West Nile virus existence in humans and mosquitoes in Alexandria Governorate

West Nile virus [WNV] is a zoonotic mosquito-transmitted arbo-virus belonging to the genus flavivirus in the family Flaviviridae. The aim of the present study was to determine the role of WNV in human cases with fever of unknown etiology and to study the immune status to WNV among healthy humans. In addition, the prevalence of WNV in Culex mosquito vectors was estimated. The study included 210 patients [with undiagnosed acute febrile illness for more than 2 days; admitted to Alexandria Fever Hospital during a period of one year], 200 healthy humans [volunteer blood donors accepted for donation at Alexandria Regional Blood Bank] and 200 mosquito pools [from six administrative districts of Alexandria]. WNV antibodies of the 1gM and lgG types were detected in patients and healthy humans using enzyme linked immunosorbent assay [ELISA], respectively. WNV was detected in mosquito by virus isolation on Vero cell culture. WNV 1gM antibodies were detected in 56 [26.7%] patients, while WNV lgG antibodies were detected in 42 [21%] out of the 200 healthy humans. WNV was isolated from 27 [13.5%] out of the 200 mosquito pools. Patients in the age groups 20- and 40- had the highest percentages of WNV 1gM antibodies. The highest WNV gM antibodies positivity rates occurred in spring and in fall seasons. Male samples had significantly higher percentage of the IgG antibodies than female samples [25.6%Vs 13.3%]. Conclusion: WNV should not be overlooked in diagnosis of fevers as the main problem may be not due to the disease itself but the economic consequences from the hospitalization of indeclinable numbers of patients. WN disease can be difficult to monitor; almost unpredictable and appearing unexpectedly, this disease has to be surveyed and the viral circulation rapidly detected so that the sanitary authorities can take protective measures

TT virus among blood donors in Alexandria

TTV is a non enveloped, single-stranded, circular- DNA virus that has been assigned to the Family Circiniviridae. The primary mode of TTV transmission was proposed to be transfusion [and hence its name]. Little is known about the clinical significance and the natural history of TTV infection. Hence, responsibility of the virus for specific liver disease is still debated. In our study, we tested ninety five blood donors attending Kom El-Decka regional blood bank in Alexandria for the presence of TTV DNA in their sera by PCR technique. The same samples were tested for ALT and AST levels by colorimetric technique and for HBsAg and anti-HCV by the ELISA technique. Out of the 95 blood donors, 46 [48.4%] had TTV DNA in their sera. None of the 95 blood donors included in this study was positive for HBsAg, while 22 [23.2%] were anti-HCV positive. Out of the 22 anti-HCV positive blood donors, 13 [59.1%] were TTV DNA positive, while out of the 73 anti-HCV negative blood donors, 33 [45.2%] had TTV DNA in their sera. There was no statistically significant difference between the prevalence of TTV DNA and anti-HCV in blood donors. No biochemical evidence of liver disease potentially linked to the TTV infection was observed in our blood donors who were TTV DNA positive. Furthermore, the occurrence of elevated serum AST and ALT was most often linked to HCV rather than TTV

Detection of herpes simplex virus and candida infection with special emphasis on their possible role in human squamous cell carcinoma and its variants

Sixty seven cases of human oral S.C.C. with its intra oral variances were investigated microbiologically, histopathologically, histochemically and immunologically. Yeasts were isolated from 85% of examined cases. "Candifast test" showed that Candida albicans was the commonest form of the detected fungi, followed by C. parapsilosis and C. tropicalis, while the least in frequency was the Torulopsis glabrata. Yeasts were more detected in females, elders and tobacco smokers. Two cases of well differentiated S.C.C were surprisingly detected, and for the first time in literature, associated with a specific granulomatous reaction and showed positively impregnated fungi. While negative reactions for fungi were noticed in all lymphoepitheliomas, almost all the verrucous carcinoma were positive. Viral inclusion bodies were demonstrated for the first time by MT. This method was rapid, economic and could be used as a pilot study before applying the more specific monoclonal. antibody techniques or in-situ hybridization methods. Comparing the results of HSV hybridization with that of candida infection we found that both could be detected in some cases. The results indicate that viral and fungal factors may be synergetic in the development of oral carcinomas

Role of helicobacter pylori in the genesis of gastric ulcerations among smokers and non-smokers

