Background: Episiotomy pain is the most common complaint among postpartum women. One of the simple nursing interventions to decrease it and improve the healing process is applying the crushed ice gel pads. The present study aimed to evaluate the effect of applying crushed ice gel pads on episiotomy pain and wound healing among postpartum primiparous women. A quasi-experimental study design was used. A total of 200 postnatal women (intervention and control group) were selected from the postpartum ward and outpatient clinic at El-Manail maternity Hospital, Egypt. Four Tools for data collection were used: "women structured interviewing sheet, Numeric Rating Scale, shortform McGill pain questionnaire, and the standardized REEDA Scale". The Results of the study revealed that the mean age of the sample was 26.8± 5.8 years old. There was a statistically significant reduction in the level of episiotomy pain at first day, 3 days, and seven days postpartum between the two groups. Also, the study group REEDA score decreased to 2.72 ± 4.6 and 1.1 ± 3.8 during the posttest. Added to that, most of the intervention group (92.0%) had good episiotomy wound healing while more than half of the control group (57.0%) still has poor and mild healing. Conclusion: Women who applied the crushed ice gel pads at postpartum period experienced a lower level of episiotomy pain, had good episiotomy wound healing, and had better ability to perform daily living activities during the posttest than the control group. Recommendations: The nurses should be aware of the importance of crushed ice gel pads for postpartum primiparous women, and they should encourage them to apply the crushed ice gel pads at the hospital as well as home to improve their episiotomy wound healing and maintain comfort.

Introduction: Breast engorgement is a painful condition that affects a huge number of postnatal women. It is associated with unsuccessful breastfeeding, mastitis, and breast inflammation. So, there is a need to increase awareness regarding the efficiency of different nursing interventions as: warm compresses and cold cabbage leaves to treat breast engorgement. The aim of the study was to reduce the level of breast engorgement among the postnatal mothers and to compare the effect of warm compresses versus cold cabbage leaves on breast engorgement. Methods: A Quasi-experimental (equivalent pre-posttest group) research design was adopted. Setting: This study was conducted at postnatal ward and outpatient clinic at El-Manial Maternity hospital, Cairo Governate, Egypt. Subjects: A total of 90 postnatal mothers.They were randomly assigned into two groups (45 for each). Tools: Four tools were used to collect data; Maternal structured interviewing questionnaire, Six-points engorgement scale, Visual Analog Scale, and LATCH breastfeeding scale. Results: The mean age of the mothers was 26.6 ± 4.3 years old. More than twenty percent of each group suffered from firm and tender breasts (22.2% & 28.9%). Also, there was a statistically significant difference between the pre and post symptoms of breast engorgement, levels of breast engorgement, pain score, and engorgement score for both groups (p < .05*). Hence, both the interventions were effective in relieving pain and reducing breast engorgement. Conclusion: An application of cold cabbage leaves and warm compresses are effective for relieving breast engorgement. In addition, there was a statistically significant difference between the pretest and posttest of pain score and engorgement score for both groups (p < .001*). Recommendation: Nurses should be trained to include cold cabbage and warm compresses nursing approaches for managing breast engorgement in their discharge teaching plan. Also, prevention and early detection of breast engorgement should be done for all postnatal women.

Background: Muscle cramps occur frequently among elderly hemodialysis patients, which can be avoided by the application of intradialytic stretching exercises. Purpose: Determine the effect of intradialytic stretching exercises on muscle cramps among elderly patients undergoing hemodialysis. Setting: The study was conducted at hemodialysis unit in Meet Khaqan Health Center affiliated to Shebin El-Koum Fever Hospital. Sample: The study subjects comprised of a convenience sample of 50 elderly patients who were registered in dialysis unit's files. Instruments: First, Structured interviewing questionnaire. Second, cramp questionnaire chart and visual analogue scale. Results: There was a highly statistically significant difference in the level of muscle cramps pre and post implementation of intradialytic stretching exercises (p < 0.001**). Conclusion:There was a significant reduction in the muscle cramps level after application of the intradialytic stretching exercises. Thus, these exercises are an effective and simple measure to prevent or reduce severity of muscle cramps among elderly hemodialysis patients. Recommendations: Intradialytic stretching exercises should be combined with routine nursing care for hemodialysis patients.

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Background/Aim: Orthostatic hypotension is an important problem that commonly occurs in elderly people. It causes a burden on public health, is associated with impaired motor performance, and negatively affects physical functioning and activities. This study aimed to detect the risk of orthostatic hypotension in elderly people. Materials and methods:A descriptive research design was used. The study was conducted at the Badr geriatric home and outpatient clinic of Fayoum university hospital, Egypt. Subjects: A total of 300 elderly individuals. Tools: Structured interview questionnaire, Orthostatic Hypotension Symptom Assessment Questionnaire, and supine to stand test.Results: About three-fifths of the sample were aged 60-69 years old and more than one third of the participants (34.0%) were aged 70-79 years old. In addition, 53.3% of the clients were male and 46.7% were female. Regarding to the residence, more than three quarters of the participants (79.3%) were from rural areas and 40.0% of them were illiterate, not working (86.7%), and married (62.0%). In addition, 24.0% of the elderly clients suffered from orthostatic hypotension (OH) which affected activities that required walking or standing for a long time. In addition, a longer time was required for a shower (86.1%), prolonged bed rest (55.6%), carbohydrate-heavy meals (54.2%), obesity (52.7%), hypertension (43.1%), diabetes mellitus (36.1%), cardiac diseases (27.8%), and anemia (16.7%) were the main precipitating factors for OH in elderly clients. Conclusion:Approximately one-fifth of the clients suffered from OH. The main precipitating factors included a long time for a shower, prolonged bed rest, heavy carbohydrate meals, obesity, hypertension, diabetes mellitus, cardiac diseases, and anemia. Recommendations: All older adults especially those with chronic diseases should receive regular monitoring of blood pressure to detect OH and prevent complications.

Background: Falling among elders is the most causative factor of unintentional injuries resulting in disability and hospitalization. Aim: Was to identify the modifiable and non-modifiable risk factors and the adverse consequences of falling among elderly people. Methodology: A descriptive study was conducted on 384 elderly participants at Minia governorate, Egypt. Tools: A structured questionnaire, Timed Up and Go Test Scale, Katz Scale, and Mini-Nutritional Assessment questionnaire were used. Results: Findings showed that 45.6% of the participants were at risk of falling based on the performed timed up and go test and 63.5 % of them had a falling history. Female gender, age, and chronic diseases were the main non-modifiable risk factors, while the detected modifiable factors of falling included; absence of toilet seats (95.9 %), absence of grab bars (76.2%), poor lighting (56.6%), and slippery floor (54.1%). Additionally, 93.4% had a lack of assistive devices, inactivity (81.6%), anemia (65.2%), and poor vision (50.8%). Likewise, 73.0%, 35.2%, 26.6%, and 100% of the fallers reported back pain, cut wounds, fractures, and fear respectively as adverse consequences. Conclusion: Hazardous environment, declined physical activities, walking problems, lifestyle, malnutrition, and body mass index were the most reported modifiable risk factors of falls. Recommendations: Early detection of the modifiable risk factors is essential for preventing falling and its adverse consequences among elderly people.