Zagazig University Research Articles

Incidence of cataract and glaucoma in children with nephrotic syndrome undergoing steroid treatment

Background Nephrotic syndrome (NS) is by far, the most common glomerular disease in childhood period and is considered as one of the main aetiologies of child exposure to systemic steroids. High-dose corticosteroids for NS, are usually prescribed by pediatrians for a long period. Posterior subcapsular cataract (PSC) and increased intraocular pressure (IOP) are the two most common ocular complications associated with steroid treatment. The exact incidence, prevalence, severity, and time of cataract and glaucoma onset in those childrens have not yet been thoroughly investigated. Aim Evaluating the incidence of cataract and glaucoma in children with NS receiving steroid treatment during and after treatment cessation. Patients and methods This cohort prospective study was done at the Pediatric Nephrology Clinic at Zagazig University Children’s Hospital in co-operation with the Department of Ophthalmology, Zagazig University, for detailed eye examination. Totally 48 children with primary NS who received corticosteroids either as a single treatment or with other treatment modalities for more than 3 months were included in our study. Clinical features plus laboratory tests confirmed by renal biopsy were the main parameters used in the diagnosis of NS. Results Posterior subcapsular cataracts (PSC) were observed in 14 patients (29.2%). All studied patients had normal intraocular pressure ranging between 10 and 20 mmHg in both eyes during the follow-up period with no glaucomatous optic disc changes observed. Conclusion A significant number of children with NS treated with steroids are liable to develop cataracts and glaucoma that may progress and need surgery to preserve vision, so they have to be well diagnosed and followed-up.

Prevalence of Iron Deficiency Anemia among Pregnant Females Attending Antenatal Care Unit at Zagazig University Hospitals

Prevalence of Iron Deficiency Anemia among Pregnant Females Attending Antenatal Care Unit at Zagazig University Hospitals

Electrolyte profile in COVID-19 patients: insights into outcomes

BackgroundSome evidence has provided that electrolyte disorders may be present upon presentation of patients with COVID-19 infection. We investigated serum sodium, potassium, calcium, magnesium, and phosphorus levels in large numbers of critically ill COVID-19 patients to identify its possible prognostic value in these patients.MethodsThis retrospective study included patients confirmed with COVID-19 infection admitted to critical care units of Zagazig University Hospital all over 1 year, from May 1, 2020, to April 30, 2021. We analyzed the data for possible correlations between serum electrolytes and patients’ outcomes.ResultsAmong 600 patients included in the study with a mean age of 51.33 ± 16.5 years, 44.16% were mechanically ventilated, and 30.66% died during hospital admission. Serum sodium, potassium, phosphorus, magnesium, and calcium were 141.96 ± 5.4, 4.33 ± 0.66, 3.76 ± 1.26, 2.21 ± 0.52, and 8.55 ± 0.85 respectively, at admission to the ICU. Unfavorable admission course and mortality were significantly associated with high normal serum sodium, potassium, and phosphorus levels and a low normal calcium level.ConclusionAlthough mean serum sodium, potassium, calcium, magnesium, and phosphorus were within normal levels in patients with COVID-19 at presentation, serum sodium, potassium, and phosphorus were significantly higher in those with poor outcomes, whereas calcium was significantly lower in those with poor outcomes.

Antibacterial and Anti-Biofilm Activities of Cinnamon Oil against Multidrug-Resistant Klebsiella pneumoniae Isolated from Pneumonic Sheep and Goats.

