ABSTRACT
Background: the presence of antithyroid antibodies [ATA] are frequently encountered in general population and approximately 1/5 of childbearing age women are positive for the antithyroid peroxidase antibody [TPO-Ab] or antithyroglobulin antibody [TG-Ab]. Autoimmune thyroid diseases are rather frequent in women in the childbearing age, affecting 5-20% of them. They are characterized by the presence of antithyroglobulin and antithyroperoxidase antibodies, grouped under the definition of ATA. ATA are often detected in subjects complaining of hypo- or hyperthyroidism, but are no rarely found in patients without any sign of thyroid dysfunction
Aim of the Work: to investigate the impact of antithyroid antibodies on pregnancy outcome in cases of one or two failure of Intracytoplasmic Sperm Injection [ICSI] cycle
Patients and Methods: the present study is a prospective study. This study was conducted at Ahmed Oraby IVF center [private center], and was approved by the Medical Ethical Committee of Al-Azhar University. Informed consent was obtained from every patient according to Hospital Ethics Committee. Age of patients, diseases status and previous treatments were recorded. This study was done on 50 patients complaining of infertility with history of one or two failure of ICSI cycle and patients divided into two groups, in the ATA positive group, 25 women were positive for TG-Ab and/or TPO-Ab, 25 women negative for TG-Ab and/or TPO-Ab served as controls. All patients did not receive any adjuvant treatment, such as glucocorticoids, anticoagulants, or other adjuvants. Patients with other autoimmune diseases, or positive for anticardiolipin antibody, antinuclear antibody, lupus anticoagulant, or rheumatoid factor were excluded from this study
Results: there were no significant differences in age, BMI, basal LH, FSH levels, cause of infertility and duration of infertility between two main groups. No significant differences in terms of the days of ovarian stimulation, estradiol level, total gonadotropins dose, number of oocytes retrieved, available embryos and blactocysts number neither of embryos transferred nor in rates of fertilization, implantation and clinical pregnancy between two main groups were found. The only statistically significant among the ATA positive group increase the abortion rate was found p value 0.02
Conclusion: patients with anti-TPO antibodies showed no significant differences in fertilization, implantation, pregnancy rates, live birth rates but higher risk for miscarriage following intracytoplasmatic sperm injection-ICSI and embryo transfer when compared with those negative for anti-thyroid antibodies
ABSTRACT
Background: Various populations of regulatory T cells play a central role in the development of peripheral tolerance to allergens. Culturing of CD4+ T cells isolated from peripheral blood of allergic patients with vitamin D induces the generation of stable IL-10 producing CD4+CD25+ Treg cells suppressing the proliferation of T helper cells obtained from the same patients. The immune regulatory role of vitamin D in allergic patients has been controversial and obviously needs a more clarifying research work
Aim of the work: to determine the percentage of induced T regulatory cells producing interleukin 10 after stimulation of T regulatory cells with cow milk allergen in the presence of vitamin D in culture. This aims to further in-vitro study the immune regulatory role of vitamin D in cow milk allergic patients
Results: there is association between decreased level of vitamin D and milk-allergy, as serum level of 25[OH] D3 was insufficient in 16 [80 %] patients [10- 29.9 ng/ml] while 4 [20%] patients were sufficient [30-100 ng/ml]. Addition of vitamin D, in culture, induces the production of CD4+ CD25hi Foxp3+ IL10+. Treg cells within peripheral blood mononuclear cells [PMNCs] isolated from allergic children who had insufficient vitamin D, but not in allergic children who had normal level of vitamin D
Conclusion: this work provides further evidence for an important role of 1,25[OH]2D3 as an immune-modulatory molecule and suggests that supplementation of vitamin-D-deficient individuals, who are reported to have reduced numbers of circulating and Foxp3+ IL10+ Treg cells, may represent an attractive therapy for enhancing endogenous populations of Treg cells in allergy
ABSTRACT
