Zagazig University, Faculty of MedicineZagazig University Medical Journal1110-143125420190701The Need for Surveillance of Antimicrobial Resistance in Developing Countries: Practice Makes Perfect4904913756110.21608/zumj.2019.12726.12260ENAhmed MoradAsaad0000-0002-1422-1117Journal Article20190619Zagazig University, Faculty of MedicineZagazig University Medical Journal1110-143125420190701Novel Laboratory Biomarkers in Critically Ill Patients4924993758510.21608/zumj.2019.11160.11600ENSamia MohamedMassoudKhaled MohamedElsayedKhaled MohammedAlanwerMuhammad SeddeeqSaadJournal Article20190627The crucial care placing desires early checks which permit clinicians to properly stratify patient hazard, to diagnose organ disorder early, and to set a focused remedy speedy. This raises the idea of biomarkers. An excellent biomarker check have to be secure, clean to perform, as non-invasive as viable, completed at the bedside or with a (quite) easy laboratory test, speedy, distinctly precise for the sickness, its subtypes and reasons, and touchy for as early detection as feasible. Biomarker checks were categorized clinically into: precursor, screening, indicative, stage, and predictive. Biomarker assessments can also contain measurements immediately on organic media or measurements which include brain imaging which do not contain direct sampling of organic media however measures modifications inside the composition or feature of the nervous system. The biomarkers mentioned in this article are biomarkers of cardiovascular illnesses, breathing illnesses, renal illnesses , as well as biomarkers of disorders of the nervous system , biomarkers of infection and biomarkers of gastrointestinal illnesses. A panel of biomarkers appears to be a probable answer for accomplishing a whole affected person assessment together with a good enough medical evaluation and tracking.Zagazig University, Faculty of MedicineZagazig University Medical Journal1110-143125420190701Levofloxacin versus Clarithromycin-based Therapy for Eradication of Helicobacter Pylori Infection: A Comparative Study5005073758910.21608/zumj.2019.8141.10510ENNeveen GeorgeElantounyAshraf AhmedAbo BakrRehab HosnyEL-SokkaryYousif ElsayedElshahatJournal Article20190627<strong>Background</strong><strong>:</strong> Helicobacter pylori (H.pylori) infection causes multiple upper gastrointestinal diseases but optimal therapeutic regimen which can eradicate infection in all the cases has not yet been defined. Antimicrobial resistance has decreased eradication rates for H.pylori infection worldwide. The aim of the present study was to compare between the efficacy and tolerability of levofloxacin versus Clarithromycin based triple therapy in eradication of H.pylori infection.<br /> <em> </em><strong>Subjects and Methods:</strong> In this comparative cross sectional study, 142 patients with epigastric pain and dyspepsia and positive stool antigen test and only 35 of them were further confirmed by Rapid Urease Test during upper endoscopy (endoscopy was indicated) were enrolled. They were divided into 2 groups The first group (levofloxacin group) was treated with levofloxacin (500 mg daily) plus amoxicillin (1 gm twice a day) plus pantoprazol (40 mg twice daily) for 2 weeks. The second group (clarithromycin group) was treated with clarithromycin (500 mg twice a day) plus pantoprazol (40 mg twice daily) plus amoxicillin (1 gm twice a day) for 2 weeks. For treatment evaluation Stool antigen test was performed after four weeks after cessation of therapy.<br /> <strong>Results:</strong> H.pylori eradication was successful in 84.5% of the levofloxacin group and 69% of the clarithromycin group (P=0.001). The adverse effects were less frequent in levofloxacin-based than clarithromycin-based Ttiple therapy.<br /> <strong>Conclusion:</strong> Triple therapy with levofloxacin-based regimen has better efficacy than clarithromycin-based regimen.Zagazig University, Faculty of MedicineZagazig University Medical Journal1110-143125420190701Role of Magnetic Resonance Imaging in Diagnosis of Endometrial and Cervical Malignancies5085193759810.21608/zumj.2019.8036.10450ENHagar OsamaElkadyHadeer SafwatFahmyHosam NabilAlmassryEna Abd El AzizEl SammakJournal Article20190627<strong>Background</strong>: Endometrial and cervical cancers are common worldwide for gynecological cancers. MRI has been shown to be the most accurate non-invasive technique for endometrial and cervical cancer staging, which is necessary to make the right medical treatment decision, since accurate staging is crucial for the appropriate treatment. Functional MRI (dynamic contrast, diffusion-weighted imaging) in perfect combination with conventional MRI are used to make correct diagnosis and accurate staging.