The primary objectives were to isolate and identify Klebsiella pneumoniae (K. pneumoniae), and determine the antimicrobial resistance patterns and biofilm formation abilities of the isolates. Additionally, the study aimed to investigate the antimicrobial and anti-biofilm effects of cinnamon oil against K. pneumoniae isolates. A cross-sectional study was conducted from March 2022 to April 2023 to collect 200 samples (including 156 nasal swabs and 44 lung specimens) from pneumonic sheep and goats admitted to the Veterinary Teaching Hospital of Zagazig University, Egypt. K. pneumoniae was isolated from a total of 72 (36%) samples, with 53 (73.6%) isolates recovered from nasal swabs and 19 (26.4%) from lung samples. Among the samples, 52 (36.9%) were from sheep and 20 (33.9%) were from goats. Antimicrobial susceptibility testing of the 72 K. pneumoniae isolates to 18 antimicrobials revealed that all isolates were resistant to ampicillin, amoxicillin/clavulanic acid, cefotaxime, ceftriaxone, tetracycline, colistin, fosfomycin, and trimethoprim/sulphamethoxazole. None of the isolates were resistant to amikacin, imipenem, and norfloxacin. Multidrug resistance (MDR) was observed in all K. pneumoniae isolates recovered from sheep and goats. The average MAR index was 0.71, ranging from 0.50 to 0.83. Regarding biofilm formation, among the K. pneumoniae isolates with a high MAR index (n = 30), 10% exhibited strong formation, 40% showed moderate formation, 43.3% displayed weak formation, and 6.7% did not form biofilms. Additionally, the biofilm-forming genes treC and fimA were present in all 28 biofilm-forming K. pneumoniae isolates, while the mrkA gene was detected in 15 (53.6%) of the 28 isolates. MDR K. pneumoniae isolates with strong biofilm formation abilities were treated with cinnamon oil at varying concentrations (100%, 75%, 50%, and 25%). This treatment resulted in inhibition zone diameters ranging from 35 to 45 mm. Cinnamon oil exhibited lower minimum inhibitory concentration and minimum bactericidal concentration values compared to norfloxacin for all isolates. Additionally, cinnamon oil significantly reduced the expression of biofilm-associated genes (treC, fimA, and mrkA) when compared to isolates treated with norfloxacin or untreated. In conclusion, this study identified a high level of MDR K. pneumoniae with strong and moderate biofilm formation abilities in pneumonic sheep and goats in Sharika Governorate, Egypt. Although cinnamon oil demonstrated potential antibacterial and anti-biofilm properties against K. pneumoniae, further research is required to investigate its effectiveness in treating K. pneumoniae infections in pneumonic sheep and goats.

Endoscopic management of acute sigmoid volvulus in high risk surgical elderly patients: a randomized controlled trial

BackgroundMost patients with sigmoid volvulus are of old age with multiple comorbidities. So, the risk of surgery for those elderly patients is usually associated with increased rates of morbidity and mortality. Early intervention is required for managing sigmoid volvulus to avoid its serious complications; therefore, early endoscopic untwist of sigmoid colon can be performed followed by endoscopic fixation of sigmoid colon under sedation in this category of the patients to avoid development of high risk surgical complications following surgical fixation of sigmoid colon or sigmoidectomy after initial simple loop colostomy procedure to relieve obstruction.MethodsThis prospective randomized controlled clinical trial included all patients who developed acute sigmoid volvulus and were referred to the Zagazig University Hospital Emergency Department between December 2020 and August 2022. The study was prospectively approved by Zagazig University Faculty of Medicine Institutional Review Board (Approval Number: 9989/23-10-2022) and was retrospectively submitted in http://clinicaltrials.gov in November 2022 (http://clinicaltrials.gov ID: NCT05620446). Included eligible patients were simply randomized at a 1:1 ratio to “Endoscopic Group (EG)” or “Surgical Group (SG)” via drawing of sealed envelopes containing computer-generated random numbers prepared by a third party before start of intervention.ResultsSample size included 18 patients divided into 2 equal groups. (1) Endoscopic group included 9 patients who were subjected to endoscopic untwist of sigmoid colon followed by endoscopic fixation of sigmoid colon under sedation; (2) Surgical group included 9 patients who were subjected to surgical fixation of sigmoid colon or sigmoidectomy after initial simple loop colostomy under general anesthesia. In comparison between both groups, there were statistically significant differences regarding length of hospital stay and procedure time. Unfortunately, there were no statistically significant differences regarding postoperative complications and co-morbidities. Eight patients in the endoscopy group demonstrated excellent quality of life, and one demonstrated good quality of life; unlike the surgical group, there were 3 patients with excellent quality of life, 5 patients with good quality of life, and 1 patient with poor quality of life. So there was statistically significant difference regarding quality of life between both groups. During the 9-month follow-up period, both groups demonstrated no cases of recurrence post-fixation.ConclusionEndoscopic management of acute sigmoid volvulus is effective and safe in elderly high risk surgical patients (either in managing the intestinal obstruction caused by volvulus or in definitive treatment of volvulus).

