Zagazig University, Faculty of MedicineZagazig University Medical Journal1110-143121120150101PREDICTIVE ROLE OF CDX2, MUC2 AND MUC6 IN PROGRESSION OF CHRONIC GASTRITIS TO CARCINOMA115445410.21608/zumj.2015.4454ENAssafIDepartment of Pathology, Faculty of Medicine, Zagazig University.El GoharyMDepartment of Pathology, Faculty of Medicine, Zagazig University.ZaherIDepartment of Pathology, Faculty of Medicine, Zagazig University.Atwa .A.Department of Pathology, Faculty of Medicine, Zagazig University.Journal Article20171207Background and aim: The material of this study comprises 57 gastric biopsies including paraffin blocks selected from the archives of Pathology Department, Faculty of medicine, Zagazig University in addition to 10 freshly randomly selected endoscopic biopsies were obtained from the Endoscopy Unit of Tropical Medicine department, Faculty of Medicine, Zagazig University hospital in the period from 2011-2013 to examine the expression of CDX2,MUC2 and MUC6 in cases of chronic gastritis, gastric metaplasia, gastric dysplasia and cancer and study the role of these markers as predictors of progression of chronic gastritis to carcinoma.<br />Methods: Immunohistochemical analysis of CDX2, MUC2 and MUC6 was performed using 50 cases for chronic superficial gastritis, chronic atrophic gastritis, chronic atrophic gastritis with intestinal metaplasia, gastric dysplasia and gastric cancer.<br />Results: CDX2 and MUC2 were negative in 11/11 cases of chronic superficial and chronic atrophic gastritis on the other hand, CDX2 was positive in 3/3 cases of complete intestinal metaplasia while CDX2 was positive in 10/12 cases of incomplete intestinal metaplasia. CDX2 was positive in 6/8 cases of low grade dysplasia and 2/4 cases of high grade dysplasia. CDX2 was positive in 62.5% of cases of gastric adenocarcinoma and was positive in 2/2 cases of mucinous carcinoma. 2 /2 of signet ring carcinomas showed negative CDX2 expression. MUC2 was positive in all cases of complete and incomplete IM (3/3 and 12/12 respectively). MUC2 was positive in 7/8 cases of low grade dysplasia and 2/4 cases of high grade dysplasia. MUC2 was positive in 50% of cases of gastric adenocarcinoma. MUC2 was positive in all studied cases of mucinous carcinoma. 2 /2 of signet ring carcinomas showed negative MUC2 expression. MUC6 was positive in 11/11 cases of chronic superficial and chronic atrophic gastritis. It was positive in 11 cases of incomplete intestinal metaplasia. MUC6 was positive in 1 case of low grade dysplasia and 1case of high grade dysplasia and 5 cases of gastric cancer but all 3 cases of complete intestinal metaplasia showed negative MUC6 expression. MUC6 was positive in 37.5% of cases of gastric adenocarcinoma and in 2/2 cases of signet ring carcinomas. MUC6 expression was negative in studied 2 cases of mucinous carcinoma.<br />Conclusion: Gastric carcinomas are classified into gastric and intestinal phenotype on the basis of mucin expression.CDX2 transcriptional factor has a role in the formation and progression of intestinal metaplasia (IM) among the diverse gastric disorders such as gastritis, dysplasia and Gastric cancer(GC). CDX2 may be closely related to IM and The intestinal-type GC. Further loss of CDX2 in incomplete intestinal metaplasia (IM) could be a key step that may precedes the morphological change to dysplasia and may help to predict the risk of gastric cancer.CDX2 and MUC2 can be considered as a marker of intestinal metaplasia. MUC6 can serve as a marker for pyloric metaplasiahttps://zumj.journals.ekb.eg/article_4454_ab89ab1fd61b46b9f1900312149e320d.pdfZagazig University, Faculty of MedicineZagazig University Medical Journal1110-143121120150101IS IMPLEMENTATION OF WHO SURGICAL SAFETY CHECKLIST (2009) WILL REDUCE THE RATE OF MAJOR POST OPERATIVE COMPLICATIONS AT ZAGAZIG UNIVERSITY HOSPITAL? (AN INTERVENTION STUDY)115445510.21608/zumj.2015.4455ENAmanyAboel-SeoudDepartments of Public Health ,Faculty of Medicine, Zagazig UniversityFadiaEl-SabbaghDepartments of Public Health , Faculty of Medicine, Zagazig