The determination of fungus in vitro antifungal susceptibility has been reported to be important for the ability to eradicate pathogenic dermatophytes. This work aims to assess the in vitro activity of fluconazole, ketoconazole and itraconazole against dermatophytes from dermatophytosis patients before and after oral antifungal therapy with itraconazole. The study was conducted on 80 patients with dermatomycosis attending the Deramtology Outpatient Clinic of Zagazig University Hospitals. The patients were clinically diagnosed and mycologically confirmed as having tinea capitis [42], tinea corporis [18], tinea pedis [12], tinea ungium [5] and tinea cruris [3]. All patients received a course of pulse itraconazole therapy. The clinical specimens were collected from all patients before and after 3 months of itraconazole oral therapy. Identification of dermatophytes to the species level was performed by colony morphology, microscopy and biochemical and physiological tests. All dermatophytes isolates were subjected to antifungal susceptibility testing by E-test method. In this work, the most frequently isolated species was T. rubrum, comprising 25 [31.25%] isolates, followed by T. mentagrophytes [21 isolates, 26.25%], T. violacium [17 isolates, 21.25%], M. canis [7 isolates, 8.75%], T. schoenlinii [6 isolates, 7.5%] and M. audouinii [4 isolates, 5%]. The most active agent against all dermatophytes species was itraconazole with an MIC range of 0.094 - 12 micro g/ml., MIC50 values of 0.125-0.5 micro g/ml and MIC90 values of 0.25-8 micro g/ml., followed by ketoconazole [MIC range of 0.0.64-24 micro g/ml., MIC50 values of 0.38-1 micro g/ml. and MIC90 values of 2-8 micro g/ml]. The least active agent was fluconazole [MIC50 of 64- >/= 256 micro g/ml. and MIC90 of 128- >/= 256 micro g/ml]. MIC values higher than MIC90 were observed for the azole drugs when testing isolates obtained post-treatment from four tinea unguium patients. In conclusion, our data showed that itraconazole was the most active azole against all dermatophytes isolates. Furthermore, the increase in MIC values for azole drugs found for some of our isolates after therapy might raise the possibility of increased antifungal resistance. Further studies on larger samples of dermatophytes are recommended to correlate the MIC values with the clinical outcome for each isolate-drug combination to allow clinician adapting different therapeutic options. In addition, these studies could be beneficial for investigation of development of in vitro resistance in dermatophytes species, and for management of cases clinically unresponsive to treatment
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Background and study aim: Laryngeal squamous cell carcinoma [SCC] is the most frequent tumor of the head and neck region. Apoptosis is a genetically regulated cell death involved in the deletion of cells in normal as well as malignant tissues. Inhibition of apoptosis or programmed cell death may be critical both in the development of cancer and in determining response to therapy. Apoptotic sensitivity is modulated by Bcl-2-related proteins through interactions between positively and negatively acting family members. It has been shown that the proteins of the bcl-2 gene family heterodimerize and homodimerize with each other and the relative proportions of these dimers may determine whether or not a cell becomes apoptotic. A hallmark of apoptosis is DNA degradation. Circulating DNA has generally been referred to as cell free DNA. In various pathologic conditions, qualitative and quantitative changes in circulating DNA have been shown. In this work, we studied the expression of Bcl-2, Bcl-xL and Bax and the serum DNA fragments in patients with primary squamous cell carcinomas of the larynx and their correlations with the clinicopathologic tumor parameters
Materials and methods: The study included 55 patients with primary laryngeal squamous cell carcinoma without distant metastasis. The expression of apoptosis related factors Bcl-2, Bcl-xL and Bax was studied by immunohistochemical staining of the biopsy specimens that were obtained before the administration of any treatment. Also, blood samples were taken to study the serum DNA fragments using cell death detection ELISA technique. Thirty five healthy males were chosen as a control group for serum DNA analysis matching in the ages with the 55 laryngeal carcinoma patients
Results: Twenty three cases [42%] were classified high Bax and 32 cases [58%] low Bax. High expression of Bax was associated with low T category, early clinical stage, low grade histology, negative lymph node metastasis and glottic location of tumors. Thirty cases [54.5%] were classified high Bcl-2 and 25 cases [45.5%] low Bcl-2. High Bcl-2 expression was associated with high grade histology, high T category, advanced clinical stage, positive regional lymph node metastasis and supraglottic location of tumors. Thirty three cases [60%] were classified high Bcl-xL and 22 cases [40%] low Bcl-xL. There was an inverse relation of Bcl-xL protein expression to the tumor histological grade as Bcl-xL expression decreased with decreasing tumor differentiation. Bcl-xL protein expression was negatively correlated with regional lymph node metastasis. No significant correlation was found between Bcl-xL expression and the parameters of tumor site, primary tumor size and clinical stage. There was a significant difference in concern to DNA fragmentation products among the studied laryngeal carcinoma patients with an increase in DNA fragmentation with increase in the tumor histological grade, primary tumor size and clinical stage of the tumor. The values of DNA fragmentation levels were significantly higher in patients with supraglottic tumors and also in patients with regional lymph node metastasis than without metastasis