Current status of TORCH infection Seroprevalence in pregnant women: a cross-sectional study in Al Sharqia Governorate, Egypt

BackgroundTORCH infections during pregnancy significantly impact neonatal and maternal mortality rates worldwide. This study aimed to gather baseline serological data for pregnant women's immunological status to infection and determine if definite TORCH pathogens (cytomegalovirus, rubella virus, and Herpes simplex virus) were associated with Toxoplasma infection, to improve prenatal care and provide appropriate infection control strategies.MethodologyBlood samples were gathered from 210 pregnant women attending Al Zagazig University hospitals from February to May 2023. Samples were examined for specific IgM and IgG antibodies against TORCH pathogens by electrochemiluminescence technique.ResultsRegarding TORCH infection, 60 (28.6%) cases were seronegative, while 77 (36.7%), 63 (30.0%), 56 (26.7%), and 15 (7.1%) were positive IgG antibodies against Toxoplasma gondii, cytomegalovirus, rubella virus, and Herpes simplex virus, respectively. There was no estimate for IgM for cytomegalovirus, rubella virus, or Herpes simplex virus, indicating that no primary infection had been detected during the pregnancy. There was a statistically significant association between seroprevalence of toxoplasmosis infections (IgM and IgG) and age group ≤ 25 years, which is the most common childbearing age group. Cytomegalovirus seropositivity was found in those beyond 25 years (P-value 0.001). Antibodies to mono-infections were found in 97/210 (46.2%) subjects. It is substantially higher under-25 years age group, 71/97 (73.2%), P-value of 0.001. 45/210 (21.4%) participants had antibodies to two agents, with no significant difference in the age group over 25 years, 26/45 (57.8%). Antibodies to three agents were assessed in eight instances, all under 25 years.ConclusionsAccording to our findings, serological evaluation for the TORCH complex in all pregnant women is recommended to determine infection immunity, current immunization regimens, and infection reactivation. Low TORCH antibodies rates amongst pregnant women in Egypt's Sharqia governorate might be an appropriate starting point for prenatal screening initiatives.

Intralesional bivalent and quadrivalent human papillomavirus vaccines didn't significantly enhance the response of multiple anogenital warts when co-administered with intralesional Candida antigen immunotherapy. A randomized controlled trial.

Treatment of anogenital warts (AGWs) is challenging. Candida antigen immunotherapy has been proven to be a safe and relatively effective therapeutic modality; nevertheless, some patients may experience a partial or no response. Combining Candida antigen with other immunotherapies has been proposed to improve the cure rate. Immunotherapy with human papillomavirus (HPV) vaccines has been tried with conflicting outcomes. This study aimedto assess the efficacy and safety of intralesional Candida antigen, either alone or in combination with intralesional bivalent or quadrivalent HPV vaccines, for treating multiple AGWs. Eighty patients with multiple AGWs were included and randomly assigned to four equal groups: group A treated with intralesional Candida antigen only; group B treated with intralesional bivalent HPV vaccine (Cervarix) and Candida; group C treated with intralesional quadrivalent HPV vaccine (Gardasil) and Candida; and group D (control) treated with intralesional saline. Complete clearance of lesions was detected in 40%, 20%, and 60% of patients in Candida monotherapy, Cervarix/Candida, and Gardasil/Candida groups, respectively, whereas 40%, 60%, and 20% of patients in the three groups, respectively, showed partial response. Only 10% of the control group had a partial response. Therapeutic outcomes were significantly better in the three treatment groups compared to the control group, with no statistically significant difference between the Candida monotherapy group and the combination groups, but the response was significantly better in the Gardasil/Candida group than in the Cervarix/Candida group. No statistically significant difference was found between the studied groups regarding the development of side effects. Moreover, no recurrence was detected in any of the groups throughout the 3-month follow-up period. Based on our results,combining intralesional HPV vaccines with Candida antigen immunotherapy may haveno significant benefit for treating multiple AGWs. Candida antigen may be recommended as a relatively effective and inexpensive therapeutic modality. The combination of Gardasil and Candida was also effective but very expensive. The results of the Cervarix/Candida combination were unsatisfactory. This clinical trial was registered and approved prospectively by the ethical review board at Faculty of Medicine, Zagazig University.

