Role of circulating fosciola antigens and IgG4 isotype in assessment of cure from fascioliasis

Sixty-eight individuals were included in this study; 30 of them were presented with Fasciola infection, 20 were infected with other parasites [infected control group] and 18 individuals were parasite- free [normal control group]. For all groups, stool analysis by modified formol-ether technique and Kato thick smears for egg counts and the circulating Fasciola antigens [CFAgs] and anti-Fasciola IgG4 isotype were estimated by ELISA technique. Complete blood count, liver functions tests and abdominal ultrasonography were performed for all Fasciola-infected patients. Patients with fascioliasis received a myrrh-derived drug [mirazid] in a dose of 10 mg/kg b. Wt., one hour before breakfast for six consecutive days. Re-measuring of the above parameters was performed one and three months after therapy. The detection of CFAgs was found to be a useful marker for the assessment of core. No cross-reaction was observed between Fasciola and other parasites using CFAg [100% specificity]. The level of these antigens was positively correlated with the signs of cure, parasitologically, clinically or ultrasonographically. The detection of IgG4 isotype was found to be a more sensitive and accurate immunodiagnostic tool for fascioliasis, but it was not a useful marker for the assessment of cure. Mirazid drug possesses a high therapeutic efficacy [100% cure rate] on fascioliasis without remarkable side effects

Opportunistic intestinal parasites among children with chronic liver disease

Two hundred children were included in this study; 80 patients showing clinical and/or biochemical evidence of chronic liver disease, 80 children immunocompromised due to causes other than chronic liver disease and 40 healthy controls. All were subjected to detailed history, thorough clinical examination, investigated by liver function tests and stool examination by special techniques for opportunistic intestinal parasites. Autoimmune chronic hepatitis represented 12.5% of cases with chronic liver disease, 30% of hepatic schistosomiasis, 25% of congenital cholestasis, 20% of chronic viral hepatitis and 12.5% of metabolic liver diseases. The incidence of opportunistic intestinal parasites with chronic liver disease [92.5%] was nearly similar to the immunocompromised patients [90%] and significantly higher than the controls [30%]. Mixed infection was not detected in the controls, while 57.5% of patients with chronic liver disease and 35% of the immunocompromised ones were infected by two parasites and 12.5% of each group was infected by more parasites

Evaluation of schisto-fast test in diagnosis of schistosomiasis

We conducted a prospective study to evaluate the Schisto-fast test as rapid method for diagnosis of active Schistosomiasis. Fifty patients with active Schistosomiasis were diagnosed by detecting Schistosomal eggs in stool, urine and rectal snips, fourteen persons infected with helminthes other than Schistosomiasis[to detect cross-reaction], and eighteen persons as a control group were included in the present study. Schisto-fast test and ELISA for detection of circulating antigen were done before and after anti-bilharzial therapy. The present study showed that Dot- ELISA test was positive in 100% and 68% in patients before and after anti-bilharzial treatment respectively, while ELISA test was positive in 96% and 16% in patients before and after treatment respectively. Also it was found that Dot- ELISA test was positive in 10/18 [55.6%] in normal control, and 57.14% [8/14] of infected control with other helminthes; while ELISA test was negative in normal control and positive in 14.29% [2/14] of the infected controls. It is our conclusion that the Dot- ELlSA test is not a reliable for diagnosis of Schistosomiasis, and ELlSA test can be used in detecting circulating Schistosomal antigen

Pathological changes in mice vaccinated with swap, challenged and treated with praziquantel

Not only SWAP vaccinated mice and challenged with Schistosoma mansoni cercaria [100 +/- 20 / mouse] showed a significantly decrease in worm burden of perfused vaccinated mice compared with control non vaccinated infected mice, but also minimized the size and number of granuloma in different tissues [intestine, spleen and liver] compared with infected control. Praziquantel therapy showed a significant decrease in egg granuloma size and number in the intestine but the liver showed less significant decrease in egg granuloma size and number. This observation may aggravate hepatic fibrosis, especially if some worms are still viable and shift to the liver due to partial drug resistance and/or incomplete therapy. These data may guide and recommend follow up and repeat therapeutic dose to surely kill and prevent worms from shift to the liver. There is a synergism between drug therapy and vaccination, which showed marked decrease in egg granuloma size and number in the liver, while the intestine was nearly cured. Finally SWAP vaccinated mice showed a partial protection due to acquired immunity but the mice are still susceptible to infection with Schistosoma

Lithium clearance and sodium lithium counter transport in insulin dependent diabetes mellitus

Our study was conducted on 24 insulin dependent diabetic patients in comparison to 10 normal healthy control subjects. the group of the patients were classified according to the results obtained into 3 groups. The list was eight diabetic patients without nephropathy, the second was eight diabetic patients with nephropathy and the third was eight diabetic hypertensive patients, Both diabetics and control were subjected to full clinical examination and laboratory investigations [plasma lithium, lithium clearance, fractional Iithium clearance [FcLi] and sodium-lithium counter transport [Na [+] /Li [+] CT]. The results showed mild elevation of serum sodium in IDDM groups compared to control. FcLi showed a highly reduction in IDDM groups compared to control group. Na [+] /Li [+] CT showed a statistically significant elevation in IDDM groups compared to control group

