Mould infection, immunological tests and ventilatory lung function among cotton dust exposed workers

A cross-sectional study was carried out in the Shartex spinning and weaving company at Sharkia Governorate to determine the respiratory effect of cotton exposure. Seventy three cotton-exposed workers and 50 healthy workers [control group] were studied. Respiratory symptoms, ventilatory function tests, mycological examination of sputum and immunological examination for fungal reaction against different moulds and cotton extracts were assessed. Respiratory symptoms were frequently reported by exposed workers compared with controls. Among exposed workers, 11 [15.1%] had symptoms of byssinosis and 26 [35.6%] chronic bronchitis. This work has documented reduced lung function associated with work place exposure to cotton dust. Those workers with respiratory symptoms had significantly impaired lung function compared with asymptomatic workers Mould were significantly isolated from exposed workers than control group [P<0.001]. Different mould were isolated as Asp. niger, Cladosporium, Alternaria and others but only Asp. niger was the most significant isolate [P<0.01]. Also, exposed workers were more liable to develop immediate skin hypersensitivity reaction to specific cotton extracts [15.1%] and fungal antibodies [10.9%]. However, none of the control subjects gave either skin positive test to cotton extract or positive precipitin reaction. On regression analysis: both smoking and current exposure to cotton dust were the most significant risk factors of byssinosis, chronic bronchitis and impairment of both FEV1 and FVC.Also, duration of cotton exposure and increasing age were significant indicators for loss of FEV1 and FVC respectively.While, current cotton exposure was the only risk factor associated with frequent isolation of mould.In conclusion, workers exposed to cotton dust had increased respiratory symptoms and significant reduction in ventilatory capacity, also they develop immediate skin hypersensitivity reaction to cotton extract, fungal antibodies with more positive sputum culture for fungi than non exposed controls.So, it is recommended that lung function tests should be performed and can be used for routine medical surveillance. Also, anti-smoking programme must be applied

Evaluation of laboratory techniques in diagnosis of ocular chlamydia trachomatis

Trachoma, an infectious keratoconjunctivitis caused by Chlamydia trachomatis, is a leading cause of preventable blindness in developing countries like Egypt. Eighty patients diagnosed clinically as ocular trachoma were subjected to our study, they included 32, 28 and 20 patients as mild, moderate and severe stages according to WHO classification scheme. Also, twenty healthy subjects were investigated as control group. Conjunctival swabs were taken for preparation of smears stained by Giemsa and Direct Immunoflourescence [DIF] for microscopic detection of trachoma inclusion bodies. Tears were obtained for detection of specific IgA using an enzyme linked immunosorbent assay [ELISA], serum was investigated for detection of specific IgA, IgG and circulating immune complex [CIC] using ELISA and C[3] complement component using radial immunodiffusion plates [RID.] Microscopical examination of conjunctival smears for Chlamydia trachomatis inclusion bodies revealed that [DIF] stain was statistically highly significant than Giemsa stain [p < 0.001]. DIF stain proved good sensitivity and specificity, 60.3% and 97.3% respectively, than Giemsa stain for detection of trachoma inclusion bodies. Specific IgA for Chlamydia trachomatis in serum and fears were detected and showed highly significant correlation [p < 0.001] when compared with the control group. Also, detection of both local and serum specific IgA were higher in mild and moderate stages than in severe one. While no significant correlation [p > 0.05] between local and serum IgA in all stages and the control group. Serum specific IgG was statistically significant [p < 0.01] in patients than the control group. In spite of detection of CIC and C[3] in different stages of C. trachomatis, no significant correlation between the patients and the control group [p > 0.05] was detected. This indicates that CIC and C[3] determination in serum do not appear to play a role in diagnosis of ocular trachoma. Sex distribution showed no significant correlation [p > 0.05] neither in patients nor the control group. In conclusion, DIF was of value in detection of Chlamydia trachomatis in conjunctival smear, it is rapid and easy to perform where reasonable facilities for culture diagnosis are not available. Furthermore, detection of specific local and serum IgA antibodies to C. trachomatis was relevant in diagnosis using ELISA, especially when dealing with a large sample size as in endemic areas