Viral hepatitis c infectivity of nasal secretion: PCR evaluation

The present study aimed to evaluate the prevalence of hepatitis C virus [HCV] infection in nasal lavage [NL] fluid of patients had no history of previous HCV infection. The study was designed as a 2-arm screening study: Group N included 200 randomly chosen patients and started by testing NL fluid for presence of anti-HCV antibodies [anti-HCV Ab] and those with positive result underwent determination of sero-positivity. The other arm consisted of another patients' group [Group S; n=200] underwent determination of sero-positivity, and those proved positive underwent determination of positivity of their NL fluid for anti-HCV Ab. PCR identification of HCV RNA was conducted for all positive sera and NL fluid. Anti-HCV Ab were detected in NL fluid of 7 patients with detection rate of 3.8% and in serum samples of 10 patients with a detection rate of 5% and an overall detection rate of patients with anti-HCV positive of 4.4%. The 7 patients with anti-HCV Ab positive NL fluid were sero-positive; while only 6 of the 10 sero-positive patients had anti-HCV Ab positive NL fluid, thus, determination of anti-HCV Ab in NL fluid could detect sero-positive patients with sensitivity rate of 76.4%. Qualitative PCR detection of HCV-RNA identified viral RNA in 14 serum samples; 13 samples were sero-positive and NL fluid positive and one was sero-positive but NL fluid negative, while the other 3 sero-positive samples were free of viral RNA. Thus, NL fluid anti-HCV Ab positivity could identify patients with viremia with sensitivity and accuracy rates of 92.8% and 94.1%, respectively and could exclude the presence of viremia with a negative predictive value of 75%. Using ROC curve analysis, defined determination of positivity of NL fluid as specific predictor for the presence of viremia with AUC=0.673, while sero-positivity showed AUC=0.500. To evaluate the infectivity of NL fluid, PCR identification of HCV viral R1VA in NL fluid was conducted for all NL fluid samples proved positive for antibodies and could detect HCV-RNA in 3 samples with infectivity rate of 17.6%.. It could be concluded that positivity for anti-HCV Ab was detected in 4.4% of the studied population supposed to be free of HCV infection and anti-HCV Ab determination in NL fluid could predict viremia with accuracy rate of 94.1% and could be considered as specific predictor with AUC=0.673 with an infectivity rate of NL fluid was 17.6%

Role of granulocyte-colony stimulating factor [G-CSF] as early marker in diagnosis of neonatal sepsis

Neonatal sepsis is a life-threatening disease with an incidence of 1 to 10 per 1000 live births, and a mortality rate of 15% to 50% [Remington and Klein 1990]. The clinical signs of neonatal sepsis are nonspecific and indistinguishable from those caused by a variety of neonatal noninfective disorders, such as aspiration syndrome, maladaptation. and respiratory distress syndrome [RDS]. It is therefore recommended for all neonates who develop these signs to start empirical antimicrobial therapy [Remington and Klein, 1995]. Our work was carried out on 56 neonates [37 males and 19 females] selected from Benha University Hospitals and from "Center EI Gameeia El Shareya for neonates at Nasr City" in the period from March 2002 to January 2003. For each case we performed G-CSF serum level and the preliminary laboratory tests [CBC, CRP, blood cultures] and accordingly our patients were classified into 3 groups: Group I: [Proven sepsis with +ve blood culture result]. Group II: [Suspected sepsis with -ve blood culture result and suspected clinical and laboratory sepsis] and Group III: [Non-septic neonates with -ve blood culture and - ve CRP]. Our results were tabulated, statistically analyzed and recommendations were put

Direct immunofluorescence and cell culture as two different laboratory methods for detection of chlamydia trachomatis in chronic cervicitis

This Study was conducted on 60 non pregnant women, suffering from lower genital discomfort for detection of Chlamgdia trachomotis in their cervices by 2 different laboratory methods [Direct immunofluorescence and cell culture]. Chiamydia trachomotis [C. trachomatis] was detected in 14 [23.33%] out of 60 women by direct immunofluorescence [DIF] compared to 16 [26.67%] out of 60 by cell culture C.trachomatis was common in young age [15-<30y] the percentage is 47.62% while older females [30 - <45y] and [45-56y] had less infection 23.81% and 5.65% respectively. The infection is common in rural areas than urban areas. 11[34.38%] out of 32 women living in rural areas compared to 5 [17.86%] out of 28 women living in urban areas were positive for C. trachomatis. C. trachornatis infection is common in females with cervicitis, 7 [46.7%] out of 15 females with cervicitis had C. trachoinatis infection compared to 31.3% in cervical erosion, 15.4% in females with discharge and 12.5% in females suffering from irritation. We conclude that Although cell culture is more sensilive than DIF, but the difference is statistically insignificant. Cell culture will remain the best choice where medical or legal implications are important, and DIF will probably remain a widely used test for laboratories that process relatively small number of specimens