Interferon gamma release assays [IGRA] in the diagnosis of active pulmonary tuberculosis

Tuberculosis is one of the deadliest diseases over the world. Diagnosis of pulmonary- TB depends on combination various parameters. IGRA measure T cell release of IFN-gamma in response to M.TB antigen. WHO policy statement on IGRA use in low and middle countries is not established yet. The present study aimed to compare between tuberculin skin test [TST] and interferon gamma release assay [IGRA] in the diagnosis of active tuberculosis infection and study the effect of 3 months of first line of anti-TB therapy on the positivity of the IGRA test. 40 Egyptian patients were included in the study, and assigned as two groups; Group I comprised 20 patients with negative sputum for AFB by Ziehl-Neelsen stains with positive sputum culture for M.TB and Group II [IIa and lIb] that included 20 patients with positive sputum and Ziehl-Neelsen for AFB before and after 3 months of first line of anti-TB therapy. All patients were subjected to full history taking, clinical examination, X- ray chest, lab investigations, ESR measurements, microbiological tests and EL1SA measurement of Quantiferon-TB Gold. Lower significant values were found in group IIb than group IIa as regarding clinical parameters and 1[st] and 2[nd] hours ESR. IGRA test and TST showed sensitivity [91.18%, 76.4%], specificity [83.33%, 66.67%], positive predictive value [96.88%, 92.86%], negative predictive value [62.5%, 33.3%] and accuracy of [90%, 75%] respectively. IGRA results had no statistical significant differences between the studied groups with poor agreement with TST [[k]= 0.025].1GRAS test had high sensitivity' and specificity in diagnosis of active TB. More studies are needed to evaluate the effect of anti-TB therapy on IGRA level

study on the effect of Myrtus communis and Olibanum on Giardia lamblia infection in Egypt

Giardia lamblia is one of the most common protozoal infections in humans. Although metronidazole [MTZ] is the drug of choice for treatment of giardiasis, yet its chemical composition poses major threats. The search for new alternative therapeutic approaches for this parasitic disease in replacement of MTZ. The effect of Myrtus Communis [MC; called Aas plant in Arabic] and Olibanum [OL; called Leban in Arabic] on G. lamblia were studied. Extracts of MC [methyl alcohol, petroleum ether, chloroform, ethyl acetate and aqueous extracts] amid ethanol extract of OL were used. In vitro culture of G. lamblia trophozoites on TYI-S-33 medium was done, followed by inoculation of the plants' extracts in three different concentrations. This was evaluated by trophiozoite multiplication, adherence assay and electron microscopic study. The in viva effect was evaluated by histopathological study of the duodenum of experimentally infected mice after treatment by each herb. All plant extracts affected G. lamblia trophozoites in a manner dependent on concentration and time of exposure. In low concentration, both herbs significantly decreased the in vitro adherence of tropliozoites when compared to infection control group, while there was no statistical difference when compared to MTZ control group. Extensive ultrastructural changes of Giardia trophozoites were evident after 48 hours exposure to each medical herb. Histopathological examination of duodenum of G. lamblia infected mice showed epithelial microvillus abnormalities, which improved after administration of MC and OL extracts. Results confirm the antiparasitic effect of MC and OL on G. lamblia as an alternative to MTZ, to overcome its resistance and hazards

Phytochemical and biological investigations of excelsa R. growing in Egypt Ailanthus

Phytochemical investigation of the root bark of Ailanthus excelsa R. revealed the presence of alkaloids and quassinoids. Two alkaloids, one furanocoumarin and two quassinoids were isolated by the chromatographic methods and identified using different spectral methods IR, UV, MS and 1HNMR. GLC analysis of the unsaponifiable matter revealed that cholesterol and hexacosane as the major constituents, hexadecane was the lowest known constituent. GLC analysis of the fatty acid methyl esters revealed that oleic acid is the maj or fatty acid. The unsaturated fatty acid fraction is composed mainly of oleic and linoleic acids. The alcoholic, chloroformic and aqueous extracts of the stem bark showed inhibitory effect on the motility of rabbit intestine. The chlorofonnic extract showed inhibitory effect while the alcoholic extract exhibited stimulatory effect on rat uterus and the aqueous extract showed a dual effect depending on concentration. Only the alcoholic extract showed moderate analgesic, antipyretic and anti-inflammatory activities. The three extracts, as well as, one of the isolated quassinoids showed antileukemic activity. The alcoholic and chloroformic extracts showed activity against Gram positive bacteria

Enhanced fibrinolysis in ulcerative colitis

This study investigated the fibrinolytic system in 20 patients with proven UC and 10 control patients with noninflammatory bowel disease. All patients were not receiving either corticosteroids or sulphasalazine at the time of investigation. Both plasma plasminogen levels and plasma alpha 2 antiplasmin level in UC patients were not significantly different from those in controls. However, fibrin/fibrinogen degradation products test was significantly positive in UC patients [90%] and negative in all control patients [P <0.05]. Euglobulin clot lysis time was significantly shortened in UC patients compared with control patients [P <0.05]. It was concluded that the combination of positive fibrin/fibrinogen degradation products, shortened euglobulin clot lysis time, and normal plasminogen and alpha 2 antiplasmin levels in patients with UC could be an indication for low-grade reactive fibrinolysis

