@article { author = {Abdelsalam, Lobna and Ali, Yehia and Elkashishy, Kamal and Nour Eldeen, Eman}, title = {PROGNOSTIC VALUE OF COMBINED IMMUNOHISTOCHEMICAL EXPRESSION OF BMI1 AND EZH2 IN ASTROCYTOMA}, journal = {Zagazig University Medical Journal}, volume = {23}, number = {4}, pages = {1-11}, year = {2017}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2017.4696}, abstract = {Background: Although current improvements in surgery, chemotherapy and radiotherapy, the still survival of astrocytoma’s patient is poor. It is assumed that the combined expression of BMI1 and EZH2 may be associated with malignant transformation of astrocytomas and also it may reveal the biological aggressiveness of this disease.Aim of work: assessment the value of the combined immunohistochemical expression of BMI1 and EZH2 and their correlation with the clinicopathological characters and prognosis in astrocytoma patient.Subjects & Methods: BMI1 and EZH2 expressions were evaluated using immunohistochemical staining in 70 patients 40 cases with astrocytomas and 30 cases of non-neoplastic brain tissue. The relationship between their expressions and clinicopathological factors were analyzed.Results: A significant difference (P<0.002) between expression of BMI1 and EZH2 in astrocytoma compared to corresponding non-neoplastic brain tissue. A significant association was found between high expression of BMI1 and EZH2 and WHO high grades in astrocytomas. No statistically significant association was found between BMI1 or EZH2 with gender of patients, age at diagnosis, site and size of tumor (P > 0.05). The spearman correlation analysis revealed a significant positive association between BMI1 and EZH2 expressions (r = 0.311; P=0.05) revealing direct relationship between BMI1 and EZH2.Conclusions: BMI1 and EZH2 were involved in astrocytoma malignant transformation and poor prognosis in astrocytoma particularly glioblastoma.}, keywords = {BMI1,EZH2,astrocytoma,PcG,glioblastoma and GSCs}, url = {https://zumj.journals.ekb.eg/article_4696.html}, eprint = {https://zumj.journals.ekb.eg/article_4696_2050270dfb9a9eaf56fc46997218bd84.pdf} } @article { author = {Alnaimy, Mohammed and Abou-sharkh, Abdelmonem and Nasr Al-deeb, Mahmoud and Abdelrahman, Ayman}, title = {EVALUATION OF DEEP ANTERIOR LAMELLAR KERATOPLASTY VERSUS INTRACORNEAL RING SEGMENTS IN TREATING MODERATE KERATOCONUS}, journal = {Zagazig University Medical Journal}, volume = {23}, number = {4}, pages = {1-15}, year = {2017}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2017.4697}, abstract = {Background: Keratoconus can cause gradual distortion of vision due to progressive myopia and irregular astigmatism. keratoconus is classified into four stages. The treatment is stage specific starting from glasses or hard contact lenses in the very early stages passing to intra corneal ring segments(ICRS) with or without collagen cross linking(CXL) in the second stage then deep anterior lamellar keratoplasty (DALK) or intra corneal ring segments in the third stage ending with penetrating keratoplasty in the fourth stage.Patients and Methods: This study included 50 Patients from attendants to outpatient clinic Ophthalmology Department, Zagazig University. Those patients were diagnosed as moderate keratoconus according to modified Amsler classification. The patients were divided randomly into 2 equal groups each one involved 25 eyes. The patients of the first group had DALK using the double bubble modification of the Big Bubble (BB) technique while patients of second group had femto assisted intrastromal corneal ring segment (KERA) implantation. The patients were followed up for 12 months. This prospective randomized interventional study aimed to evaluate and compare intracorneal ring segments (ICRS) versus deep anterior lamellar keratoplasty (DALK) in treating moderate keratoconus. A complete ophthalmic examination was performed, including visual acuity, refraction, and keratometric readings.Results: The primary outcome measure in this study was the best corrected visual acuity (BCVA) at the end of follow up period which is 12 months while the secondary outcome measures were the uncorrected visual acuity (UCVA), mean spherical and mean K value. In the first group (DALK group) the mean UCVA preoperatively was 0.05 ± 0.001 and mean BCVA preoperatively was 0.08 ± 0.001while postoperatively