<br /> <strong>Objective</strong>: The aim of the study is to assess the role of magnetic resonance imaging (MRI) in staging of endometrial and cervical cancer.<br /> <strong>Methods</strong>: This study was carried out at Radio diagnosis Department, Zagazig University Hospitals, the present study was carried on 37 patients of endometrial and cervical cancer. Conventional MRI, contrast enhanced MRI and diffusion weighted imaging were done.<br /> <strong>Results:</strong> The combination of conventional and functional MR images is particularly beneficial for the evaluation of endometrial and cervical carcinoma stages. This study included 37 female patients with postmenopausal bleeding, vaginal abnormal bleeding, vaginal abnormal discharge and pelvic pain due to several pathologies, 24 cases of endometrial carcinoma and 13 cases of cervical cancer. All patients underwent conventional MRI, MRI with contrast and diffusion weighted imaging. Biopsies were made for all cases for tissue characterization and histological types identification.<br /> <strong>Conclusion: </strong>Our results show that magnetic resonance imaging is the best technique for initial endometrial and cervical tumor staging. In order to obtain high diagnostic accuracy, adequate patient preparation, protocol optimization and MRI reporting expertise are essential.Zagazig University, Faculty of MedicineZagazig University Medical Journal1110-143125420190701Breast Reduction with a Superomedial Pedicle (Hall-Findlay’s Technique): Zagazig University Hospital Experience5205283760710.21608/zumj.2019.8133.10570ENTarek EzzatAbd El-LatifMohamed HassanAbd El-AlAhmed MohamedAliAli MuftahShahoutJournal Article20190627<strong>Background:</strong> Breast reduction remains a commonly performed operation, with more than 122,000 breast reductions performed in 2013 (American Society for Aesthetic Plastic Surgery (2014). Breast reduction, also known as reduction mammaplasty, is a procedure to remove excess breast fat, glandular tissue and skin to achieve a breast size more in proportion with the body and to alleviate the discomfort associated with excessively large breasts (macromastia). <strong>Aim of the study:</strong> was to evaluate the short-time outcome effects of superomedial pedicle using Hall-Findlay’s technique of the breast reduction, to evaluate the effects on operative time, short-time outcome, the short-term effects and the complication rate of superomedial pedicle of the breast reduction. <strong>Methods:</strong> A total of 12 consecutive patients with bilateral breast hypertrophy underwent superomedial pedicle breast reduction in Plastic Surgery Unit, Zagazig University Hospital were included in this study during the year 2018. The operation was performed according to Hall-Findlay superomedial pedicle technique. All operations were performed by a double team of surgeons, with each team including a resident and a senior surgeon who was the leader of the operation. <strong>Results: </strong>Superomedial pedicle can be safely utilized in large size breast reduction without an expanded danger of NAC. <strong>Conclusions:</strong> The Hall-Findlay technique has aesthetic results and low complication rates in patients underwent breast reduction. We plan to expand the patient population that can undergo this technique, so more patients can benefit from its advantages.Zagazig University, Faculty of MedicineZagazig University Medical Journal1110-143125420190701Is The Combination of Glasgow Coma Scale and Transcranial Doppler Pulsatility Index Improving The Prediction of Outcome in Traumatic Brain Injury Patients?5295383790810.21608/zumj.2019.10082.10740ENNaglaa F.AbdelhaleemHowaydah A.OthmanGhada M.Abdel RazekHmed H. S.SolimanEssam F.Abdel GalelJournal Article20190629<strong>Background:</strong> Glasgow coma scale (GCS) is a familiar scoring system with a standard statistical association with neurological outcome, it has many limitations that minimize its ability in prediction of Traumatic brain injury (TBI) patients' outcome. Transcranial Doppler (TCD) is a noninvasive aid in this field that can improve outcome prediction.
Objective: This study aims to explore the effect of combination of GCS and Pulsatility Index (PI) in the prediction of outcome of TBI patients.
<strong>Patients and Method:</strong> This study was performed in Zagazig University Hospital (ZUH). 103 traumatic brain injured patients were engaged in the investigations with hospital days of 1, 2, 3, and 7 or until patient discharge. The study was performed by TCD along with GCS recordings. Prognosis was also assessed by the Glasgow outcome scale (GOS).
