contralateral ear in acquired cholesteatoma [a clinico-radiological study]

Fifty patients with unilateral cholesteatoma and 25 control subjects with bilateral normal ears were subjected to otomicroscopical and audiological assessment. Axial and coronal sections for the mastoid bone at 1 mm slice thickness were done for all ears. A simplified method was used to find out the surface area [SA] of the air cells at each individual section and automatically calculate the total volume of the mastoid air cells. Otomicroscopically, 72% of the contra lateral ears showed signs of retraction pockets, granulation tissues or chronicity. Audiologically, 20% of the controlled ears showed moderate to severe conductive hearing loss, while 10% showed mixed hearing loss. As regards mastoid pneumatization, the mean air cell volumes were 6.1, 12.68 and 29.92 cc in cholesteatomatous, contralateral and control ears, respectively. This indicated a highly significant difference in the mean air cell volume between the control ears and the other two groups

Evaluation of different serological tests in mansonian schistosomiasis and correlation to hepatitis B virus infection

A total of 70 bilharzial mansonian patients [group I, 20 intestinal mansonian patients, group II, 20 hepatosplenic mansonian patients without ascites, group III, 30 hepatosplenic mansonian patients with ascites] and 30 normal controls were studied. Using the circumoval precipitin test [COPT], there was a statistically significant difference between sensitivities in group I and group III with higher sensitivity for group I. Using either the indirect hemagglutination test [IHA] or the indirect fluorescent antibody test [IFAT], there was no statistically significant difference between the sensitivities in the different bilharzial groups. No statistically significant difference was found between the three tests in groups I and II, respectively. A statistically significant difference was found between the sensitivities of COPT and IHA in group III, and between the sensitivities of COPT and IFAT in group III, also. No statistically significant difference was found between the sensitivities of IFAT and IHA in group III, neither between the percentages of positivity of hepatitis B surface antigen [HBsAg] in the different bilharzial groups, while each of the three groups showed highly statistically significant difference compared with the control group. No statistically significant difference was found between the positivities of HBsAg and the different titers of either IHA or IFAT in each group

Evaluation of direct and indirect methods in diagnosis of chronic intestinal schistosomiasis in Menoufia governorate

A comparative study of Kato thick smear method, modified Ritchie concentration technique [MRCT], rectal snip biopsy and indirect hemagglutination [IHA] test were done on 50 patients with chronic intestinal schistosomiasis from Monoufia Governorate, an area of Nile Delta endemic for schistosomiasis. Study revealed that a single Kato-preparation was not sufficient to determine correctly the prevalence of Schistosoma mansoni infection particularly in chronic cases [22%], the accuracy was maximized by examining stool samples obtained from the same patient by MRCT [46%]. Rectal snip biopsy and IHA test showed high positivity rate of 80% and 74%, respectively. It is recommended to combine stool examination by MRCT with either rectal snip or IHA test according to the condition of patient as the former can not be performed on routine basis

Specificity of orude and purified fasciola antigens in immunodiagnosis of human fascioliasis

A study has been done to find the effect of purification of crude antigens extracted from adult F. gigantica and F. hepatica on the cross reactions encountered in C.I.E.P., I.H.A. and E.L.I.S.A. serological techniques with sera o other parasitic and non-parasitic diseases. It was performed on 75 patients and 20 healthy controls. It was found that sera of many diseases may cross-react with crude Fasciola antigen in serological diagnosis. These diseases include schistosomiasis, hydatidosi, amoebic liver abscess, heterophyiasis, trichinosis, non parasitic liver diseases [liver neoplasms, pyogenic liver abscess, viral hepatitis and acute leukaemic] and rheumatoid arthritis. Partial purification of crude Fasciola antigens is a suitable method to avoid cross reactivity when using C.I.E .P. or to diminish them when using E.L.I.S.A. No need for this purification when using I.H.A. So using partially purified adult Fasciola antigens C.I.E.P. was the most specific test [100%] of followed by E.L.I.S.A. then I.H.A