H. Pylori infections were investigated by three different methods: Serologically, microbiologically and biochemically, in 210 male patients aged 20-40 years. Gastric ulcers were diagnosed in 126 patients with which H. Pylori infection showed significant high association [X2 = 162.8]. Smoking showed a positive role in magnifying such a problem. Smokers were carrying a higher rate of infection than non-smokers, among patients with gastric ulcers [99% compared to 79%]. The risk of getting H. Pylori infection was computed in different smokers categories. Heavy cigarette smokers were found to be on top of the list, followed by moderate to mild cigarette smokers and common hubble-bubble smokers while, neither private hubble-bubble nor cigar/pipe smokers showed significant risk [odds ratio = 8.2, 4.3, 4.1, 1.1 and 0.8, respectively]

pattern of nosocomial infection: prospective study on a 200 bedded hospital

Nosocomial infection [NCI] was studied prospectively in a 200-bedded hospital, among 10918 total discharges. NCI prevalence rate [attack rate] was found to be 1.44% of the total discharges. According to departments, nursery showed the highest rate [4.66%], followed by ICU [2.32%]. Blood [septicemia] was the commonest site for NCI [43.67% of total NCI], followed by upper respiratory tract [13.39%]. Staphylococcus epidermidis took the upper hand in bacterial etiology of NCI [29.11% of total NCI], followed by Klebsiella [17.72%]. Antibiogram was also studied for the causatives. Policies and procedures for control of infections in hospital were reformulated and stressed in accordance

Identification of HLA-DR antigens expression on normal oral mucosa with comparative histochemical studies in oral lupus erythematosus

Seventeen tissue specimens of normal oral mucosa were immunohistologically studied for HLA-DR localization. The non-keratinized mucosa revealed mild and focal reaction, at the basal, parabasal and midzonal area, while the keratinized mucosa differed and revealed basal and parabasal distribution, only. The gingival mucosa showed more reaction than the palatal epithelium. This might be due to inflammation. As regard to these regional variations observed from the HLA-DR expression, it could be suggested that it may be due to sex, age, keratinocyte differentiation, epithelial permeability or immune status. Twelve biopsy specimens of patients suffering from oral LE were immuno and histochemically studied comparing the DLE and SLE types. There was intracytoplasmic plaque like HLA-DR reaction involving the spinous cell layers of the oral DLE epithelium, whereas the SLE demonstrated strong reactions expressed by the whole keratinocytes, i.e. from top to bottom distribution, with total intracellular immunoreaction. According to the present observations, there was a spectrum of auto destruction marked with HLA-DR expression ranged from basal cell layer degeneration present in both DLE and SLE, focal cellular vacuolization plus intraepithelial vesicular formation, noticed in DLE, till full gamut of HLA-DR expression seen on SLE keratinocytes

Enzyme-linked immunosorbent assay [ELISA] in the diagnosis of active pulmonary tuberculosis

This study evaluates the sensitivity and specificity of an enzyme - linked immunosorbent assay [ELISA] for the detection of antibodies against Mycobacterium tuberculosis antigen. Twenty seven of the 35 patients with pulmonary tuberculosis had positive serology with an antibody titre of 10 nineteen of them had positive serology with an antibody titre of 100. All the 27 patients with positive serology were either smear or culture positive or both. Twenty six of the 35 control group had. negative serology and 9 had positive serology with an antibody titre of 10. The test has a sensitivity of 77.14% and a specificity of 74.29%

Activated peripheral blood mononuclear cells: a possible substitute to B-lymphocytes in HLA-DR determination

The serological determination of class II antigens is still a mandatory test prior to allotransplantation. It is known that these antigens are normally expressed on B-lymphocytes and monocytes. The B-lymphocytes that constitute 10-15% of total blood lymphocytes are the cells currently used for HLA-DR typing. To avoid HLA-DR typing difficulties, or even impossibilities that are frequently encountered among some patient groups, we studied the response of peripheral blood mononuclear cells [PBMNC] - as an alternative sources of cells for class II antigen typing - to in vitro mitogen and interleukin-2 activation and propagation. Although the patients included in this study were selected having pre-known HLA-DR typing difficulties, all of them could be adequately typed by this method

Urinary tract infection among hospitalized patients: evaluation of rapid methods for its detection

Urinary tract infections were searched for among 2200 patients admitted in three main hospitals in Alexandria. Of them 231 [10.5%] showed 105 or more colony forming units/ml in their urine by culturing technique. Age and sex and a significant role in the distribution of bacteriuria. E. coli was the organism of highest prevalence among bacteruria cases. The isolated organisms showed highest sensetivity to Cefobid, Amikacin and Nitrofurantion. The validity of six rapid screening test was also evaluated in relation to the conventional culturing method. The highest diagnostic efficiency was found in relation to bacterial counting in the sediment of the centrifuged urine