ABSTRACT
Background: Mycobacterium tuberculosis [MTB] is the causative agent of tuberculosis [TB], which remains the leading cause of morbidity and mortality worldwide. The emergence of drug-resistant strains of MTB has put status of TB to threatening levels
Aim of the Work: was to detect MTB along with rifampicin [RIF] resistance using Genexpert [MTB/RIF]. Its diagnostic, sensitivity and specificity were evaluated by comparing with conventional technique
Patients, Materials and Methods: This prospective study was conducted on two hundred and seven Egyptian patients at Abbasia Chest Diseases Hospital, from November 2016 to December 2017, and comprised clinically and radiologically diagnosed TB suspected cases. This study was approved by the Ethical Committee of faculty of medicine, Alazhar University and the Ethical Committee of Ministry of Health and after Verbal consents from the patients or their parents were taken. Pulmonary specimens [sputum and bronchial lavage] and pleural effusion as an extra-pulmonary specimen were included. All samples collected were sent to TB laboratory of Abbasia Chest Diseases Hospital for further analysis
Result: Out of the 26 Genexpert [MTB/RIF] positive samples for MTBC, 3 [11.54%] showed RIF resistance and diagnosed as MDR-TB. Using LJ and MGIT cultures for drug sensitivity test [DST] on 31 and 34 positive TB samples; respectively, the same three specimens showed resistance to rifampicin [RIF]. Four positive specimens were also resistant to streptomycin [STR] using the previously mentioned cultures. Moreover, resistant to INH was reported in five positive TB samples using the same cultures. Finally, it was found that all positive specimens were sensitive to Ethambutol [ETH]
Conclusion: Although the conventional methods remain the gold standard for diagnosing pulmonary TB, delayed diagnostic times demand for more rapid and sensitive nucleic acid amplification techniques. Genexpert [MTB/RIF] assay is simple, rapid and accurate method for detecting mycobacterial tuberculosis
ABSTRACT
A clinically distinct subset of Irritable Bowel syndrome [IBS] could be induced or exaggerated by bowel infection that is called post-infective IBS [PI-IBS] which is characterized by diarrhea predominant symptoms with less psychiatric illness. The purpose of this work was to study whether some bowel infections contribute to the pathogenesis of IBS and whether the treatment of such infections reduces IBS symptoms. 100 patients with symptoms suggestive of IBS according to Rome II Criteria were chosen from Internal Medicine outpatient clinic-Al Hussein university hospital. They were 64 females and 36 males, aged 18-52 years old with mean age 38.2 +/- 3.6 years. They were submitted to: full clinical examination and frequent stool examinations [direct smear and culture] before, soon after and six months after administration of drug therapies for common stool-positive associated bowel infections [diloxanide for E. histolytica, metronidazole for Giardia lamblia, Ketoconazole for Candida, ciprofloxacin for Salmonella and neomycin for Pseudomonas]. Results obtained showed that 24% of patients had diarrhea predominant symptoms, 13 patients [54%] out of them had history suggestive of acute gastroenteritis. 80 patients had initial positive stool examination and continued the post treatment six months follow up study. Out of them, 13 patients had stool positive for Salmonella typhi mixed with E. histolytica; ten of them [76.9%] showed a statistically significant persistent clinical and laboratory improvement after ciprofloxacin therapy [P < 0.01]. So Salmonella typhi may be implicated in IBS pathogenesis. Six patients showed isolated Giardia lamblia infection; four of them [66.7%] showed a statistically significant persistent clinical and laboratory improvement after metronidazole thereby [P < 0.05]. Giardia lamblia parasite may be considered in triggering or exaggerating IBS symptoms. 24 patients had isolated E. histolytica infection; only one of them [4.2%] showed sustained clinical and Laboratory improvement after diloxanide therapy -statistically insignificant result- [P > 0.05]. This finding makes the correlation between E. histolytica infection and IBS is unlikely. 20 patients had isolated Candida overgrowth on stool examination; eight of them [40%] showed a statistically significant clinical and laboratory improvement after Ketoconazole therapy [P < 0.05]. Therefore Candida overgrowth may induce or exaggerate IBS symptoms. Finally, no growth was noticed for shigella sp. or E. coli, this may exclude the role of such organisms in IBS pathogenesis
ABSTRACT
The concentration of fibronectin was measured in the tears of 15 patients one day before and then every two days after cataract extraction, in patients who received local antibacterial and anti- inflammatory drugs. It was found that there is a significant increase in the concentration of fibronectin in the tears following cataract extraction. The curve representing the postoperative concentration of fibronectin is biphasic with two peaks, the first at the 2nd day and the second peak at the 6th day. On the 12th day, the concentration of fibronectin of fibronectin had almost reached the preoperative level