Ultrasonography and computed tomography in gallbladder tumours

Twenty cases of gall bladder tumours were diagnosed by ultrasound and C.T. at the radiology department of Ain Shams University, during the period from January 1984 to December 1988. They were 4 males and 16 females, with age ranging between 28 - 74 years. They were proved surgically to be benign polyps in 5 cases and carcinoma in 15 cases [14 adenocarcinoma and 1 squamous cell carcinoma]. Both sonography and computed tomography are superior and accurate diagnostic modalities. We found that both techniques are complementary, rather than competitive. However U/S can be considered as an initial screening modality

ACID-base status in predialysis patients

The aim of the present study was to characterize the nature of acid-base disturbance in predialysis patients and to study its possible relation to various clinical and biochemical data. Acid-base parameters including PH, serum bicarbonate and PCO[2] were studied in 50 predialysis patients [24 hours before dialysis], in addition to blood urea, serum creatinine and serum electrolytes; sodium, potassium, calcium and phosphorus. Renal metabolic acidosis was detected in 74% of patients, with significant reduction of serum bicarbonate, blood PH and PCO[2]. PH concentration decreased a bicarbonate concentration fell and PCO[2] decreased in direct relation to the fall in bicarbonate. No constant relation was found between the severity of acid-base disturbance and other clinical and biochemical data, although advanced forms of CRF were associated with some degree of renal metabolic acidosis. Mild electrolyte changes were detected in predialysis patients

Tarsal Tunnel Syndrome, review of the literature and results of surgical decompression

This study was conducted on 14 patients, 10 males and 4 females. Their ages ranged between 24 and 54 years with a mean age of 38.8 years. The right side was affected in 8 cases, the left in 5 cases, one case had bilateral affection constituting 15 feet. All cases had the clinical diagnosis of tarsal tunnel syndrome. Nocturnal pain, numbness and paraesthesia of the sole an toes were the commonest presenting complaints, distal sensory deficits were encountered in 4 cases [4 feet] and motor deficit in one case [one foot]. Electrophysiologically, distal sensory latency was more sensitive in diagnosing the condition than distal motor latency. Decompression and posterior tibial neurolysis was carried out with a complete disappearance of symptoms within seven days postoperatively in all, but one case [one foot], who had distal motor deficit, where only moderate improvement was gained. The posterior tibial nerve was found normal in ten feet, this supported the theory of local vascular impairment. In the remaining five feet, nerve flattening, thickening, perineural fibrosis, proximal and or distal fusiform swelling and dilated tortuous posterior tibial vein were the encountered pathological findings. Early decompression of the tarsal tunnel with meticulous neurolysis of the posterior tibial nerve was recommended in all cases of tarsal tunnel syndrome before the occurrence of motor neurological deficit

Incidence of lumbosacral anomalies of segmentation, spondylolysis and spondylolisthesis in low back pain

The material consisted of 100 subjects not complaining of low back pain and acting as controls, and 100 patients suffering from low back pain without history of trauma or distal neurological deficit. They were examined radiologically for lumbosacral anomalies of segmentation, spondylolysis and spondylolisthesis. Their age was 20-50 years and 50% of each group were males. They were examined clinically and radiologically by anteroposterior, lateral, two oblique and st and ing lateral views. The lumbosacral and sacrovertical angles were measured. Lumbar myelography was done in 20 patients. Thirty-eight patients had 51 anomalies; 14 sacralization, 3 lumbarization, 25 spondylolysis and 9 spondylolisthesis. Four control cases had 14 anomalies; 9 sacralization and 5 lumbarization. Spondylolysis affected the fifth lumbar vertebra in 72% and spondylolisthesis the L5/S1 level in 67%. Lumbarization and spondylolysis were significantly more common in males. The lumbosacral angle was significantly increased in lumbarization and sacralization as compared with other anomalies. In ten cases of lumbarization and sacralization not associated with spondylolysis, a complete improvement of low back pain was obtained by physiotherapy

Closed treatment of humeral shart fractures with special reference to cast brace treated cases

One hundred and forty-nine patients with unilateral closed diaphyseal humeral fractures were classified into two groups. One was treated by cast brace [87 patients] and the other with different conventional methods, U-shaped slab, hanging cast, body b and age and shoulder spica [62 patients]. The comparison of the results of treatment in both groups showed that significantly earlier rate of union was obtained in the cast brace series, especially in females in the age group 30, less than 45 years and 60 years or older, in proximal and middle third fractures and in transverse and comminuted fractures. Lower rates of joint stiffness angulation deformity and non-union were also obtained in the cast brace treated cases

Assessment of serum T3 and T4 levels in patients with chronic renal failure on regular dialysis

This study was performed on 20 patients with chronic renal failure on regular dialysis [15 patients on regular hemodialysis and 5 patients on routine peritoneal dialysis] all patients were clinically euthyroid. The aim of this work was to study the changes in total serum T3 and T4 levels, either before or after the setting of regular dialysis in patients with chronic renal failure. The present study revealed that there is no alteration in both total serum T3 or T4 levels in patients with chronic renal failure on both modalities of dialysis either after single or repeated settings. The present study also revealed that there is no relationship between serum levels of blood urea, serum creatinine, creatinine clearance or serum cholesterol to the serum levels of thyroid hormones