Role of toxocariasis in some allergic skin diseases

Allergic skin diseases are cutaneous reaction attributed to multiple potential causes. One of these causes is toxocaral infection. In order to explore its role we examined two groups of children suffering from atopic dermatitis [AD] [26 children aging up to 15 years Group I] and chronic idiopathic urticaria [CIU] 24 children of the same age [Group II]. In addition to 30 apparently healthy children free from any skin disease, they were considered as control group [Group III]. Antitoxocaral IgG antibodies detected by ELISA were found among 15%. 21% and 10% of the three groups respectively with a statistical significant difference in the chronic idiopathic urticarial group [CIU] and the level of antitoxocaral IgG was significantly higher among the two groups versus the control one [P<0.05]. Specific antitoxocaral IgE detected by immunosorbent agglutination assay [ISAGA] revealed that, positivities to specific IgE were 7.7% and 12.5% in the atopic dermatitis and chronic idiopathic urticarial groups respectively with a high statistical significant difference versus the control group [P<0.001]. Estimation of eosinophils among the different groups revealed that, eosinophilia was found among the examined groups with a highly staistical significant difference than the control [P<0.001] and hypereosinophilia was present in patients showed positivity for IgE specific for toxocaral infection. It could be concluded that, toxocaral infection most probably has a role in some idiopathic skin allergic diseases as atopic dermatitis and chronic idiopathic urticaria

Diagnosis of congenital cerebral toxoplasmosis by detection of low avidity specific IGG antibodies in cerebrospinal fluid

To assess the role of congenital toxoplasmosis as a causative agent of the CNS disorders in human off springs, 105 newborns, infants, preschool and school children with these disorders were observed. They consisted of three groups. The first were 24 newborns and infants to mothers seroconverted during pregnancy, the second; 39 newborns and infants whose immunocompromised mothers were Toxoplasma chronically infected before pregnancy, the third, 42 children who were clinically free at birth but presented with CNS disorders 4-9 years later; their mothers were with chronic Toxoplasma seropositivity at the time of the survey. Anti-Toxoplasma IgG antibodies were sought in the sera of mothers and sera and CSF of the off springs. Specific intrathecal IgG antibody production was estimated by calculating Goldman Witmer Coefficient [C] and by calculating the CSF to serum antibody avidity ratio [AR] exploiting an ELISA that included dissociation of antigen-antibody complexes with 6 Mure a solution. C value > 8 and AR value < 0.5 were detected in 5 [20.8%] members of the first group, 3 [7.6%] of the second and 4 [9.5%] of the third. These values corresponded with the response to specific therapy. The antibody avidity in the diagnosed newborn sera [

Zinc, copper and immunoglobulins levels among resistant and susceptible schistosomal cases to praziquantel therapy

Praziquantel [PZQ] efficacy is known to depend in part on the host immune response to infection. The study of schistosomal cases that resist or tolerate PZQ therapy after multiple doses includes the host immune system, the drug and the schistosomes characters In the present work, a trial to assess serum trace elements [Zinc and Copper] by Atomic absorption spectrometry and to evaluate humoral imrnune response of susceptible [cured] and resistant [non-cured] schistosomal cases for PZQ therapy by ELISA to measure antischistosomal antibodies [Anti-SWAP IgG and 1gM] of schistosomal cases in a rural area of Nile Delta of Egypt. There are insignificant variations of serum trace elements [Zinc and Copper] levels between 4 different groups of schistosomal cases that received single, double [40 mg/kg] and triple doses [60 mg/kg b.w.] of PZQ, while serum Copper among schistosomal cases are significantly higher than healthy control cases. These results may denote that PZQ cannot affect trace elements levels among different groups of schistosomal cases. Moreover, no significant variations in the level of the schistosomal antibodies [Anti-SWAP IgG and IgM] among different groups of schistosomal cases which may indicate on the integrity of immune response of infected cases either susceptible or resistant cases for PZQ therapy. The detection of few schistosomal cases resist or tolerate [innate insusceptibility] PZQ after 3 doses may guide to resistant strains of schistosomes to P29 therapy especially with drug abuse that may confirm the need for further studies to elucidate etiological factors for drug resistance because PZQ is the milestone in the chemotherapeutic control of schistosomiasis

Immediate post-abortion intrauterine contraceptive device insertion

To evaluate immediate post-abortion IUCD insertion, 200 women with spontaneous first trimester abortion were selected. IUCDs were inserted immediately post-abortion in 90 women, within 2-3 weeks after abortion in 30 women and after the first menses in 70 women. Blood loss was estimated during the first post-abortive 24 hours as well as the first and the second menses. All patients were followed for six months post insertion. In this study, it was found that the incidence of leukorrhea was significantly higher among post-abortion IUCD users than among non users. There was a significant reduction in the menstrual blood loss, in the incidence of menorrhagia and inter- mensrual bleeding in immediate post-abortion IUCD users in comparison to interval IUCD users. The incidence of other side effects and complications of IUCD [i.e. pain, infection, expulsion and pregnancy] in immediate post-abortion IUCD users were comparable or even lower than in the interval IUCD users. These data suggested that immediate post-abortion IUCD insertion is a safe and recommendable procedure