Detection of occult HBV infection by nested PCR assay among chronic hepatitis C patients with and without hepatocellular carcinoma

Occult hepatitis B virus infection [OBI] has been reported among patients with chronic hepatitis C virus [HCV] infection and hepatocellular carcinoma [HCC]. This study aimed to evaluate the prevalence of OBI in chronic hepatitis C patients with and without hepatocellular carcinoma. A total of 40 chronic hepatitis C patients who were negative for HBsAg, were enrolled into the study. They were classified into two groups: Group I which included 20 patients with chronic hepatitis C only whereas Group II included 20 patients with chronic hepatitis C and HCC. Detection of HBV DNA was done by nested-PCR using two sets of primers specific for surface and X viral genomes in serum and liver tissue of patients. Genotyping system based on PCR using type-specific primers was done for HBV-DNA positive intrahepatic samples. OBI was detected in the liver tissue in 23/40 [57.5%] of chronic HCV infected patients, 18 [78.3%] of whom belonged to group II, conferring a 90% prevalence of this group. In serum, HBV-DNA was detected in 9/40 patients [22.5%], 7 [77.8%] of whom belonged to group II. Among the 23 positive intrahepatic HBV-DNA samples studied, HBV-genotype D [34.8%] and B [26.1%] were more predominant, whereas HBV-genotype C [13.1%] and A [8.7%] infections were the least observed, respectively; mixed genotypes were detected in 17.4% [n = 4], 3 of them were with HBV-genotype D and B, and 1 was with HBV-genotype C and A. In conclusion OBI is a fact in our community; it was detected in liver tissue of chronic HCV-infected patients, especially in cases of chronic HCC. In addition, OBI might be related to severity of necroinflammatory activity and fibrosis. Large studies are needed to confirm that co-infection could determine a worse progress of chronic liver disease in this population. Also, detection of intrahepatic HBV-DNA is more useful in diagnosis of OBI

antimicrobial effect of gutta-percha solvents on enterococcus faecalis biofilm during endodontic retreatment

The purpose of this invitro study was to evaluate the antimicrobial effectiveness of three common gutta percha solvents [Chloroform, Eucalyptol and Halothane] on Enterococcus faecalis biofilm when used during endodontic retreatment. Extracted human mandibular premolars were instrumented, infected with E. faecalis, and obturated. The gutta-percha was removed mechanically in the presence of saline or chemo-mechanically in the presence of either chloroform, Eucalyptol or Halothane. Bacterial samples were collected after gutta-percha removal, and colony-forming units [CFU] per ml were enumerated. Results showed that there was a statistically significant reduction in the mean numbers of colony forming units [p<0.05] after the Chemo-mechanical removal of gutta percha using rotary nickel titanium retreatment instruments with Chloroform, Eucalyptol or Halothane. However, the difference in the antimicrobial effectiveness among the three tested gutta percha solvents was statistically non-significant [p<0.05]

Role of anti-CCP in diagnosis of rheumatoid arthritis in comparison to rheumatoid factor

Background: RA is a chronic inflammatory disease that primarily affects the diarthroidal joints. Persistence and progression of the disease is regulated by immune mediators that continue to be defined and provide targets for immune intervention. Anti-CCP Antibodies were detected in over 80% of RA sera. This serological test has advantage of easy performance by convenient enzyme linked immunosorbent assay test

Aim of Work: This study was conducted to assess the value of anti-CCP as a marker for diagnosis and disease activity in RA patients

Subjects and Methods: The study was conducted on 75 subjects [25 RA patients, 25 disease control patients and 25 normal healthy individuals that served as a control group]. Serum anti-CCP level was measured using ELISA test. While Serum RF was measured using immune nephelometry

Results: Serum anti-CCP level was significantly higher in RA patients compared to the disease control group and the control group. Its level showed a positive significant correlation with RF, CRP, and the disease activity score. Sensitivity of the test was 74%, specificity was 100%, positive predictive value was 100% and negative predictive value was 73.5%

Conclusions: Detection of serum anti-CCP antibody in RA patients is a laboratory test that can be used as a parameter to diagnose RA

Microbiological evaluation of different overdenture abutments design

The mouth is the portal of entry of food this provides access to a wide array of microbes, the majority of which become part of the transient oral flora. Microbiological studies on samples taken from gingival pockets surrounds overdenture abutment teeth revealed different types of bacteria. The design of the overdenture prosthesis and supporting abutments affect the nature and quantity of bacterial found and that will be revealed in this study. This study was conducted to compare the microbiological changes occurring in gingival and periodontal tissue and gingival crevicular fluid as indicators of the condition of periodontium around abutments with different designs of abutment teeth of tooth supported mandibular overdenture. Subgingival bacteriological samples were taken from abutment's gingival crevice at the time of denture insertion and after three months to evaluate the effect of abutments design on the bacterial types as well as counts. The collected samples were cultured, identified and counted. A total of 20 male patients were divided into two equal groups according to abutment's length [Group I and II]. The patients' abutments were subdivided into two equal groups according to abutment's covering [A and B]. This study revealed an increase in anaerobic bacteria in both groups, with significant increase in Group I-A [patients rehabilitated with long abutments with copings] while all other groups have shown to significant difference before and after denture insertion. Insertion of overdenture accompanied with increase of anaerobic bacteria