the mean UCVA was 0.1 ± 0.02 and mean BCVA postoperatively in the 3rd month was 0.25 ± 0.02 and in the 6th month visit was 0.5 ± 0.02. In the second group (ICRS group), the mean preoperative uncorrected visual acuity (Pre UCVA) was 0.06± 0.001 while mean preoperative best-corrected visual acuity (Pre BCVA) was 0.08± 0.001. The mean postoperative uncorrected visual acuity (post UCVA) was 0.21 ± 0.02 while the mean postoperative best-corrected visual acuity (post BCVA) was 0.4 ± 0.01. All patients of both group had progressive visual improvement in their BCVA compared to the preoperative one. In both groups also, the spherical equivalent, spectacle astigmatism and mean central K value showed significant improvement postoperative compared to preoperative.Conclusion: Both femtoassisted intracorneal ring segments and deep anterior lamellar keratoplasty are safe and effective surgical alternatives in treating patients with moderate keratoconus. Both of them lead to progressive improvement in the visual outcome of keratoconus patients. Achieving the deepest possible interface to reduce scarring, achieve a posterior layer of uniform thickness, perform smooth surface sectioning of both the graft and bed, make the graft tissue of appropriate thickness, obtain the highest quality donor material, insure good coaptation of the edges and uniform traction of the sutures, and make sure there is perfect cleanliness of the interface are the factors of obtaining best visual results after DALK procedure.}, keywords = {moderate keratoconus,deep anterior lamellar keratoplasty,intracorneal ring segment}, url = {https://zumj.journals.ekb.eg/article_4697.html}, eprint = {https://zumj.journals.ekb.eg/article_4697_a6fc34a57bdce5f948e7fe2ebe7bbe5d.pdf} } @article { author = {Ghanem, Yasser and Fahmy, Khalid and Refaat, Doaa and mouhammed, Moustafa}, title = {PREOPERATIVE PREDICTION OF DIFFICULT LAPAROSCOPIC CHOLECYSTECTOMY: IN ZAGAZIG UNIVERSITY HOSPITALS}, journal = {Zagazig University Medical Journal}, volume = {23}, number = {4}, pages = {1-13}, year = {2017}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2017.4698}, abstract = {Background: Laparoscopic Cholecystectomy (LC) becomes the standard of care for patients requiring removal of gallbladder. LC may be rendered difficult by various problems encountered during procedure. Several factors have been implicated with a difficult case, but no reliable criteria are available yet to identify patients preoperatively with a difficult LC. Preoperative prediction of a difficult LC can help the patient as well as the surgeon prepare better for the intraoperative challenges and tailored approach accordingly. The present study was undertaken todetermine the association between preoperative clinical, laboratory and abdominal sonographic findings in patients undergoing LC for cholelithiasis and the technical difficulty at operation and to predict the most important indicators that affect the operation outcome in order to make the procedure safer for the patient as well as the surgeon.Methods: In 300 consecutive patients who underwent LC during 2014 to 2016 patient‟s characteristics, clinical history, laboratory data, ultrasonography results and intraoperative details were prospectively analyzed to evaluate predictors of difficult LC.Results: Gender, age, obesity, history of hospitalization for acute cholecystitis, history of previous ERCP, history of previous abdominal surgery, Gall bladder size, GB wall thickening, pericholecystic fluid collection, large multiple GB stones and liver US findings; The above mentioned factors were found to have a statistical significant association with the final operation out come.Conclusions: Obesity, presence of history of previous abdominal surgery, gall bladder wall thickness and gallbladder stone size by preoperative ultrasound; were found to be the predictive factors of difficult LC in our study.