Value of cerebrospinal fluid tumor necrosis factor-alpha [TNF-ALPHA] for rapid diagnosis of bacterial meningitis

Meningitis is common in tropical areas and also in Egypt and has a world-wide distribution This study evaluated the potential role of CSF TNF alpha in diagnosis and differential diagnosis of acute meningitis [bacterial versus aseptic meningitis]. This case-control study was conducted between Ain Shams University Tropical Medicine Department and Embaba Fever Hospital. Fifty patients with suspected meningitis were recruited during from January 2014 to June 2014. They were divided according to culture results into 2 groups: GI: 40 patients with acute bacterial meningitis [proved by CSF culture], G2: 10 patients matched according to age and sex with clinical sings of CNS infection but without laboratory evidence of bacterial origin, [Suspected cases, and negative culture]. Both groups were subjected to thorough history taking, full clinical examination, and laboratory investigations including CSF analysis and CSF TNF was measured by ELISA. The results showed a highly significant difference between cases and control regarding CSF TNF [P=0.00]. The criteria's of diagnostic validity test was 100% for all at cutoff >/= 275ng/ml and 0.05]

Evaluation of salivary and serum anti-helicobacter pylori in Egyptian patients with H. pylori related gastric disorders

Helicob acter pylori is a common and important transmissible bacterial human pathogen. Although several diagnostic tests are available for the detection of H. pylori infection, all of them have both advantages and disadvantages, and none can be considered as a single gold standard. Serological methods analyzing [serum and saliva] by using enzyme immunoassays, which are simple, reproducible and inexpensive, can detect either antigen or antibody. This study evaluated the frequency of anti- H. pylori serum and salivary antibodies positivity among Egyptian patients with gastric disorders and the validity of salivary, serum serological tests for diagnosis of H, pylori, comparing this with gold standard tests performed on endoscopy biopsy. This prospective, case-controlled study included 45 Egyptian patients who attended Ain Shams University Hospitals Cairo, Egypt between January 2013 and June 2013. There were 29 males and 16 females their mean age was 51.78 +/- 7 [range 18-60]. Among the ulcerogenic drugs, Aspirin was the most common drug [46.7%].The evidence revealed the sensitivity of Rapid Urease Test [RUT] was 100%, specificity was 71.4%, Positive Predictive value [PPV] was 88.6% and Negative Predictive value [NPV] was 100%. The sensitivity of serum IgG was 68.97% and specificity was 42.86%; while the sensitivity of serum IgA was 89.6% and the specificity was 50%. Correlating the salivary IgG results with H. pylori status diagnosed by culture, salivary IgG succeeded to diagnose 19 cases from the 31 positive H. pylori patients with a sensitivity of 63.33% and specificity of 92.86% whereas the results of salivary IgA showed a sensitivity of 80% and specificity of 92.86%

Clinical and laboratory studies of DDB in treatment of chronic hepatitis C 4. Combination therapy with amantadine hydrochloride, a pilot study in Egypt