The Prevalence of Maternal and Newborn Morbidity Following a Repeat Cesarean Section: Data From Zagazig University Hospital

Background and Objective: Cesarean section (CS) is one of the most common obstetric procedures performed worldwide, and new research indicates that the frequency of CS is increasing. Maternal-fetal morbidity and death due to CS is a serious public health problem worldwide. Our study aimed to assess the impact of multiple cesarean sections (CSs) on mother-fetal morbidity. Methods: This cross-sectional study was performed on 165 women who underwent multiple repeated CSs in our clinic and met the criteria of inclusion by evaluating their records. All women were divided into 3 groups according to the number of CSs: 2nd (n = 111), 3rd (n = 44), and 4th/5th (n = 10). Maternal-neonatal outcomes; blood transfusion needs, adhesions, APGAR scores, and respiratory difficulties were investigated retrospectively. Results: Our results revealed that adhesion (60.6 %) was the most frequent maternal complication. The prevalence of thick adhesions decreased with the number of cesarean sections performed (70, 25, and 5 cases for the previous 2nd, 3rd, and 4 or more CS, respectively). There was no statistically significant difference between the groups in terms of adhesions, uterine rupture, bladder injury, endometritis, and wound infection. NICU admission (14.5 %), Low birth weight (3.6 %), and IUGR (3.03 %) were among the unfavorable fetal outcomes. There was a significant difference among the three studied groups regarding APGAR score, maternal age, and hospital stay, while a non-significance was found in birth weight and maternal adhesion. Conclusion: Our findings support our hypothesis that the likelihood of maternal complications rises as the number of CSs rises. The manner and time of delivery have a greater impact on infant outcome than the number of CSs. There is no clear absolute barrier for the number of CSs, however, 4 or more cesarean births were recognized as the essential level for the majority of outcomes. The number of CSs must be decreased to reduce the associated issues.

Evaluation of ceftriaxone pharmacokinetics in hospitalized Egyptian pediatric patients

This study aimed to evaluate ceftriaxone pharmacokinetics that affects the achievement of targets in the treatment of critically ill children (meningitis, pneumonia, urinary tract infection, peritonitis, and infective endocarditis( who were admitted to Zagazig University Pediatric hospital in Egypt to monitor for the drug adverse effects.Blood samples were obtained from 24 hospitalized pediatric patients (ages ranging from 2.5 months to 12 years) after administering the calculated dose of ceftriaxone via intravenous bolus route. Then, ceftriaxone plasma concentrations were measured using a validated HPLC method with ultraviolet detection. The pharmacokinetic analysis was conducted using Phoenix Winnonlin Program® software.Data for total and free ceftriaxone best fitted on a one-compartment model with the first-order elimination process. Clearance of ceftriaxone is reduced for patients with reduced kidney function and increased with those with augmented renal clearance. The volume of distribution and the free fraction are increased in these patients, especially those with hypoalbuminemia with a shorter half-life time were detected. A slight increase in total bilirubin and liver enzymes has been observed after treatment with ceftriaxone in these patients. Conclusion: In most critically ill pediatric patients, the current ceftriaxone treatment regimen (50 to 100 mg/kg) offers adequate pathogenic coverage. The clearance of free ceftriaxone in all patients correlates well with their renal function (eGFR), with r2 = 0.7252. During therapy with ceftriaxone at all doses ranging from 50 to 100 mg/kg, a rise in total bilirubin was observed in these patients. Moreover, liver enzymes (ALT and AST) increased moderately (p 0.0001). So, it is recommended to monitor total bilirubin and liver enzymes during the treatment with ceftriaxone, especially for a long duration (more than 5 days) or use another agent in patients with high baseline values.What is Known:• The dosing regimen of ceftriaxone (50 to 100 mg/kg) provided optimum therapeutic outcomes.• Some studies show data for total and free Ceftriaxone best fitted on a one-compartment model while other studies show data for total and free Ceftriaxone best fitted on a two-compartment model.What is New:• Up to my knowledge this is the first study ,considering individual pharmacokinetic analysis, conducted on hospitalized Egyptian pediatric population most of them with reduced kidney function with ages ranging from 2.5 months to 12 years. Data for total and free Ceftriaxone best fitted on a one-compartment model with linear clearance of the free ceftriaxone.• In all patients, total bilirubin and liver function tests were mildly increased, making them at risk for cholestasis or ceftriaxone-induced cholestatic hepatitis.

