Diagnostic value of dot-enzyme-immunoassay test to detect outer membrane protein antigen in sera of patients with typhoid fever.

Typhoid fever is still an important public health problem in many developing countries especially in tropical parts of the world, as in Indonesia. This problem opens the way for a further study with the aim of finding an alternative serological test with a high degree of reliability for the detection of typhoid fever. Given the above mentioned purpose, a study on the reliability of a laboratory test, the dot-enzyme-immunoassay outer membrane protein (DOT-EIA-OMP) was conducted comprising sera from 207 subjects (44 adult typhoid patients, 43 adult nontyphoid patients and sera from 120 adult healthy individuals serving as controls. The result of the study revealed that the diagnostic sensitivity of the DOT-EIA-OMP test for the detection of typhoid fever can be classified as high (93.16%), the specificity as moderate (76.74%), the efficiency (accuracy), positive predictive value and negative predictive value as high (85.06%, 80.39% and 91.66% respectively). The within run and between days reproducibility of this test was very high (CV=0%). Analysis of data obtained indicated that the DOT-EIA-OMP test was a reliable screening test for the establishment of the diagnosis of typhoid fever in health centers with simple laboratory facilities. The application of this test has to be more contemplated in countries where the cost of laboratory test is a problem.

The diagnostic value of the ELISA-Ty test for the detection of typhoid fever in children.

A study on the reliability of an enzyme linked immunosorbent assay (ELISA) for the detection of typhoid fever, the ELISA-Ty test, was conducted, comprising 44 children suffering from bacteriologically confirmed typhoid fever based on the finding of a positive blood culture for Salmonella typhi, 44 children with fever caused by diseases other than typhoid fever based on the finding of negative culture of blood, urine and stool for S. typhi, and 120 healthy children as controls. This ELISA-Ty test measures the concentration of IgM and of IgG against S. typhi in serum. This test is an indirect ELISA test, based on a method that makes use of a mixture of OMPs (outer membrane proteins) in equal proportion serving as antigen, obtained from different strains of S. typhi which are prevalent locally, peroxidase goat antihuman IgG or IgM (Sigma) as conjugate and orthophenylenediamine (Sigma) as chromogen of the substrate. The result of the test was obtained through the assessment of the end product, using a micro ELISA reader (Behring) at wave length of 490 nm. The data revealed that the mean absorbent values found in children with typhoid fever, for IgM and IgG, were significantly higher (p < 0.05) when compared to those in children with non-typhoid fever as well as to those found in children of the control group. The results of this study confirm that the ELISA-Ty test has a high reliability for the detection of typhoid fever in children, based on the finding of a degree of diagnostic sensitivity as high as 95.45% and 90.91% for respectively IgM and IgG, a diagnostic specificity as high as 93.33% for IgM as well as for IgG, a high diagnostic efficiency (94.32% for IgM and 92.05% for IgG), a high diagnostic positive predictive value of 93.33% for IgM and 93.02% for IgG, high negative predictive values of 95.35% for IgM and 91.11% for IgG for use under clinical as well as under field conditions.

Retinoic acid cream (Airol cream) and benzoyl-peroxide in the treatment of acne vulgaris.

A clinical trial using Airol cream (retinoic acid cream 0.05%), Panoxyl-5 and Panoxyl-10 (benzoyl-peroxide alcoholic gel 5% & 10%) in combination and alone as topical applications for 10 weeks was carried out on 150 ambulatory patients with acne vulgaris. The results based on efficacy, drug tolerance and treatment duration show that the combined use of Panoxyl and Airol is superior to the use of either drug alone and that the combination of Airol cream (0.05%) in the morning and Panoxyl gel (5%) before retiring was the most satisfactory.

The aromatic ethylamide derivative of retinoic acid in the treatment of acne vulgaris.

A clinical trial on the aromatic ethylamide derivative of retinoic acid (Ro. 11-1430) applied topically was carried out for 10 weeks on 50 ambulatory patients suffering from various degrees of acne vulgaris. This clinical trial assessed the efficacy and side reactions of Ro. 11-1430 in the treatment of acne vulgaris, especially when used in the tropics. A comparison was made between the results obtained in this trial and those in another trial using topical retinoic acid. Analysis made in terms of efficacy, drug tolerance, patients' complaints and duration of treatment for achieving obvious alleviation of symptoms shows that Ro. 11-1430, with the exception of side reactions due to the drugs applied, was inferior to retinoic acid. Relapses as well as remissions often occurred during the period of maintenance therapy. Like retinoic acid, Ro. 11-1430 has a palliative effect only and not a curative one.

The effect of topical retinoic acid (Airol) in the treatment of tinea versicolor.

A clinical trial with retinoic acid (Airol) cream 0.05% applied topically was carried out on 50 patients suffering from tinea versicolor allocated to a random procedure. The results, judged in terms of cure rate, incidence of relapse and tolerance were very satisfactory. As regards the above mentioned criteria for a successful treatment, there was no significant difference between the lotion and cream groups. Repigmentation of the affected skin after retinoic acid occurred in a relatively shorter period compared with other anti-fungal preparations, especially when simultaneously exposed to sunlight. The therapeutic action on dermatophytes was discussed. It was pointed out that patients suffering from tinea versicolor are predisposed to dermatophyte infections and that cleanliness of the skin is a simple but essential way of preventing contamination with Malassezia furfur.