In conclusion: the study of expression of apoptosis related proteins in tumor cells and the changes in serum DNA fragmentation may contribute to the prediction of prognosis of primary laryngeal carcinoma
ABSTRACT
Background: Enterococci are gastrointestinal commensals in man and animals and they are members of the natural microbiota of a variety of fermented food products and play an important role in food processing
Aim of work: The aim of the present work is to identify the prevalence of enterococci in food samples, to identify the commonest species and to study the antibiogram pattern of isolated strains
Material and Methods: 200 food samples were examined including 50 meat samples, 60 samples chicken, 40 samples milk and 20 samples of vegetable foods and 10 samples of raw pork, sausage and fish. The samples were cultured and the isolates were identified to the species level and the antibiotic resistance pattern of the isolated strains was done by the disc diffusion method and the minimal inhibitory concentration to vancomycin
Results: Enterococci were isolated from 161 samples with a rate of 81% of total samples and 212 isolated enterococcus species. Their distribution in different food samples was calculated. All enterococcus isolates were resistant to different antibiotics, 14% of E.faeclis strains were resistant to vancomycin and 16% of E.faecium strains were resistant to vancomycin
Conclusion: The poultry is one of the main sources of enterococci to colonize the human gut. Multiple antibiotic resistant enterococci are found in all types of food samples. Raw pork and meat play a potential role as reservoirs of enterococci
ABSTRACT
Rapid identification of microorganisms in blood cultures is necessary to optimize suitable treatment at an early stage. Fluorescence in situ hybridization [FISH] can reduce the time to identification of pathogens in growth-positive blood cultures. So this work aimed to: [i] evaluate the use of FISH with oligonucleotide probes for identification of pathogens in growth -positive blood cultures, [ii] compare the time taken by FISH and traditional methods for identification of pathogens in growth -positive blood cultures, and [iii] determine the potential clinical benefits of FISH technique. In this study, 120 blood cultures with a positive growth index as determined by the automated blood culture system were examined simultaneously by both traditional laboratory methods and FISH method. For this purpose, oligonucleotide probes that are complementary to portions of the 16S or 23S rRNA of the specific bacteria and of 18S or 26S rRNA of the specific yeasts were used, and allowed identification of about 95% of pathogens known to be associated with bacteremia. For all 120 blood cultures, microorganisms were grown after 1 day and identification to the family, genus, or species level was achieved after 1-3 days, while 108 samples [90%] were similarly identified by FISH within 3-4 h only. Staphylococci were identified in 67 of 69 samples [97%], Streptococci and Enterococci in 11 of 11 samples [100%], gram - negative rods in 25 of 34 samples [74%] and fungi in 4 of 4 samples [100%]. The sensitivity and specificity of individual probes exceeded 95% , except for the Enterobacteriaceae probe [93%]. Cross hybridization occurred with the Klebsiella pneumoniae probe for Klebsiella oxytocic. The time gain of FISH compared to that of culture identification was more than 18 h for bacteria and 42 h for yeasts. In conclusion, FISH is a rapid and reliable method for identification of majority of pathogens in blood cultures from septicemic patients. With further extension of the number of probes and a reduction in the turnaround time, FISH will become a very useful diagnostic tool in the diagnosis of bloodstream infections
ABSTRACT
Children receiving multiple transfusions or cancer chemotherapy are at an increased risk of acquiring and spreading hepatitis B [HBV] and/or hepatitis C [HCV] virus infections. Concurrent infections with both viruses are increasingly recognized and the reciprocal influence of dual infection remains controversia1. Hepatitis B virus [HBV] infections in patients who lack detectable hepatitis B surface antigen [HBsAg] is considered occult infection