Daily step counts before, during, and after COVID-19 pandemic: a smartphone-tracking study of university students in Egypt and Saudi Arabia

BackgroundCOVID-19 pandemic has drastically changed people’s lifestyles and daily routines around the world. This study aimed to investigate changes in daily step counts – as an indicator of physical activity – before, during, and after the pandemic among university students in Egypt and Saudi Arabia and to identify regional and gender factors that may have influenced physical activity during these periods.MethodsA total of 1273 university students from Egypt (Assiut University and Zagazig University) and Saudi Arabia (Taif University, King Faisal University, and Imam AbdulRahman Bin Faisal University) provided valid data on their daily step counts recorded by a smartphone application (iPhone Health App) from January 2019 to December 2021. The data was divided and averaged based on three periods: the pre-pandemic year (January to December 2019), the first pandemic year (January to December 2020), and the second pandemic year (January to December 2021).ResultsThe results showed a significant decrease in daily steps from pre-pandemic to the first pandemic year, followed by an increase in the second pandemic year. However, daily step counts did not fully recover to pre-pandemic levels in male Egyptian and marginally in male Saudi participants. In both nationalities, female participants did not show a significant difference in daily steps between the pre-pandemic and second-pandemic years. Female Egyptian participants had significantly lower daily step counts than male Egyptian participants, and a gender difference in daily steps was also observed in Saudi female participants in the pre-pandemic and the second pandemic year but not during the first pandemic year.ConclusionThese findings outline the need for strategies in Egypt and Saudi Arabia to promote physical activity and reduce sedentary behavior, especially among young women, to mitigate the negative consequences of COVID-19 and meet physical activity guidelines.

Assessment of asthma mimics among newly diagnosed bronchial asthma patients in Zagazig University Hospitals

BackgroundBronchial asthma may mimic different diseases regarding their similar clinical presentations, so accurate assessment is required to exclude other possible diagnosis before confirming the diagnosis of bronchial asthma. The aim of the study was to identify the percentage of patients in whom the diagnosis of current asthma was confirmed or ruled out after clinical, spirometric assessment, and utilizing all the possible investigations.MethodsA cohort study of newly diagnosed bronchial asthma in adults aged ≥ 18 years were recruited from chest outpatient clinic and chest department. History taking, clinical examination, chest X-ray, and spirometry were done for all patients, while chest high-resolution computed tomography (HRCT), CT pulmonary angiography, or different endoscopies were done when indicated.ResultsTwo hundred recently clinically diagnosed asthmatic patients were recruited with a mean age of 43.2 and 53.4 years in the asthma group and asthma rule out group, respectively. About 55.5% of the studied patients were ruled out to have bronchial asthma after serial assessments of symptoms and spirometric function. There was increased chest wheeze as a respiratory symptom among asthma patients than the other group (p ˂ 0.001), while hemoptysis was significantly a more presenting symptom among patient group whose asthma diagnosis is ruled out (p = 0.009). About 87.6% of asthma confirmed group showed predominant reversible airway obstructive. The sputum cytology analysis of the bronchial asthma group of patients was 42.7% eosinophilic, 24.7% neutrophilic, and 32.6% mixed cellularity. After consuming all the available investigational tools, the most common diseases found among asthma rule out group were cardiac disorders, chronic obstructive pulmonary disease, psychological disorders, rhinitis, and gastro-esophageal reflux disease with percent of 11.5%, 9%, 8.5%, 8%, and 6%, respectively.ConclusionsUtilizing all the available investigational tools in the present study allowed to exclude bronchial asthma and diagnose critical diseases that need specific and urgent therapies as heart diseases, subglottic stenosis, pulmonary hypertension, and interstitial lung diseases.Trial registrationClinicalTrials.gov NCT05776537. Retrospectively registered on 6 March 2023.