UniversityYehiaZakariaDepartments of General surgery , Faculty of Medicine, Zagazig UniversityMonaIbrahimDepartments of Public Health, Faculty of Medicine, Zagazig UniversityJournal Article20171207Background: Surgical care is associated with a considerable risk of complications and death that represents a substantial burden of disease worthy of attention from the public health community worldwide. A surgical checklist is an inexpensive tool that will facilitate effective communication and teamwork to prevent patient harm. Aim & Objectives: This study aims to improve the safety of surgical care to decrease morbidity and mortality associated with surgery at Zagazig University Hospital through the following objectives: 1- To assess the performance of surgical team (surgeons, anesthetists and nurses) about surgical safety before and after intervention. 2- To assess the incidence of major post-operative complications before and after intervention. 3- To assess surgical team attitude about patient safety in operating rooms (OR) before and after intervention. 4-To increase the awareness for all surgical team about surgical safety to decrease post operative complications. Subjects & Methods: an interventional study was conducted in general surgery department of Zagazig University Hospital during the Academic year 2012-2014. Comparing 157 patients before and 157 patients after intervention who are 16 years of age or older undergoing inpatient major surgical operation were consecutively enrolled in the study and all surgical teams (surgeons, anesthetists and nurses) of the selected group were included during the period of the study. The study was carried out through 3 phases. Results: Results of this study showed that there was a high statistically significant reduction in 30 days major post-operative complications after implementation of WHO surgical safety checklist, the total number of complications decreased from 50.96% to 27.39% (p = 0.0001), in-hospital mortality decreased from 3.18% to 0% (p = 0.02). There was statistical significant improvement of surgical team attitude about OR surgical safety after intervention (p<0.05), there was high statistical significant negative correlation between physician and nurse coordination and occurrence of postoperative complications(r= -0.27) (p<0.05). The checklist was considered easy to use by 94.6% of physicians, 62% of nurses. Conclusion: In conclusion, this study revealed that a relatively simple education program for implementation of WHO surgical safety checklist was associated with reduction in major post-operative complications and mortality in a hospital with a high standard of care. It is recommended to use the Surgical Safety Checklist in all operative procedures.https://zumj.journals.ekb.eg/article_4455_eba92949953c84a3cf206015cf297798.pdfZagazig University, Faculty of MedicineZagazig University Medical Journal1110-143121120150101INTERLEUKIN 23 AND INTERLEUKIN17 IN PSORIASIS, ATOPIC DERMATITIS AND LICHEN PLANUS: A SEROLOGICAL STUDY17445610.21608/zumj.2015.4456ENAlshimaaIbrahimDermatology and Venereology Department, Faculty of medicine, Zagazig UniversityLabibZTDermatology and Venereology Department, Faculty of medicine, Zagazig UniversityNofalAADermatology and Venereology Department, Faculty of medicine, Zagazig UniversityBoghdadiGSMedical Microbiology and Immunology Department, Faculty of medicine, Zagazig UniversityJournal Article20171207Introduction: The classical Th1/Th2 paradigm previously defining atopic dermatitis, psoriasis and lichen planus has recently been challenged with the discovery of Th17 that is now recognized to produce a group of distinctive cytokines such as interleukin 17 under the control of interleukin 23. Aim: to evaluate the role of Interleukin 23 and interleukin17 in the pathogenesis of psoriasis, atopic dermatitis and lichen planus. Methods: The study included three groups of patients, psoriasis, atopic dermatitis and cutaneous lichen planus each group containing 20 patients, in addition to 20 age and sex matched healthy controls. The levels of IL23 