) was used to achieve the aim of the study. Setting the study was conducted at medical department in Menoufia University hospital and Shebin El-kom teaching hospital. Sample a purposive sample of 97diagnosed patients were included .Results: it was found that, (88.7%) were in the age group (40-60) years, the majority of studied  patients (91.8%) were  female, 59.8% had secondary education , The highest frequency (76.3%) were married. There were highly statistically significant difference between pre and post intervention program regarding pain, anxiety and stress score levels in case group than control group, also there was highly statically significant positive relationship between pains, stress and anxiety (.000) i.e., when stress and anxiety increased, pain increased. Conclusion: Implementation of message therapy has a positive effect on   improving stress, anxiety and pain. Recommendation: Based on the results of this study we recommend use of message therapy or improving stress, anxiety and pain among cardiac surgical patients.

Abstract: Diabetic ketoacidosis (DKA) is a leading cause of morbidity and mortality in children with type 1 diabetes. Aim: The aim of the current study was to evaluate the effect of using clinical pathway on outcomes of children with type one diabetes mellitus suffering from Diabetic Ketoacidosis. Subjects and method: A quasi experimental research design was utilized. The current study was conducted at Pediatric intensive care unit (PICU) and pediatric ward of Benha Specialized Pediatric Hospital and Benha University Hospital. Sample of 60 children (30 as the study group and 30 as the control group) who were admitted at PICU and pediatric ward with DKA were participated in the study. The following tools were utilized for data collection, questionnaire sheet, self care activity sheet, self care hygiene sheet, nutrition assessment sheet, Glasgow coma scale, dehydration level, diabetic follow up sheet and follow pathway design for the study group Results: The study revealed that there were statistically significant differences between diabetic children regarding DKA before and after implementation of a clinical pathway. Children in the study group had early improvement in DKA follow up sheet as well as reduced length of hospital stay than those in the control group. Conclusion: Clinical pathway was effective in improving children suffering from DKA and follow up among diabetic children. Recommendations: Clinical pathways of care of diabetic ketoacidosis should be applied for children with diabetic ketoacidosis and provision of training program for nurses about clinical pathway.
Keywords: Clinical pathway, Type one diabetes mellitus, Diabetic Ketoacidosis.
Title: Effect of Using Clinical Pathway on Outcomes of Children with Type One Diabetes Mellitus Suffering From Diabetic Ketoacidosis
Author: Rahma Soliman Bahgat, Fatma Ahmed Elsobkey
ISSN 2394-7330
International Journal of Novel Research in Healthcare and Nursing
Novelty Journals

Abstract: Patient safety (PS) is one of the most important and essential elements of quality in the healthcare setting. A meta-analysis was performed to assess the status of patient safety culture using the Hospital Survey on Patient Safety Culture (HSOPSC). In this meta-analysis study, data were collected through searching database scientific index research engine, which provided by Thomson and Reuters, and using keywords like “patient safety”, “patient safety culture”, and “Hospital Survey on Patient Safety Culture”, Out of 300 retrieved articles, 17 articles were entered into the study. To calculate the overall Patient safety culture score and perform the meta-analysis, the computer software Statistical package for the social sciences (SPSS V, 20) was used. The highest result was Teamwork within hospital units 78.1%, and the lowest result was 46% in non-punitive response to the error. Represent the respondent responses for patient safety culture mean in their hospitals, were 50% excellent/very good, 40% acceptable, and 9% poor failing. The present study showed that differences exist between studies when implementing the questionnaire (HSOPSC) in their hospitals. The results reported in all studies showed the dimension Teamwork within units was the best rate with a positive perception of the health staff. However, results report in all studies showed the dimension that the lowest rate was a non-punitive error with a negative perception of the hospital staff, for insecure that their errors reported are kept in their personnel file and held against them.
Keywords: Patient safety (PS), Patient Safety Culture, HSOPSC.
Title: Quality of Patient Safety Culture: A Meta-Analysis of Data from Hospitals
Author: Moath Mohammad AlQassim
ISSN 2394-7330
International Journal of Novel Research in Healthcare and Nursing
Novelty Journals

