Background and objective: Adherence to medications is the backbone to effectiveness of a treatment. Adherence to antiepileptic drugs (AEDs) is essential to prevent the risk of seizures recurrence. The aims were to study the effect of teaching strategies on adherence to antiepileptic drugs, recurrence of seizures, and identify factors affecting the adherence level among epileptic patients.Methods: Research design: Quasi-experimental design. Setting: Neurology Department at Neurological and Psychiatric Assiut University Hospital. Sample: A purposive sample of sixty male and female adult patients diagnosed with epilepsy. Tools: Tool I-Patient assessment sheet. Tool II-Morisky Medication Adherence Scale. Tool III-Liverpool Seizure Severity Scale.Results: There was a statistically significant difference between pre and post applying of teaching strategies as regard drug adherence and recurrence of seizures among epileptic patients (p < .001). Also, forgetfulness, side effects of medications, and absence of family or friend were the main factors of non- adherence to AEDs.Conclusions and recommendations: Teaching strategies had statistical significant effects on adherence to antiepileptic drugs and on reducing recurrence of seizures among epileptic patients. Simple educational pamphlet for epileptic patients and their family members to improve adherence to AEDs should be available in Neurology Department and Outpatient Neurology Clinics.

Background: Non-adherence to dialysis is a cause for concern as it leads to several life-threatening complications. Several factors can contribute to non-adherence in dialysis patients. The aims to identify factors contributing to nonadherence among chronic renal failure patients undergoing haemodialysis sessions. Methods: Research design: Descriptive research design.Setting : Dairout General Hospital at haemodialysis unit. Subjects :A purposive sample of 95 adults patients, male & female, their age ranged from 18-65 years, undergoing haemodialysis and agreed to participate in the study. Tools : Tool (1):Patient assessment. Tool (2):Non-adherence contributing factors questionnaire among chronic renal failure patients. Results : Six categories of factors contributing to non-adherence among chronic renal failure patients undergoing haemodialysis sessions were identified. These were patient related factors, sociodemographic factors, psychological factors, therapy related factors, disease related factors and health care related factors.Conclusion: Non-adherence remains a major obstacle in the effective management of chronic kidney disease (CKD) patients. Recommendations:There is need for collaborative approach to devise measures that eliminate relevant contributing factors to non-adherence among chronic renal failure (CRF)patients.

People with Systemic Lupus Erythematous need for social support more than others due to Systemic Lupus Erythematous' often caused severe and unpredictable symptoms; also can be affected multiple system. The study aimed to determine the pattern of Social support among Systemic Lupus Erythematous patients; also to identify the risk factors among Systemic Lupus Erythematous patients at outpatient clinics, Assiut university hospital. Patients and methods: The study was conducted in Rheumatology clinic at Assiut university hospital. The total sample size was (104); total coverage technique used in this study. Tools: Two tools were used, first tool: A structured interview questionnaire sheet which included two parts; demographic data and questions regarding risk factors and the second tool; it included Social Support Assessment scale. Results: more than half (55.8%) of patients had high level of social support after disease compared to 39.4% of them had moderate and high level of social support before disease also, Sunlight exposure was the most risk factors among Systemic Lupus Erythematous patients. Conclusion: there was statistically significant differences between total score of social support before and after disease (P value=0.001*). Recommendation: Health education about rheumatologic services for community to early detection, diagnosis and treatment.

Back ground:Peptic ulcer is an excavation that forms in the mucosal wall of the stomach, pylorus, duodenum and in the esophagus. Tele-nursing has a great contribution to ensuring continuity of care for patients following hospitalization. Aim: To evaluate effect of tele-nursing instructions on adherence to therapeutic regimen and improving symptoms for patients with peptic ulcer.Patients and Methods: Research design: Aquasi experimental research design (study and control). Setting: Tropical Medicine and Gastroenterology department at El -Rajhi liver Hospital at Assuit University hospital .Sample:A purposive sample of 60 male and female patients diagnosed with peptic ulcer.Tools: Tool (I):Patient's assessment sheet.Tool II: Morisky Medication Adherence Scale (MMAS-8).Results: Statistically significant difference in adherence level of study group before and after telenursing instructions (2.03±1.67&6.93±0.91) respectively. While in control group there was no statistically significant difference in adherence level (2.13±1.38& 3.6±1.43).Also , there was improving in symptoms for patients with peptic ulcer among study group than control group after applying tele-nursing instructions.Conclusion:Telenursing instructions improved adherence level of patients to therapeutic regimen and improved symptoms for patients with peptic ulcer Recommendations: Further studies aimed at improving patient adherence using telenursing strategiesf or patients with peptic ulcer should be applied.

Background:Chemotherapy-induced neutropenia (CIN) is the main dose limiting toxicity of systemic chemotherapy and it is associated with significant morbidity, mortality and treatment cost.Aim:Of the study was to evaluate effect of designed nursing instructions on knowledge and self-care behavior among patients with chemotherapy-induced neutropenia.Research design: Pre-post research design was utilized.Setting: The study was conducted at internal Medical Oncology Department at South Egypt Cancer Institute.Sample: Sixty adult patients with chemotherapy induced neutropenia. Tools of data collection: Tool (I): Patient assessment sheet, Tool (II): Self-care behavior assessment.Results: There was a highly statistically significant difference between pre and post applying of designed nursing instructions as regard patients' level of knowledge and self- care behavior of the studied patients (p<0.01).Conclusion: The designed nursing instructions improved knowledge and self-care behavior among patients with chemotherapy-induced neutropenia.Recommendation: Each neutropenic patient should be given a booklet including knowledge about neutropenia, importance, and how to practice standards self-care behavior. Education of patients and families are keys to prompt recognition about potentially life-threatening symptoms associated with neutropenia.