and IL17A were determined in serum samples by ELISA and correlated with the disease severity which was evaluated using specific severity index for each disease. Results: The serum levels of IL23 and IL17 were found to be significantly higher in the diseased groups when compared to healthy controls. The highest levels of IL-23 and IL-17 were reported in psoriasis vulgaris followed by lichen planus and the lowest levels of IL23 and IL17 were reported in atopic dermatitis. The correlation of IL23 and IL17 levels with disease severity was not statistically significant in the three groups. Conclusion: IL23 and IL17 may play a role in the pathogenesis of the three diseases but cannot be used as a marker of disease severity. On the other hand, the significant positive correlation between IL-23 and IL-17 in the three diseases suggests that those factors affect IL-23 will be reflected on IL-17 levels.https://zumj.journals.ekb.eg/article_4456_eeac5ffe8818478583bb9b49b145764e.pdfZagazig University, Faculty of MedicineZagazig University Medical Journal1110-143121120150101HORMONAL AND METABOLIC RESPONSES TO MODERATE AND HEAVY RESISTANCE EXERCISE LOADS IN MALE SUBJECTS17445710.21608/zumj.2015.4457ENEl-AyadiEl-AbedGIT (liver and metabolic diseases), Faculty of Medicine, Zawia Univ, LibyaShoushaS.Physiology, Nutr. Dept., Fac. Pub. Health, Zawia Univ., LibyaJournal Article20171207Forty healthy male subjects as volunteers participated in two different exercise load protocols (moderate and heavy loads), 20 subjects for each. The exercise protocols were carried out in the morning after fasting overnight, five times a week for 30 minutes a day for four weeks. Blood samples were withdrawn before the start and immediately after finishing the exercise protocols, from the antecubital vein, and the obtained plasma were kept at -20 °C until analysis. The hormone level of growth hormone (GH), testosterone, cortisol, insulin, T3 and T4, were determined by RIA technique, while the plasma concentrations of glucose, non-esterified free fatty acids (NEFFAs), triglycerides (TG) and total protein (TP) were measured biochemically. The results revealed a significant increase in the hormone levels of GH, testosterone, cortisol, insulin and T4,; and a significant increase in the concentration of NEFFAs and TG, while the plasma T3 levels and plasma glucose concentration showed a significant decrease in both exercise load protocols. Moreover, the T3 levels indicated a positive correlation coefficient (r) with glucose concentration, and a negative (r) with both NEFFAs and TG. On the other hand, T4, insulin and cortisol revealed a negative (r) with glucose and a positive (r) with both NEFFAs and TG. The results reported here were similar to a great extent to that reported in starvation. Thus, it would clearly appear that the exercise protocols can be considered as a good regimen program.https://zumj.journals.ekb.eg/article_4457_347b64e8795131e95cbd7c5fffb387b9.pdfZagazig University, Faculty of MedicineZagazig University Medical Journal1110-143121120150101PREVALENCE OF HEPATITIS C INFECTION AMONG DIABETICS TYPE 2 AT SHARKIA GOVERNORATE, EGYPT110445810.21608/zumj.2015.4458ENEssamAminInternal Medicine Departments, Faculty of Medicine,Zagazig University Hospital, EgyptAdelGhorabInternal Medicine Departments, Faculty of Medicine,Zagazig University Hospital, EgyptMohamedMohamedInternal Medicine Departments, Faculty of Medicine,Zagazig University Hospital, EgyptAmalZidanClinical Pathology Departments, Faculty of Medicine,Zagazig University Hospital, EgyptJournal Article20171207Background: HCV virus infection and type 2 diabetes mellitus are two major public health problems in Egypt. Egypt has the highest HCV virus prevalence in the world and is considered the ninth in rank of the highest prevalence of diabetes worldwide. The mutual relationship between diabetes and increased HCV infection may be due to the association of HCV with hepatic steatosis, insulin resistance and decrease of adiponectine synthesis as well as the nature of diabetes and its inherent