}, keywords = {Preoperative,Difficult,Laparoscopic cholecystectomy,prediction}, url = {https://zumj.journals.ekb.eg/article_4698.html}, eprint = {https://zumj.journals.ekb.eg/article_4698_6aea12e2a91bd02f8ef2f610fa57ef0b.pdf} } @article { author = {Orabi, Eman}, title = {STANDARD ISOLATION PRECAUTIONS EDUCATIONAL INTERVENTION ON UNDER GRADUATE MEDICAL STUDENTS OF ZAGAZIG UNIVERSITY}, journal = {Zagazig University Medical Journal}, volume = {23}, number = {4}, pages = {1-14}, year = {2017}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2017.4699}, abstract = {Background Standard Precautions is the primary strategy and foundation for Successful hospital acquired infection control. The routine implementation of standard precautions greatly reduces the risk of nosocomial infections in the absence of a definitive diagnosis. The aim of this study was to estimate the effect of an educational intervention program on standard isolation precautions on knowledge, attitude of medical students of Zagazig University. Methods: An interventional study was used. Setting: The study was conducted at faculty of Medicine Zagazig University. Sample: The study sample consisted of 135 medical students in Zagazig University. Tools: Data was collected through: An interviewing questionnaire to assess sociodemographic characteristics of participants, their knowledge and attitude before and after educational intervention regarding standard isolation precautions. Results: The majority of studied sample has significant improvement in knowledge and attitude towards standard isolation precautions (p<0.05) after implementation of the health education program. The total knowledge and intention to change practice of the participants regarding standard isolation precautions showed statistically significant improvements after the intervention ( 92% and 74.9%) respectively after the intervention compared with (18.5% and 42.3%) respectively before intervention( p<0.001). Conclusion and recommendation: This study concluded that health education about standard isolation precautions improved knowledge and attitude of the studied medical students, so more interventions are needed to increase the knowledge about SIPs and Infection Control among medical students.}, keywords = {Health education program,standard isolation precautions,Infection control,Medical students}, url = {https://zumj.journals.ekb.eg/article_4699.html}, eprint = {https://zumj.journals.ekb.eg/article_4699_4cb38483f8a1a170e18be544b54c9fa6.pdf} } @article { author = {Shaker, Amany and Samir, Hanan}, title = {STUDY OF CHRONIC KIDNEY DISEASE AND ANEMIA IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) PATIENTS}, journal = {Zagazig University Medical Journal}, volume = {23}, number = {4}, pages = {1-9}, year = {2017}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2017.4700}, abstract = {The relation between chronic obstructive pulmonary disease (COPD) and chronic kidney disease (CKD) has been largely undescribed and the occurrence and frequency of anemia in COPD has rarely been studied, so the aim of this study is: to estimate the frequency of undiagnosed CKD among COPD patients and to verify whether concealed CKD is prevalent in COPD population, and to assess the frequency of anemia in COPD patients and its relation to the severity of the disease. Patients and methods: this study included 100 stable COPD patients with various degrees of severity. They were divided into 2 groups: group (І): patients with mild to moderate severity of COPD (n=43) and group (П): patients with severe to very severe COPD (n= 57). All studied patients were subjected to: pulmonary function tests, complete blood count, erythropoietin level measurement, glomerular filtration rate measurement, and arterial blood gases analysis. Results: there was a statistically non- significant increased frequency of concealed chronic renal failure (CRF) in patients of group (П) than that of group (І). But a significant increased frequency was seen in overt CRF in patients of group (П) than that of group (І) with a statistically significant positive correlation between COPD severity and renal function reduction . As regards the frequency of anemia, there was a statistically significant high frequency of anemia in patients of group (П) than that of group (І) with a statistically very highly significant negative correlation between COPD severity and hemoglobin level. Conclusions: 1) CRF occurs in high rates in COPD patients and it is related to the disease severity. 2) Anemia is a frequent co-morbidity among COPD patients especially in those with severe disease.}, keywords = {COPD,Chronic Kidney Disease,Anemia}, url = {https://zumj.journals.ekb.eg/article_4700.html}, eprint = {https://zumj.journals.ekb.eg/article_4700_981dfcdd8da5a803a56b4d7bafb6037c.pdf} }