Applicability of Roche cobas amplicor PCR for detection of M.tuberculosis in clinical respiratory specimens

The Cohas Amplicor Mycobacterium tuberculosis [CAMTB] assay was evaluated for routine detection and identification of Mycobacterium tuberculosis complex [MT-BC]. 80 sputum samples from 80 suspected patients were tested by AFB smear, Lowenstein -Jensen media culture and by CAMTB. 50 patients were sputum AFB smear negative and patients were subjected to bronchoscopy for bronchoalveolar lavage [BAL] samples which were tested by the same methods, and results were compared. The sensitivity, specificity, PPV and NPV of the CAMTB with sputum samples were 95%, 90%, 90 and 94% respectively

Diagnostic value of cardiac troponin I in patients with pulmonary embolism

The main aim of this study is to test the value of estimation of serum troponin I as a marker of right ventricular ischaemia and /or dysfunction in diagnosis of patients with pulmonary embolism aiming for more accurate risk stratification of these patients to detect those who are in need for more aggressive therapy. 22 patients 14 females and 8 males with confirmed pulmonary embolism based mainly on ventilation perfusion lung scan in 14/22 cases, spiral CT angiography in 1 case and combined echocardiographic evidence of right ventricular strain in addition to clinical presentation of acute dyspnoea in absence of major chronic obstructive pulmonary disease in seven cases. Patients were divided into two main groups according to both their haemodynamic state and /or the presence of abnormal echocardiographic parameters. Group A includes 8 patients with normal haemodynamic status and echocardiographic parameters; group B includes 14 patients with abnormal echocardiographic parameters of the right ventricle. They were further subdivided according to their haemodynamic status into 6/14 patients [43%] with abnormal haemodynamic status and 8/14 patients [57%] with normal haemodynamics. Serum troponin I was considered elevated above 0. IMcg/L, it was found restrictly elevated in 11/14 of patients [79%] and borderline in 3 patients [21%] in group B compared to 0/8 in group A, the difference was statistically significant [p=0.004]. Serum Troponin I was found to be statistically significant higher in patients with abnormal haemodynamics compared to patients with normal haemodynamics in group B [p=0.04] Troponin I was found to be significantly positively correlated with right ventricular size [r 0.529, p<0.01], pulmonary artery pressure [r 0.659, p<0.001]. Serum troponin I may be a helpful diagnostic tool in patients with pulmonary embolism and may improve the risk stratification of these patients as its elevation is significantly correlated with other adverse prognostic factors in these patients such as haemodynamic status, right ventricular size and pulmonary artery pressure and its elevation even in absence of haemodynamic alteration may point to aggressive intervention in these patients