الفهرس 
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Abstract
The present study was conducted on 42 patients of matched age and sex. Their ages ranging from 15 - 72 years and they were 23 male and 19 female. They were admitted to Emergency Hospital of Mansoura University, and all of them needed surgical interference. In addition to 9 healthy volunteer of matched age and sex as a healthy control group. The patients were subjected to through clinical examination and Acute Physiology and chronic Health Evaluation (APACHE II) severity score was calculated for every case. The patients were classified according to this score into three groups : First group : APACHE score less than 8 (n = 25 ) Second group : APACHE score 8 - 10 ( n = 11 ) Third group : APACHE score more than 10 ( n = 6 ) Blood samples were withdrawn from all patients ( n = 42 ) at the time of admission and before receiving any treatment, a second blood sample were taken from 23 cases after surgical procedure and a third sample were taken from 13 case at the time of discharge or before death.