complications and/or frequent parental exposure. Objective: determination of the prevalence of HCV infection in type-2 diabetics in Sharkia Governorate and to explore the predominant risk factors for HCV infection and its relation to some demographic parameters of this locality. Subjects and methods: A cross sectional randomized study was conducted to 642 patients, regardless of gender, body weight, educational level or socioeconomic levels, at multicentre managing diabetic patients at Sharkia governorate. All patients were subjected to detection of HCV-ab by third generation ELISA and HBA1C level<br />Results:<br />The prevalence of HCV infection among type 2 diabetic patients at Sharkia governorate approximates 38.7 %. Higher prevalence was detected among patients between 45 & 65 years old, low socioeconomic level, low educational level, and those who share personal utensils, have other family members infected with HCV. Patients who previously transfused, previous hospitalized, previously received parenteral anti-bilharzial therapy and those receiving insulin injections are also at high risk. Conclusion: As high as 39% of type-2 diabetics at Sharkia Governorate are HCV-infected. Apart from classic risk factors, The most significant independable factors associated with development of HCV infection in type 2 diabetics are low socioeconomic standard and low educational level. Previous blood transfusion, family members infected with HCV, parenteral antibilharzial treatment, sharing personal utensils and previous hospitalization may play also a role.https://zumj.journals.ekb.eg/article_4458_fc11b464f79d1f6c22444d07bbd8f208.pdfZagazig University, Faculty of MedicineZagazig University Medical Journal1110-143121120150101NEUTROPHIL GELATINASE–ASSOCIATED LIPOCALIN (NGAL) AS AN EARLY BIOMARKER OF ACUTE KIDNEY INJURY IN HEPATIC PATIENTS113445910.21608/zumj.2015.4459ENYousefKadryInternal Medicine Department, Faculty of Medicine, Zagazig University, Egypt.Abd AllahAbd AllahInternal Medicine Department, Faculty of Medicine, Zagazig University, Egypt.AtefAliInternal Medicine Department, Faculty of Medicine, Zagazig University, Egypt.HishamOmarClinical Pathology Department, Faculty of Medicine, Zagazig University, Egypt.Journal Article20171207Background :Acute kidney injury(AKI) is common in cirrhosis but differential diagnosis remains a challenge. Serum creatinine (SCr) less sensitive in reflecting renal dysfunction in cirrhotic patients. Aim of the Work: to study the usefulness of NGAL as an early biomarker of AKI in cirrhotic patients. Subjects and Methods: 80 subjects included, classified into 3 groups: GroupΙ: 10 control subjects. Group Π (GpΠ): 40 compensated hepatic patients without AKI, further subdivided into four subcategories: (GpΠa1): 10 patients with HCV under interferon plus ribavirin therapy. (GpΠa2): 10 patients with HCV not under interferon or ribavirin therapy. (GpΠb): 10 patients with Bilharzial liver fibrosis. (GpΠc): 10 patients with combined HCV and Bilharzial liver fibrosis. Group Ш (GpШ): 30 decompensated hepatic patients with AKI, further subdivided into three subcategories: (Gp Шa): 10 patients with Acute tubular necrosis . (Gp Шb): 10 patients with hepatorenal syndrome . (Gp Шc): 10 patients with Pre-renal azotemia. All participants were subjected to the routine lab investigations in addition to specific lab test plasma NGAL (pNGAL).Results: No significant difference was found in kidney function parameters (SCr, urea, GFR) between patients with AKI and patients without AKI. However, patients with AKI had higher pNGAL compared to patients without AKI. There were significant difference among group III subcategories, patients with ATN had pNGAL levels markedly higher (mean 295 ng/ml) compared to those of patients with PRA (mean 86.5 ng/ml), Patients with HRS had intermediate values {mean 142 ng/ml}. In patients with ATN, pNGAL markedly rise within 3 hrs of kidney injury compared to SCr which rises after 24 hrs. Among GpΠ subcategories, no significant difference was found in either pNGAL or kidney