Specific immunoglobulins in schistosomiasis

Specific and total immunoglobulins antibodies levels to Schistosoma antigens were determined in 44 patients with S. mansoni infection. No Significant increase was observed in parasitic specific IgG, IgM, and IgA levels in both acute and chronic infections. On the other hand, significant increased specific IgE antibodies was demonstrated in both acute and chronic infections of bilharziasis. The results revealed that increased immunoglobulins was not Specific to Schistosomiasis infection. Also, No correlation was observed between clinical course of the infection and immunoglobulins levels

Evaluation of some direct diagnostic methods in intestinal parasitic infections

Stool specimens of 100 cases attending the outpatient clinic of Cairo Medical Center Hospital suffering from gastro-intestinal disturbances were examined for intestinal parasites by direct smear, trichrome stained smear and formol ethyl acetate concentration methods. Although formol ethyl acetate concentration method gave the best results [45%], followed by trichrome stain [37%] then direct smear [32%] yet, for a reliable diagnosis a combination of several techniques is required

Estimation of acquired immunity to schistosoma mansoni infection in hamsters

Estimation of acquired immunity to homologous infection with S. mansoni was done in hamsters immunized and challenged by cercariae to investigate the effect of different degrees of maturation of the parasite on a challenge infection. It was found that elimination of the parasite in second infection in all cases occurred maximally before reaching the lung as shown from the high percentage of reduction in the lung schistosomula which did not increase too much in adult worm count. Immunity started minimally from the 3rd week, significantly from the 6th week and reached the maximum on the 8th, this which could explain the role of eggs in stimulating immunity which coincided with the onset of egg production. It was found that acquired immunity increased with increasing the dose of initial infection

comparative study between IFAT, COPT, CHR and IDT in the diagnosis of schistosomiasis mansoni

Human sera were collected from various localities in Egypt from 103 cases of parasitologically confirmed schistosomiasis mansoni and 20 volunteers free from parasitic diseases. The presence of antischistosomal antibodies were detected in vivo by intradermal test [IDT] and in vitro by IFAT, COPT and CHR. The results showed that the sensitivities of the 4 serological tests ranged from 71%-98% in acute cases and 83.5% -96% in chronic cases. It was observed that IFAT showed the best sensitivity in both acute and chronic cases in general with a percentage of positivity 96%

Sensitivity of crude and purified fasciola antigens in immunological diagnosis of human fascioliasis

A study has been done to find the effect of purification of crude antigens, extracted from adult Fasciola gigantica and Fasciola hepatica worms on the sensitivity of some serological techniques in diagnosis of fasciolosis. Using CIEP test, it was found that the partially purified antigens of both Fasciola species were less sensitive than their corresponding crude ones. Using IHA, it was revealed that the difference between results of crude and partially purified antigens for the two species were statistically insignificant. So, in applying this test, there is no need for the partially purification of antigen. By using ELISA, the partially purified antigens showed higher sensitivities for detection of fascioliasis than their corresponding crude ones. Partially purified F. gigantica and F. hepatica antigens gave nearly the same results whether using CIEP, IHA or ELISA. However, ELISA was the most sensitive technique followed by IHA, then CIEP

immunodiagnosis of schistosoma mansoni infection in the different clinico-parasitological stages

A total of 52 bilharzial mansoni patients were examined, 20 patients with early intestinal infection with living ova in stools, 20 patients with hepatosplenomegaly, but without ascites also with viable ova in stools, and 12 patients with hepatosplenomegaly and ascites without ova in stools, but in the rectal snip. Also, 20 normal persons were examined. An IDT test was performed by S. mansoni adult worm antigen. S. mansoni adult worm and egg antigen extracts were used for performing CIEP, IHAT and ELISA tests showed statistically the same high sensitivity. In cases with hepatosplenomegaly whatever the clinical [with or without ascites] or the parasitological status [passing or not passing ova in stools] of the patients, the ELISA test with egg antigen is found to be a highly sensitive and specific test