Aim of work: this work was designed to: a] study the prevalence and risk factors of occult HBV infection in children and adolescents with hematological disorders and malignancies, with or without HCV infection, and b] detect the correlation between occult HBV and HCV infections
Material and Methods: The study included 96 poly-transfused children and adolescents. Patients were 47 with hematological disorders [Group 1, median age 11.7 years] and 49 with hematological malignancies [Group 2, median age 8.1 years]. Sera were tested for HCV antibodies, HCV-RNA [nested RT-PCR], NBV markers [HBsAg, Anti-HBcAb IgM and total and HBeAg] and HBV-DNA [nested PCR for "s", "c" and "x" regions]
Results: anti-HCV was detected among 38/47 [80.9%] in Group 1 [24/47; 51% HCV-RNA+ve] and 8/49 [16.3%] in Group 2 [11/49; 22.4% HCV-RNA+ve]. Overall, HBV-DNA was positive among 39.6% [l4/47; 29.8% in Group 1 and 24/49; 49% in Group 2]. HBV-DNA "c" region was positive in 35.4% [14/47; 29 8% in Group 1 and 20/49; 40.8% in Group 2]; "s'' region in 4 leukemics [one, was both "c" and "s" regions +ve] and "x" region in one leukemics [also "c" region +ve]. Twenty one patients [21.9%] had occult HBV infection and twelve of them [57.1%] were HCV-RNA+ve [8/47; 17% in Group 1 and 4/49; 8.2% in Group 2]; whereas 8 patients [8.3%] [Group 2] showed overt HBV-infection [HBsAg+ve / HBV-DNA +ve HCV-RNA-ve]
In conclusion, occult HBV infection is not uncommon in immunocompromised children with chronic HCV infection. The high prevalence of occult HBV infection [particularly core DNA] may have clinical implications in the pathogenesis and therapy of HCV-induced chronic liver disease
ABSTRACT
Candida is a heterogeneous genus. C. albicans, the most common is known to possess a number of virulence determinants that enable it to invade tissues and colonies there, as germ tubes, pseudohyphae and adhesion molecules. Diseases due to other Candida species are now increasing, so how other nonalbicans Candida can cause such diseases. The aim of this work is to search for virulence determinants in Candida isolates from pathological lesions and commensal sites, including: germ tube, pseudohyphae, adhesion ability, extracellular phospholipase, proteinase and haemolysin and the ability to form biofilms, and to find any correlation between these virulence determinants and the pathologic state of Candida isolates. The study was performed on 120 Candida isolates, 88 from 315 patients [27.9%] and 32 commensals from 56 volunteers [57%]
Results: C. albicans [53.3%], C. tropicalis [30.8%], C. parapsillosis [5%], C. glabrata [4.2%] and C. krusi [2.5%] were the isolated species. C. albicans possess the significant virulence determinants: it's the only Candida that form germ tubes, adhesion ability of most its strains, high phospholiase, proteinase and haemolysin level from most strains and significant ability to form biofilms however other Candida species as C. tropicalis possess the ability to form pseudohyphae, secrete phospholipase, proteinase and haemolysin. This study also showed that isolates from pathological lesions of various Candida species possess virulence determinants to more significant degree than commensal isolates
Conclusion: there are important extracellular enzymes and ability to aggregate in biofilms that confer on Candida species virulence. These factors may be as important as cellular structures: germ tube, pseudohyphae and integrin like molecules, and typing methods according to virulence factors referred to wide differences between pathogenic and commensal isolates of Candida species
ABSTRACT
This prospective study was performed on 20 consecutive patients with suspected or known colonic neoplasia to evaluate the sensitivity and accuracy of a new virtual colonoscopy technique for the detection of colorectal lesions in comparison with optical [conventional] colonoscopy as the standard of reference. They were 12 males and 8 females with age ranging between 48-72 years and mean age of 56.3 years. All patients were subjected to a thorough history and clinical examination, routine laboratory tests and abdominal ultrasonography. After standard bowel preparation, all patients underwent a non-contrast helical CT scan of the abdomen and pelvis followed by conventional colonoscopy in the same day. The images of CT colonography were reconstructed into a virtual colonoscopy [VC] presentation and compared with subsequent conventional colonoscopy in a blinded manner. Conventional colonoscopy identified 22 polyps 5 mm or greater in 12 patients, and no polyps were detected in 8 patients. Virtual colonoscopy correctly identified 5 polyps of 9 polyps 5-9 mm in size, and 11 of 13 lesions greater than or equal to 10 mm in diameter. Per-patient findings of VC for lesions 5-9 mm were; sensitivity 55.6%, specificity 81.8%, positive predictive value 71.4%, negative predictive value 69.2%, over all accuracy 70% and for lesions greater than or equal to 10 mm were; sensitivity 91.7%, specificity 87.5%, positive predictive value 91.7%, negative predictive value 87.5%, over all accuracy 90%. It could he concluded that VC is feasible and has excellent sensitivity and specificity for detection of colorectal lesions 10 mm and larger and provide another effective complement for the diagnosis and screening