<strong>Results:</strong> The sensitivity and negative predictive value of PI was more than GCS in TBI patients (GCS 3-15), as they were (67.5% versus 50%) and (81.1% versus 74.3%), respectively. The combination of both PI and GCS increased the sensitivity and the negative predictive value up to 70% and 83.3%, respectively. PI had higher sensitivity, positive and negative predictive values than GCS in the identification of secondary neurologic deterioration (SND) in mild and moderate TBI patients (73.3% versus 40.0%, 61.1% versus 50.0%, and 92.0% versus 83.9%, respectively), while the combined value of both PI and GCS increased both sensitivity and positive predictive value up to 76.7% and 66.7%, respectively.
<strong>Conclusion:</strong> The combination of GCS and PI would improve the prediction of outcome.Zagazig University, Faculty of MedicineZagazig University Medical Journal1110-143125420190701Interlay Technique Tympanoplasty: Surgical Difficulties with Variable Grafts5395473791010.21608/zumj.2019.10135.10760ENAlaa El-Din MohamedEl-FekyMagdy KamelAbdelmaksodSaid Abdel-MonemMohamedRamadhan YousufRamadhan Abd AldaemJournal Article20190629<strong><span style="font-family: 'Times New Roman','serif';">Background:</span></strong><span style="font-family: 'Times New Roman','serif';"> Perforation of the tympanic membrane is most commonly the result of chronic ear disease. However, it can also result from various forms of trauma, which includes iatrogenic and direct physical injuries, burns, scalds and pressure effects. Most of these perforations heal spontaneously, whereas the remaining long-standing perforations that lead to recurrent ear discharge need tympanoplasty.<strong> Objectives</strong>: the aim of this study was to evaluate the results of interlay technique of tympanoplasty with respect to graft uptake and hearing status and to compare surgical difficulties between variable grafts. <strong>Patients and Methods</strong>:A total of 20 Patients included in the study were 6 males and 14 females, their age ranged from 10 years to 50 years presented with dry large central tympanic membrane perforations being inactive for at least one month without treatment were operated by interlay myringoplasty . <strong>Results</strong>: </span><span style="font-family: 'Times New Roman','serif'; mso-fareast-language: AR-SA; mso-bidi-language: AR-EG; mso-no-proof: yes;">In our study, we recorded the success rate to be 90% in interlay myringoplasty and this is in accordance with the success rate reported by other studies using interlay technique</span><span style="font-family: 'Times New Roman','serif';">. <strong>Conclusions:</strong> Interlay tympanoplasty results in excellent graft uptake and good post operative air bone gap (ABG) closure. A main advantage of this technique includes prevention of anterior blunting, lateralization and medialization of graft. Interlay tympanoplasty abolishes chances of epithelial cyst formation as in overlay technique and myringitis due to endothelium overgrowth as in underlay technique</span>
<strong><span style="font-size: 14.0pt; line-height: 115%; font-family: 'Times New Roman','serif';">Interlay Technique Tympanoplasty: Surgical Difficulties with Variable Grafts</span></strong>
Zagazig University, Faculty of MedicineZagazig University Medical Journal1110-143125420190701Comparison between Total Intravenous Anesthesia Using Propofol and Inhalational Anesthesia Using Isoflurane on the Quality of Surgical Field in Spine Surgery5485553791110.21608/zumj.2019.10174.10790ENAhmed AbdelkhalikAbdullah1234-1234-1234-1234Samia MohammedMasoud1234-1234-1234-1234Howaida KamalAbdellatifOlfat AbdelmonemIbrahem1234-1234-1234-1234Journal Article20190629<strong>Background:</strong><strong> </strong>Spinal surgery in adults can vary from simple to complex and can also have variable anticipated surgical blood loss. There are several factors that can put patients at increased risk for greater intraoperative blood loss<strong>.</strong> This study aimed to compare between total intra venous anesthesia (with propofol) and inhalational anesthesia (with isoflurane) on the quality of surgical field in spine surgery.
<strong>Patients & Methods: </strong>A prospective comparative randomized clinical study for comparison between total intra venous anesthesia (with propofol) and inhalational anesthesia (with isoflurane) on the quality of surgical field and hemodynamics of patients in spine surgery. Thirty patients in the age group of 21–50 years with ASA physical status Classes I and II, undergoing spine surgery were randomly divided into two equal groups of fiften each. In Group S: received isoflurane-based inhalational anesthesia and in Group P: were administered TIVA with propofol. All patients in both groups were assessed for: hemodynamics (heart rate,mean arterial blood pressure), respiratory profile ( SpO2 %, end tidal CO2), surgical field rating scale, surgeon satisfaction, total blood lost and amount of transfused blood during surgery.