Impact of flail chest injury on morbidity and outcome: ten years’ experience at a tertiary care hospital in a developing country

BackgroundOne of the worst types of severe chest injuries seen by clinicians is flail chest. This study aims to measure the overall mortality rate among flail chest patients and then to correlate mortality with several demographic, pathologic, and management factors.MethodologyA retrospective observational study tracked a total of 376 flail chest patients admitted to the emergency intensive care unit (EICU) and surgical intensive care unit (SICU) at Zagazig University over 120 months. The main outcome measurement was overall mortality. The secondary outcomes were the association of age and sex, concomitant head injury, lung and cardiac contusions, the onset of mechanical ventilation (MV) and chest tubes insertion, the length of mechanical ventilation and ICU stay in days, injury severity score (ISS), associated surgeries, pneumonia, sepsis, the implication of standard fluid therapy and steroid therapy, and the systemic and regional analgesia, with the overall mortality rates.ResultsThe mortality rate was 19.9% overall. The shorter onset of MV and chest tube insertion, and the longer ICU, and hospital length of stay were noted in the mortality group compared with the survived group (P-value less than 0.05). Concomitant head injuries, associated surgeries, pneumonia, pneumothorax, sepsis, lung and myocardial contusion, standard fluid therapy, and steroid therapy were significantly correlated with mortality (P-value less than 0.05). MV had no statistically significant effect on mortality. Regional analgesia (58.8%) had a significantly higher survival rate than intravenous fentanyl infusion (41.2%). In multivariate analysis, sepsis, concomitant head injury, and high ISS were independent predictors for mortality [OR (95% CI) = 568.98 (19.49–16613.52), 6.86 (2.86–16.49), and 1.19 (1.09–1.30), respectively].ConclusionThe current report recorded mortality of 19.9% between flail chest injury patients. Sepsis, concomitant head injury, and higher ISS are the independent risk factors for mortality when associated with flail chest injury. Considering restricted fluid management strategy and regional analgesia may help better outcome for flail chest injury patients.

Combination Influences of NPK Fertilizers and Bradyrhizobium Inoculation on the Yield, Chemical Constituents and Guaran Production of Guar (Cyamopsis tetragonoloba, Taub.) Plant

At the Experimental Farm (Ghazala Farm) of the Agric. Fac., Zagazig University, Egypt, two field experiments were conducted through the two successive summer seasons in 2019 and 2020. This was an effort to improve the guar plant’s yield and productivity. The experiment was set up as a split-plot design with NPK fertilization as the main plot and bio-fertilization as the sub-plot. The Bradyrhizobium spp. inoculation rates were (0.0, 200 and 400 g/feddan), while the NPK fertilization levels were (0.0, 75, 100, and 125% of recommended level). Ammonium sulphate (20.5% N) at 200 kg/feddan, calcium super phosphate (15.5% P2O5) at 200 kg/feddan, and potassium sulphate (48% K2O) at 100 kg/feddan were the NPK fertilization recommended rates (RR). The obtained results showed that, in comparison to control and the other levels under study, guar plants fertilized with 125% RR significantly increased yield components as well as total carbohydrates content, and NPK percentages in seeds and guaran production. Additionally, compared to the control and lowest inoculation rates of Bradyrhizobium, the maximum inoculation rate (400 g/feddan) considerably recorded the highest values of all the aforementioned parameters. The majority of the study’s findings demonstrated that fertilized guar plants with 125% RR of NPK fertilization, together with 400 g/feddan of Bradyrhizobium inoculation rate, might aid to improve guar plant (Cyamopsis tetragonoloba Taub.) yield, chemical constituents and guaran production.

