Role of fast-ELISA and western blot in diagnosis of human fascioliasis using crude adult worm and excretory/secretory fasciola antigens

Human fascioliasis is becoming one of the public health problems in Egypt. Because of the similarity of fascioliasis manifestations and other hepatobiiary diseases, the clinical diagnosis of this disease is usually difficult. Diagnosis of human fascioliasis using different worm antigens [crude worm antigen [CW] and excretory/secretory antigen [EIS]] and different methods [Falcon assay screening test enzyme linked immunosorbent assay [FAST-ELISA] and immnoelectrotransfer blot [Western Blot]]. The second objective is to compare between FAST-ELISA and Western Blot using the same antigen, also to compare between the use of [CW] antigen and [E/S] antigen in each method aiming to evaluate the immunodiagnostic potential of both techniques and both antigens. The third objective is to detect the most specific and sensitive immunoreactive bands in both CW and E/S Fasciola antigens by western blot technique. One hundred and fifteen individuals [40 with chronic fascioliasis, 15 with suspected acute fascioliasis, 40 infected with other parasites and 20 apparently healthy] were included in this study. Sera, urine samples and repeated stool samples were collected from all cases. The stool samples were examined for presence of different parasites and Fasciola eggs were counted by Kato-Katz technique. Fasciola [CW] and [E/S] antigens were prepared. Sera were tested by [FAST-ELISA] and [Western Blot] techniques using [CW] and [E/S] antigens. FAST-ELISA using [E/S] gave better results than that using CW antigen, as the recorded sensitivities and specificities were 97.5% and 98.3% with E/S antigen and 92.5% and 86.7% with crude antigen respectively. By using each of CW antigen and E/S antigen, Western blot was more sensitive and specific than FAST-ELISA in diagnosis of human fascioliasis. After fractionation of both antigens by electrophoresis and immunoblotting, it was found that 27 KDa of Fasciola E/S antigen was the best fraction [100% sensitive and specific]. Immnoelectrotransfer blot [western blot] is more sensitive and specific than FAST-ELISA. In immnoelectrotransfer blot, 27 KDa of E/S antigen was the most specific, sensitive and accurate band that could detect Fasciola antibodies in all Fasciola infected patients

Congenital adrenal hyperplasia in the Palestinian

Between 1985-1999, congenital adrenal hyperplasia [CAH] was diagnosed in 37 children in Gaza Strip, 19 [58%] were diagnosed in the last 5 years, the estimated incidence is 1.02/1000. This figure may be higher as there are 20 children died with suggestive evidence of CAH. Classic CAH were diagnosed in 33 [89%] and 4 [11%] as 11 hydroxylase deficiency. Girls were 20 [61%] and boys 13 [39%]. Salt losers, were 19 [85%], 11 girls and 8 boys. Females were diagnosed earlier than males. Mean age of diagnosis for females is 40 weeks and for males 54 weeks. Salt losers were diagnosed earlier than non salt losers. Mean age of diagnosis for salt losers is 7.5 weeks while non-losers 98 weeks. Salt losers girls were diagnosed earlier than boys

Study of pulmonary function tests in insulin dependent diabetes mellitus

Thirty patients complaining from insulin dependent diabetes mellitus were selected for the present study. A set of ventilatory lung function parameters was measured in each patient [N=30] and control subjects [N=10] using an electronic spirometer. The studied group showed a highly significant [p<0.001] reduction in SVC, FEV1, FEV1 / FVC, FEF 25-75% and PEFR when compared with control group. The present study showed insignificant difference in the spirometric parameters when diabetic group with duration of diabetes more than 5 years compared with diabetic group with duration of diabetes 5 years or less. Also, insignificant difference were observed in patients with blood glucose level above 200 mg/dl and those with blood glucose below 200 mg/dl. From the present study we concluded that both restrictive and obstructive ventilatory defect were observed in insulin dependent diabetes mellitus. These ventilatory disorders had no relation to both the duration and glycemic control of diabetes We recommend the periodic evaluation of pulmonary function using spirometer in insulin dependent diabetic patients even though not symptomatized and to remember that the base line is not the same as for healthy subjects

Verification of the laryngeal mask position using the fiberoptic laryngoscope

Fifty patients were studied by fiberoptic laryngoscopy through the LMA and after its insertion. Respiratory obstruction was seen in 6 patients [12%]. Five patients with obstruction were due to down- folding of the epiglottis [one complete and four partial]. One patient with partial obstruction was due to forward displacement of the posterior cricoid area with in-folding of large aryepiglottic folds. Strangely enough, in the patient with complete obstruction, the epiglottis obstructed the fenestrated end of the LMA itself and not the laryngeal inlet. The vocal cords could be visualized in 90% of patients. The epiglottis was seen within the cuff in 62% of cases and still the device functioned satisfactorily. It is no longer recommended to remove and reinsert the LMA if the epiglottis lies within the cuff, provided that the respiratory parameters are within normal. The esophagus was seen within the cuff in 6% of cases, so the device does not protect against aspiration of gastric contents

Experience in a new percutaneous approach to the axillary vein for central venous catheterization

The new infraclavicular approach to the axillary vein was tried in 60 patients scheduled for central venous catheterization. It was successful in 55 patients. There was a low incidence of complications: Catheter malposition [6.7%], arterial puncture [5%], transient parasthesia [5%] and hematoma [1.6%]. Apart from difficulty in locating the vein in markedly obese patients, the results of this study confirmed the reliability, safety and effectiveness of this approach

Comparison of propofol [diprivan] and thiopentone for short gynecological procedures

Two hundred fit female patients undergoing minor gynaecological operations were divided into two groups. All patients received 0.6 mg atropine sulphate as a premedication. The first group received propofol 2.5 mg/kg while the second received thiopentone 4 mg/kg. Increments of both drugs were given when needed. Anaesthesia was maintained with N2 O/O2 via a face mask. Pulse, blood pressure and EGG were monitored. Induction time, side effect and recovery time ere observed. In group I, pain on injection, apnoea and drop of the blood pressure showed a higher incidence than in group II, while in the latter excitatory movements, cough, hiccup, laryngeal spasm, nausea and vomiting were completely absent. Recovery times were significantly shorter after propofol. This finding together with the quality of anaesthesia make propofol preferable and especially useful for day case surgery/

Measurement of respiratory system compliance during mechanical ventilation

In 26 acutely ill patients mechanically ventilated for management of respiratory failure, respiratory system compliance [static and dynamic] was determined. The difference of compliance between survived [16 patients] and died [10 patients] cases was statistically significant. In survived cases, there was statistically significant difference between compliance measured on starting mechanical ventilation and that measured just before weaning. Serial measurements of compliance every 2 hours were done in two cases with HRDS, and there was gradual improvement of complianced of survived cases coinciding with the rise of Pa O2. In conclusion, respiratory system compliance is a useful index for monitoring and follow up of mechanically ventilated patients. In HRDS, it can be used as an indicator for best PEEP