Evaluation of the enzyme-linked immuno-electro transfer blot [EITB] technique using hydatid cyst antigens B/5 and total IgG antibodies in laboratory diagnosis of human hydatidosis

To evaluate the validity of the Enzyme-linked Immuno-electro Transfer Blot [EITB] technique to diagnose human hydatidosis using sheep hydatid fluid antigens and human sera infected with hydatidosis. After preparing parasite antigen from sheep hydatid cyst fluid, all collected human sera infected with hydatidosis and other parasitic diseases as well as normal individuals, were analyzed by EITB test to evaluate its validity in diagnosing of hydatidosis. Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Iran. Seventy patients infected with hydatidosis confirmed by surgery, 15 with fasciolosis, 10 with toxocariasis, 15 with strongyloidiasis, 5 with amoebiasis, 10 with trichostrongylosis and 30 normal controls. The sensitivity, specificity, positive and negative predictive values of EITB test. Using total IgG antibody isotype, the sensitivity, specificity, positive and negative predictive values were 95%, 88.5%, 86.4%, 95.5% 97.3%, 64.8%, 60.3% and 97.7% for antigens Band5 respectively. The total IgG antibodies in hydatidosis patients documented the parasite AgB subunits i.e 12, 16, 23 kDa, also larger subunit of Ag5, namely 39 kDa. The study showed that although, EITB method was a time consuming test, but due to high validity could be considered as an authentic technique, especially when the diagnosis is vague and time is not imperative. Vic- Chancellery for Research, Tehran University of Medical Sciences, Iran. No Conflicts of interest exists

Diuretic therapy and ascitic fluid pattern in heart failure

It is claimed that diuretics can change the pattern of ascitic fluid analysis in heart failure, but, it has remained a controversial issue. To test the hypothesis that in heart failure diuretics change the transudative pattern of ascites to exudative. In a prospective study, 50 patients [32 male, 18 female] with a mean age of 49 years [range, 26-67 years], and ascites secondary to heart failure were randomly allocated to two therapeutic groups. Group I: 30 patients received furosemide and group II: 20 patients received triamtrene H for two weeks. Abdominal paracentesis was performed before, and one and two weeks after diuretic therapy. The difference in ascitic fluid total protein [AFTP] and cell count was not significant at baseline between the two groups. In patients on furosemide, the change in AFTP compared to the baseline was significant [p<0.001 and p<0.001, respectively] one and two weeks after therapy. In patients on triamtrene H, the change in AFTP one and two weeks after therapy compared to the baseline was significant [p<0.01 and p<0.001, respectively]; ascitic fluid met exudative criteria in three patients [15%]. In group I patients, the difference in ascitic fluid cell count, one and two weeks after therapy was statistically significant [p<0.001 and p<0.001 respectively] compared to the baseline. In group II, the difference in ascitic fluid cell count one and two weeks after therapy compared to the baseline was not significant. In group I: 23 patients [76.6%] showed a significant change in their ascitic fluid pattern while in group II: 3 patients [15%] showed ascitic fluid changes toward the exudative pattern [p<0.05]. In patients with heart failure, furosemide changes transudative ascitic to exudative; the change is more significant in the amount of protein than in the cell count, and occurs at the end of the first week of therapy and continues thereafter