A comparative study between laparoscopic trans-abdominal retromuscular repair and intraperitoneal onlay mesh repair techniques in ventral hernia

Background A hernia is a projection of an organ or part of an organ through a defect in the body wall. When compared to open procedures, laparoscopic ventral hernia repair has consistently demonstrated lower overall complication rates, shorter hospital stays, and faster return to work. Aim To compare the efficacy and safety between laparoscopic transabdominal retromuscular mesh (TARM) repair and laparoscopic (IPOM) repair in the treatment of patients with ventral hernia in Zagazig University Hospitals as a single center experience. Patients and methods This study is a prospective randomized clinical trial carried out upon 48 patients who were randomized by closed envelope method into two groups: Group (A): had undergone Laparoscopic TARM repair. Group (B): had undergone Laparoscopic IPOM repair. Results There was statistically significant variation between groups concerning cost which was significantly lower in laparoscopic TARM repair. Group B was lower regard intra operative complication rate but not significantly, but regard postoperative complication Group A significantly associated with Seroma and Group B significantly associated with Bulge. Complicated cases were significantly younger and wider regarding hernia width. Conclusion TARM repair technique was more time consuming but with less cost in comparison to the IPOM technique. TARM has the advantage of defect closure and avoiding mesh contact with abdominal viscera.

Prevalence and Characterization of Carbapenem-Resistant Klebsiella pneumoniae isolated from the intensive care units of Zagazig University Hospitals

Prevalence and Characterization of Carbapenem-Resistant Klebsiella pneumoniae isolated from the intensive care units of Zagazig University Hospitals

Health-Related Quality of Life Among Women with Ovarian Cysts

Background: Ovarian cysts are a common finding in women of the reproductive age group. Aim: To evaluate the relationship between ovarian cysts and quality of life among women of reproductive age. Patients and Methods: A descriptive study was conducted at gynecological outpatient clinic and endoscopic unit in Zagazig university hospital. Sampling: A convenient sample was selected from 200 women with ovarian cysts. Data collection tools: 1) Socio-demographic Questionnaire. Quality of life was assessed with the 36-ItemShort Form Health Survey; 2) Physical and biological assessment; 3) Numeric pain scales and 4) Quality of life in women with ovarian cyst. Results: The results of the study revealed that the majority of women in the age group 17-50 years. Most of them complained of abdominal heaviness and fullness and loss of appetite, respectively. Moreover, most of them had moderate and severe pelvic pain, respectively. Also, more than half of them had severe pain that interfered with their normal physical activities. Moreover, most of women had average level regarding psychological and physical health. Conclusion: Health Related Quality of Life was significantly decreased in women with ovarian cyst. Thus, women with suspected or diagnosed ovarian cysts should seek immediate medical help because early diagnosis and treatment are beneficial in improving their quality of life.

Association of serum CD14 level and functional polymorphism C-159T in the promoter region of CD14 gene with allergic rhinitis