Subject(s)
Humans , Male , Female , Colonography, Computed Tomographic , Ultrasonography , Sensitivity and Specificity , Prospective Studies , Colonoscopy/methodsABSTRACT
It is current opinion that concealed and manifest accessory pathways are indistinguishable with respect to their location, and contribution to orthodromic reciprocating tachycardia This study aimed at comparing the clinical and Electrophysiological characteristics of concealed and manifest accessory pathways, assessment of immediate results and complications of radiofrequency ablation and detection of the recurrence rates of accessory pathways after radiofrequency ablation. This study was carried out in National Heart Institute and Zagazig University Hospital and included 37 patients that were referred because of symptomatic supraventricular tachycardia [SVT] refractory to medical treatment. They were divided into two groups: Group 1; twenty two patients with manifest accessory pathway on resting ECG and Group II; fifteen patients were proven retrogradly in the electrophysiological study [BPS] to have concealed pathway after exclusion of patients with AVNRT. Patients with more than one accessory pathway, Accessory pathway and associated SVT due to other mechanisms were excluded from the sturdy. All patients in both groups were subjected to Full history taking, Complete general and local examination of the heart, twelve lead surface ECG, Echo-Doppler Study and electrophysiological study to diagnose the mechanism of tachycardia and to localize the accessory pathway and radiofrequency ablation of accessory pathway. Then follow up was done to the patients for the next 6 months on regular basis in the outpatient clinic for recurrence of symptoms, resting ECG for resumed manifest pre-excitation, documented attacks of tachycardia, need for antiarrhythmic and need for redo. Symptoms pattern did not differ significantly between the two studied groups, with palpitation occurred in 100% in both groups, dizziness 40.4% in group I and 46.6% in group 11, syncope 18.18% in group I and 6.66% in group 11, dyspnea 27.27% in group I and 26.66% in group II, and sweating 18.18% in group land 13.33% in group II. Palpitation was the most common presenting symptom in both groups. Accessory pathway mediated tachycardia caused significantly higher rate of hospitalization in group II, There was no associated cardiac disease in any of our patients. We did not find any patient with accessory pathway and congenital heart disease. AVRT was correctly diagnosed in 8 patients [53%] in group II. The success of radiofrequency ablation of accessory pathways depends on accurate localization of accessory pathway. In our study 91% of group II patients had orthodromic tachycardia and 9% had antidromic tachycardia and 100% of group II patients had orthodromic tachycardia. Radiofrequency ablation was attempted in 21 patients in group I. In group II RF ablation was attempted in all patients. The acute success was comparable in both groups with no significant difference. In group I the acute success was 90% while in group II it was 85.5%. Complications in our study were met with in group I with one patient developed VF during catheter ablation, one patient developed RBBB, one patient had complete heart block necessitated insertion of permanent pacemaker, and one patient had deep vein thrombosis, and in group II one patient developed complete heart block, and one patient had deep vein thrombosis. The recurrence rate was 9% in group I while it was 6.6% in group H with non significant difference in both groups. Patients with concealed accessory pathway are older, has longer history of arrhythmia, and more frequent hospitalization than patients with manifest AR. Radiofrequency ablation is safe and effective therapy for AP mediated tachycardia with comparable success, complications, and recurrence in manifest and concealed AP
Subject(s)
Humans , Male , Female , Catheter Ablation/methods , Echocardiography, Doppler , Signs and Symptoms , Follow-Up StudiesABSTRACT
Methicillin resistant S. aureus [MRSA], besides having established itself as a major hospital pathogen, is now beginning to prevail in the community. However, several notable differences were found to exist between hospital acquired strains [HA-MRSA] and community acquired strains [CA-MRSA]. Panton-Valentine leukocidin gene [PVL] is a cytotoxin which was found to represents an important virulence factor in some strains of S. aureus which cause some sorts of severe infections. The aims of this study were to assess the association of PVL gene with HA-MRSA and CA-MRSA and the role of this gene in pathogenesis of these infections