Abstract: Silent colonic perforation by ventriculoperitoneal shunt catheter and later patient presenting with catheter prolapsing from anal opening is seen less frequently 1. We had recently this child 1 years old a case of hydrocephalus with ventriculoperitoneal shunt presenting in above scenario. Patients are completely asymptomatic with no features of toxemia indicating a chronic process 2.Treatment involves pediatric surgical help in removing the shunt catheter, waiting for a sterile cerebrospinal fluid sample via repeated cultures and replacement of shunt catheter in a different quadrant in abdominal cavity.

Abstract: School crisis is one of the most dangerous events that can jeopardize students, teachers, and all school staff life. It could have a negative reflection upon school safety and equilibrium. School teachers are the first persons who can interfere and help if any problematic situation occurs. Therefore, the aim of this study is to investigate the impact of a designed educational program about first aid & crisis management on females governmental preparatory school teachers ‘ knowledge and practices at Al-Jouf region, Saudi Arabia. Subjects and Method: Research Design: two groups Pretest-Post Test Quasi experimental design. Subjects: A stratified random sample of 265 preparatory school teachers were selected from the randomly selected settings at Al-Jouf Region then, randomly divided into two groups; study & control (132 teachers in the study group and 133 teachers in the control group). 6 Governmental Preparatory schools in Al-Jouf region, were randomly selected out of 26 schools. Instrumentations: Two tools were utilized to collect data pertinent to the study; 1- First aid & crisis management knowledge interview questionnaire schedule for female governmental preparatory school teachers at Al-Jouf region,& 2- First aid & crisis management practice observational check lists for female governmental preparatory school teachers at Al-Jouf region. Furthermore, a positive correlation was put into evidence between age, experience, knowledge, and practices regarding first aid and crisis management among the study group subjects. Enrichment of female governmental preparatory school teachers at Al-Jouf region with up to date knowledge and practices concerning first aid & crisis management might have positive impact on maintenance of school safety, stability and equilibrium. the study recommends wide coverage investigation and implementation of this research finds all over the Saudi Arabian schools.

Abstract: We report an interesting image finding of marked hypertrophy of cervical and lumbosacral nerve roots and plexuses in a patient with Chronic Inflammatory Demyelinating Polyradiculoneuropathy (CIDP).

Abstract: Pain caused by some therapeutic and nursing procedures has been a major concern of health care providers. Pain resulting from IM injection should not be underestimated, because in the light of fact that a painful injection might affect serious apprehension of injection, which may lead a patient to postpone looking medical help as well as, it can harm the nurse-patient relationship. Decreasing patients' pain is critical for all nurses in the light of numerous reasons. Administration of medications is a responsibility of the professional nurse. Intramuscular (IM) injections are a widespread and painful part of routine health care.  Moreover, injection pain is a common complaint of patients especially chronic patients who are experiencing repeated injection that let them escape, sometimes faint, to keep away from visiting the physician, or even refuse essential treatments. Pain is the most common reason for self deferral from injections by the inpatient and outpatient clients in the hospital. Providing pain relief is considered a most basic human right, so it is the responsibility of the nurse to use most effective approach to pain control. However, good injection techniques can make the experience relatively painless for the patient. Over the years, clinicians have tried to explore various methods to reduce pain, including the pain of injections. Nurses play a greater role in minimizing the pain and discomfort during any invasive procedure. Nurses have the responsibility to educate patients related to various aspects and keep themselves updated. Various teaching strategies are used to increase knowledge, such as lecturing, demonstration, discussion and self-education. These methods of self-education have an advantage over the others as the learner can educate himself at his own pace and it also stresses on rereading.
Abbreviations: IM, Intramuscular; WHO, World Health Organization.