function parameters. Conclusions: pNGAL is an early biomarker of AKI and it can also discriminate type of AKI in cirrhosishttps://zumj.journals.ekb.eg/article_4459_8c9d400e00ea3805e950a4b5dd2c6cd6.pdfZagazig University, Faculty of MedicineZagazig University Medical Journal1110-143121120150101EFFECT OF HONEY BEE ON SOME ANTIOXIDANT ENZYMES AND LIPID PROFILE IN HYPERCHOLESTEROLEMIC MALE ALBINO RATS111446010.21608/zumj.2015.4460ENAzizaEl-ShafeyZoology Department, Faculty of Science, Benha University, Benha, Egypt.MoshiraSeliemZoology Department, Faculty of Science, Benha University, Benha, Egypt.SafaaEl-ZawahryZoology Department, Faculty of Science, Benha University, Benha, Egypt.EmanShahenZoology Department, Faculty of Science, Benha University, Benha, Egypt.DoaaMahmoudZoology Department, Faculty of Science, Benha University, Benha, Egypt.Journal Article20171207The present study investigates the effect of administration of honey bee on serum antioxidant enzymes "catalase, superoxide dismutase (SOD) and glutathione peroxidase (GPx)" and lipid profile in hypercholesterolemic male albino rats. Eighty four male albino rats weighting 150±20g were divided into six groups as follows: control group (freely supplemented with standard diet), coconut oil treated group (0.5 ml daily), cholesterol treated group (400 mg/kg b.w dissolved in 0.5 ml coconut oil), honey treated group (1 ml/rat of 20% honey bee), cholesterol and honey treated group and cholesterol before honey treated group. All treatments were by oral administration for two months. The results showed that, after one and two months coconut oil treated group showed significant increases in catalase and high density lipoprotein cholesterol (HDL-C) and significant decrease in low density lipoprotein cholesterol (LDL-C), while GPx significantly increased after two months. Treatment with cholesterol for one and two months caused significant decreases in antioxidant enzymes and significant increases in total cholesterol "TC" and LDL-C, while total lipid (TL), triglyceride (TG) and very low density lipoprotein cholesterol (VLDL-C) were significantly increased after two months. After one and two months, honey bee treated group showed significant increases in antioxidant enzymes and HDL-C and significant decreases in TG, LDL-C and VLDL-C, while TL was significantly decreased after two months. After one and two months, cholesterol and honey and cholesterol before honey treated groups showed non significant changes in antioxidant enzymes while these groups showed significant increases and decreases in HDL-C and LDL-C respectively. These results indicated that honey administration with or after cholesterol treatment acted for ameliorating the disturbances in antioxidant enzymes and lipid profile that induced by hypercholesterolemia. Honey bee administration for two months is more effective than one month in return of most measured parameters to about control values.https://zumj.journals.ekb.eg/article_4460_8f38965ebb080b2777ac86d1afcd337d.pdfZagazig University, Faculty of MedicineZagazig University Medical Journal1110-143121120150101DETECTION OF JAK2 MUTATION IN CASES OF MYELODYSPLASTIC SYNDROME18446110.21608/zumj.2015.4461ENMervatAzabClinical pathology Department , Faculty of Medicine, Zagazig University, EgyptOlaHusseinClinical pathology Department , Faculty of Medicine, Zagazig University, EgyptMervatAminClinical pathology Department , Faculty of Medicine,Zagazig University, EgyptJournal Article20171207Background: JAK2V617F is a tyrosine kinase gain-of-function mutation in exon 14 that results from a guanine-to-thymine transversion at nucleotide 1849 with substitution of valine to phenylalanine at codon 617. The in vitro expression of JAK2V617F results in the constitutive activation of the JAK-STAT pathway and resultant cytokine-independent growth. Aim of the work: Detection of JAK2 mutation in cases of MDS and MDS/MPN to provide practical guidelines, which can allow for a reproducible classification of these types when encountered in clinical practice, and that will benefit