<strong>Results: </strong>Regarding mean blood pressure, it was less in group P than group S. Regarding heart rate values, it was less in group P than group S .Regarding total blood loss, it was more in group S .Group P had better surgical field rating than group S. The surgeon operating on the group receiving propofol had better satisfaction. There were no significant differences between the studied groups regarding ETCO2 and SpO2 over time.
<strong>Conclusion:</strong> In spine surgery, using TIVA with propofol provides better hypotensive anesthesia, decreases blood loss during surgery and also provides good quality of surgical field as compared to using inhalational anesthesia with isoflurane.Zagazig University, Faculty of MedicineZagazig University Medical Journal1110-143125420190701Different Endoscopic Approaches Addressing Frontal Sinus5565663791210.21608/zumj.2019.10189.10800ENMohamed KamalMobashirNasser NaguibNasrAhmed MohamedElhady AnanyAhmed EmadEl Din El MaghawryJournal Article20190629<strong><span>Background:</span></strong><span> Chronic frontal sinusitis as a component of chronic rhinosinusitisis is one of the greatest challenges in rhinology. The endoscopic endonasal approach to the frontal sinus became the standard approach in chronic rhino sinusitis refractory to medical management. </span>
<strong><span>Objectives: </span></strong><span>The aim of this work is to assess different approaches addressing frontal sinus disease in twenty four patients with chronic frontal sinusitis resistant to medical treatment for a period not less than twelve weeks in Otorhinolaryngology Department in Zagazig University Hospitals from March 2018 to November 2018.</span>
<strong><span>Patients and methods: </span></strong><span>Patients’ age ranged from 20 to 58 years with a mean of 32.6 ± 10.68. These patients had two different approaches on each nasal side: Zero angled endoscopic approach (to perform standard uncinectomy and anterior ethmoidectomy including resection of ethmoidal bulla with middle turbinate preservation then removal of agger nasi cells accessing frontal sinus) and resection of the superior attachment of uncinate process (with preservation of ethmoidal bulla then using 70 degree angled endoscope to expose the frontal sinus).</span>
<strong><span>Results: </span></strong><span>In both techniques, preservation of ethmoid artery, middle turbinate and lamina papracyae were maintained. Residual mucopurulent discharge in the frontal recess area was found in 4 sides (10%) and managed medically. Endoscopic assessment revealed lateralization of middle turbinate in 6 sides only (15 %) which had ethmoidectomy prior to frontal sinusotomy.</span>
<strong><span>Conclusion:</span></strong><span> Addressing frontal sinus through intact bulla technique is less invasive guarding against anterior ethmoidal artery injury, scarring at frontal recess area and frontal ostium restenosis.</span>Zagazig University, Faculty of MedicineZagazig University Medical Journal1110-143125420190701The Significance of BRCA-associated Protein (BAP1) and Calretinin Expression in Malignant Pleural Mesothelioma and Non-small Cell Lung Carcinoma: An Immunohistochemical Study5675763791410.21608/zumj.2019.9703.10890ENHend Alaa EldinHadhoudYehia ElalfyAliAmira AminSalemMai MohammedAbdelwahabJournal Article20190629<strong><em>Background: </em></strong>Malignant pleural mesothelioma (MPM) and non-small cell lung carcinoma (NSCLC) are common diseases with rising incidence, patients have different prognosis and are treated differently, and thus it is very important to diagnose these malignancies properly. This differential diagnosis is not easy. The aim of this work is to evaluate the role of BRCA-associated protein (BAP1) and calretinin in the differentiation between mesothelioma and non-small cell lung carcinoma.<strong> <em>Methods</em></strong><strong><em>:</em></strong>BRCA-associated protein (BAP1) and calretinin were assessed by immunohistochemistry in 44 lung paraffin blocks, malignant pleural mesothelioma (22 cases) and non-small cell lung cancer (22 cases).<strong> <em>Results:</em> </strong>BAP1 expression was observed in 20/22(90.9%) of cases of non small cell lung carcinoma, while only 8/22 (36.4%) of malignant pleural mesothelioma showed positive BAP1 immunoreactivity. There was a statistically significant difference in BAP1 expression between non-small lung carcinoma and malignant pleural mesothelioma (p value = 0.001)<strong>.</strong> Calretinin expression was observed only in 3/22 (13.6%) of cases of non-small cell lung carcinoma, while 18/22 (81.8%) of malignant pleural mesothelioma showed positive calretinin immunoreactivity. There was a statistically significant difference in calretinin expression between non-small lung carcinoma and malignant pleural mesothelioma (p value< 0.001). BAP1 has sensitivity of 90.9%, specificity of 63.6%, predictive value positive (PVP) of 71.4% and predictive value negative (PVN) of 87.5%. Calretinin has sensitivity of 81.8%, specificity of 86.4%, PVP of 85.7% and PVN of 82.6%.