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Background: Hepatic encephalopathy is a neuropsychiatric complication associated with liver cirrhosis. It occurs in up to 80% of patients with cirrhosis. Aim: To evaluate effect of nursing teaching guidelines on patients' knowledge regarding minimizing hepatic encephalopathy. Research design: Pre/post-test research design was utilized. Setting The study was conducted at Tropical Medicine and Gastroenterology department at El-Rajhi liver Hospital. Subjects and Methods: Thirty adult patients with liver cirrhosis. Tool: Structured interview questionnaire was utilized for data collection with three parts (sociodemographic, medical data and pre/post knowledge questionnaire). Results: The present study revealed that there was a highly statistically significant difference in the level of knowledge before, immediately post and after three months from application of nursing teaching guidelines. There was no statistically significant relation was documented between patient's knowledge and occurrence of hepatic encephalopathy, ascites and bleeding after three months from application of nursing teaching guidelines. Conclusion: It was concluded that level of knowledge regarding minimizing hepatic encephalopathy was improved after application of the nursing teaching guidelines. Recommendations: A written teaching guidelines hand book in simplified term should be available and distributed for cirrhotic patients about preventive measures of hepatic encephalopathy.

Aim: To assess the awareness among glaucoma patients at Upper Egypt Governorate hospitals. Research design: Descriptive cross sectional research design was used in this study Setting: The study was conducted in ophthalmology outpatient clinics (male & female) at Assiut University Hospital & Al-rmad Hospital, Elmina and Sohag Governorate. Subjects: The sample of this study total coverage of glaucoma patients included (1000), the researcher taking the sample during one year, this sample aged 50 years and above. Tool of study: One tool was used in this study include three parts, part I: patient demographic characteristics, part II: medical data, part III: knowledge about risk factors and self-practice regard glaucoma. Results: The most of patients age ranged between 60:80 year, nearly three quarter (74.6%) of them were females, and 80% of them comes from urban areas. The majority of studied sample (84.5%) unaware about glaucoma disease and show statistical significant difference between awareness of them and their education, P≤0.05. Also, there was no significant difference between knowledge of studied sample and their residence.

Death rate of patients with liver cirrhosis is 41.6% in Egypt. It is important to assess the nutritional status of this group of patients because these patients suffer from protein-calorie malnutrition. Aim: Assessment of nutritional status in patients with liver cirrhosis in Assiut university hospital.Patient and Methods: 60 adult patients with liver cirrhosis as a study group were conducted at Tropical Medicine and Gastroenterology Department at Assiut University hospital. Tools utilized for data collection were :(I) patient assessment and (II) nutritional assessment. Results: The main causes of patients with liver cirrhotic were HCV and HBV infection. Malnutrition was prevalent in 85% of patients. The most common malnutrition risk factors were dry mouth, taste alteration, food intolerance, multiple medications and the presence of ascites. Conclusions: the majority of patients with decompensated liver cirrhosis were malnourished regardless the etiology of liver cirrhosis. Identifying the patients that are approaching the state of malnutrition by simple and easily applied methods is necessary in order to provide nutritional support. Recommendations: Nutritional support and regimen, advice and guidelines by dietitian should be undertaken for all cirrhotic patients to prevent the occurrence of complications of malnutrition and improve clinical outcome.

Background: Sickle cell anemia (SCA) is a hereditary chronic genetic blood. Aim: To evaluate the impact of nursing instructions protocol on health promotion life style for patients with sickle cell anemia. Research design Quasi-experimental research design. Setting: New Valley (El Kharga general hospital). Patient and Methods Thirty adult patients with sickle cell anaemia. Tools: "Structured interview patient questionnaire". Tool (II): Health promotion Model-Instruments to measure health promoting lifestyle. Results: More than half of the studied sample was male with mean age (27.96±8.84). There was a highly statistically significant difference in the Patients' health promotion was increased after the implementation of the booklet; particularly in the areas of the health responsibility, physical activity, nutrition and Non-significant difference in interpersonal relations. Conclusion: The study findings supported all research hypotheses as it had been proven that the nursing instruction protocol had statistical significant effect on minimizing pain and improving health promotion lifestyle. Recommendations: It is important to educate patients about how to modify life style to healthy life, relieve and manage sickle cell anemia complications.