ABSTRACT
We aimed for detection of bacterial DNA [bactDNA] in spontaneous bacterial peritonitis [SBP] by polymerase chain reaction [PCR] and its prognostic relevance in cirrhotic patients with culture-negative non-neutrocytic ascites [CNNNA]. approximately 60% of patients with spontaneous bacterial peritonitis [SBP] are ascites culture negative. Of each 77 patients with cirrhosis and ascites, two samples including blood and ascitic fluid [AF] were taken. Blood samples were obtained for routine biochemical study and PMN count. AF samples were used for biochemical analysis and aerobic and anaerobic culture. BactDNA was detected by polymerase chain reaction [PCR] using bacterial universal 16srRNA gene primer. Of all AF samples, 3 [3.9%] were positive for bacterial culture [one streptococcus a hemolytic and two E.coli]. The mean number of PMN in AF was 63. BactDNA was detected in 33 [42.9%] of 77 of samples [group A] and bactDNA was absent in 41 [53.2%] of samples [group B]. Blood WBC, prothrombin time, LDH, serum total protein, AF WBC, serum albumin, AF albumin, AF total protein, serum total bilirubin, AST, ALT and BUN were not statically different among group A and B. Hepatitis B, 41[45%], was the most frequent cause of cirrhosis. Hepatitis B is the common cause of cirrhosis in Iranian cirrhotic patients. Also, current study showed that high number of Iranian cirrhotic patients with CNNNA carries bactDNA in their AF. The clinical findings as well as clinical laboratory data in patients with CNNNA are independent to bactDNA status in their ascitic fluid
ABSTRACT
This study was to determine the sensitivity, specificity, positive predictive value [PPV], negative predictive values [NPV] and agreement between two methods of the stained gastric imprint cytology smears and stained gastric specimen biopsy mucosal methods for detection of H. pylori. Air-dried imprint smears of gastric biopsies from 330 patients were stained by the Grunwald- Giemsa method in the endoscopy suite and examined for H. pylori, providing results within minutes. The grade of H pylori infection was documented. The same biopsy was processed and stained with HandE and Grunwald- Giemsa stains, and reviewed by two different pathologists blind to the imprint cytology results. Ninety-four of the 238 patients were male with a mean age of 46 [ +/- 16.4] years. Based on histology, the H. pylori prevalence was very high at 77.87% and according to cytology H.Pylori prevalence was high at 75.45% in this region our country. The sensitivity and specificity of imprint cytology in the detection of H. pylori were 96.88% and 90.12%, respectively. The PPV and NPV were 96.88% and 90.12%, respectively. The agreement between two diagnostic methods was 95.26% which confirms reliability of imprint cytology method for ion of H.pylori detection. Gastric imprint smears stained with Grunwald-Giemsa method is a rapid and cost effective method in addition to histology for detecting H. pylori in patients undergoing upper gastrointestinal endoscopy and biopsy. It does not require any additional biopsy