@article { author = {Sheta, Yasser and Salem, Ihab and Ismail, Waleed and Hafez, Abeer}, title = {VALUE OF FECAL CALPROTECTIN AS A NON-INVASIVE MARKER DIFFERENTIATING ORGANIC FROM FUNCTIONAL BOWEL DISEASES}, journal = {Zagazig University Medical Journal}, volume = {19}, number = {4}, pages = {1-6}, year = {2013}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2013.4262}, abstract = {Background: Bowel diseases are very common, most of them are functional not organic in nature but clinicians suffer a lot in differentiating between the two categories especially the management is completely different. The symptoms of functional bowel diseases can be very similar to organic inflammatory bowel diseases like ulcerative colitis. In many cases the definitive diagnosis needs invasive procedures including lower colonoscopy and biopsy for histopathological documentation. Aim of the work: To evaluate the clinical value of fecal calprotectin as a non invasive marker differentiating organic from functional bowel diseases in correlation with endoscopic and histopathological examinations. Subjects and methods: The study included 40 patients, selected to represent 2 groups: group (I) included 20 patients with ulcerative colitis (UC) proved by colonoscopy and histopathology who further subdivided into sub-groups according to activity and site of involvement; and group (II) included 20 patients who had symptoms suggestive of irritable bowel syndrome (IBS) and in whom colonoscopy was found to be normal served as control. All participants were subjected to thorough history taking, physical examination and routine laboratory investigations. Calprotectin in feces was measured using the enzyme-linked immunosorbent assay (ELISA).Results: Fecal calprotectin concentration in the patients with UC was significantly higher than in patients with IBS (Mean values ± SD; 201.7 ± 46.7 μg/g vs, 22.3 ± 10.1 μg/g, P < 0.01). A significant difference was also found in the patients with active UC in comparison to UC patients without sign of activity (Mean values ± SD; 220.2 ± 31.1 μg/g vs, 167.3 ± 23.9 μg/g, P<0.05). The sensitivity of fecal calprotectin at cut off value 195.5 μg/g; as activity marker of UC was 82.2 % while its specificity was 85.7 %., Positive predictive value was 90.1% and negative predictive was 66.6%. Conclusion: Fecal calprotectin can differentiate with great acceptance between organic and functional bowel diseases and can be used as a rational fecal marker for intestinal inflammation in clinical practice. This kind of marker is relatively precise, simple and noninvasive and could give a crude idea about the activity of the lesions.}, keywords = {fecal calprotectin,ulcerative colitis,enzyme-linked immunosorbent assay}, url = {https://zumj.journals.ekb.eg/article_4262.html}, eprint = {https://zumj.journals.ekb.eg/article_4262_6c52e61063823ff952f83f0099ad8def.pdf} } @article { author = {I., El-kateb and Ahmed, Magdy and Mohammed, Samah and Mostafa, Mona}, title = {EVALUATION OF THYROID NODULES USING THYROID PEROXIDASE AND GALECTIN-3:AN IMMUNOHISTOCHEMICAL STUDY}, journal = {Zagazig University Medical Journal}, volume = {19}, number = {4}, pages = {1-8}, year = {2013}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2013.4263}, abstract = {Background and aim: Thyroid gland carcinoma is a very prevalent neoplasia worldwide. The majority of malignant and benign lesions of the thyroid can be cytologically established. However, to distinguish between malignant and benign lesions histological demonstration is often required for a precise diagnosis. The aim of this study is to detect the ability of thyroid peroxidase (TPO) and Galectin-3 (Gal-3) to differentiate between thyroid malignant and non-malignant thyroid nodules. Methods: 50 formalin-fixed, paraffin embedded tissue blocks of different thyroid lesions were previously diagnosed and were sectioned at 3-4 μ thick and stained with hematoxylin and eosin (H&E) stain to confirm the histopathologic diagnosis, assess the subtypes of the lesions and assess the histopathologic grading and then were subjected to galectin-3 (Gal-3) and thyroid peroxidase (TPO) immunostaining. Results: In this retrospective histologic study, galectin-3 had a sensitivity of 93.3% for papillary thyroid carcinoma and 50% for follicular thyroid carcinoma. Thyroid peroxidase (TPO) had a sensitivity of 60% for papillary and 12.5% for follicular carcinoma. The combination of galectin-3 and TPO had a sensitivity of 100% for papillary and 50% for follicular carcinoma.Conclusion: This study confirms previous observations that galectin-3 alone is highly sensitive for papillary carcinoma but not adequately sensitive for follicular carcinoma. The combination of galectin-3 and TPO is complementary as a diagnostic and prognostic tool for patients with papillary carcinoma.}, keywords = {Thyroid peroxidase,galectin-3,Thyroid carcinoma,Immunohistochemistry}, url = {https://zumj.journals.ekb.eg/article_4263.html}, eprint = {https://zumj.journals.ekb.eg/article_4263_5b8440c8eb2a05b4fc347a4c2ef51d8a.pdf} } @article { author = {Nada, Aml ada}, title = {CORRELATION BETWEEN VITAMIN D3 AND FASTING PLASMA GLUCOSE, A1C AND SERUM LIPIDS IN NON-DIABETIC SUBJECTS}, journal = {Zagazig University Medical Journal}, volume = {19}, number = {4}, pages = {1-5}, year = {2013}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2013.4264}, abstract = {Objective: To study the correlation between vitamin D3 and fasting plasma glucose, haemoglobin A1c, and lipids in non diabetic persons . Patients and methods: Eighty-eight healthy Saudi females; aged 18 to 50 years were recruited from an endocrine clinic in a tertiary care hospital in southern region of Saudi Arabia. Exclusion Criteria: Diabetes mellitus, malabsorption, significant cardiac, hepatic, oncologic, renal or psychiatric disease. Use of medications known to affect serum vitamin D3, plasma glucose or lipid profile. After an overnight fasting blood samples were collected for laboratory measurement of fasting plasma glucose, lipids, haemoglobin A1c (HbA1c) and vitamin D3 [25(OH)D3].Results: Fasting plasma glucose inversely correlated to vitamin D3 level (p=0.034). No significant correlation was found between vitamin D3 and HbA1c (p=0.23) or any of the components of lipid profile. Conclusion: It seems that vitamin D3 affects glucose homeostasis. The lower the vitamin D3 level, the higher the blood sugar. Vitamin D3 level is not correlated to HbA1c in our study population of non-diabetic females. This may be attributed to age and ethnicity of the study group. Vitamin D3 level is not correlated to fasting lipid profile. }, keywords = {}, url = {https://zumj.journals.ekb.eg/article_4264.html}, eprint = {https://zumj.journals.ekb.eg/article_4264_b459caa158fe8678147f7ef9bbdf82e6.pdf} } @article { author = {Amin, Abdelaziz and Ahmed, Taha and Seksaka, Mahmoud and Elhaieg, Dalia}, title = {SUBMUCOUS FIBROID: DIFFERENT PRESURGICAL CLASSIFICATION METHODS AND THEIR EFFECT ON HYSTEROSCOPIC SURGICAL MANAGEMENT}, journal = {Zagazig University Medical Journal}, volume = {19}, number = {4}, pages = {1-6}, year = {2013}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2013.4265}, abstract = {Objective: To compare the degree of difficulty and outcome measures of hysteroscopic myomectomy of submucous fibroid according to 2 classification systems. Methods: This prospective study conducted in the Cytogenetic & Endoscopy unit, Zagazig University Hospitals during the period from July 2009 to July 2012, included 100 patients candidates for hysteroscopic resection of submucous fibroids. All fibroids were diagnosed and assessed by saline infusion sonohysterography and diagnostic hysteroscopy. Presurgical classification was performed according to the two classification systems; the European Society of Endoscopic Surgery (ESES)–considering only the penetration of the fibroid into the myometrium – and STEPW considering size, topography, extension, penetration and wall affected. Primary outcome measure was incomplete resection of the fibroid. Secondary outcome measures were operating time (in minutes), the fluid deficit (in milliliters) and any intraoperative complications. Sensitivity, specificity and kappa measure of agreement were calculated for each