Ocular complications are common in the critical care setting but are frequently missed due to the focus on life-saving organ support. In critically ill patients, normal eye protection mechanisms, such as tear production, blinking, and keeping the eye closed, are impaired. This study aims to: assess risk factors for ocular surface disorders among adult critically ill patients. Design: Exploratory research design. This study was carried in intensive care units at Assiut university hospital. Subjects: A convenience sampling of 60 adults patients. Tools: Two tools were utilized to collect data of study, tool I: Patient assessment sheet. Tool II: Risk factors assessment sheet. Method: The researcher assessed risk factors, eye lid closure and occurrence of ocular surface disorders. Results: The exposure of adult critically ill patients to ocular surface disorders was high related to right eye were 51% in 7 th day, related to left eye were 48% in 5 th day. Regarding type of abnormalities in right eye, the result revealed that 80.8% were mixed in 6 th day and 3.2% were corneal abrasion in7 th day. Conclusion: The study confirmed that important risk factors for ocular surface disorders in Intensive Care Unit (ICU) patients were: lagophthalmos, level of consciousness, mechanical ventilation, sedation and muscle relaxant, length of ICU stay, fluid misdistribution and respiratory microorganism. Recommendation: It is necessary to disseminate protocols and guidelines for eye care in ICU patients to reduce the risk.

Background: Intensive care unit was a stressful environment. Therefore nurses encounter additional obstacles when caring for obese patients in ICU. These obstacles must be identified for proposing a solution and enhancing safe and quality nursing care to critically ill obese patients. The aim of this study was to assess obstacles that face nursing staff toward the care of critically ill obese patients in the intensive care unit. Design: Cross-sectional descriptive research design. Subject: All available critical care nurses and obese patient at Assuit University Hospitals within 6 months. Setting: The study was carried out at General, Trauma, Anesthesia, and Cardiac ICU at Assiut University Hospitals. Two tools were utilized to collect data; a patient assessment sheet and a nurse's self-administered questionnaire about obstacles in the care of critically ill obese patients. Method: Nurses' obstacles during the care of critically ill obese patients about equipment and clinical practice were obtained by using a self-administered questionnaire. The questionnaire was translated by a researcher to Arabic format in order to suit the nurses' language and their level of understanding. Results: Most nurses' obstacles regarding equipment were lack of proper cuff size 76.7%, lifters 66.7%, and bariatric bed 60.0%. According to clinical practice, turning and repositioning 91.1%, blood pressure measurement76.7%, and calculate calories 67.8%. Conclusions: Nurses' obstacles in the care of critically ill obese patients increase with an increased number of obese patients. Recommendations: Overcome these obstacles are essential in hospitals through the application of new strategies to provide appropriate patients care.

To examine the frequency and predictive factors for bowel incarceration following transjugular intrahepatic portosystemic shunts (TIPS) placement to treat refractory cirrhosisinduced ascites.MATERIALS AND METHODS: Ninety-nine patients with known hernias at the time of TIPS placement were identified. Their electronic medical records were reviewed and pertinent preprocedural, procedural, and outcome variables were recorded. Patients were divided between those that suffered incarceration (study group) and a control group of those with a hernia who did not suffer incarceration.RESULTS: Twelve of the 99 patients (12.1%) suffered hernia incarceration, of which seven (7.1%) suffered incarceration in the first 90 days. One patient who suffered incarceration ultimately died from complications of the incarceration. When comparing all patients who suffered incarceration to controls, incarceration patients were found to have significantly higher albumin levels (mean 3.13 versus 2.73, p¼0.02). When just considering those who had incarcerations in the first 90 days to controls, incarceration patients were less likely to have improvement in their ascites (p¼0.04).CONCLUSIONS: Incarcerated hernias occur frequently after TIPS placement and can lead to significant morbidity and mortality. Clinicians should be aware of this complication and counsel patients on presenting symptoms prior to placement.

Coronary Angiography has become a main diagnostic procedure for diagnosis of Coronary Artery Disease (CAD). Aim: this study was carried out1-to investigate the impact of knowledge aboutearly ambulationon patients' satisfaction among post coronary angiography2-early ambulation after 2 hours versus 6 hours.Design: a quasiexperimental design. Setting: in catheterization and coronary care units.Subjects: A convenience sample of all adult educable and mentally competent male and female patients aged from (18-60 years old) who had undergone a nonemergency coronary angiography (CA) through femoral artery during a period from July 2010 to June2011 were eligible for inclusion in the sample.Tools: four tools were utilized to collect data pertinent to the study, tool I assessment of patients after femoral sheath removal and angiography related data tool II: pre/post femoral coronary angiography knowledge sheet toolIIIpre/post femoral coronary angiography observation check list.toolIV satisfaction assessment sheet. Methods: pretest knowledge sheet filled out by the patient and observation checklist sheet was checked by the researcher for both groups ,the teaching protocol has been implemented for patient in terms of session ,each session ranged from 6-10 patients for theoretical and practical contents ,then immediately post knowledge sheet test filled out by the patient and observation checklist sheet was checked by the researcher for both groups Results: Finding of the present study revealed that significant improvement of all parameters with values of less than p=0.001 in response to give information among the two groups CA. Conclusion: educating patients before diagnostic cardiac catheterization can effectively improve level of knowledge and satisfaction.

Aim of the study: the study was aimed to evaluate the effect of teaching program on nurse`s performance regarding Guillian Barre Syndrome patients at neurological Care Unit at Assuit University Hospital. Research design: Quasi experimental research design was utilized in the study. Subject and method: the study was carried out on a convenience 30 nurses who participating in Guillian Barre patient care. One tool have been utilized to gather the information, tool I structure questionnaire divided into three parts: part 1 demographic characteristics of the nurses, part 2 pre/post knowledge assessment questionnaire, part 3 pre/post practice observational checklist. Tool had been utilized in 3 phases; preparatory, implementation and evaluation phase,with applying of teaching program for nurses about knowledge and practice about the care of Guillain-Barre syndrome patients. Results: The frequent of nurses had unsatisfactory whole expertise pre teaching program (12.56±2.45) compared with post teaching program (21.5±1.52) the suggest score had been improved significantly (P=0.000), additionally the majority of nurse`s practice have been inadequate pre teaching program (127.93±44.58) compared with post teaching program (248.5±9.11). Conclusion: the find out about used to be illustrated that the teaching program leads to improvement in nurse`s knowledge about Guillain-Barre syndrome patients. Recommendation: Continuous nursing training and preparing programs on neurological intensive care unit should be well planned at Assiut university hospital.