Role of cancer antigen 125 in active pulmonary tuberculosis

Conventional TB diagnosis continues to rely on smear microscopy, culture and chest radiography. Other non-conventional approaches include detection of immunological response and the search for biochemical markers. Cancer antigen 125 [Ca-125] was evaluated mainly in patients with extra pulmonary TB. This study was designed to detect the role of Ca-125 in differentiating pulmonary tuberculosis from other pulmonary infections. Also to determine the value of Ca-125 was an indicator of response to anti-tuberculous drugs. Eighty patients were included in the study, 27 with active pulmonary TB and 33 with other pulmonary infections. Twenty healthy volunteers were used as a control group. Measurement of serum Ca-125 was performed once in all groups, it was re-assayed after 4 months of anti-tuberculous drugs among patients with active pulmonary TB. There was a significant increase of Ca-125 among patients with active pulmonary TB than the other groups, which decrease significantly after anti-tuberculous drugs. The sensitivity and specificity of Ca-125 were found to be 81.4% and 95%, respectively, at a 34.6 U/ml cut-off point. Ca-125 can be a useful marker in differentiating pulmonary TB from other pulmonary infections and in assessment the response to anti-tuberculoussis drugs

Spontaneous bacterial peritonitis: diagnostic value of creative protein and tumour necrosis factor-alpha and their blood-ascitic gradients

Background and aim of work: spontaneous bacterial peritonitis is an easily treatable disease but major obstacles were encountered in its diagnosis. The aim of this study was to evaluate the diagnostic efficacy of CRP and TNF-a in the ascitic fluid and their blood-ascitic gradient among cirrhotic patients with SBP versus those with sterile ascites

Subjects and methods: the study was conducted on 45 patients with liver cirrhosis. They had different etiologies, however all were positive for HCVAb. All patients were ascitic. According to the results of aerobic cultures in conjunction with·· polymorphnuclear neutrophil [PMN] count of ascitic fluids, cirrhotics were classified into two groups: Group I: 25 cirrhotic patients with SBP, [18 males and 7 females]. Their ages ranged from 25 to 69 years with mean +/- SD of 50.41 +/- 8.2 years. Group II: 20 cirrhotic patients with sterile ascites [9 males and 11 females]. Their ages ranged from 39 to 72 years with mean +/- _SD of 51.5 +/- 9.3 years. Both groups were subjected to the following: full history taking, clinical examination, complete blood picture, erythrocyte sedimentation rate, liver function tests, prothrombin time and concentration, renal function tests, fasting and 2 hours postprandial blood glucose, HBs Ag and HCV Ab. LDH, CRP and TNF-alpha were measured in serum and ascitic fluid. Ascitic fluids were also subjected to estimation of sugar, protein and albumin; counting of PMN/cmm and aerobic microbiological culture. Blood-ascitic gradients of albumin, LDH, CRP, TNF-alpha were calculated. Abdominal ultrasonography was done

Results: patients in group I showed a significant decrease of total protein in ascitic fluid in comparison with those in group II [P=0.04]. Ascitic fluid levels of LDH, CRP and TNF-et were higher in patients of group I than those in group II which were statistically significant as regard to LDH and CRP[p=0.0"3,0.001 respectively]. Serumascitic gradients of CRP and TNF-alpha were higher in-group I than group II. There was a significant difference between both groups regarding TNF-a. [P==0.04].There was a significant correlation between ascitic LDH and ascitic CRP [p=0.006]. There was a significant positive correlation between ascitic CRP and ascitic neutrophil count [p=0.002]. Sensitivity of ascitic fluid CRP and TNF-alpha were to be similar. However, the former had a higher specificity

Conclusion: ascitic fluid CRP can be correctly classify SBP and sterile ascites. It has the same sensitivity of ascitic TNF-alpha with a higher specificity It is considered as a cheap, easy and effective tool for diagnosis of SBP. · List of abbreviations: SBP: Spontaneous bacterial peritonitis. LDH: Lactate dehydrogenase. CRP: C-reactive protein. TNF-alpha: Tumour necrosis Factor alpha

role of fibronectin and TNF-alpha in early detection of diabetic nephropathy

Diabetes mellitus is a major health problem in large areas of the world. Diabetic nephropathy has become the major cause of end-stage renal disease [ESRD] [Kikkawa R. et al., 2003]. In this work, we study the role of measuring of TNF- alpha and fibronectin for possible early detection of diabetic nephropathy. This study was carried out on 45 individuals. It included 15 apparently normal healthy individuals [group I], 15 patients with NIDDM less than 5 years duration [group II], 1.5 patients with NIDDM more than 10 years duration [group III]. All individuals were thoroughly examined clinically including careful general, heart, chest and abdominal examination as well as neurological examination, fundus examination. ECG and US examination was done for all patients. All individuals were investigated with complete urine analysis, urine culture, fasting and 2 hrs postprandial blood glucose, kidney function tests, glycated hemoglobin [HbA1c], microalbumin [Albumin / creatinine ratio [ACR]]. Plasma fibronectin and TNF- alpha were done for all patients, fibronectin and TNF-alpha were markedly elevated in group III. We concluded that measurement of plasma fibronectin and TNF-alpha level may be used as marker for follow-up reflecting vascular endothelial changes in the course of diabetic nephropathy