classification at their best cut off. P value less than 0.05 is considered significant.Results: Myomectomy was considered incomplete in 8 out of 104 fibroids (7.7%) According to ESES, 2 belonged to type 0 and 6 belonged to type 1.Risk ratio and 95% confidence interval (CI) was 0.56 (0.07-3.3) and the difference was not significant (p=0.7); whereas according to the STEPW classification, the incomplete myomectomies were one in group I (1/8, 12.5%) and seven in group II (7/8, 87.5%). The risk ratio (95% CI) was 0.02 (0.0-0.18) and the difference was significant (p= 0.000). Considering the area under the ROC curve, the dichotomized STEPW scores performed better than the dichotomized ESES scores (P<.001). Conclusion: The application of STEPW classification of submucous fibroid gives better prediction of myoma removal than ESES classification.}, keywords = {submucous fibroid classification,hysteroscopic myomectomy,ESES,STEPW}, url = {https://zumj.journals.ekb.eg/article_4265.html}, eprint = {https://zumj.journals.ekb.eg/article_4265_8624ea8f6b588453b473a43ab40f92a6.pdf} } @article { author = {Taeima, Mohammad and Abd El.Kader, El.Shabrawy and Gouhar, Ghada and El.Fawal, Muhammad}, title = {ROLE OF TRANS-CATHETER EMBOLIZTAION OF UTERINE ARTERY IN UTERINE BLEEDING}, journal = {Zagazig University Medical Journal}, volume = {19}, number = {4}, pages = {1-8}, year = {2013}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2013.4266}, abstract = {Background: Abnormal uterine bleeding in terms of menstrual disorders and postmenopausal bleeding are common clinical problems in both primary and secondary care. Advances in diagnostic and therapeutic technologies have offered opportunities to improve the outcomes of women suffering with these complaints. Interventional radiology is a relatively new, exciting and rapidly evolving subspecialty of radiology in which both vascular and non-vascular diseases are treated by minimally invasive approaches. Uterine-artery embolization was introduced as an alternative technique for treating cases with vaginal bleeding . Since then it has become increasingly accepted as a minimally invasive, uterine-sparing procedure Aim of the work: The aim of this work is to evaluate role of trans-arterial embolization of uterine artery in uterine bleeding . Patients and methods: The study was carried out on twenty patients suffering from uterine bleeding for different causes. Those patient undergoes pelic us ( trans abdominal & trans vaginal ) , Doppler Us exam & in some cases MRI to determine cause of abnormal uterine bleeding before the embolization. Then after embolization those patient had been followed up for 6 months with pelvic UD & Doppler . In 7 patient interstitial fibroids was diagnosed as the cause of the abnormal uterine bleeding . other 6 patient uterine AVM ( all of them after gynecological procedure ) was the cause. In the rest ( 7 patient ) no specific lesion was diagnosed by US or MRI only increased vascularity of the uterus was detected by the Doppler exam. Results: The most common presenting symptoms of the patients abnormal bleeding, were anemia, low back pain, had frequency of micturition and dyspareunia .All our 20 patient had marked improvement – most shows disappearance of symptoms - after the procedure. All severs from post embolization syndrome ( nausea, vomiting & abdominal pain ).No major complication had occurred for any of our patient. Conclusion: UAE is the best treatment for abnormal uterine bleeding that not only stop the bleeding but also preserve uterus & can keep the patient fertile for further conception. UAE is save & has no major complication , however , it’s a high coast technique.