of JAK2 inhibitor treatment. Patients and methods: This study comprised 40 newly diagnosed patients divided into two groups: Group I : 20 patients with MDS, Group II: 20 patients with MDS/MPN (2 cases aCML,10 cases CMML,8 cases JMML).All members of this study were subjected to the following :full history taking ,complete clinical examination, routine laboratory investigations including:CBC, stained smear for morphological examination , B.M. aspirate & examination, cytogenetic analysis and detection of JAK2 V617F mutation by Allele Specific PCR technique. Results: In typical forms of MDS JAK2 V617F mutation was very rare (5%) However, a higher percentage of this mutation (55%) was found in patients with MDS/MPN. Positive JAK2 patients with high TLC, LDH may be the main pathology but if negative JAK2 with high TLC, LDH and platelets, we should searched for other mutation that may be in other area of JAK family. Conclusion: our study stated that the presence of JAKV617F mutation may assist in diagnosis of MDS/MPN group than MDS group (odds ratio [OR], 23.2; 95% confidence interval[CI], (2.5-208.6); P=0.001).https://zumj.journals.ekb.eg/article_4461_b8abfafcdc1e33198e121afa929a1362.pdfZagazig University, Faculty of MedicineZagazig University Medical Journal1110-143121120150101EFFECT OF FISH OIL AND ANIMAL FAT SUPPLEMENTATION ON LIPID FRACTIONS AND THYROID HORMONES IN ADULT MALE RATS17446210.21608/zumj.2015.4462ENEl-AyadiEl-AbedGIT (liver and metabolic diseases), Faculty of Public Health, Zawia University, Libya.Journal Article20171207Epidemiological studies have demonstrated that n-3 polyunsaturated fatty acid (PUFA) consumption is associated with a reduced risk of atherosclerosis and hyperlipidemia. It is well known that lipid metabolism is also influenced by thyroid hormones. The aim of the current study was to test whether fish oil versus beef fat supplementation would affect lipid metabolism in correlation with thyroid hormones in adult male rats. In this investigation, dietary lipids (fish oil) and (beef fat) were fed to adult male albino rats. Both dietary lipids were fed in concentration of 27% and 45 % of the diet’s dry matter, for 14 days. At the end of the experiment, the animals were sacrificed; the plasma and liver fractions including cholesterol, triglycerides, high and low density lipoprotein were measured biochemically; and the plasma levels of T3 and T4 were determined using RIA. The results revealed the following: (a) the fish oil diets decreased the plasma lipid fractions, except the high density lipoprotein which was increased, while the beef fat diets increased the plasma lipid fractions except the high density lipoprotein which was decreased. (b) the beef fat diets increased the liver lipid fractions more than the fish oil diets. (c) the T4 levels showed non significant change . (d) the plasma T3 levels revealed a significant increase in the animal groups fed the diets containing 27% of either fish oil or beef fat. These results suggested that fish oil has a hypolipidemic effect while beef fat has a hyperlipidemic effect. Furthermore, the influence of lipid calories on the plasma T3 levels may be more pronounced than that of carbohydrate when a normal amount of carbohydrate was ingested.https://zumj.journals.ekb.eg/article_4462_f237ec5364cfcfe6d5483578bf5e0c7e.pdfZagazig University, Faculty of MedicineZagazig University Medical Journal1110-143121120150101SMALL "PIGTAIL" CATHETER AND FIBRINOLYTIC INSTILLATION FOR MANAGEMENT OF PEDIATRIC PLEURAL EFFUSION17446310.21608/zumj.2015.4463ENOsamaAmerPediatrics, Diagnostic Radiology Departments, Faculty of Medicine, Zagazig UniversityKhaledSalahPediatrics, Diagnostic Radiology Departments, Faculty of Medicine, Zagazig UniversityMohammedTaeemaPediatrics, Diagnostic Radiology Departments, Faculty of Medicine, Zagazig UniversityHebaEmamCardiothoracic surgery Departments, Faculty of Medicine, Zagazig UniversityMohammedAlAnwarCardiothoracic surgery Departments, Faculty of Medicine, Zagazig UniversitySamehS.Cardiothoracic surgery Departments, Faculty of