Occupational risks and safety of children aged from 6 to 16 years, employed as farm workers in El-Minia Governorate "case control study"

While agriculture provides work opportunities for children, these opportunities also lead to potential risks. Biological and toxic chemicals may have different effects at different stages of devolvement and may be more damaging to children than to adults. Assessment of the impact of working in different agricultural activities on children aged from 6 to 16 years, to obtain comprehensive analysis of the work related hazards and risks. Children's health relies on the interaction between their environment [living and working conditions] and their developmental status. This study, included 40 children exposed to agricultural working risks and 40 children from the same villages away from agricultural activities as a control group. All children were subjected to special questionnaire, clinical examination, abdominal sonar, parasitology and laboratory examination. Demographic features showed no difference between the groups [Table I], but the education status [Table I] and socio economic class [Table II] showed a significant difference. Respiratory symptoms and signs showed a significant more incidence in the exposed group [Table III], Schistosomiasis was evident in a higher percentage in the exposed group [Table IV, V]. Laboratory results showed less hemoglobin level and RBCs count [Table VII]. Liver function parameters showed no difference between the groups expcet SGPT level [Table VIII]. This study showed that there are different occupational risks and hazards to this newly emerging occupational group [i.e. children], in the form of illiteracy, anemia, bilharzial infestation with its sequale and respiratory tract affection. Therefore it is mandatory to establish guidelines for children's work in the industry of agriculture to avoid occupational risks and to provide safety

Evaluation of interleukin -8 [IL-8] and granulocyte colony -stimulating factor [G-CSF] for early diagnosis of neonatal sepsis

The objective of this work was to evaluate the role of IL-8 and G-CSF in early diagnosis of neonatal sepsis and to determine if they are helpful in planning strategies to safely reduce the use of antimicrobials in neonates with clkinical signs of sepsis. IL-8 and G-CSF were measured in serum by ELISA technique, along with blood cultures, CRP, CBC including immature-to-total neutrophil [I/T] ratio for 36 neonates [22 term and 14 preterm] with suspected sepsis and 15 healthy neonates as controls. Sensitivity, specificity, positive and negative predictive values were calculated for IL-8, G-CSF, CRP and I/T ratio. Serum levels of IL-8 and G-CSF were significantly higher in infected group as compared to the control group, but there were no significant differences of serum levels of both markers between full term and preterm neonates, and also between cases with positive blood cultures and those with negative blood cultures. There were positive correlations between both markers with band cells%, I/T ratio and CRP, but no correlations were found with gestational age, Hb%, platelet count and total leucocytic count. The best sensitivity was observed with combined IL-8 and CRP [94.6%], followed by IL-8 [90%], G-CSF combined with CRP [89%] and IL-8 with G-CSF [88.3%]

Rheumatic manifestations and autoimmune profile in hepatitis C virus infected patients

The objective of this study was to determine the occurrence and frequency of rheumatic manifestations and serological markers of autoimmunity in HCV patients and the correlation of rheumatic manifestations with liver affection and autoimmune profile. Seventy-five patients [50 males and 25 females] with anti-HCV antibodies and 25 controls [16 males and 9 females] with no anti-HCV antibodies were studied. The mean age of the studied patients was 46.5 years +/- 10.8 [ranged from 26 - 70 years]. They were subjected to full history, thorough clinical examination and radiological and laboratory investigations. Autoimmune profile cryoglobulin, rheumatoid factor [RF], antineutrophil cytoplasmic antibodies [perinuclear and cytoplasmic, PANCA and CANCA], antinuclear antibodies [ANA], antismooth muscles antibodies [ASM], anticardiolipin antibodies IgG, ImG and IgA [ACLIgG, ACLIgM and ALCIgA], anti-liver kidney microsomal antibodies [LKM-1], anti Ro and La antibodies, polymerase chain reaction [PCR-RNA] and complement -3 and 4 [C3, C4] were tested. In conclusion, a high frequency of rheumatic manifestations and autoimmune markers in HCV infected patients was found. An investigation of risk factors for HCV infection is pertinent in a patient presenting new rheumatic manifestations. The most frequent mode of rheumatic illness in patients with HCV is dry eye and or dry mouth [Sjogren syndrome]. Hence, it is better to do ELISA as routine investigation in patients with dry eye and or dry mouth

Ultrasonographic patterns of splenic and hepatic lymphoma

Twenty-five cases of lymphoma were studied, only 20 cases had splenic and/or hepatic infiltration as detected by the examination of splenic aspiration and liver biopsy, of which two cases had Hodgkin's disease and 18 had non-Hodgkin's lymphoma. The main ultrasonographic pattern of the spleen was the focal lesions observed in 14 cases, either hypoechoic in 11 or target lesions in three cases and the other pattern, which is the diffuse low echoes, was observed in six cases which could suggest lymphomatous infiltration of the spleen. The ultrasonographic pattern of the liver showed focal lesions in only three cases and diffuse low echoes in the remaining 17 cases. These patterns are nonspecific and may be difficult to distinguish from other forms of hepatic diseases or malignant infiltration