Drug susceptibility testing of pulmonary tuberculosis by nitrate reductase assay

Treatment of multidrug-resistance tuberculosis [MDR-TB] remains a challenge and its success depends on how quickly a case of TB is identified as drug resistant and whether an effective drug therapy is available. As a drug susceptibility test [DST], nitrate reductase assay [NRA] might help in management of MDR-TB patients. This study was conducted to evaluate NRA as a drug susceptibility test [DST] for the four primary anti-tuberculosis drugs [Isoniazide [INH], Rifampicin [RIF], Streptomycin [SM] and Ethambutol [EMB]]. A total of 30 isolates of M. tuberculosis were subcultured for 28 day to be fresh isolates and subjected to NRA. The results were recorded after 10 days of incubation and compared to that of the proportion method [PM] as a gold standard. Susceptibility testing for INH and RIF revealed relatively higher efficiencies when compared to that of the PM. For INH and RIF, the efficiencies were 93.3% and 90%, respectively. The sensitivity of the NRA as a DST for INH was 89.4%, while that for RIF was 93.3%. The specificities of NRA for INH and RIF were 100% and 86.6%, respectively. The predictive value of sensitivity for INH was 84.6% and that of RIF was 92.8%. The predictive value of resistance for INH was a high as 100%, while that of RIF was 87.5%. Susceptibility testing for SM and EMB showed relatively lower efficiency compared to PM. The efficiencies of NRA for SM and EMB were 86.6% and 76.6%, respectively. The sensitivity of the NRA as a DST for SM was 78.9%, while that for EMB was 40%. The specificity of the NRA for SM was 100% and that of EMB was 95%. The predictive values of sensitivity for SM and EMB were 73.3% and 76%, respectively. The predictive value of resistance for SM was 100% and that of EMB was 80%. NRA is a simple, rapid and inexpensive technique of high performance when used as susceptibility testing for both INH and RIF, but was not good for SM and EMB

Fas expression on peripheral blood t lymphocytes in systemic lupus erythematosus [SLE]: relation to disease activity and lupus nephritis

Introduction: Systemic lupus erythematosus [SLE] is an autoantigen driven T cell dependent autoimmune disease. Lupus nephritis is one of the most serious complications in SLE, occurring in up to 60% of the patients. SLE patients show increased apoptosis of peripheral blood mononuclear cells [PBMCs], especially T lymphocytes and decreased resistance of activated T cells to apoptosis. Fas, also known as APO-1 or CD95, is a cell surface protein that triggers apoptotic cell death with characteristic cytoplasmic and nuclear condensation and DNA fragmentation. The aim of this work was to evaluate Fas expression [as an apoptotic marker] on peripheral blood T lymphocytes in SLE patients in relation to disease activity and lupus nephritis

Subjects and methods: Thirty-five SLE patients and 15 normal controls were studied. Disease activity was assessed by SLAM score and patients were divided according to: a] disease activity [mildly active group with SLAM score <6, moderately active group from 6-12 and severely active group >12], b] the clinical presentation including the presence or absence of either lung, cardiac, neurological affection or nephritis as well as regard, c] WHO classes of lupus nephritis. Laboratory investigations included CBC, ESR, serum creatinine, urine examination, 24 hours urinary proteins, ANA and Anti-dsDNA, flowcytometric analysis of percentage of Fas expression [CD95+] on peripheral blood T lymphocytes [CD3+] and percutaneous renal biopsy in indicated patients with evidence of nephritis

Results: Percentage of CD3+CD95+ cells from SLE patients was statistically significantly increased compared to healthy controls [p<0.05]. Comparative study among the patients according to SLAM score was statistically significant [p<0.05] using ANOVA test with the highest percentage of apoptotic T lymphocytes in severely active group. When comparing each group with the control one, results showed statistically significant more apoptotic T cells in severely active SLE patients compared with controls. However, although the apoptotic T cells were increased in moderately active SLE patients, the data did not reach statistical significance in comparison with healthy controls nor with the mildly active group [p > 0.05]. Apart from nephritis [p<0.05], Fas expression was not associated with the clinical presentation of the patients, as regard the presence or absence of lung, cardiac or neurological affection [p>0.05]. The percentage of Fas expression was higher in class IIb than either class III or IV as well as patients without nephritis and those with nephritis without indication for renal biopsy [27.32+/-13.62 vs. 19.8, 19.14+/-5.12, 14.8+/-3.57 and 17.2+/-6.8]. However, on comparing only the patients who did renal biopsy, the renal parameters as well as the percentage of CD3+CD95+ cells was statistically non significant [P > 0.05]. Correlation between the percentage of CD3+CD95+ cells and different parameters revealed highly significant positive correlation as regard ESR, current steroid treatment dose and SLAM scoring, [p<0.001], statistically significant positive correlation as regard platelets, nephritis, arthritis, fever, lymphadenopathy and chronicity index in renal biopsy [p < 0.05], and tendency toward urinary albuminuria and casts. [p= 0.061 and 0.056 respectively]

In conclusion: The increased CD3+ CD95+ cells from patients with SLE and its correlation with disease activity suggests that abnormalities of apoptosis may be related to the pathogenesis of the disease [especially with high grades of activity] and its serious complication, nephritis. In patients with nephritis, the lower Fas expression [CD95+] on peripheral blood T lymphocytes [CD3+] in patients with class IV nephritis than those with class IIb nephritis could be possibly explained by the effect of treatment or by the natural process of the proliferative disease itself. However, further studies including large number of SLE patients, evaluating apoptosis both systemically and locally in tissue biopsies and studying various apoptotic pathways are needed to understand its role in the pathogenesis of the disease and its value as a therapeutic target