Medicine, Zagazig UniversityJournal Article20171207Background: Pediatric pleural effusion, particularly empyema, is a serious cause of childhood morbidity and prolonged hospitalization. Objective: This study objective was to evaluate the effectiveness of pigtail catheter placement plus alteplase (tPa) instillation intrapleural in treatment of parapneumonic effusion. Methods: A two-arm study was inducted to compare children who treated by pigtail catheter plus intarpleura tissue plasminogen activator (tPa) with children who were treated by thoracostomy tube drainage alone. Also, a cost effectiveness analysis was conducted on the basis of clinical outcomes and cost data available about each treatment strategy group. Result(s): Over the preiod of our study, 46 children were involved in group I with parapneumonic effusion treated by pigtail catheter plus intrapleural TPA and 24 children were involved in group II who were treated by thoracostomy tube drainage alone. The Length Of hospital Stay (LOS) was significantly shorter for 1st treatment strategy (group I) in addition to 0% failure rate (no surgical intervention needed). Group I strategy of management was the least expensive. Conclusion(s): Pigtail cathter plus intrapleural tPa is the more effective least expensive treatment strategy in management of children with parapneumonic effusion.https://zumj.journals.ekb.eg/article_4463_0b794e6932383785f7f3e81ae6efdbdb.pdfZagazig University, Faculty of MedicineZagazig University Medical Journal1110-143121120150101SENTINEL LYMPH NODES DISSECTION VERSUS AXILLARY LYMPH NODES DISSECTION IN PATIENTS WITH EARLY BREAST CANCER AND SENTINEL NODES METASTASES17446410.21608/zumj.2015.4464ENNabilHamrahGeneral Surgery Department, Faculty of Medicine, Zagazig University.AlaaKhalilGeneral Surgery Department, Faculty of Medicine, Zagazig University.MohammedAbdel-AalGeneral Surgery Department, Faculty of Medicine, Zagazig University.NadiaIsmailGeneral Surgery Department, Faculty of Medicine, Zagazig University.TahaBaiomyGeneral Surgery Department, Faculty of Medicine, Zagazig UniversityIbtsamHussienGeneral Surgery Department, Faculty of Medicine, Zagazig UniversityJournal Article20171207Background: Sentinel lymph node biopsy (SLNB) has become the standard method for axillary staging of breast cancer with reliable accuracy and less morbidity compared with axillary lymph node dissection (ALND) aiming to minimize the rate of patients with negative axillary status who undergo ALND and restricted only to patients with positive axillary lymph node.<br />Objective: To compare the results of SLN dissection only and that of ALN dissection regarding the morbidity and locoregional recurrence.<br />Patients and methods: A hundred patients with histologically confirmed invasive breast cancer T1/T2N0M0 and SLN positive for metastases (≤3 SLNs) were entered the study and divided randomly into two groups. Group I: Fifty (50) patients underwent SLN dissection only. Group II: Fifty (50) patients underwent SLN dissection and ALN dissection.<br />Exclusion criteria: Patients with >3 positive SLNs, patients with matted nodes, patients with gross extranodal disease and patients received neoadjuvant hormonal therapy or chemotherapy.<br />Statistical analysis: SPSS version 15.<br />Results: Adverse surgical effects were reported in both groups. In SLND group (6%) had seroma while in ALND group (16%) had seroma, wound infection was (4%) in SLND and (8%) in ALND, postoperative parasthesia after 1 year was (16%) in SLND and (44%) in ALND, postoperative lymphoedema after 1 year was (4%) in SLND and (10%) in ALND and axillary recurrence was (2%) in SLND and no recurrence in ALND.