Methods: Two groups of patients with different types of infections were included in this study: the first group included 150 patients with hospital acquired infections and the second group included 85 patients with community acquired infections. All isolated S. aureus strains were tested for methicillin resistance by determination of MIC [minimum inhibitory concentration] using agar dilution method. All the detected MRSA isolates were tested for the presence of PVL gene by polymerase chain reaction [PCR]
Results: within the isolated CA S. aureus strains, MRSA isolates were found to be significantly higher compared to MRSA isolates from HA S. aureus infections [30/52: 57.7% and 25/74: 33.7% respectively]. PVL gene was detectable in 16/30 [53.3%] of CA-MRSA isolates while this gene was not found in any of HA-MRSA [0/25: 0%]. In CAMRSA isolates, PVL gene was found in 2/2 [100%] of cases with pneumonia, 8/10 [80%] of cutaneous abscesses, 4/4 [100%] of cases with furunclosis, 1/3 [33.3%] of finger pulp infections, 1/2 [50%] of breast abscesses while no isolates from cases with cellulites, impetigo or osteomyelitis harbored the PVL gene
Conclusion: our results revealed that PVL gene is strongly associated with CA-MRSA while it is not associated with HA-MRSA. PVL gene is mostly associated with primary necrotic infections [abscesses, furunclosis and Pneumonia], but not with invasive and secondary infections commonly encountered in HA S. aureus infections. The results of this study drive the attention to the current increase of CA-MRSA in Egypt which makes implementation of infection control guidelines of great concern to prevent more dissemination of MRSA in the community or to hospitals. A wide scale study of CA and HA-MRSA is recommended on the national level in Egypt to investigate the general prevalence rate, pathogenesis and the changes in antibiotic resistance and their relations to PVL gene and other genetic and virulence factors which may allow better management and control of these infections
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Staphylococcus epidermidis [S.epidermidis] is a frequent cause of infections of indwelling medical devices especially those with orthopedic implants. S.epidermidis grows on medical devices as an adherent biofilm consisting of cells enmeshed in a sticky, extracelluar slime that is firmly attached to the underlying surface. The slim matrix makes S.epidermidis biofilm highly resistant to antibiotics and host defenses and nearly impossible to eradicate. The aim of the study is to determine importance of slime formation in S. epidermidis orthopedic prosthesis infections and to investigate if slime formation has an effect on its antibiotics sensitivity. 80 coagulase negative staphylococcus strains [CoNS] were isolated from 200 tissue specimens of patients with orthopedic prothesis infections. Out of these 80 CoNS, 52 [65%] strains were S.epidermidis. Isolated S. epidermidis were plated on Congo red agar and subjected to PCR to detect icaA and icaD genes to identify and confirm slime producing strains respectively. All biofilm producing strains were subjected to MIC and MBEC using Calgary Biofilm Device[CBD]. 36 [69%] S. epidermidis strains were slime [biofilm] producers and 16 [31%]strains were non slime [non biofilm] producers by CRA, while by PCR 39[75%] strains of S. epidermidis were biofilm producers and 13 [25%] strains were non biofilm producers. The results also revealed that the minimal biofilm eradication concentrations [MBECs] were higher than the corresponding conventionally determined MICs for all antibiotics tested. MIC 50 and MBEC 50 for vancomycin, were 2 micro g/ml versus 8 micro g/ml, gentamycin, 1 micro g/ml versus 32 micro g/ml, oxacillin, 4 micro g/ml versus 16 micro g/ml, erythromycin, 8 micro g/ml versus 64 micro g/ml, ciprofloxacin, 0.5 micro g/ml versus 2 micro g/ml and cephalothin 4 micro g/ml versus 16 micro g/ml. MIC90 and MBEC90 for vancomycin were 4 micro g/ml versus16 micro g/ml, gentamycin, 16 micro g/ml versus 128 micro g/ml, oxacillin, 8 micro g/ml versus 128 micro g/ml, erythromycin, 16 micro g/ml versus 128 micro g/ml, ciprofloxacin, 4 micro g/ml versus 8 micro g/ml and cephalothin 32 micro g/ml and 128 micro g/ml. The results of the present study confirm that ica genes can be considered a virulence marker in the pathogenesis of implant associated orthopedic infection by S. epidermidis. This study also demonstrates marked differences between the results of susceptibility testing performed according to standard NCCLS guidelines and testing based on biofilm susceptibility testing
