Fast plaque assay technique for detection of mycobacterium tuberculosis in sputum samples of newly diagnosed cases of pulmonary tuberculosis

Tuberculosis [TB] is a serious public health problem that especially prevalent in developing countries. An essential element in the control of TB is the rapid, sensitive and specific identification of the causative agent. Mycobacteriophages constitute a potentially useful approach for detecting viable Mycobacterium tuberculosis bacilli as well as for susceptibility studies. The aim of this study is to evaluate the diagnostic value of the Phage Tek MB kit for pulmonary tuberculosis in comparison with standard Lowenstein-Jensen [LJ] media and staining techniques for respiratory specimens. Sputum specimens submitted for diagnosis of mycobacterial disease at Ain Shams University hospital from August to November 2004 were included in the study. Specimens were studied using both of the conventional methods [direct microscopic examination and culture in LJ medium] and the Phage Tek MB assay. The sensitivity, specificity, positive and negative predictive value for the FAST Plaque TB assay relative to that of culture were 65.52, 100, 100 and 52.38%, respectively. The sensitivity was much higher in smear positive samples in comparison to smear negative ones [73.91% and 33.33%, respectively]. FAST Plaque TB proved to be specific, and rapid. It is able to detect M. tuberculosis in clinical samples within 1 day with 100% specificity, long before culture results]. Also it is cheap technology in comparison to PCR and would be suitable for use by routine microbiology laboratories, especially in developing countries

Thrombin-activatable fibrinolysis inhibitor and prothrombin fragment 1+2 in type II diabetics: possible relation to albuminuria and macrovascular complications

Forty type II diabetic patients [diabetic group] and 40 healthy age- and sex-matched persons [control group] were enrolled. The study involved assessment of body mass index [MBI], glycemic state [fasting and postprandial blood glucose, glycated hemoglobin [HbAlc]], low- density lipoprotein cholesterol [LDL], albuminuria by urinary albumin excretion rate [UAE], plasma PF 1+2 and TAFI, also, reverse transcriptase-polymerase chain reaction [RT-PCR] for TAFI mRNA in adipocytes and cell cultures. Plasma PF 1+2 and TAFI showed significant positive correlations with CVD risk factors including BMI, LDL and albuminuria. Also, they showed significant positive correlation with history of arterial and venous [only for TAFI] CVD. Mean values for these markers were statistically higher in the diabetic group compared to the control group. Furthermore, their values were statistically higher in patients with history of CVD compared to those without prior history. In conclusion, plasma PF 1+2 and TAFI reflected a prothrombotic and hypofibrinolysis state that may explain the increased CVD among diabetics. TAFI gene expression in adipocytes would explain the increased risk of CVD among obese diabetics

D-dimer, thrombin-antithrombin complexes and compression ultrasound in diagnosis of DVT during pregnancy

The objective of this study was to determine whether the fibrinolysis marker [D-dimer] as well as the coagulation activation maker [thrombin-antithrombin [TAT] complexes] would be of an additional help in the diagnosis of deep vein thrombosis [DVT] in pregnant women. Eighty pregnant women were chosen and divided into two groups: First, study group which comprises 40 pregnant women with DVT in the current pregnancy and second, control group which included 40 healthy pregnant women. The mean values of D-dimer and TAT were significantly higher in the study group compared to the control group. At a cutoff line 500 ng/ml, D-dimer sensitivity and specificity were 87.5% and 90.0%, respectively. At a cutoff line 2.2 ug/l, TAT sensitivity and specificity were 87.5% and 82.8%, respectively. Neither gestational age or parity nor type of DVT showed an effect on mean results of these markers. In conclusion, D-dimer and TAT have reasonable sensitivity and specificity in the diagnosis of DVT among pregnant women. These sensitivity and specificity are not affected by type of DVT, gestational age or parity

Evaluation of thyroid nodule diagnosed during pregnancy

This study was undertaken to evaluate the course and manage thyroid nodules and also to estimate the changes in thyroid functional status levels among pregnant women. Thirty-two pregnant women with thyroid nodules were examined by ultrasound [US] and biopsed by fine needle aspiration [FNA] for cytopathological and immunohistochemical [IHC] phenotyping using antibodies for thyroglobulin [Tg] and calcitonin. Serum samples were obtained and thyroid stimulating hormone [TSH], free T4, T3, Tg, calcitonin and human chorionic gonadotropin [beta- hCG] were assessed. US showed that 19 [59.4%] of the 32 patients had multiple colloid nodular goitre with a dominant clinically palpable nodule, while 13 [40.6%] of patients had true solitary thyroid nodules. The true solitary thyroid nodules were as follows; two well-differentiated papillary carcinoma, one Hashimoto's disease and 10 as benign colloid follicular adenomas. Patients with thyroid nodules had lower serum TSH and higher Tg levels at 1st trimester. Appearance of new thyroid nodules were detected in 4 [12.5%] women as pregnancy advanced. Compared with control group subjects with thyroid nodules had higher urinary iodine excretion. No difference could be detected in TSH and Tg levels throughout pregnancy between women with preexisting or newly formed nodules. Beta-hCG showed a positive relationship with fT3, fT4, and inversely related Tg and TSH