}, keywords = {Uterine Bleeding,fibroids,Embolization}, url = {https://zumj.journals.ekb.eg/article_4266.html}, eprint = {https://zumj.journals.ekb.eg/article_4266_31c38a1c49f63d51d51b7c7557f19e0b.pdf} } @article { author = {Saleh, Abdel Moneim and Ibrahema, Azza and El-Behidy, Tarek and El-Nemr, Amr}, title = {COMPARATIVE STUDY BETWEEN MINILAPAROTOMY HYSTERECTOMY AND LAPAROSCOPIC HYSTERECTOMY FOR BENIGN UTERINE LESIONS}, journal = {Zagazig University Medical Journal}, volume = {19}, number = {4}, pages = {1-9}, year = {2013}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2013.4267}, abstract = {Objective: The aim of the work is to investigate whether minilaparotomy hysterectomy for benign uterine lesions might be a reasonable alternative to laparoscopic hysterectomy in terms of operative and postoperative short-term outcomes.Methods: 105 patients scheduled to undergo total hysterectomy for a benign uterine lesion were divided into 3 groups according to their selection of the method of intervention after counseling: Group A (35 patients) minilaparotomy hysterectomy using conventional sutures.Group B (35 patients) minilaparotomy hysterectomy using bipolar vessel sealing system (Ligasure).Group C (35 patients) laparoscopic hysterectomy using Ligasure.Result(s): The operating time in Group A (84.7  9.9 minutes), group B (55.3  7.8 minutes), while group C ( 94.8  16 minutes).The duration until resumption of intestinal sounds in group C (12.3  2.5 hours) in comparison to group A (17.4  1.9 hours) and group B (16.5  1.76 hours). Blood loss in group B (99.1 ± 30.8 ml) ,group A (130.3 ± 54.4 ml) and group C (136.6 ± 6.6 ml). The longest hospital stay occurred in group A (31.8 ± 5.7 hours) versus groups B (20.7 ± 2.5 hours) and C (19.3 ± 6 hours). The highest pain score was observed in group A (5.2 ± 1.1) versus groups B (3.8 ± 1.6) and C (3.7 ± 1.2).There was no significant difference in the incidence of intraoperative or postoperative complications.Conclusion(s): The use of ligasure bipolar vessel sealing system in minilaparotomy hysterectomy was associated with less operative time and intraoperative blood loss, while it was comparable to laparoscopic hysterectomy in hospital stay and postoperative pain scoring with low morbidity and a short hospital stay. It may be a suitable alternative to laparoscopic hysterectomy which is ideal in areas which lack high laparoscopic experience or facilities.}, keywords = {Minilaparotomy hysterectomy,laparoscopic hysterectomy}, url = {https://zumj.journals.ekb.eg/article_4267.html}, eprint = {https://zumj.journals.ekb.eg/article_4267_070fe5d762d53949374daefa053b226b.pdf} } @article { author = {Zaitoun, Moustafa and Shallal, Yousry and Alanwar, Amal and Ammar, Islam}, title = {COMPARATIVE STUDY BETWEEN LAPAROSCOPIC AND OPEN OVARIAN CYSTECTOMY ON OVARIAN RESERVE}, journal = {Zagazig University Medical Journal}, volume = {19}, number = {4}, pages = {1-9}, year = {2013}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2013.4268}, abstract = {Objective: To investigate the impact of electrocoagulation on ovarian reserve after laparoscopic excision of ovarian cysts and the possible mechanisms. Design: A prospective study. Setting: Obstetrics and Gynecology Department of a university hospital. Patient(s): 100 patients with benign ovarian cysts undergoing ovarian cystectomy.Intervention(s): Laparoscopic ovarian cystectomy using bipolar electrocoagulation and laparotomic ovarian cystectomy using sutures after the excision of ovarian cysts. Main Outcome Measure(s): Follicle-stimulating hormone (FSH & AMH) assays and transvaginal ultrasound evaluating basal antral follicle number, mean ovarian diameter, and ovarian stromal blood flow velocity at cycles 1, 3 and 6 after surgery. Result(s): When comparing the bipolar group with the suture group, a statistically significant increase of the mean FSH value was found in bilateral-cyst patients at 1-, 3- and 6-month follow- up evaluations and in unilateral-cyst patients at the 1-month follow-up evaluation. When comparing the bipolar group with the suture group, a statistically significant decrease of the mean AMH value was found in bilateral-cyst patients at 1-, 3- and 6-month follow- up evaluations and in unilateral-cyst patients at the 1-month follow-up evaluation. Statistically significant decreases of basal antral follicle number and mean ovarian diameter were found during the 3-, 6-month follow-up evaluations as well as statistically significant decreases of peak systolic velocity at all of the follow-up evaluations.Conclusion(s): Electrocoagulation after laparoscopic excision of ovarian cysts is associated with a statistically significant reduction in ovarian reserve, which is partly a consequence of the damage to the ovarian vascular system.