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Escherichia coli [E.coli] is the most important etiologic agent of childhood diarrhea and represents a major public health problem in developing countries. Aim of this work was to investigate the role of diarrheagenic E.coli in Egyptian children below 5 years age using multiplex PCR and to evaluate multiplex PCR in rapid diagnosis of enteric infections caused by diarrheagenic E.coli strains. Rectal swabs were taken from 83 children under 5 years age with diarrhea and 33 age-matched controls. All E.coli isolates were O serotyped using E.coli O polyvalent and monovalent antisera and subjected to multiplex PCR assay with specific primers, eae primer of eaeA [gene of intimin of EHEC and EPEC], primer bfpA of bfpA [structural gene for the bundle-forming pilus of EPEC], primers VT1 and VT2 of vt1 and vt2 genes [genes of shiga toxins 1 and 2 of EHEC respectively], primer LT of eltB [gene of labile toxin of ETEC], primer ST for estA [gene of stable toxin of ETEC], primer SHIG of ial [invasion-associated locus of the invasion plasmid found in EIEC] and primer EA of pCVD [the nucleotide sequence of the EcoRIPstI DNA fragment of pCVD432 of EAEC]. The study revealed that diarrheagenic E.coli strains were significantly isolated from patients more than control using multiplex PCR. Out of 70 E.coli strains isolated from patients, 17[24.3%] isolates were proved to be diarrheagenic by multiplex PCR where 53 [75.7%] isolates were non diarrheagenic. Out of 30 E.coli isolates recovered from control group, 1 [3.3%] isolate was proved to be diarrheagenic by multiplex PCR where 29 [96.7%] isolates were non diarrheagenic[Chi-square=18.5 and p
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C. pneumoniae is an obligatory intracellular bacterium responsible for upper and lower respiratory tract infections. This work was carried out to study the association between C. pneumoniae infection and coronary heart disease [CHD]. This study included 70 patients, divided into two groups[Group I ,included 55 patients with acute coronary syndromes: 32 patients with acute myocardial infarction and 23 patients with unstable angina Group II, It included 15 patients with previously diagnosed chronic coronary heart disease]and healthy Control Group [Group III],It included 22 healthy subjects as control. Venous blood samples were collected from all patients and controls for: determination of total blood cholesterol level, detection of C. pneumoniae-specific IgG by ELISA and detection of C. pneumoniae DNA in the peripheral blood mononuclear cells by PCR The results of this study showed that: C. pneumoniae-specific IgG was detected by ELISA in 83.6% of the acute patients, 73.3% of the chronic patients, and 68.2% of the healthy control subjects.There was no statistically significant difference among the different studied groups as regarding the prevalence of C. pneumoniae-specific IgG antibodies.C. pneumoniae IgG seropositivity among the CHD patients was correlated with smoking but not with age, male sex, hypertension, diabetes mellitus or hypercholesterolemia. C. pneumoniae-specific DNA was detected by PCR in the PBMCs of 61.8% of the acute patients, 26.7% of the chronic patients, and 18.2% of the healthy control subjects. Positive PCR results were significantly higher among the whole studied CHD patients [acute plus chronic] compared to the control subjects. Also, positive PCR results were significantly higher among the acute patients than both the chronic patients and the healthy controls. In contrast, the difference between the chronic patients and healthy controls as regarding the prevalence of C. pneumoniae DNA in the PBMCs was not statistically significant. C. pneumoniae DNA positivity among the patients [either the whole patients or acute patients only] was not significantly correlated with age, sex or any of the studied classic coronary risk factors [smoking, hypertension, diabetes mellitus and hypercholesterolemia]. After adjustment for the classic coronary risk factors and demographic characteristics in the multiple logistic regression analysis, C. pneumoniae infection [as indicated by PCR positivity] was associated with the CHD.No statistically significant difference was found between C. pneumonia DNA positive and C. pneumoniae DNA negative patients [either the whole patients or acute patients only] as regarding the prevalence of C. pneumoniae-specific IgG. This study concluded that: C. pneumoniae DNA detection in the PBMCs was found to be an independent predictor for CHD, particularly acute coronary events.The prevalence of C. pneumoniae DNA in the peripheral blood was found to be higher among the acute CHD patients with recurrent attacks than those with first attacks.C. pneumoniae IgG seropositivity was unreliable predictor for the presence of C. pneumoniae DNA in the CHD patients