<strong> <em>Conclusion:</em></strong> BAP1 and calretinin IHCcan be used with other immunohistochemistry panel to differentiate between malignant pleural mesothelioma and non-small lung carcinoma.Zagazig University, Faculty of MedicineZagazig University Medical Journal1110-143125420190701Assessment of Calprotectin as a Serodiagnostic Marker for Neonatal Sepsis5775863794110.21608/zumj.2019.10031.10980ENTarek HamedAttiaHatem MohammedHussienAhmed MoradAsaad0000-0002-1422-1117Ziad AhmedEsmat0000-0003-3252-7475Journal Article20190629<strong>Background: </strong>Despite recent advances in neonatal care, sepsis remains a worldwide leading cause of morbidity, mortality and prolonged hospital stay in NICUs, so that the accurate and early diagnosis of neonatal sepsis is a relevant problem. Calprotectin is an antimicrobial, calcium and zinc binding heterocomplex protein that could be used as a nonspecific marker for activation of granulocytes and mononuclear phagocytes. Therefore, calprotectin has been proposed for the diagnosis of inflammatory conditions.
<strong>Objective</strong>: This study aimed to evaluate the diagnostic value of serum Calprotectin in newborns with suspected sepsis.
<strong> Methods: </strong>This case control study comprised 40 neonates, 20 neonates with suspected clinical sepsis and other 20 healthy neonates with no clinical signs of sepsis as a control group. Serum level of calprotectin was measured for all neonates recruited in this study, by a commercial ELISA assay
<strong>Results: </strong>Among the cases group, a total of 15 neonates (75%) had positive blood culture. Serum calprotectin levels were significantly higher in septic group than non- septic and control groups as mean Serum Calprotectin was 2.5±0.95 μg/ml, 1.58±0.25 μg/ml and 1.01±0.29 μg/ml, respectively.
<strong> </strong>Significant positive correlations were found between calprotectin levels and WBCs and IM ratio, while negative correlations were found between its level and lymphocytes and platelets. In our study, Calprotectin sensitivity and specificity values were 92% and 93.3%, respectively.
<strong>Conclusion: </strong>Serum calprotectin levels were significantly higher in neonates with sepsis. Its levels correlated well with other laboratory markers of sepsis and neonatal mortality. It is a sensitive diagnostic marker for neonatal sepsis.Zagazig University, Faculty of MedicineZagazig University Medical Journal1110-143125420190701The Retrograde Approach As an Alternative for Failed Antegrade Access for Difficult Below the Knee Chronic Total Occlusions5875933794310.21608/zumj.2019.10414.10990ENTarek EzzatAbd El-LatifAyman Abd ElhamidSalemAbd Elrahman MohamedGameelAbdulmunem MohamedAllafiJournal Article20190629<strong>Background:</strong> Critical limb ischemia occurs when the blood flow to the leg is insufficient to maintain the metabolic requirement of the tissue in the resting state.<strong> Objectives</strong>: This study was to describe the technical aspects of the retrograde approach as an alternative for failed antegrade access for difficult below the knee chronic total occlusions. <strong>Patients & Methods:</strong> This study was conducted as retrospective and prospective interventional study that included 18 patient with CLI of deferent ages and sex who were admitted to the department of vascular surgery at Zagzaig university Hospitals.<strong> Results</strong>: we can deduce the major predictive values of technical and clinical success related to endovascular intervention which were lesion characteristics represented in its length and nature, picture of presentation and co-morbid conditions. <strong>Conclusions:</strong> Retrograde tibiopedal approach can be used safely as a bailout to increase the technical success rate and limb salvage for failed antegrade recanalization of popliteal and infrapopliteal arterial occlusions.Zagazig University, Faculty of MedicineZagazig University Medical Journal1110-143125420190701Assessment of Cartilage Strip and Bone Cement in Ossiculoplasty5946003794810.21608/zumj.2019.10415.11000ENMagdy IbrahemGoudaMohammad Abdel AzeemMohammadHazem SaeedMohammadMohammad Abdel HameedAbdel GhanyJournal Article20190629<strong>Background and aim:</strong> Complete disruption of the ossicular chain can result in up to 60 dB hearing loss. Hearing restoration surgery comprises ear drum repair and ossicular chain reconstruction in ears housing defective ossicles. The aim of this study was to assess cartilage strip and bone cement in ossiculoplasty.
