Association between entamoeba histolytica/dispar and helicobacter pylori infections in patients with gastrointestinal complaints

This research studied the prevalence of different intestinal parasitic infections amongst H. pylori infected patients and assessed the association impact in the pathogenesis of H. pylori infection at the Tropical Medicine and Gastroenterology outpatient clinic, South valley University Hospitals. A total of 80 stool samples were collected. H. pylori infection was diagnosed by detecting the H. pylori antigen in stool. Accordingly, patients were divided into 2 groups: H. pylori positive cases [group I] and was 50 cases [62.5%] and H. pylori negative cases [group II]. H. pylori positive cases were subjected to upper endoscopy. There was a significant association between parasitic infections and H. pylori in patients with gastrointestinal complaints [P

Application of molecular methods of genetic counseling in inherited forms of renal tubular acidosis for preventive strategy

Renal tubular acidosis [RTA] results from failure of the kidney to acidify the urine resulting in a state of hyperchloraemic metabolic acidosis with a normal anion gap. Three main clinical types of RTA are now recognized [proximal, distal and hyperkalemic] but the number of possible causes is large. Inherited forms of distal RTA have three variants: autosomal dominant and autosomal recessive with or without deafness, while the inherited forms of proximal RTA include many variants as autosomal recessive proximal RTAt cystinosis, Fanconi-Bickel syndrome [FBS] and Wilson's disease. Thus, we conducted a prospective study to screen all the documented cases of inherited RTA in pediatric nephrology outpatient clinic in MUCH for relevant gene mutation. This study was carried out in the period from November 2009 to February 2012. The study comprised 17 Egyptian families having documented cases of inherited RTA. We found three families compatible with the clinical diagnosis of FBS, two families compatible with the clinical diagnosis of cystinosis and 12 families of dRTA. All patients were subjected to a thorough history, full clinical examination and laboratory investigations. Pedigree construction was done for each family. Radiological investigations were done for some cases including plain x-ray for racketic findings, abdominal ultrasound and echocardiography done for those with clinical findings coping with congenital or acquired heart diseases. Liver biopsy was done for those with hepatomegaly. Molecular workup was done in the form of DNA extraction, agarose gel electrophoresis, polymerase chain reaction of the extracted DNA and sequencing for the specific gene according to each disease. We found two new mutations in GLUT2 gene and an old missense mutation [re-enumerated] in three families of FBS. We found a novel truncating mutation in CTNS gene associated with a severe clinical course and double heterozygosity for two known mutations in the other family. Two novel mutations were detected in two out of 12 families of dRTA in ATP6VOA4 gene. We concluded that although these diseases are not rare in the Egyptian population, evolving new mutations could add some allelic variants. Moreover, studying phenotype-genotype pattern of different mutations is crucial for linkage analysis

Drug susceptibility testing of pulmonary tuberculosis by nitrate reductase assay

Treatment of multidrug-resistance tuberculosis [MDR-TB] remains a challenge and its success depends on how quickly a case of TB is identified as drug resistant and whether an effective drug therapy is available. As a drug susceptibility test [DST], nitrate reductase assay [NRA] might help in management of MDR-TB patients. This study was conducted to evaluate NRA as a drug susceptibility test [DST] for the four primary anti-tuberculosis drugs [Isoniazide [INH], Rifampicin [RIF], Streptomycin [SM] and Ethambutol [EMB]]. A total of 30 isolates of M. tuberculosis were subcultured for 28 day to be fresh isolates and subjected to NRA. The results were recorded after 10 days of incubation and compared to that of the proportion method [PM] as a gold standard. Susceptibility testing for INH and RIF revealed relatively higher efficiencies when compared to that of the PM. For INH and RIF, the efficiencies were 93.3% and 90%, respectively. The sensitivity of the NRA as a DST for INH was 89.4%, while that for RIF was 93.3%. The specificities of NRA for INH and RIF were 100% and 86.6%, respectively. The predictive value of sensitivity for INH was 84.6% and that of RIF was 92.8%. The predictive value of resistance for INH was a high as 100%, while that of RIF was 87.5%. Susceptibility testing for SM and EMB showed relatively lower efficiency compared to PM. The efficiencies of NRA for SM and EMB were 86.6% and 76.6%, respectively. The sensitivity of the NRA as a DST for SM was 78.9%, while that for EMB was 40%. The specificity of the NRA for SM was 100% and that of EMB was 95%. The predictive values of sensitivity for SM and EMB were 73.3% and 76%, respectively. The predictive value of resistance for SM was 100% and that of EMB was 80%. NRA is a simple, rapid and inexpensive technique of high performance when used as susceptibility testing for both INH and RIF, but was not good for SM and EMB

Hormonal, sonographic, and body composition changes in Egyptian adolescent girls with hyperandrgenie manifestation