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The effect of surface corrosion of ceramo-metallic dental porcelain finished by autoglazing, overgIazing and polishing on their surface roughness and bacterial accumulation was studied. Thirty samples were constructed from one type of commercial available ceramo-metallic porcelain [VMK 95, Vita, Germany]. These samples were divided into 3 groups [10 samples each]. Each group represented one type of finishing method. Then each group was subdivided into 2 subgroups 5 samples each]; the first subgroup [control], this subgroup was not subjected to corrosion test, while the second subgroup was subjected to corrosion test. The two subgroups were then subjected to surface roughness test, followed by a bacterial accumulation test. The results showed that there wasn't a statistical significant difference between the surface roughness of the tested ceramic for the autoglazed and the overglazed groups before and after corrosion. While there was a statistical difference between these two groups and the polished group before and after corrosion test. At the same time there was a significant difference between the two subgroups of the polished group. Overglazed recorded the least surface roughness, while the polished ceramic recorded the highest surface roughness. Polished ceramic showed bacterial accumulation and it had increased due to corrosion test. While Overglazed and autoglazed ceramic didn't record any bacterial accumulation. The microscopic examination of the accumulated bacteria revealed two species of bacteria gram positive bacilli anthrocoid and gram positive diplococci pneumococci
Subject(s)
Humans , Male , Lipoma , Intussusception/diagnosis , Colonic Diseases , Ultrasonography , Tomography, X-Ray ComputedABSTRACT
The Aim of the study is to investigate the value of insulin-like growth factor-I in the maternal serum and cord blood as possible predictors of fetal growth and neonatal anthropometric parameters, and to correlate this with the severity of preeclampsia. A cohort cross sectional study. maternal serum and cord blood from 80 pregnant patients with preeclampsia [mild and severe] were investigated for IGF-I levels using ELISA technique and the results correlated to severity of preeclampsia, pattern of intra uterine fetal growth and neonatal outcome by Apgar score. A significant positive correlation was found between fetal and maternal IGF-I levels and birth weight and neonatal length and head circumference [P < 0.001]. Cord blood but not maternal IGF-I had a highly significant negative correlation with the severity of preeclampsia. Cord blood IGF-I was significantly higher in mild compared to severe preeclampsia cases and appropriate compared to small for gestational age [65.41 +/- 25.5 vs. 41.5 +/- 11.7 and 61.05 +/- 22.76 vs. 38.57 +/- 15.05 respectively P < 0.001]. Both fetal and maternal IGF-I are good predictors of fetal growth, and neonatal outcome by Apgar score in preeclampsia, although the predictability offered by maternal IGF-I may be less reflective with advancing gestational age. Fetal but not maternal IGF-I is a good marker for the severity of preeclampsia
Subject(s)
Humans , Female , Insulin-Like Growth Factor I , Fetal Blood , Fetal Development , Pregnancy Outcome , Cross-Sectional Studies , Birth WeightABSTRACT
In this prospective randomized study, we investigated the value of laparoscopy in the diagnostic evaluation for possible appendicitis and its therapeutic efficacy when gynaecological conditions were encountered in 90 women of childbearing age. 85 laparoscopies [94.4%] were satisfactory where the entire appendix and pelvic viscera could be visualized, 58 were thought to have acute appendicitis, 16 salpingitis, 2 ruptured ovarian cyst, 2 adnexal torsion, one tuboovarian abscess, 2 mesenteric lymphadenitis and 4 were thought to have no pathological condition. Histological diagnosis confirmed acute appendicitis in 54 patients; 50 correctly diagnosed at the time of laparoscopy and 4 diagnosed at the time of laparotomy following unsatisfactory laparoscop. Salpingitis was finally diagnosed in 24 patients: 16 correctly diagnosed by the laparoscope and 8 were diagnosed retrospectively after removal of normal appendicies. Laparotomy was avoided by confirmation of non-surgical diagnosis in 22 patients [24.4% = negative laparotomy rate when laparoscopy was performed]. Sixteen of these patients were found to have acute salpingitis, 2 mesenteric lymphadenitis and 4 with no pathological finding. If laparotomy had been performed, the negative laparotomy rate would have been 33.3%. Successful laparoscopic procedures were achieved in all gynaecological conditions encountered. We conclude that diagnostic laparoscopy can reduce the negative laparotomy rate in premenopausal female patients presenting with suspected acute appendicitis and has a therapeutic capability when gynaecological conditions are faced