The Effect Of Sexual Counseling Program On Pain Level And Sexual Function Among Women With Dyspareunia

Dyspareunia is a sexual dysfunction manifested as pain in reproductive organs before, during or soon after sexual intercourse. In spite of the fact that this disorder may be found in both genders, it is much more frequent in women. For these women, sexual activity results in burning pain that can alter a woman’s sense of sexual competency and identity. Study aim was to determine the effect of sexual counseling program on pain level and sexual function among women with dyspareunia. The study setting was conducted at obstetrical& gynecological clinics in El-mansoura University Hospital after obtaining hospital director approval. A subject was consisted of 392 women: 107 out of them with dyspareunia and 100 women complete counseling program, Tools three tools were used by the researchers to collect pertinent data consisted of Women Structured Interviewing Schedule, Dyspareunia Self Assessment Tool, and Female Sexual Function Index (FSFI). Results revealed that 27.3% of the study sample was complained with dyspareunia their age was ranged between 20-40 years with a mean age of 33.79±5.92 years. Regards FSFI scores a difference existed between pre and post scores in favor of post scores.  t= 18.7 (P<0.001) with highly statistical significant difference regarding Desire t= 4.6, (P>0.001), Arousal t=7.97, (P>0.001), Orgasm t= 3.7 (P 0.002), Satisfaction t=12.9, (P>0.001) and Pain t=26.4, (P>0.001).  Conclusion female dyspareunia is an under recognized and significantly affected women and their sexual function, the present study proved also that sexual counseling program was effective on pain level and sexual function improvement among women with dyspareunia. Recommendations include application of sexual counseling program on wide range of women complaining sexual problems. Also, sexual health or problem inquiry should be ask as an important part of health care services and the health care team should be encouraged to initiate discussions about dyspareunia and in service education program for nurses about how to deal and manage various sexual problems is must. Key words: Counseling    Pain level       Sexual function       Dyspareuni

Effect of Nursing Intervention on Clinical Outcomes and Patient Satisfaction among Upper Gastrointestinal Bleeding

Upper gastrointestinal (GI) Gastrointestinal (GI) bleeding is an extremely common clinical problem, resulting in significant morbidity, mortality, and cost. Aim: determine the effect of nursing intervention on expected clinical outcomes and satisfaction of patients with upper gastrointestinal bleeding. Design: This quasi-experimental design. Setting: was conducted at the emergency department. Sample: a convenience sample 50 adult patients diagnosed with upper gastrointestinal bleeding (UGIB). Tools: used for data collection included sociodemographic and medical data sheet, patient clinical outcome and patient satisfaction. Results: Statistically significant differences were found between the study and control group after application of nursing intervention regarding patients' clinical outcomes items ( bleeding attack, vital signs, laboratory tests, mental status and medical co-morbidities) at level P= 0.040, 0.000, 0.001, 0.066 and 0.045respectively, highly statistically significant differences were existed between the study and control group after application of nursing intervention regarding level of patients' satisfaction as a total score recorded 77.20±4.24 for the study group while it was 57.68±10.6 for the control group, achievement of the average scores for the most of the checklist items which related to nurses' performance. Conclusions: Findings illustrate that nursing intervention improve patients' expected clinical outcomes and their satisfaction. Recommendations: These findings suggest that generalization of the standardized nursing intervention in form of booklet for patients with UGIB at all hematemsis departments of Mansoura University Hospitals is important to maximize the expected clinical outcomes for patients with UGIB. Keywords: Upper gastrointestinal bleeding, Nursing intervention, Patient satisfaction, Outcom

Effect of Cardiac Rehabilitation Program on Lifestyle Pattern of Patients with Myocardial Infraction

Cardiovascular disorders are the leading cause of mortality and morbidity in the industrialized world, accounting for almost 50% of all deaths annually. The survivors constitute an additional reservoir of cardiovascular disease morbidity. In the United States alone, over 14 million persons suffer from some form of coronary artery disease (CAD) or its complications. Traditionally, cardiac rehabilitation has been provided to somewhat lower-risk patients who could exercise without getting into trouble. So, this study aimed to examine  the effect  of the cardiac rehabilitation program on lifestyle practices by patients with myocardial infarction.  Settings. The study was conducted at the cardiac ICU and coronary care unit of the Main University Hospital at  Mansoura University. Subject. The study included a convenience sample of 50 adult patients admitted to the previously mentioned settings during the study period and having (M.I). we included in this study patients from both sex, adult less than 60 years. Results,  Finding of the present study revealed that, there was highly statistical significant positive change in lifestyle pattern of patients with myocardial infarction to control the physiological problems associated with the disease and medications received after implementation of the cardiac rehabilitation program. Keywords: Cardiac rehabilitation, myocardial infarction, compilations, lifestyle practice