This study was conducted to assess the prevalence of hyperandrogenic disorders especially polycystic ovary syndrome [PCOS] in a random sample of adolescent girls in our locality, as well as to identify the clinical; hormonal, ultrasonic, and body composition characteristics associated with such disorders. Two hundred school girls [15-18 years old] were selected by multi-stage random sampling from different secondary schools, and screened for hyperandrogenic disorders by a validated questionnaire. Thorough history taking, physical and gynecologic examination, complete hormonal, pelvi-abdominal pulse inversion harmonic imaging [PlHl], and body composition assessment by bioelectrical impedance [BIA] were done for students presenting with menstrual dysfunction and/or clinical hyperandrogenism and 8 controls from the 4th to the 7th day of the menstrual cycle. Twenty-five out of the 200 students were thoroughly evaluated. Eighteen adolescents of the examined students [72%] were finally diagnosed as PCOS, 5 [20%] as idiopathic hyperandrogenism and 2 [8%] s non-classic congenital adrenal hyperplasia [CAH]. Despite normal weight percentiles and body mass index [BMI] for age and sex in 83.3% and 88.9% of students with PCOS respectively, fat mass, trunk fat percentage, trunk fat mass, and trunk free fat were significantly higher in PCOS patients compared to controls. PCOS was the most common hyperandrogenic disorder in this study. Combined menstrual dysfunction and clinical hyperandrogenism had adequate sensitivity and high specificity in the prediction of PCOS. PIHI is an adequately sensitive preferential diagnostic tool of PCOS in virgin adolescents who may have central adiposity. Body composition assessment by BIA in PCOS is valuable in detecting central adiposity which could be correlated to parameters of insulin resistance

Sensitivity and specificity of wet mount, culture and PCR in diagnosing trichomonas vaginalis infection in females attending the gynecology clinic of Minia University Hospital

Background and Objectives: trichomoniasis affects approximately 180 million women worldwide. It can have an atypical or even asymptomatic course. Therefore, to accurately diagnose this disease, microbiological investigation is necessary. The aim of this study was to compare wet mount, culture and polymerase chain reaction [PCR]based approaches to establish which method[s] was [were] more efficient in the laboratory diagnosis of trichomoniasis

Study design: one hundred fifty female patients attending the Gynecology Clinic of Minia University Hospital were examined clinically and by different diagnostic tools for detection of T. vaginalis in vaginal samples. For analysis of sensitivity and specificity of the methods used, the PCR technique was used as a gold standard diagnostic tool

Results: T. vaginalis infection was diagnosed in 11 [7.33%], 19 [12.7%], and 50 [33.3%] patients using wet mount, culture in Diamond's medium and PCR techniques, respectively. Although the wet mount for diagnosing T. vaginalis is specific, its sensitivity was poor [22%]. On the other hand, while the sensitivity and specificity of culture technique were 38% and 100%, those of PCR were 95% and 100%, respectively

Conclusion: comparison of different methods for diagnosis of T. vagina/is showed that at least two techniques, such as culture and PCR, have the potential for better diagnosis of infection. PCR detection of T. vaginalis was highly specific and sensitive, but its availability and cost effectiveness is questionable. However, PCR could provide a better alternative for laboratory diagnosis of trichomoniasis by culture

Study of cardiac events during hemodialysis in end stage renal diseases

This study included 40 male patients with end stage renal disease [ESRD] on hemodialysis [HD] for more than six months, three times/week and 20 healthy subjects as controls. All of them were subjected to laboratory investigations, resting ECG, Holter ECG monitor and echocardiographic examination for the assessment of cardiovascular disorders and its risk factors. Arrhythmia and other ECG changes were found in all patients and in only two of the controls. Patients developed arrhythmia and ischemia during HD sessions, which was improved after dialysis. All patients showed structural changes in the myocardium, which were explained by the presence of anemia, increased serum uric acid, hyperparathyroidism and hypertension

Correlation between left ventricular systolic function and distribution of aoronary artery disease

A total of 140 patients was included in this study. All patients were subjected to coronary angiogram and left ventriculogram. Ninety-five patients had an evidence of coronary artery disease [CAD], 26 had single vessel disease, 25 had 2-vessel disease and 44 had 3-vessel disease. Systolic left ventricular function was correlated with the severity of coronary atherosclerosis. Left ventricular systolic function is usually impaired with the improvement of coronary atherosclerosis

Nerve electroneurography variability in normal Egyptian volunteers

The aim of this work was to reproduce the published data on the right/left difference in normal test persons and to determine whether the amplitude ratio is constant overtime after repeated measurements. Bilateral electroneurography [EnoG] was conducted on 50 normal Egyptian volunteers. Four measurements were performed at one week intervals on every subject. The results indicated that the mean amplitude ratio was 11% +/- 6%. Repeated measurements on the same individual differed from 0%-29%. The 99% confidence interval computed from the data ranged from 9%-13% amplitude ratio