Helicobacter pylori stool antigen test: evaluation of diagnostic accuracy in Egyptian patients with dyspepsia

Thirty-six H. pylori infected patients [proved by positive Grams stained film, rapid urease test, culture and histopathology] as well as ten non-infected patients selected among 120 Egyptian patients presenting with dyspepsia were included in the present study. There was no statistically significant difference between H. pylori positive and negative patients concerning their presenting symptoms. The endoscopic examination revealed that gastritis was more prevalent in H. pylori infected patients. A significant relation was found between the complaint of regurgitation and the endoscopic finding of hiatus hernia as well as between the complaints of heart burn and epigastric pain on one hand and the endoscopic detection of gastritis on the other hand. The histopathological examination of gastric biopsies revealed that gastritis in its moderate degree was more prevalent in H. pylori infected patients than in the controls. Stool specimens collected from 36 H. pylori positive patients and 10 ten non-infected controls were examined by an enzyme immunoassay for the detection of H. pylori antigens [Premier Platinum HpSA]. The HpSA test was positive in 35 out of the 36 H. pylori infected patients and in 2 out of the 10 non-infected cases. The sensitivity and specificity of the test were 97.2% and 80%, respectively. The overall accuracy rate was 93.5%. The positive and negative predictive values for HpSA test were 94.6% and 89%, respectively

prevalence of psoriatic toe nails with onychomycosis: an Egyptian study

There is some controversy about the prevalence of onychomycosis in patients with psoriasis compared with non-psoriatics. The aim of this Study was to investigate the prevalence of fungal infection in patients with psoriasis with toe-nail affection and to compare the type of fungal elements in psoriatic nails with fungal infection with those in patients with onychomycosis. One hundred cases were included in the present study and were classified into two groups: group of 50 patients complaining of psoriasis with toe-nail affection; the other group of 50 patients without any clinical signs of psoriasis and complaining of toe-nail onychomycosis. Nail specimens were collected from both groups of patients and examined by direct microscopy using 20% freshly prepared KOH and by culture on Sabouraud dextrose agar with added chloramphenicol and cycloheximide and another culture on Sabouraud dextrose agar with added chloramphenicol only. Our results revealed that 23 cases [46%] out of 50 cases of psoriasis with toe-nail affection had mycological evidence of onvchomycosis while 27 cases [54%] gave negative mycological results and these results indicate high prevalence of onychomycosis among the psoriatic patients with toe-nail involvement and such prevalence is higher among males [32%] than females [14%]. In the group of patients with psoriasis with toe-nail affection; identification of the causative fungi revealed that non -dermatophyte molds were isolated in high percentage [45.83%], followed by yeasts [33.33%] and finally dermatophytes [20.83%] and these results were similar to those of the group of patients with onychomycosis alone with respect to isolated species. Accordingly, psoriatic patients with nail affection should be routinely examined mycologically to rule out the presence of onychomycosis and to effectively treat those patients. These patients often need to break old habits and learn new, healthier, habits to achieve an optimal therapeutic response and prevent re-infection. Appropriate nail care should be explained to the patients and they should stop a range of potentially risky behaviors as using occlusive foot wears on wet skin. Drying of feet following ablution in Moslems should be stressed upon