Allergic rhinitis (AR) is an inflammatory disease of the upper respiratory tract affecting a significant number of the world’s population. It occurs as an IgE-mediated immune response of the nasal mucosa to inhaled allergens. The human Cluster of Differentiation 14 (CD14) is a glycosyl-phosphatidylinositol-anchored molecule expressed on the surface of monocytes and macrophages and functions as a receptor to lipopolysaccharides and inhaled endotoxins that may stimulate interleukins production by antigen-presenting cells. Consequently, CD14 plays a substantial role in allergic diseases and may become one of their etiological causes. This study aimed to determine the association between C-159T polymorphism in the CD14 gene promoter region and serum CD14 levels and the risk of Allergic rhinitis Egyptian patients and to test the validity of serum CD14 level measurement in predicting AR. This case–control study included 45 patients with AR referred to Allergy and Immunology Unit, Zagazig University Hospital, Zagazig, Egypt, and 45 healthy subjects as controls. Serum CD14 levels were measured by ELISA. The polymerase chain reaction-restriction fragment length polymorphism technique was used to detect C-159T gene polymorphism in the CD14 promoter region. There was a significant association between CD14 serum levels and AR incidence (P < 0.001), with patients having higher serum CD14 levels than controls. In addition, a significant association (P < 0.001) was detected between serum CD14 levels and the severity of AR, as well as elevated serum CD14 levels in severe and the most severe cases. On the molecular level, there was a statistically significant relationship between patients and the control group regarding the CD14 genotype (P < 0.001), where CT and TT genotypes and T allele were primarily associated with the cases group, indicating that the risk of AR was significantly associated with the inheritance of the TT genotype. Additionally, a statistically significant association was found between the severity of AR and CD14 genotype (P < 0.001), where TT genotypes were mainly associated with severe and the most severe cases. In the studied groups, there was a statistically significant difference (P < 0.05) between the CD14 genotype and serum CD14 levels, with TT genotypes being associated with higher CD14 levels. The results obtained in this study revealed that serum CD14 level is a potential biomarker for the diagnosis of AR and, at the genetic level, a potential predictor of disease.

Retrospective study on the predictive survival variables and therapeutic response in differentiated thyroid cancer

Introduction: The most established endocrine problems are thyroid cancer. Differentiated thyroid cancers (DTCs) usually come in papillary and follicular forms [1]. Thyroid cancers are now more time-honored than ever, accounting for 1% of all cancer instances recognized yearly [2]. Follicular kinds have a better impact than aggressive anaplastic types, while follicular types have a higher outlook than papillary types. Objective: How long-term survival for patients with unique thyroid carcinomas is predicted to be? Age, sex, bulk size, participation of lymph nodes, far away organ metastasis, surgical intervention, and differentiation Methods: At the medical institution of Zagazig University, the surgical department, 123 patients obtained thyroid surgical process for differentiated carcinoma between 2018 and 2022. (96 for papillary sort most cancers and 27 for follicular kind cancer). Post-operative mortality, histopathology findings (multifocality and differentiation), local and distal lymphatic invasion, Results: Follow-up At the surgical branch of the Zagzig University, ninety-six sufferers with papillary cancer underwent surgery; the typical patient age was once 43.7 /-16.0 years, and the male to girl ratio used to be 1:7. The 5-year mortality price after follow-up used to be 90.9% for papillary forms and 84.0% for follicular types, respectively. The average follow-up period was once 4.6 /- 4.9 years. Twenty-seven instances (average age: 49.5 /- 15.9 years, males: 7, females: 20, male to girl ratio: 0.35%) underwent follicular carcinoma surgery. Conclusions: Age type of pathological character of thyroid tumor affecting the survival of patients

Factorial validity of the self-compassion scale among female University students: A comparative study between Saudi and Egyptian cultures.

The study aims to verify the factorial structure of the self-compassion scale across different cultural contexts. The sample included 1039 students, divided into 521 students from Zagazig University (ZU) and 518 from Princess Nourah University (PNU) in the Kingdom of Saudi Arabia (KSA), which were chosen randomly. Exploratory factor analysis was used to test the stability of items on the dimensions. The results showed stability along with kindness with self, isolation, common humanity, and self-judgment factors. On the other hand, confirmatory factor analysis demonstrated that the results of this study yielded the best fit for the total sample. Then factor analysis across the two groups was used to verify the existence of differences between Saudi and Egyptian cultures. The analysis results revealed that the Egyptian environment model is superior to its Saudi counterpart and that there are no differences between the two cultures using the factorial differences indicators RMSEA, NNFI, GFI, and SRMR. This study's outcomes can have global implications for promoting self-compassion as a tool for improving mental health and well-being across cultures.

Toxicology Screening Testing in Patients Undergoing Elective Surgeries: Zagazig University Hospital

Toxicology Screening Testing in Patients Undergoing Elective Surgeries: Zagazig University Hospital