RESUMEN
The prevalence of patients with end stage renal disease [ESRD] who needs dialysis and/or transplantation has more than doubled in Egypt during the past two decades. The early recognition and the institution of proven therapeutic strategies are important and beneficial. To determine the prevalence of CKD in Qena district and to evaluate the risk factors associated with CKD. A sample of 450 candidates aged from 20 years and older from two villages from Qena district participated, they were interviewed using questionnaires. Physical examination, urinanlysis, blood samples and abdominal ultrasound were done. The prevalence of CKD in Qena district, was 30.2% and the frequency of CKD stages I,II,III and IV in this study were 10.9%, 7.6% ,8.9% ,2.9% respectively of total studied sample. The study showed that hypertension was the commonest risk factor [13.1%] followed by diabetes [10.2%], past history of stone [7.8%].The other risk factors were past history of bilharziasis [3.8%], chronic urinary tract infection [3.3%], chronic non steroidal anti inflammatory drugs use [1.8%], gout [1.6%], polycystic kidney disease [0.9%], systemic lupus[0.9%], past history of proteinuria [0.7%] and rheumatoid arthritis[0.7%]. CKD has a high prevalence in Qena district, and the commonest risk factors were HTN and DM
RESUMEN
Noninvasive diagnosis of pleural tuberculosis [TB] remains a challenge due to the paucibacillary nature of the disease. As Mycobacterium tuberculosis [MTB]-specific T cells are recruited into pleural space in TB effusion; their indirect detection may provide useful clinical information. Evaluation of pleural fluid interferon [INF]-gamma levels vs Quantiferon -TB Gold In tube assay [QFT- IT] in blood and its adapted variants, using pleural fluid or isolated pleural fluid cells in the diagnosis of pleural TB. Thirty-eight patients with pleural effusion of unknown etiology presented at Assiut University Hospital, Egypt, were recruited. Blood and pleural fluid were collected at presentation for INF-gamma assays. Ex vivo pleural fluid INF-gamma levels, QFT-IT in blood and its adapted variants were compared with final diagnosis as confirmed by other tools including blind and/or thoracoscopic pleural biopsy. The final clinical diagnosis was TB in 20 [53%], malignancy in 10 [26%], and effusion due to other causes in eight patients [21%]. Ex vivo pleural fluid INF-gamma levels accurately identified TB in all patients and were superior to the QFT-IT assays using blood or pleural fluid [70 and 78% sensitivity, with 60 and 83% specificity, respectively]. QFT-IT assay applied to isolated pleural fluid cells had 100% sensitivity and 72% specificity. The optimal cut-off obtained with ROC analysis was 0.73 for TB Gold assay in blood assay, 0.82 IU/ml for the cultured pleural fluid assay, and 0.94 for isolated pleural cells assay. The ex vivo pleural fluid INF-gamma level is an accurate marker for the diagnosis of pleural TB. QFT- IT assay in peripheral blood or its adapted versions of the assay using pleural fluid and/or washed pleural fluid cells had no diagnostic advantage over pleural fluid INF-gamma in the diagnosis of pleural TB