Abstract: Cholecystitis is the inflammation or swelling of the gallbladder. It can be acute in onset or chronic and persistent. In acute cases of cholecystitis, the patient complains of extreme pain that usually worsens when he/she moves, Following certain dietary changes can provide relief from cholecystitis to some extent. Aim of the study: To determine the effect of dietary modification program on pain level among cholecystitis' patients. Setting:The study was conducted at Medical department of Menofia University & teaching Hospital Design:: A quasi experimental research design was utilized to achieve the aim of study.. Sample: A purposive sample consisted of 50 adult patients had cholecysitis were undertaken Data were collected using Tool one: structured interviewing questionnaire schedule, it consisted of four parts: Part one: socio demographic data as age, sex, marital status, and education& occupation.. Part two Medical data .Part three: Knowledge about factor that affecting cholecysitis pain .Part four: A- Dietary habit. B-   24hours dietary recall Tool two: Physiological measurement Tool three: Visual Analogue Pain Scale.
Result: there was a statistical significant difference related to factor that affect cholecysitis pain pre and post dietary modification program among studied group. Also there was a statistical significant difference related to pain pre and post dietary modification program among studied group Conclusion: It is concluded that:
The program about dietary modification had a positive effect on Pain level among Cholecystitis' Patients Recommendation: - based on this study it was recommended that: special attention should be given regarding teaching family members and nurses to help change their patients behavior and helping them to comply with the prescribed therapeutic diet.

Abstract: Although nursing plays a fundamental role in blood transfusion, but nursing research on this subject is still inadequate. Blood transfusion is a lifesaving management for many medical conditions; the nurse should maintain the safety during blood transfusion by applying principles of blood transfusion safety based on an intentional blood transfusion safety policy. The aim of the study: The study aimed to examine the effects of intervention training module regarding hospital nurse's preparedness for patient's blood transfusion safety Methods: quasi-experimental design, (study& control) comparative study, pre-post-tests used to achieve the study aim. A convenience sample of 400 nurses working in hospital settings, two tools were used to collect data, 1-Structured interviewing questionnaire: consists of two parts:- Part-A: Socio-demographic  data related to nurses in the study which included the following characteristics: nurses sex, age, qualification, number of years' experience, Part-B: Structured designed questionnaire used to collect the nurses knowledge related to blood transfusion preparation, safety, common reactions and nursing actions for each type of reaction ( theoretical part of module). 2- An Observational checklist used for the practical part of the module.  The main results: the current study revealed that, most all groups had bachelor degree, they aged in between 25-35 years, the mean score of total knowledge and practice increased after the intervention training module for both studied groups; there was high significance between both groups (study & control) related to post knowledge and practice, on the other hand there were no differences between Egypt and Sudan study groups in relation to post-knowledge and practice. A strong positive correlation between some of socio-demographic characteristics, post-knowledge and practice for both studied groups. Recommendations: the study recommended that establishment of Hospital Blood Transfusion Committee and Hospital Blood Transfusion Team for review and reporting blood transfusion incidents through local risk management, establishment educational programs centers in all hospitals which responsible updating and refreshing the nurses knowledge and practice; workshops which emphasizing on the evidence-based practices about critical nursing interventions as blood administration within all hospital  settings, these services must be included the recently graduated nurses, conduct similar studies  by including  more additional demographic variables.

Keywords: Blood transfusion, blood transfusion reactions, Blood transfusion safety, Training module for nurses.
Title: Effects of Intervention Training Module Regarding Hospital Nurse's Preparedness for Patient's Blood Transfusion
Author: Abeer El-Said Hassane El-sol, Hanan Mohammed Mohammed, Ragaa Gasim Ahmed Mohmmed
ISSN 2394-7330
International Journal of Novel Research in Healthcare and Nursing
Novelty Journals