<br />Conclusion: SLND mapping and excision is the standard of care for axillary staging for patients with early invasive breast cancer and clinically node-negative disease.https://zumj.journals.ekb.eg/article_4464_1866b1654e9d7dfe43cbd271e89b2c21.pdfZagazig University, Faculty of MedicineZagazig University Medical Journal1110-143121120150101SUBCLINICAL EATING DISORDERS AND THEIR COMORBIDITY WITH MOOD AND ANXIETY DISORDERS IN ADOLESCENT GIRLS IN SHARKIA GOVERNORATE110446510.21608/zumj.2015.4465ENShimaaAminPsychiatry Department, Zagzazig University, Zagazig, EgyptEmanElsafyPsychiatry Department, Zagzazig University, Zagazig, EgyptMohammedNegmPsychiatry Department, Zagzazig University, Zagazig, EgyptNagdaElmasryPsychiatry Department, Zagzazig University, Zagazig, EgyptJournal Article20171207Background: Eating disorders are complex psychiatric syndromes in which cognitive distortions related to food and body weight and disturbed eating patterns can lead to significant and potentially life threatening medical and nutrition complications.<br />Aim of the work: To evaluate the prevalence of subclinical form of eating disorders and the association between it and mood disorders (Major Depressive disorder, Dysthymia) and anxiety disorders in adolescent girls in Sharkia governorate<br />Subject and Methods: in this two-stage cross-sectional study, we screened 2000 secondary school-student girls using (EDT) ,and CSID-1(for eating disorders) .Those scoring more than 30in EDT, and +ve SCID-1 (N=471) and a control group randomly selected from those scoring lower than 30, and –ve SCID-1 for eating disorders (N=215). To differentiate types of eating disorders (anorexia nervosa, bulimia nervosa, and EDNOS (subclinical eating disorders). All subjects(+ve SCID-1) involved in stage 2 were examined for mood disorders (depression, dysthymia) by using beck scale for depression, SCIA-I scale for dysthymia, and anxiety disorders by using taylor scale.<br />Results: the prevalence of subclinical eating disorders were 25.5% (SAN 3.5%, SBN 3.0%, SWC 10.0% and SBED 9.0%), there were statistically significant differences in socio-demographic data between the SEDS groups (Subclinical anorexia nervosa is low significant in BMI than other groups), Prevalencedepressive disorder 10.8%, MDD in SEDS patients were 2.5%, dysthymic disorder 4.0 % and generalized anxiety disorder 5.4%.<br />Conclusion: Subclinical eating disorders are more frequent than typical eating disorders. Subclinical forms of eating disorders may represent a high risk group for developing serious eating disorders, identifying this group will give an opportunity of prevention. Mood disorders (MDD, dysthymia ) and generalized anxiety disorder are more frequent in subclinical eating disorders.https://zumj.journals.ekb.eg/article_4465_de95166b5aafed2bd552dbf06781d1b3.pdfZagazig University, Faculty of MedicineZagazig University Medical Journal1110-143121120150101SERUM 25 OH VITAMIN D IN CHILDREN WITH BACTERIAL PNEUMONIA18446610.21608/zumj.2015.4466ENWagdyEl-sayedDepartment of Pediatric and Clinical Pathology; Banha Teaching HospitalEmanAamerDepartment of Pediatric and Clinical Pathology; Banha Teaching HospitalJournal Article20171207Background: Bacterial pneumonia of is common cause of pediatric mortality and hospital admission. Different risk factors for pneumonia are there. One possible risk factor is vitamin D deficiency .Objective: We determined 25 OH-vitamin D in bacterial pneumonia.to evaluate whether its level has relation to pathogenesis and management of the disease Design: case-control study Methods: 25 OH-vitamin D was determined by competitive enzyme immunoassay (EIA) commercially available kit in 36 cases with pneumonia CRP was determined by ELIZA "high sensitive CRP" .ESR done by Wintrobe method The results were analyzed and compared with 16 controls using SPSS 20 Results: Vitamin D level in pneumonia cases was significantly lower in patients compared to controls and showed negative correlation with C-reactive protein and weak negative correlation ESR. Vitamin D did not show any relation to age, sex, weight or other clinical symptoms as dyspnea and fever Also did not show any relation to RBCs, Hb, or WBCs .Conclusion: We conclude that level of 25 OH-vitamin D is low in children with bacterial pneumonia and correlates negatively with CRP with possible relation to disease severity.https://zumj.journals.ekb.eg/article_4466_8e3143bc2fceedc5c00f1e21e3d1ebf6.pdf