}, keywords = {ovarian cysts,laparoscopic ovarian cystectomy,Electrocoagulation,ovarian reserve}, url = {https://zumj.journals.ekb.eg/article_4268.html}, eprint = {https://zumj.journals.ekb.eg/article_4268_d446a54cf0bc30f0abacf544863d8447.pdf} } @article { author = {Ibrahim, Samia and Mostafa, Aza}, title = {SERUM VITAMIN D LEVEL IN CHILDREN WITH ATOPIC DERMATITIS AND ITS RELATIONSHIP TO THE SEVERITY OF THE DISEASE.}, journal = {Zagazig University Medical Journal}, volume = {19}, number = {4}, pages = {1-6}, year = {2013}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2013.4269}, abstract = {Background: Atopic Dermatitis (AD) is an allergic inflammatory skin disease with significant cost and morbidity to the patients and their families. Vitamin D has been suggested to have a role in the pathogenesis of allergic disorders, including AD. Objective: The aim of the study was to measure the serum levels of vitamin D in the form of 25-hydroxy vitamin D in children with AD and to correlate them with the severity of the disease. Patients and methods: The study included forty children with the clinical diagnosis of AD. Using Scoring Atopic Dermatitis (SCORAD) index, the patients were divided into three groups; mild (SCORAD index<25), moderate (25-50) and severe (>50). Vitamin D levels were measured in the sera of the patients using Chemiluminescent method. Specific IgE to Staphylococcus aureus (S.aureus) Enterotoxins (A, B and C) and Malessazia furfur (M.furfur) in the sera of the patients was also measured using Immunocap system. Results: AD was mild in 16 patients, moderate in 14 patients and severe in 10 patients. The mean SCORAD index ±SD was 14.01±5.6, 38.71±7.8 and 60.8±7.5 in the three groups respectively. Mean vitamin D levels ±SD in the sera of the patients in ng ml-1 were sufficient (36.3±13.06) in 15 patients, insufficient (26.6±7.4) in 16 patients and deficient (19.8±5.2) in 9 patients. There was a significant inverse correlation between the serum levels of vitamin D and the severity of AD (r=-0.48, P=0.003). There was also a significant difference between the mean serum level of vitamin D in mild and moderate AD (P<0.05), and mild and severe AD (P<0.05). Specific IgE to S.aureus enterotoxin and to M.furfur antigens was more in patients with severe AD who had deficient levels of vitamin D than in those with mild or moderate disease. Conclusion: Vitamin D level is inversely related to the severity of the disease in AD patients and consequently it may have a role in its treatment.}, keywords = {missed}, url = {https://zumj.journals.ekb.eg/article_4269.html}, eprint = {https://zumj.journals.ekb.eg/article_4269_40521d9d53922e1b61b1fe39ec01e28b.pdf} } @article { author = {Soliman, Ahmed and Mohammed, Samy and Rashed, Magdy and Morsy, Ashraf}, title = {PERCUTANEOUS DISCECTOMY FOR TREATING DISCOGENIC LOW BACK PAIN}, journal = {Zagazig University Medical Journal}, volume = {19}, number = {4}, pages = {1-9}, year = {2013}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2013.4270}, abstract = {Objective: to evaluate the role of percutaneous lumbar discectomy in treating discogenic low back pain.Method : The technique of percutaneous discectomy was evaluated in 34 cases of discogenic low back pain between September 2009 and September 2012. Intervention was performed after failure of conservative management. Inclusion criteria were complaints of back pain with or without radicular leg pain and failure of six weeks of conservative care. The diagnosis of discogenic pain was confirmed with imaging studies "MRI" and positive provocative discography with elicitation of concordant pain. Exclusion criteria were presenting with disc extrusion, evidence of previous back surgery, infection or spinal instability, and marked spinal stenosis, and non-qualifying results on provocative discography. Follow up period was 12 months using visual analogue score (VAS) and Oswestry disability index.Results: This prospective evaluation demonstrated pain relief defined as 2 points or more relief in VAS, in 63% of the patients at 6 months and 50% of the patients at 1 year regarding the back pain.Conclusion: percutaneous disc decompression using percutaneous discectomy is a safe and effective procedure in alleviating discogenic back pain with or without radicular leg pain.