a b s t r a c tBackground: Among healthcare professions, critical care healthcare workers (HCWs) have one of the most stressful jobs. This study was conducted to determine the relationship between job stress and burnout syndrome (BOS) among nurses and healthcare technicians at the surgical emergency department and intensive care unit of Critical Care department at the Alexandria University Hospital. Methods: A cross-sectional approach was conducted from October 2014 to March 2015. Eighty-two nurses and healthcare technicians participated in the research (response rate = 80.39%). Data was collected by an interview questionnaire using selected subscales of NIOSH Generic job stress Questionnaire and Maslach Burnout Inventory of Health and human service Questionnaire. The relationship between BOS and job stress was examined using bivariate and multivariate analyses. Results: Although majority of participants reported variation of workload (84.15%), quantitative overload (76.8%), responsibility for peoples' life (69.5%) and lack of perceived control (63.41%), yet, 85.4% were satisfied with their job. Moreover, high levels of emotional exhaustion was reported by the majority of participants (80%), while less than one third reported either high levels of depersonalization or low levels of personal accomplishment domains of BOS. In multiple regression analysis, skill underutilization, variation in workload, and intragroup conflicts were negatively associated with BOS domains. While, job satisfaction and responsibility for peoples' life were positively associated with personal accomplishment domain of BOS. Conclusion: Critical care HCWs had high BOS. The study concluded that reducing intragroup conflict, improving skills utilization, and raising job satisfaction are crucial to reduce BOS among critical care HCWs. More attention and psychological support is recommended to critical care HCWs. Ó 2017 Alexandria University Faculty of Medicine. Production and hosting by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Background: Members of the NFκB [p65] family have potential diagnostic and prognostic role in various inflammatory diseases and Lymphomas. Aim: We studied NFκB [p65] in paraffin blocks of hepatitis-C-virus [HCV] positive genotype-4 and HCV negative diffuse large B-cell lymphoma [DLBCL] patients, aiming at identification of its differential expression and prognosis in DLBCL and its subtypes; GCB and ABC. This is to establish its relation to HCV infection and its role in lymphogenesis. Besides assessing the role of new directly acting antiviral drugs [Sofusbuvir/Ledipasvir] concomitantly administered to [CHOP] combination in HCV positive DLBCL. Subjects and Methods: NFκB [p65] expression was assessed using Anti-NFκB [p65] antibody semi-quantitative technique in 30 newly diagnosed DLBCL patients [HCV positive [n = 15], HCV negative [n = 15]. Results: NFκB [p65] expression was higher in the HCV positive DLBCL patients than their HCV negative counterpart, with a positive correlation with the viral load [r = 0.536, p = 0.088]. NFκB [p65] expression was significantly more frequently detected in the ABC subtype than GCB subtype [p = 0.04]. Patients who expressed NFκB [p65] had higher incidence of extranodal involvement, advanced stages, higher LDH levels and IPI score. Besides, the expression of NFκB [P65] revealed an inferior overall response [OR] [p = 0.044]. Higher complete response rates to CHOP concomitantly with antiviral [ledipasvir/sofosbuvir] were encountered in the HCV positive group. In HCV positive group, NFκB [P65] displayed a positive relationship with the viral load and liver enzymes [p = 0.04], besides an inverse relation with serum albumin. This raises the possibility that NFκB [p65] expression is suggestive of the hepatic necro-inflammation in HCV pa-How to cite this paper: El tients. The ABC group presented more in advanced stages than GCB. Higher frequency of the ABC subgroup exhibited intermediate to high viral load, while it was less in the GCB. A statistically significant difference was found in the NFκB [p65] positive patients as regards MUM1 expression among the two groups [p ≤ 0.001]. Double positive [CD10+, MUM1+] and triple negative [CD10-, BCL6-, MUM1-] cases were encountered in the HCV positive group, and were characterized with a high NFκB [p65] expression. Conclusion: NFκB [p65] is expressed in patients with DLBCL, more frequently in ABC than in GCB subtypes. Expression of NFκB [p65] is associated with poor response to therapy in DLBCL. The NFκB [p65] disclosed an increased expression in HCV positive DLBCL compared to HCV negative group. The viral load displayed a positive correlation with the NFκB [p65] expression. Simultaneous administration of DAAs in combination with CHOP disclosed a better response and high tolerability.

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