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Body position enhances oxygen transport by the operational effect of gravity on cardiopulmonary and cardiovascular function. This study was aimed to investigate the effect of knee-chest, semi-sitting, and right lateral position on preterm neonates with respiratory distress syndrome. Subjects and Method: A quasi-experimental research design was utilized, and it was carried out at the Neonatal Intensive Care Unit at the Obstetric and Pediatric Minia University Hospital. A purposive sample was composed of 57 preterm neonates with respiratory distress syndrome. One tool was used, which included two parts: Preterm bio-demographic data and an assessment sheet for monitoring respiratory system functions. Results: The knee-chest position significantly improved respiratory rate, decreased heart rate, and increased oxygen saturation flowed by the right lateral position. Also, improvement of respiratory rate, heart rate, and oxygen saturation when using knee-chest position in the items of newborn age, gestational age, and birth weight at P-value <0.0001 and improved oxygen saturation when using semi-sitting. Conclusion: Both knee-chest and right lateral positions effectively improve the respiratory system function among preterm neonates with respiratory distress syndrome compared to a semi-sitting position.Recommendation: Program education for neonatal nurses about applying for knee-chest position among incubated preterm infants with respiratory problems.

Introduction: Advantages of breastfeeding are indubitable. But painful, sore nipples are upsetting for the mothers and may lead to stop nursing before the commended time. Aim of the study: explore the effect of olive oil, coconut oil, breast milk on nipple soreness among lactating mothers. Methodology: Experimental study involved 135 postpartum women visited outpatient as postpartum follow up for labor in Itay El-baroud Central Hospital and National Medical Institute of Damanhour City, Egypt. They were randomly categorized into three groups: Group 1 (using Olive oil), group 2 (using Coconut oil) and group 3 (Using breast milk). Nipple trauma score (NTS) was used to assess nipple soreness at 1st, 7th, 14th day post intervention. Results: there was highly significant difference between mean score of olive oil group and coconut oil group at 1st , 7th , 14th with p value <0.01. While, there was slight significant difference at breast milk group at p value <0.05. While, there was highly significant difference between mean scores of three groups at 7th and 14th day with p value <0.01. But, there was no significant difference between three groups at 1st day with p value >0.05. Conclusion: According to these findings, the current study detected that olive oil, coconut oil and breast milk had positive effect on management of nipple soreness, breast milk had least effect while olive oil had highest effect.

Background: Pain is an inherently human experience with the Arteriovenous Fistula Puncture, especially among children. Thus, it becomes of utmost importance to devote modern technologies to lessen this annoying sensation aside from the suffering from the disease itself. Thereof, this study aimed to evaluate the effect of immersive virtual reality intervention during arteriovenous fistula puncture on pain intensity among children undergoing hemodialysis in El Beheira Governorate, Egypt. Methods: A non-randomized controlled trial was executed in eight governmental hemodialysis units (that were assigned to receive pediatric cases), representing eight administrative districts. All the available children who fulfilled the inclusion criteria were incorporated in the study (36 children). Five tools were used: Socio-demographic and Medical History Structured Interview Schedule, Physiological Pain Indicators, Numerical Pain Rating Scale, Procedural Behavior Rating Scale and the Gold-Rizzo Immersion and Presence Inventory. Results: The Analysis of Covariance test (ANCOVA) proved a large effect size of virtual reality intervention on all pain measures (η2≥0.06). A statistically significant improvements in the mean scores of all the physiological pain measures was found after virtual reality intervention as compared to baseline (P0=<0.05) and standard care (P2<0.05). Most of the studied children reported either mild (58.3%) or moderate (27.8%) pain with no severe pain after virtual reality intervention with a statistically significant mean difference compared to the baseline (p0<0.001) and standard care (p2<0.001). A significant difference was proved between the virtual reality intervention and standard care concerning the observed pain behaviors during the procedure (p2<0.001). A high level of immersion with the virtual reality intervention was revealed among the studied children with a mean percent score of 90.97 ± 7.23. Conclusion & recommendations: Virtual Reality intervention proved to be efficient in lessening pain intensity among children undergoing hemodialysis. Thereof, it is recommended to be incorporated in the routine care of pediatric hemodialysis units.