}, keywords = {Discogenic pain,percutaneous discectomy,discography,minimally invasive spine}, url = {https://zumj.journals.ekb.eg/article_4270.html}, eprint = {https://zumj.journals.ekb.eg/article_4270_923a71a295220793db89acbcd43b8f32.pdf} } @article { author = {Elfawal, Magdy and Dawoud, Osama and Shalaby, Mohamed and Alnaggar, Ahmad}, title = {ROLE OF ULTRASOUND AND MAGNETIC RESONANCE IMAGING IN TRAUMATIC SHOULDER JOINT INJURIES.}, journal = {Zagazig University Medical Journal}, volume = {19}, number = {4}, pages = {1-9}, year = {2013}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2013.4271}, abstract = {Aim: The aim of this study is to evaluate role of magnetic resonance imaging and ultrasound in diagnosis of traumatic shoulder injuries. Patients and methods: Fifty patients who had one or more of post traumatic shoulder dislocation, pain or limitation of the affected shoulder joint movements were examined by gray scale ultrasound and conventional magnetic resonance imaging. Results: 18 cases were diagnosed as supraspinatus tears (11 partial tear and 7 complete tear). 8 cases were diagnosed as supraspinatus tendinosis. Four cases were diagnosed as acromioclavicular joint lesions 2 of them were diagnosed as acromioclavicular joint separation and 2 cases were diagnosed as acromioclavicular joint osteoarthritis and all of cases with acromioclavicular joint lesions were associated with impingement syndrome. 11 cases were diagnosed as Hill Sach`s fracture; 5 of them were associated with Bankart lesion. Two cases were diagnosed as biceps tendon instability. Four cases were diagnosed as biceps tenosynovitis. Conclusion: ultrasound should be increasingly used as the first-line imaging modality in the assessment of traumatic shoulder lesions. Further magnetic resonance imaging is needed in order to evaluate the joint in more detailed manner }, keywords = {Shoulder joint,Trauma,musculoskeletal,Ultrasound,Magnetic Resonance Imaging}, url = {https://zumj.journals.ekb.eg/article_4271.html}, eprint = {https://zumj.journals.ekb.eg/article_4271_617ed55368b749439e9daf71bbcb916c.pdf} } @article { author = {El-sayed, Wagdy and Aamer, Eman}, title = {SERUM COPPER, MAGNESIUM AND ZINC LEVEL IN WHEEZY INFANTS}, journal = {Zagazig University Medical Journal}, volume = {19}, number = {4}, pages = {1-7}, year = {2013}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2013.4272}, abstract = {Trace elements are micronutrient present in small amount in the body they have antioxidant and immune-regulatory function and possibly have role in pathogenesis in infant wheezes. We estimated serum level of copper .zinc magnesium in 30 wheezy infants versus 10 control Both groups were age, sex and weight matched. Serum copper, magnesium was significantly higher in patient versus control (48.6±36.8 &2.57± 0.69 respectively in cases vs. 21.7±5.7 &2.18± 0.11 respectively in control ) p was 0.00 &0.006 respectively. Serum zinc was not significantly different between patients and control (83.7±12 in cases vs 85.3±36.2 in control ) ,p was 0.832 .Serum copper was significantly lower in wheezy cases with bronchopneumonia than wheezy cases without (29.5±19.5 vs 55.5±39.5) p was 0.028 ,while zinc was higher in these cases than those cases without (108.2±34.5 vs 67.9±33,8) p was 0.034 .There was no significant difference between wheezy bronchopneumonia and non-infection cases regarding magnesium (2.97±1.2 vs 2.4±0.3) p was 0.232 .Their results prove that possible environmental zinc, copper accumulation in children may play role pathogenesis in infant wheezes ,also proves ant infection role of copper}, keywords = {missed}, url = {https://zumj.journals.ekb.eg/article_4272.html}, eprint = {https://zumj.journals.ekb.eg/article_4272_b1abf00eb83a88a98401808e12abe4b0.pdf} }