Immunodiagnositics of visceral toxocariasis

Twenty-five suspected cases of visceral toxocariasis and 25 apparently healthy controls, were tested in four serological tests; namely, precipitin absorption test [PAT], counter immunoelectrophoresis [CIEP], indirect fluorescent antibody test [IFAT], and enzyme linked immunosorbent assay [ELISA]. Adult Toxocara worm antigen was used in PAT and CIEP as saline extract and as frozen sections [FS] in IFAT, while the embryonated eggs [EE] were used as saline extract in ELISA and as a whole in IFAT. The percentages of positivity reported were 44% by PAT, 24% with CIEP, 52% with IFAT [EE], 48% with IFAT [FS], and 52% in the ELISA. In the apparently healthy control group, only one subject gave positive result with PAT and ELISA at titers of 1/16 and 1/64, respectively. The EE antigen proved to be more sensitive than adult worm antigen, where it was used in IFAT and ELISA and gave the highest percentage of positivity and the highest titer [1/256 and 1/4096, respectively]. It was noticed that the children below the age of 10 years, were statistically significant by all tests except CTEP

application of s mansoni adult and soluble egg antigens for the serodiagnosis of schistosomiasis by CIEP, IHA and Elisa

The sero-reactivity of 82 schistosomiasis infected patients were studied by the use of the CIEP, IHA and ELISA tests using S. mansoni adult worm antigen [AWA] and soluble egg antigen [SEA]. CIEP with AWA showed a progressive sensitivity decreased with advance of S. mansoni infection, and increased in sensitivity by SEA. The test was more sensitive in the early cases of S. haematobium infection by AWA, while by SEA it was more sensitive in the late cases. There was no difference in sensitivity of the test with either antigens in mixed bilharzial infection. IHAT with AWA showed high sensitivity in the different stages of S. mansoni infection, but sensitivity decreased with the progress of clinical status of S. mansoni in SEA was utilized. Also, IHAT with AWA was more sensitive for the diagnosis of mixed bilharzial infection than with SEA. ELISA test with SEA showed a progressive increase in sensitivity with the advance of S. mansoni. Also, the test with SEA was more sensitive than with AWA and for the diagnosis of cases of mixed bilharzial infection, while S. haematobium infected cases showed a lower sensitivity than S. mansoni or mixed bilharzial infection cases, if the ELISA test is performed with either antigens

Relationship between schistosomiasis and arthropathy

This study was carried out to suggest criteria for diagnosing arthritis associated with schistosomiasis. One hundred and eighty cases were classified into three clinical groups: Group I [120 patients with schistosomal arthritis], group II [20 patients with schistosomal non-arthritis], group III [20 arthritic non-schistosomal patients] and 20 controls [group IV]. Four tests were done to exclude other causes of arthritis; namely, erythrocyte sedimentation rate [ESR], Rose-Waaler test [RW] for rheumatoid factor [RF], antinuclear antibody test [ANA] and determination of serum uric acid [SUA] level. A history, clinical examination, urine and stool examination, intradermal test [IDT], indirect hemagglutination test [IHAT], circumoval precipitin test [COPT] and complete blood picture were performed for all groups. Twenty patients were selected randomly from group I and received praziquantel to be followed up 6 months later. Bilharzial ova were found in the excreta of groups I and II. The percentage of positive IDT, IHAT and COPT in groups I and II was 90.8%, 90%, 88.3% and 85%, respectively. Blood picture showed mild anemia and from low to moderate eosinophilia. ESR was moderately raised. RF positivity was 6.6%, 10%, 65% and 5% in the four groups, respectively. ANA positivity was 1.6%, 0%, 50% and 0%, respectively. There was a marked improvement of arthritic manifestations after praziquantel in 90% of cases

study on pyrexia of unknown origin associated with eosinophilia

Among forty cases presenting with pyrexia of unknown origin [P.U.O.] and eosinophilia, parasitic causes was encountered in 62.5% of them. There was a significant correlation between pyrexia due to parasitic infestation and eosinophilia [P > 0.05]. The study stimulates speculations that the degree of eosinophilia can be considered as a parameter for diagnosis of parasitic causes in cases of pyrexia of unknown origin