Detection of anti-fasciola istypes among poatients with fascioliasis before and after treatment with mirazid

Stool examination using modified Kato thick smear method was performed to detect Fasciola eggs and other parasites. Abdominal pain was the major presenting symptom [87.7%], followed by pallor [83.3%] and fever [16.7%]. Anemia and hepatomegaly were recorded in 77.7% of the patients compared with 27.7% with splenomegaly. Abdominal ultrasonography revealed hepatomegaly and common bile duct dilatation in 77.7% of the patients. Moreover, five cases showed diagnostic olympic game rings. All patients had positive IgG4 levels, 55 cases were positive for specific total IgG and IgG1; whereas only 24 cases had positive IgG2 levels. All negative controls showed no cross reactions. On the other hand, ELISA detecting IgG4 showed the highest specificity [95%], followed by IgG2 [85%] and the least specific test was obtained with the detection of IgG [70%] and IgG1 [65%]. One month after treatment, 91.1% of the patients were completely cured and even after another two-month follow up. In completely cured patients, none of anti- Fasciola isotypes was significantly changed. So, the detection of anti- Fasciola isotypes, especially IgG4, is very specific for the accurate diagnosis of human fascioliasis

Predicting ulcer disease in dyspeptic patients by H. Pylori testing rather than endoscopy

To validate accuracy of the Rapid Blood Test [RBT] in predicting peptic ulcer disease in dyspeptic patients. Rationale: Most patients with dyspepsia have no pathology at endoscopy, thus are exposed to unjustified risk, cost, and inconvenience associated with this invasive assessment. Setting: Medical World Polyclinic and Dar Al-Shefa Hospital, Riyadh, KSA. Patients: One hundred patients with ulcer- like dyspepsia. All patients underwent a RBT followed by endoscopy with antral biopsies for histology and urease slide test [CLO test]. Sixty-five% of the patients were "gold standard" H. pylori positive [positive CLO test, positive histology], 30% were "gold standard" negative [negative CLO test, negative histology], and 5% had conflicting CLO test and histology results. Patients with peptic ulcer disease included 31% of all dyspeptic patients, 42% of H pylori-infected patients, and 7% of non-infected individuals. RBT could determine H. pylori status with a sensitivity of 91% and specificity of 77%. Positive and negative predictive values of the test were 89% and 79% respectively. In predicting peptic ulcer disease, RBT was sensitive in 93% of patients and specific in 41%. Positive and negative predictive values of the test were 41% and 93% respectively. Conclusions: RBT is reliable in determining H. pylori status. However, we cannot predict the development of peptic ulcer disease merely on the presence or absence of H. pylori

Prevalence and predictors of bone mineral density in inflammatory bowel disease

Osteoporosis is established in inflammatory bowel disease [IBD] but the mechanisms underlying this disorder has not been well defined. The aim of this study was to assess bone mineral density [BMD] in inflammatory bowel disease [IBD] and evaluate any potential differences between crohn s disease [CD] and ulcerative colitis [UC]. Also we will try to define biochemical markers that predict the changes in BMD. Twenty six patients with recently diagnosed [3-6 months] crohn s disease [9 patients] and ulcerative colitis [17 patients] and 15 age and gender matched healthy controls were enrolled in the study. IBD is diagnosed on clinical, radiological and colonoscopic basis. BMD of lumbar spines, femur and radius were assessed using dual energy x-ray absorptiometry within 3 months after establishing the diagnosis. Laboratory work included: serum calcium, phosphate, alkaline phosphatase and free osteocalcin. Results showed that, BMD is significantly decreased in IBD in comparison to control group [P- value <0.001], with femur more affected than vertebra [P<0.05]. BMD is more affected in CD patients than those with UC: 65% [CD]. 55% [UC] ate osteopenic and 35% [CD], 17% [UC] are osteoporotic. In CD femur T-score shows significant inverse correlation to the-disease duration [r= - 0.72] and in UC patients spine T- score is inversely related to the age [r= - 0.58] and femur T-score is significantly related to sex [more negative in males]. Serum calcium, phosphorous and alkaline phosphatase are not associated with significant difference between patients and control group [P<0.05] and there is an inverse correlation between osteocalcin and lumbar spine BMD [r=0.37, P<0.05]. In conclusion, IBD patients have significant lower BMD value and BMD is more affected in CD patients than those with UC. Osteopenia is related to disease duration in CD, while it is related to age and male sex in UC. Free osteocalcin is an independent risk factor for low BMD of lumbar spines