Abstract:  Self-care is a concept frequently referred to in both the theory and the clinical practice of nursing. Renal transplantation represented an alternative to dialysis for many patients with end stage renal disease.  An important function of the nurse is to prepare the patient for a lifetime of self-care management and monitoring care. The aim of this study was to assess the effect of self-care nursing educational intervention for Post Renal Transplant Recipients among Adolescents. Subject and Method: Design: A quasi experimental design (Study/ Control) was used. Setting: This study was carried out in Mansoura Urology and Nephrology center. Sample: convenience sample of forty renal transplant recipients were enrolled in this study (Study/Control). Tools for data collections were 1) an interviewing questionnaire for assessing socio-demographic characteristics, health history and patient’s knowledge,2). Post renal transplant recipients Observational checklist for self-care for practical skills for measuring:- vital signs, recording fluid balance, assessing edema, taking medications and measuring the weight, post renal sign of complications, infection, rejection, and drug side effects, 3) the Rosenberg Self-Esteem Scale for Post Renal transplant recipients for assessing of self-esteem. The findings revealed that; there was significant significance difference between study and control group regarding mean total knowledge and total self-care (P<0.001). Also, about two third of patients (65%) in the study group had a positive self-esteem compared to 54% in the control group post renal transplant. Conclusion: Self-care nursing educational intervention had an effect on increasing renal transplant recipient's knowledge and self-care practices, decreased the post renal transplant complications and had a positive self-esteem of the study group. Recommendation: encouraging the implementation of self-care nursing educational intervention for all renal transplants to adapt functioning and prolongation of normal life.

Abstract: Cancer screening is a national health priority, especially for colorectal cancer. Colorectal cancer (CRC) is the second most common malignancy in the Saudi population, with an increasing occurrence over the last 20 years [1]. The target of this study was to Assess community awareness of risk factors, screening and prevention of colorectal cancer among population in abha city in order to know the group of population that need more education and screen program.
Setting and Design: The research will be a part of a cross-sectional study conducted a survey by using a questionnaire.
Patients and Methods: Random, healthy individuals from abha city KSA, were approached to participate in questions multiple choice survey about CRC. Data were analyzed by demographic criteria, including age, gender, marital status, level of education, and occupation to determine if members of these groups displayed differential knowledge.
Statistical Analysis: Differences in responses by demographic data were analyzed using descriptive statistics relationship between two variable using crosstab.
Results: In total, 300 participants completed the survey. Most respondents no hear about early screening of Colorectal (50%), and 80 % not have done screened of colorectal cancer. 60% no know where the place of colorectal cancer is screening. They assess subjectively their Level of knowledge about colorectal cancer 53% poor, 37% good and 10% excellent. Highest percentage for education level about Public awareness for colorectal cancer universal by 45% and lowest unlettered by 4% which varied significantly according to level of education. About 6 from 11 diagnosed with Colorectal Cancer and have a family history of Colorectal Cancer.
Conclusions: Most of people consider their information poor about screening of colorectal cancer although those with higher education tended to answer questions correctly more often, there were some misconceptions regarding universally accepted screening protocols, symptoms, and general understanding of CRC in Saudi Arabia. A national education/screening program in Saudi Arabia is recommended to improve CRC knowledge.
Keywords: Cancer - Colorectal Cancer - Malignancy – Health.

Abstract: Work-related musculoskeletal disorders are one of the most occupational problems among nurses. The aim of this study was to examine work-related musculoskeletal occupational hazards among nurses. Design: A descriptive research design was utilized. Settings:-This study was conducted at Menoufia University Hospital and El-Shohada hospital, Menoufia Governorate, Egypt. Sample: This study included simple random sample of 160 Staff nurses working at the above settings, Egypt. Tool for data collections:- 1) A structured interviewing questionnaire it was includes; the socio-demographic data of nurses, Occupational health practice, perceptions on job risk factors that may contribute to development of work-related musculoskeletal disorders and coping strategies toward reducing the risk for development of work-related musculoskeletal disorders. 2) Job risk factors scale of 0 to 10 Adopted from Bolanle, et al., (2009)to examine risk factors that may contribute to development of work-related musculoskeletal disorders among all respondents that indicate how much of a problem (if any) each item is for the nurse by circling the appropriate number.". Results: sixty-two point three percent of the nurses have had the work related musculoskeletal disorders during last 12 months in nursing work. Work-related musculoskeletal disorders occurred mostly in low back (44.6%), knees (27.7%) and neck (11.9%). The percent of the work related musculoskeletal disorders in El-Shohada hospital were 52.5% while in Menoufia University hospital were 72%. Outpatient clinics were high percent of the work related musculoskeletal disorders in both El-Shohada and Menoufia University hospital (64.5% and 86.4% respectively). Conclusion: About two third of studied nurses had the work related musculoskeletal disorders and the low back was the most common site of pain. Years of experience had significant effect on development of the work related musculoskeletal disorders. Recommendations: Education programs on injury prevention, body mechanics and coping strategies for nurses.