<strong>Patients and methods:</strong>This is a prospective, cross sectional study and was carried out on 36 patients (27 females and 9 males) with chronic suppurative otitis media, their age ranged from 12 to 38 years. Patient were subjected to complete history taking, complete ENT examination, preoperative audiological evaluation, high resolution computed tomography "HRCT" and complete laboratory investigations. All patients were operated by tympanomastoidectomy for eradication of middle ear pathology (21 cases underwent canal wall up technique while 15 cases underwent canal wall down technique), Then reconstruction of the ossicular chain was done by cartilage strip and bone cement (30cases between malleus to stapes while 6 cases between incus to stapes). Postoperative assessment done by pure tone audiometry & tympanometry 3 & 6 months postoperatively.
<strong>Results:</strong> Regarding improvement in hearing 83.3% of our patient were improved while the remaining 16.7% were not. The result of pure tone audiometry & typanometry were significantly improved (p=0.0008). Graft taken occur in 83.3% of cases.
<strong>Conclusions:</strong> The usage of bone cement with a cartilage strip is a simple and effective method for ossicular reconstruction and associated with significant improvement in conductive hearing loss.Zagazig University, Faculty of MedicineZagazig University Medical Journal1110-143125420190701Vestibular Assessment in Chronic Obstructive Pulmonary Disease Patients6016073794910.21608/zumj.2019.9924.11080ENAmany AhmedShalabyFathy NaeemFatouhHeiba GamalEzzelregalWalid MohamedAskarJournal Article20190629<strong>Background:</strong> Chronic Obstructive Pulmonary Disorder (COPD) is a common preventable and treatable disease which is characterized by persistent airflow limitation that is usually progressive and associated with an enhanced chronic inflammatory response in the airways and the lungs to noxious particles or gases.<br /> Balance disorder is a common manifestation in people with COPD which may contribute to overall functional decline. COPD causes balance impairment through hypoxia of the inner ear, vestibular nuclei (which is more sensitive to hypoxia than other cerebral nuclei) and generalized cerebral hypoxia. In addition to musclo-skeletal weakness, visual deficits, vasculitis and poly-neuritis due to accumulation of toxins can occur.<br /> <strong>Patients and methods:</strong> A total number of 50 patients were included in the present study. They were divided into 2 groups. The control group consisted of 20 healthy subjects with no history of COPD, vertigo or hearing loss. The study group consisted of 30 patients with history of COPD..<br /> <strong>Results: </strong>Hearing affection and vestibular affection were significantly associated with COPD.<br /> <strong>Conclusion:</strong> The hearing affection among COPD patients was apparent in the high frequency range. Also, vestibular affection was shown in tests that assessed postural control.Zagazig University, Faculty of MedicineZagazig University Medical Journal1110-143125420190701Assessment of Nutritional Status of Rural Primary School Students at Abu-Kbeer District, Sharkia Governorate6086183795210.21608/zumj.2019.10679.111600ENJournal Article20190629<strong>Background</strong>: Malnutrition is one of the leading causes of morbidity and mortality in childhood worldwide. <strong>Aim of the study:</strong> to evaluate overall prevalence of malnutrition, and to assess influence of selected risk factors upon nutritional status, through assessment of nutritional status of rural school children (6‑12 years) of Abu-Kbeer district, Sharkia Governorate, measurement of Hb level, and identification of factors associated with malnutrition of the studied group.
<strong>Subjects and methods</strong>: a cross section study was conducted in Abu-Kbeer district, Sharkia Governorate during the academic year 2017-2018 on 1732 rural school students (6‑12 years), all were subjected to hemoglobin estimation, measurement of weight and height and calculating BMI and assessment of socio- demographic status , feeding practices and diet quality through a semi-structured Arabic questionnaire for their parents.
<strong>Results</strong>: 8.4% of the students were stunting, 12% were underweight, 5.5% were overweight, 7.4% were obese and 58.5% were anemic.93.5% had incomplete diet. Anemia is statistically significantly associated with female sex, very low social class, incomplete diet, stunting and underweight. No significant association was detected between anemia and age.
<strong>Conclusion:</strong> prevalence of malnutrition is high among rural school students; and anemia is strongly associated with incomplete diet. We recommend increasing public awareness especially mothers about nutritional needs of children.