Potential Role for a Panel of Immunohistochemical Markers in the Management of Endometrial Carcinoma

Background In order to improve the efficacy of endometrial carcinoma (EC) treatment, identifying prognostic factors for high risk patients is a high research priority. This study aimed to assess the relationships among the expression of estrogen receptors (ER), progesterone receptors (PR), human epidermal growth factor receptor 2 (HER2), Ki-67, and the different histopathological prognostic parameters in EC and to assess the value of these in the management of EC. Methods We examined 109 cases of EC. Immunohistochemistry for ER, PR, HER2, and Ki-67 were evaluated in relation to age, tumor size, International Federation of Gynecology and Obstetrics (FIGO) stage and grade, depth of infiltration, cervical and ovarian involvement, lymphovascular space invasion (LVSI), and lymph node (LN) metastasis. Results The mean age of patients in this study was 59.8 ± 8.2 years. Low ER and PR expression scores and high Ki-67 expression showed highly significant associations with non-endometrioid histology (p = .007, p < .001, and p < .001, respectively) and poor differentiation (p = .007, p < .001, and p <. 001, respectively). Low PR score showed a significant association with advanced stage (p = .009). Low ER score was highly associated with LVSI (p = .006), and low PR scores were associated significantly with LN metastasis (p = .026). HER2 expression was significantly related to advanced stages (p = .04), increased depth of infiltration (p = .02), LVSI (p = .017), ovarian involvement (p = .038), and LN metastasis (p = .038). There was a close relationship between HER2 expression and uterine cervical involvement (p = .009). Higher Ki-67 values were associated with LN involvement (p = .012). Conclusions The over-expression of HER2 and Ki-67 and low expression of ER and PR indicate a more malignant EC behavior. An immunohistochemical panel for the identification of high risk tumors can contribute significantly to prognostic assessments

Quality of Life among Egyptian Patients with Upper and Lower Limb Amputation: Sex Differences

Background. Limb amputation is a life-changing event that can cause significant disruptions in many important areas of existence. Aim of this study. To evaluate the quality of life (QOL) of patients with limb amputation and identify the factors affecting the quality of life of patients with limb amputation among Egyptian patients. Research Design. It was a descriptive exploratory design. Setting. The study was conducted in Orthopedics and Surgical Department in Emergency Hospital at Mansoura University Hospitals. Sample. A sample of convenience of 100 adult male and female patients who met the inclusion criteria was included. Tools. (a) Structured interview questionnaire (SIQ) was used to collect personal data, (b) short form (36) health status questionnaires: this part was utilized to assess the quality of life among Egyptian patients with amputation. Results. The result of this study indicates that most participants experienced a change in the quality of life. There is a statistically significant difference between total QOL aspects and each of the following: age, gender, educational level, and type of work. Conclusion. Limb amputation tends to cause increased disability for those amputated patients. The age, gender, place of amputation, and marital status are found as statistically significant factors with physical component and psychological component

Evaluation of Different Stabilizers and Inactivating Compounds for the Enhancement of Vero Cell Rabies Vaccine Stability and Immunogenicity: In Vitro Study

Inactivation of rabies virus is essential for rabies vaccine preparation where the inactivating compound that is currently recommended for rabies vaccine preparation is β-propiolactone (β-PL). This compound is considered better than phenol and formalin but it is expensive and potentially carcinogenic. Data revealed that Ascorbic acid (AA) with cupric ions could yield complete and irreversible inactivation of rabies virus without adversely affecting its antigenicity. Additionally, the results of testing the vaccine potency with the selected inactivating compounds were comparable (P<0.05), and ED50 was higher than the recommended World Health Organization (WHO) limits. The use of HemaGel (plasma substitute) for testing vaccine stabilization was compared with the currently used vaccine stabilizers (human albumin and lactose). HemaGel yielded better stability than the other tested stabilizers. Monitoring of cellular and humoral immune responses indicated that both the total IgG level against rabies vaccine and the IFN and IL5 levels obtained with the HemaGel-stabilized vaccines were higher than those obtained with human albumin- and lactose-stabilized vaccine candidates