Abstract: The need to apply the principles, techniques and methods of Total Quality Management (TQM) in public hospitals becomes increasingly urgent, as the benefits that are achieved result in reducing costs and providing better quality services to patients. The purpose of this research is to explore the potential applications of TQM principles in a Greek public hospital, to record the role of management and leadership in shaping the work environment and relationships, to evaluate the quality of health services and to diagnose quality problems that may exist in the hospital. This research is qualitative and the tool which was used is the questionnaire. The sample consisted of ten (10) people. The results showed that the quality problems in the hospital, mainly arose from the health policies pursued and implemented by government mechanisms, and the inability of the administration to intervene. Additionally, the quality problems which depend on the administration of the hospital mainly focus on the responsiveness, the efficiency and the behavior of health personnel.

Abstract: This report does not intent to discuss fibromyalgia as an entity, but to show that many patients diagnosed as having fibromyalgia have other identifiable pathologic processes that reasonably explain the pain syndromes attributed to fibromyalgia.1,2,3,4
This is a community-based study of 53 patients with the diagnosis of fibromyalgia made at general medicine outpatient clinics.  Most of these patients had been referred to the Department of Neurology for subsequent evaluation intended to reach a plausible and more rational diagnosis than fibromyalgia. A reasonable diagnosis that would explain the symptoms attributed to fibromyalgia was achieved in 31 patients.
The gist of the argument is that a complete physical examination and some laboratory tools are necessary before branding a patient as having fibromyalgia. Many people with the diagnosis of fibromyalgia have medical conditions that can reasonably explain the symptoms diagnosed as fibromyalgia; that is to say, fibromyalgia is not a primary disease but a symptomatic expression of another underlying process. 2,4 Therefore the causes of fibromyalgia syndrome should be investigated appropriately.

Abstract: The WHO recognizing the importance of patient safety in healthcare, adopted Resolution WHA55.18 of 2002 which outlined the responsibilities of the WHO in providing technical support to Member States in developing reporting systems, reducing risk, formulating evidence-based policies, fostering a culture of safety, and encouraging research on patient safety Objective: To review the structures, systems and practices of patient safety at the Sunyani Municipal Hospital Methods: Eleven out of the 12 WHO patient safety action areas were used to assess the hospital. A six point Likert scale of scores between 0-5 was awarded to each indicator met by the hospital as per the standard requirements. The Health Service Administrator and the Nursing Administrator were engaged over 2hours in a discussion with regards to the assessment indicators and in the end a Consensus-Based Assessment (CBA) score was awarded to the appropriate indicator met by the hospital. Results: At the end of the study, the hospital had a mean block score of 2.7(representing fair) implying that the patient safety systems, structures and practices were below the minimum score of 3.0. However, waste management in the hospital scored the highest and the best mark of 5.0 implying the hospital was doing excellently well in waste management. The hospital scored 2.8 on medication safety. One of the strengths of the hospital on medication safety was a functional Drug and Therapeutic Committee that ensured that drug use was of optimum quality. On safe surgical care, the hospital had a block score of 2.0(Fair).  
Keywords: Patient Safety, Safe Surgical Care, Medication Safety, Medical Errors, Partnership, Knowledge and Learning.
Title: ASSESSMENT OF PATIENT SAFETY SYSTEMS, STRUCTURES AND PRACTICES IN SUNYANI MUNICIPAL HOSPITAL, GHANA
Author: Barnabas Kwame Yeboah, Elizabeth Asor Mensah, Timothy Letsa, Ellis Owusu –Dabo

