Cancerous Inhibitor of Protein Phosphatase 2A as aMolecular Marker for Aggressiveness and Survival in OralSquamous Cell Carcinoma

Cancerous inhibitor of protein phosphatase 2A (CIP2A) has been identified as one of the most commonly altered proteins in humancancers. It blocks the tumor-suppressive action of protein phosphatase 2A (PP2A) complex and enhances malignancy. Thirty-fivepatients with squamous cell carcinoma of the oral cavity underwent surgical resection of the tumor. CIP2A was assessed by quantitativereal-time PCR in the resected tumor tissues and in their adjacent normal tissues. CIP2A was found to be overexpressed inall oral squamous cell carcinoma (OSCC) specimens in comparison to their surrounding normal tissue. CIP2A overexpression wasstatistically correlated with poor prognostic feature of the tumor. Thus, a high expression level of CIP2A was associated with shortersurvival. In conclusion, CIP2A is upregulated in OSCC, and its overexpression is correlated with aggressiveness of the tumor andpoor outcome and survival. It may serve as a prognostic marker of OSCC.

Dientamoeba fragilis Infection in Patients with Digestive and Non-Digestive Symptoms: A Case-Control Study

In most developing countries, Dientamoeba fragilis infection is an obscure protozoan infection. We aimed to determine a frequency and clinical importance of D. fragilis infection in Taif, Saudi Arabia. A 1-year case control study included patients with gastrointestinal (cases, n=114) or non-gastrointestinal symptoms (controls, n=90). The fecal samples were examined with the classical parasitological methods for intestinal protozoa, and by real time PCR for D. fragilis. The infection by D. fragilis was detected in 5.8% by PCR and in 4.4% patients by microscopy. The infection was identified more in control group (n=9) than in cases (n=3); a sole infection in 11 patients and mixed with Giardia in 1 patient. The other enteric parasites detected were Blastocystis sp. (8.3%), Giardia sp. (5.3%), Cryptosporidium sp. (2.9%), Entamoeba histolytica (1.4%), Entamoeba coli (0.9%) and Hymenolepis nana (0.4%). Our results tend to reinforce the need to increase awareness of D. fragilis infection in Saudi Arabia.

Diagnosis, Treatment and Clinical Features of Cutaneous Leishmaniasis in Saudi Arabia

Cutaneous leishmaniasis (CL) has been one of the most common parasitic diseases in Saudi Arabia. This study exhibits the clinical features, diagnosis, cytokine profile and treatment of CL patients in Al-Taif province. Ninety CL suspects at a tertiary care general hospital were enrolled in one-year study. Patients were interviewed, clinically-examined, and subjected to laboratory tests: skin scraping smear microscopy, OligoC-TesT commercial PCR (Coris BioConcept) and kinetoplast DNA (kDNA) PCR for Leishmania diagnosis. Interferon-gamma (RayBio; Human IFN-γ) and nitric oxide (NO) levels in patients' sera were evaluated before treatment with sodium stibogluconate (pentostam) with 20-day intramuscular drug regimen. Positive rates of microscopy, commercial PCR and kDNA PCR were 74.4%, 95.5% and 100%, respectively. Patients came to hospital mostly in winter (45.0%). CL was frequently exhibited in Saudi patients (78.8%), male gender (70.7%), age < 20 years (50.0%), rural-dwellers (75.5%) and patients with travel history (86.6%). Lesion was mostly single ulcer (93.3%), occurred in the face (67.7%). Upon pentostam treatment, 85.1% of ulcers showed rapid healing signs. Levels of IFN-γ and NO were significantly higher in the healing than the non-healing cases (P < 0.001). The kDNA PCR proved more sensitive than microscopy and OligoC-TesT commercial PCR. Our results open perspectives for IFN-γ use as a biomarker predicting treatment response.