The aim of this pilot study was to evaluate the efficacy and safety of Dimethyl Dimethoxy Biphenyl Dicarboxylate [DDB] and amantadine hydrochloride [amantadine] in treatment of patients with chronic hepatitis C virus infection [HCV]. For this objective, 80 patients with chronic HCV were selected and divided randomly into four equal groups: Group I treated with DDB, Group 2 treated with amantadine, Group 3 treated with DDB and amantadine while Group 4 treated with silymarine and acted as control group. Follow up of those patients 12 months after initiation of therapy, revealed dramatic clinical improvement of the main symptoms in patients treated with DDB and DDB-amantadine combined therapy, sustained normalization of the mean serum ALT level in 100% of DDB and DDB-amantadine combined therapy group versus 45% of patients treated with amantadine only. On the other hand there was statistically significant decrease in the mean serum AST and bilirubin level in patients treated with DDB and amantadine in comparison with the control group. Estimation of the mean serum albumin revealed statistically significant increase in DDB and DDB-amantadine treated groups, while estimation of the serum alpha-fetoprotein showed statistically significant decrease in DDB and DDB-amantadine treated groups in comparison with amantadine and control groups. Follow up of DDB and amantadine treated patients [Groups 1, 2 and 3] 6 months after therapy revealed sustained normalization of the mean serum ALT levels in 85% of patients treated with DDB-amantadine combination versus 75% of patients treated with DDB and 30% of patients treated with amantadine. Also there was statistically significant sustained decrease in the mean serum AST, bilirubin and alpha- fetoprotein levels. Serum HCV RNA detected by PCR 12 months after initiation of therapy become negative in 40% of case treated by DDB and amantadine combination, versus 15% in both DDB and amantadine treated patients and 0% in control group. Six months after cessation of therapy serum HCV RNA detected by PCR remained negative in 35% of DDB and amantadine combination treated patients versus 10% and 15% in DDB and amantadine treated patients respectively. It could be concluded that the additive value of DDB-amantadine combined therapy in chronic hepatitis C patients is a beneficial strategy which needs further studies [This is the 4[th] study in this field, Montasser, 1999, Montasser, 2000 and Montasser et al. 2000, This study was presented in Ain Shams Clinical and Scientific Society Symposium: Chronic Hepatitis C Up date 1[st] November 2000]

clinical and laboratory study of DDB in treatment of chronic hepatitis C [2] comparative studies

The aim of this study was to evaluate the role of Dimethyl Dimethoxy Biphenyl Dicarboxylate [DDB], a Chinese drug, in treatment of patients with chronic hepatitis C infection [HCV]. This is the second study in this field, in the first one, which was a pilot or preliminary study in Egypt, it was con-eluded that DDB is beneficial in treatment of patients with HCV because it improves dramatically the main symptoms and induces sustained biochemical improvement without undesirable side effects. In this study 100 patients with HCV were selected and treated with DDB. Follow up of those patients for 12 months revealed sustained clinical improvement, normalization of serum ALT, statistically significant decrease in serum AST when compared with the control group and serum HCV RNA, detected by polymerase chain reaction [PCR], became negative in 10.66% of cases [The first part of this study was presented in Ain Shams Clinical and Scientific Society Symposium: Chronic Hepatitis up to date, April 1999]

Fatal complications of acute enteric fevers

Eighty eight patients presenting with fatal typhoid complications were studied in Abbassia and Embaba fever hospitals during a 4 years period [1987 - 1991]. Criterion of inclusion in the study was either positive. blood culture in 70 [80%] cases or postmortem gross appearance of typhoid fever in 18 [20%] cases. Positive blood culture cases included 54 [77%] S. typhi and 16 [23%] S. paratyphi A. Seven [10%] cases were resistant in vitro to chloramphenicol. Postmortem examination performed in 18 [20%].cases revealed typical typhoid ulcers in ileum, jejunum and large intestine. The main clinical picture of 31 toxic, 22 encephalitic or meningeal irritating, 15 gastroenteritic, 9 pneumonic, 8 perforated and 3 haemorrhagic enteric fever cases were discussed. The tetrad of fever, toxic look, bronchitic Chest, tumid tympanitic abdomen and splenomegaly was a good sign for suggestion of typhoid diagnosis

Clinical patterns of scorpion stings in Saudi Arabia

24 Saudi Arabian patients suffering from scorpion sting were studied in Rabigh general hospital, western region of Saudi Arabia. According to the clinical severity of the disease, the cases were divided into 2 groups [1] patients presented by convulsions, coma and shock and [2] mild and moderate cases complained of pain at the site of the sting and/or other general or gastro intestinal symptoms. There was a significant increase of the total white blood count, fasting blood sugar and serum LDH when compared to controls. Clinical and laboratory findings were discussed