Abstract: Perimenopause is a natural part of a woman’s life and it is often accompanied with endocrinological, biological, and clinical features which gradually occur. Perimenopause period occurs prior to the menopause which is permanent cessation of menstruation resulting from the loss of ovarian follicular activity.
This study assessed nutritional status of perimenopausal women and their knowledge base about perimenopause, its causes and symptoms; identified the women’s anthropometric indices; and established relationship between nutrition, non-communicable diseases and perimenopause with the view of encouraging positive healthy nutritional practices and intake.
Methodology: The study adopted a descriptive cross sectional design. Sample size was calculated using Leslie-Fisher’s formula. Structured questionnaire that was piloted and validated was used to collect data. Results were analyzed using Statistical Package for Social Sciences (SPSS) version 20 and P value was set as 0.05.
Results: Findings revealed that majority of the respondents (75.2%) had good knowledge about perimenopause, (52%) opined that good nutrition delay onset of menopause and prevents non communicable diseases. Nutrition rating revealed that 8.5 were taking healthy nutrition. The anthropometric indices of the respondents showed that 59.5 had class 1 obesity, 60.8% were overweight in WHR, while 31.7% were overweight using WHtR, and 62.8% were overweight in WCR.
Conclusion: This study concluded that female elementary school teachers had good knowledge about perimenopause. Good nutrition was found to be one of the factors responsible for delay of onset of perimenopause and prevention of communicable diseases. It also concluded that most perimenopausal women were overweight.

Abstract: Ketosis-prone diabetes (KPD) or "atypical diabetes," "Flatbush diabetes," "diabetes type 1B," and "ketosis-inclined type 2 diabetes mellitus" is a boundless, developing, heterogeneous disorder portrayed by patients who give diabetic ketoacidosis or ridiculous ketosis however don't really have the average phenotype of immune system type 1 diabetes. Numerous, serious types of β-cell brokenness seem to underlie the pathophysiology of KPD. Up to this point, the disorder has did not have an exact, clinically pertinent and etiologically helpful arrangement conspire. The predominance of KPD is rising. Insulinopaenia at presentation requires escalated insulin treatment at conclusion; nevertheless, these people display a test to medicinal services experts as to how their diabetes ought to be overseen over the more extended term. With the chance to stop insulin treatment and with the presentation of oral hypoglycaemic specialists, trust in dealing with this gathering of individuals is developing. The lynchpin for foreseeing the clinical course of KPD and helping in the choice to stop insulin is evaluation of islet cell autoantibodies and beta-cell work, and the utilization of the Aβ arrangement of order appears to precisely give clinicians the biochemical bolster that, thusly, will make us more positive about dealing with these people.
Keywords: Ketosis-prone diabetes; Islet cell autoantibodies; diabetes mellitus.
Title: Increasing Attention on KPD – Flatbush Diabetes
Author: Afrânio Côgo Destefani, Trevenzoli, R. M.
ISSN 2394-7330
International Journal of Novel Research in Healthcare and Nursing
Novelty Journals

Abstract: Aim of this study was to evaluate the effect of topical application of mother milk on umbilical cord stump separation time compared to ethanol in healthy newborn. Design: A quasi-experimental design was used for the study. Setting: The study was carried out in postpartum unite of obstetrics department at Benha University Hospital Sample:  A purposive sample of 100 neonates randomly assigned into two groups (50) in mother milk group, and (50) in ethanol group. Tools: Data were collected through two main tools: Structured interview schedule and follow up observational checklist for monitoring signs of cord healing, cord separation time and signs of cord infection. Results: There was highly statistically significant difference in umbilical cord stump separation time, sign of cord infection, bleeding continuation and mucoid secretion in mother milk group as compared with ethanol group. Conclusion and recommendation: Topical application of mother  milk on umbilical cord stump care leads to quick cord separation time,  reduce the umbilical cord stump infection and it can be used as an easy, cheap and non invasive way for cord care. Therefore, it is recommended that study can be replicated on large sample size with longer duration in different setting so that the findings can be generalized to large population.