High Frequency of Enteric Protozoan, Viral, and Bacterial Potential Pathogens in Community-Acquired Acute Diarrheal Episodes: Evidence Based on Results of Luminex Gastrointestinal Pathogen Panel Assay

Infectious diarrhea is endemic in most developing countries. We aimed to investigate the protozoan, viral, and bacterial causes of acute diarrhea in Taif, Saudi Arabia. A cross-sectional prospective 1-year study was conducted on 163 diarrheal patients of various ages. Stool samples were collected, 1 per patient, and tested for 3 protozoa, 3 viruses, and 9 bacteria with the Luminex Gastrointestinal Pathogen Panel. Overall, 53.4% (87/163) of samples were positives (20.8% protozoa, 19.6% viruses, 2.8% bacteria, and 9.8% mixed). Rotavirus (19.6%), Giardia duodenalis (16.5%), and Cryptosporidium spp. (8.5%) were the mostly detected pathogens. Adenovirus 40/41 (4.2%), Salmonella (3%), Shiga toxin-producing Escherichia coli (3%), and Entamoeba histolytica (2.4%) were also detected. Norovirus GI/II, Vibrio cholerae, Yersinia enterocolitica, and Clostridium difficile toxin A/B were not detected in any patients. All pathogens were involved in coinfections except E. histolytica. Giardia (5.5%) and rotavirus (3%) were the most commonly detected in co-infections. Enterotoxigenic E. coli (2.4%), Campylobacter spp. (2.4%), E. coli 0157 (1.8%), and Shigella spp. (1.2%) were detected in patients only as co-infections. Infections were more in children 0–4 years, less in adults 40 years, with statistically significant differences in risk across age groups observed with rotavirus (P < 0.001), Giardia (P=0.006), and Cryptosporidium (P=0.036) infections. Lastly, infections were not significantly more in the spring. This report demonstrates the high burden of various enteropathogens in the setting. Further studies are needed to define the impact of these findings on the clinical course of the disease.

Evaluation of oligochromatography dipstick as a simplified molecular diagnostic tool for the diagnosis of cutaneous leishmaniasis

The demonstration of Leishmania parasite by microscopic examination of samples taken from skin lesions is of low sensitivity and requires expert parasitologists. On the other hand, molecular methods to detect Leishinania parasites are considered specific and sensitive. However, detection of amplicons by the classical methods is complex, expensive and needs equipments and highly trained personnel. This raises the demand for a simplified method of amplification and product detection. To evaluate the diagnostic accuracy of PCR Leishmania Oligo C-test for diagnosis of cutaneous leishmaniasis. The diagnostic accuracy of the Leishniania Oligo C-test was estimated in 30 skin scraping samples from patients presented at El Quorea specialized hospital, Taif, KSA. On the basis of parasitological detection of amastigotes by direct microscopic examination of Geimsa stained smears from skin lesions, patients were classified into confirmed cutaneous Ieishmaniasis [group A] and negative cases [group B]. Twenty patients were proved positive for Leishmania amastigotes by microscopic examination of stained smears. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic efficacy of the Leishmania Oligo C-test were 90%, 90%, 95%, 82%, 90%, respectively. These results indicate that this simple molecular technique may be employed for rapid diagnosis of cutaneous leishmaniasis. The Leishmania Oligo C-test showed high specificity and sensitivity when compared to results obtained by microscopic examination of skin scraping samples. The assay is a promising tool for simplified molecular detection of Leishmania parasites

Molecular identification of coproantigens of Cryptosporidium parvum compared to conventional staining techniques

To compare the immunologic techniques with the conventional staining methods [mainly modified Ziehl-Neelsen, MZN], 93 children [65 immunocompromised and 28 immunocompetent] potentially at risk of Cryptosporidium parvum were studied. Using MZN, a prevalence of 10.7% in diarrheic children was found. ELISA coproantigen and detection of 23 kDa band of immunoblotting by serum IgG were sensitive and specific. They gave 85.7% sensitivity, 100% specificity, 100% diagnostic accuracy, 100% positive predictive value and 98.9% negative predictive value. ELISA detection of serum IgG gave 85.7% sensitivity, 97.7% specificity, 96.8% diagnostic accuracy, 75% positive predictive value and 98.9% negative predictive value. So, it was concluded that 23 kDa band determined by ELISA is a valuable sensitive and specific mean of diagnosing cryptosporidiosis, as this antigen is a consistent target of the humoral immune response