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Background: Abdominal surgery is considered one of the most painful surgical procedures as the site's proximity to the diaphragm and extensive cross-innervations in the area increasing the postoperative pain. Progressive Muscle Relaxation (PMR) is a promising intervention for these complains. Aim of the study was to determine the effectiveness of progressive muscle relaxation technique on post-operative pain and postoperative quality of recovery. Research design: A quasi experimental research design with a pretest-posttest control group was utilized. Setting: at surgical departments at Damanhour National Medical Institute. Subjects: A purposive samples of 80 adult patients who are undergoing abdominal surgery were selected according to eligibility criteria. They were divided into two equal groups 40 in each study group and control group. Tools of data collection: four tools were used for data collection: Demographic and clinical Data Structured Interview Schedule, Visual Analogue Pain Scale, A modified Behavioral Pain Scale and Post-Operative Quality of Recovery Score. Results: After the intervention, PMR significantly decreased pain severity among study group compared to the control group. The severe pain intensity significantly absent from the entire study group, while it was significantly present among 42.5% of the control group. All of the study subjects had a good post-operative quality of recovery compared to only7. 5% of subjects in the control group. Conclusion: PMR significantly decreased postoperative pain and improve post-operative quality of recovery among patients after abdominal surgeries. Recommendation: PMR should be incorporated in post-operative nursing intervention protocols.

Background: Cerebrovascular Stroke (CVS) is a rapidly developing clinical focal disorder of cerebral function lasting for 24 hours or longer and leading to death, with no obvious reason other than the vascular source. Aim of the study: was to determine the effect of swallowing training rehabilitation program on severity of dysphagia and swallowing trial among patients with cerebrovascular stroke Research design: A quasi experimental research design with a pretest-posttest control group was utilized. Settings: The study was conducted at neurological inpatient units at Alexandria University Hospital. This hospital was selected because flow rate of patients with cerebrovascular stroke was satisfactory for the study. Subjects: Purposive samples of 60 hospitalized adult patients with CVS were selected according to eligibility criteria. They were divided into two equal groups 30 in each study group and control group. Tools of data collection: three tools were used for data collection namely: Patients' demographic characteristics and clinical data sheet, dysphagia severity scale and observation checklist to assess swallowing ability during swallow trial: Results: the study results revealed that there was a statistically significant difference between the study and control groups in favor of the former in relation to severity of dysphagia and swallowing trial after two weeks and one month of intervention in which the severity of dysphagia decreases among study group to 20% and 13.3% respectively in level (1) after two weeks and one month while the severity of dysphagia increases among control group to 40% and 66.7% respectively in level (1) after two weeks and one month with P = 0 .000. Conclusion:The study concluded that swallowing training rehabilitation program has significant positive effect on severity of dysphagia and swallowing trial among patients with cerebrovascular stroke. Recommendation: The developed booklet with its simple instructions and illustrations should be utilized in hospitals as a teaching aid for patient with dysphagia. Periodic health education programs for nurses to create awareness on swallowing exercises in improving swallowing ability.

Diabetic foot ulcer is a debilitative disease with severe consequences in diabetic patients. Wound healing is a complex biological process that restores skin integrity. Conventional dressings were found ineffective for these ulcers. Insulin accelerates wound healing in diabetes by enhancing growth of different cell types and affects proliferation by keratinocytes, endothelial cells, and fibroblasts. Aim of the study was to evaluate the effect of topical insulin on diabetic wound healing among patients with diabetic foot ulcer. Research design: A quasi experimental research design was utilized. Settings: The study was conducted at inpatient vascular surgery department at Alexandria Main University Hospital. Tools of data collection: One tool was used for data collection. It consisted of two parts. Part I: Socio demographic and clinical data and Part II: Bates-Jensen wound assessment tool. Results: The result of the study revealed that there was statistical significant improvement in all items of foot ulcer assessment in the study group over control after two and three weeks of daily topical insulin dressing. There was statistical significant improvement in diabetic foot ulcer severity among the study and control groups after one week, after two and three weeks daily topical insulin dressing. The findings of the present study also showed that diabetic foot ulcer in the study group need less time than the control group for complete healing. Conclusion: This study concluded that patients with diabetic foot ulcer who receive topical insulin dressing exhibit enhanced healing rate than patients who do not receive such intervention. Recommendations: Incorporate the technique of topical insulin dressing in clinical nursing curricula, evaluate this method on other type of wound than diabetic foot ulcer and in service training programs for nurses about topical insulin wound dressing.

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