ABSTRACT
Introduction: Spontaneous Bacterial Peritonitis (SBP) iscommon and serious complication of patients with livercirrhosis and ascites, without an apparent surgically treatableintra abdominal source of infection. Its prevalence rangesfrom 10% to 30%. Mortality rate was earlier reported morethan 90%, but it has now reduced to 30% -50% as a resultof rapid diagnosis and prompt initiation of antibiotics. Thepresent study was done to evaluate the various non culturemethods for the diagnosis of SBP.Material and Methods: Ascitic fluid sample were collectedaseptically from 100 cirrhotic patients with ascites. PMN(polymorphonuclear leukocyte) count was determined byNeubauer’s manual counting chamber and Leishman’s stainfor differential PMN cell counts. Granulocyte esterase activitywas detected using LER (Leukocyte esterase reagent) dipstickstrips.Results: Out of 100 samples processed, PMN cell count >250 cells/mm3 was found in 91% samples by conventionallight microscopy. Scale of > 2+ by LER strip was found in61 samples. Reading of PMN cell count of > 250 cells/mm3matched in 60 samples and < 250 cells/mm3 matched in 8 cellsby both microscopy and LER strip test. Sensitivity, specificity,positive predictive value and negative predictive value ofLER strip test was 65.9%, 88.89%, 98.36% and 20.51%respectively.Conclusion: LER strips as a screening tool for SBP haveadvantage of speed, low cost, availability at odd hours, requiresno technical expertise and can be performed everywhere.Its high specificity and PPV may help in early institution ofempirical antibiotic therapy in patients.
ABSTRACT
ResumenLas técnicas histoquímicas hoy en día permiten seleccionar áreas de tejido y generar información confiable sobre la distribución de reservas energéticas en los moluscos bivalvos durante su ciclo de vida. Mensualmente se examinaron las gónadas y la glándula digestiva (GD) de 15 individuos recolectados entre abril 2012 y febrero 2013 por técnicas histológicas e histoquímicas de microscopia de luz, para relacionar el ciclo gametogénico y la disponibilidad de reservas energéticas con los parámetros ambientales. En el ciclo gametogénico, la proporción mensual de organismos maduros fue mayor en los machos entre agosto (40 %) y noviembre (53 %), mientras que las hembras tienden a presentar un ciclo más corto y sincronizado de liberación de gametos (septiembre 67 % y octubre 60 %). Los períodos intensos de desoves coinciden en ambos sexos (octubre-enero). Entre abril-agosto 2012 y enero-febrero 2013, se observan los valores más altos del IGl (índice de glúcido), mientras que en septiembre disminuyen y alcanzaron valores mínimos entre octubre y diciembre. El IL (índice de lípidos) presentó valores máximos en abril-2012 y febrero-2013, con un valor intermedio en agosto. Los resultados indican que las reservas de la GD presentan un patrón de movilización en relación inversa con la proliferación de los gametos de ambos sexos, vinculado directamente con la disponibilidad de nutrientes como la clorofila a y el seston orgánico.
AbstractHistochemical techniques today allow you to select areas of tissue and generate reliable information on the distribution of energy reserves in bivalve molluscs during their life cycle. The main objective of this study was to describe and relate the gametogenic cycle with the availability of energy reserves and the environmental parameters. For this, we sampled and examined the gonads and digestive glands (DG) of 15 individuals collected monthly during April 2012 and February 2013. We processed and analyzed the samples by standard histological and histochemical light microscopy techniques. Our results showed that for the gametogenic cycle, the monthly proportion of mature organisms was higher for males, between August (40 %) and November (53 %), while the females tend to have a shorter synchronized cycle and release of gametes in September (67 %) and October (60 %). The intense spawning periods in both sexes was the same (October to January). Between the periods April-August 2012 and January-February 2013, we observed the highest values of IGl and glucide index (instead, a decrease was observed in September, reaching minimum values during the period October-December). Besides, the maximum values of IL, lipid index, were observed in April-2012 and February-2013, with an intermediate value in August-2013. The results indicated that the reserves of the GD have a pattern of mobilization inversely related to the proliferation of gametes in both sexes; this was directly linked to the availability of nutrients such as chlorophyll a and the organic seston. Rev. Biol. Trop. 64 (2): 849-858. Epub 2016 June 01.