comparative study on some immunodiagnostic techniques currently used for the diagnosis of lymphatic filariasis in Egypt

Since 2002, the Egyptian Ministry of Health and Population in collaboration with the WHO implemented a lymphatic filariasis elimination campaign in Egypt. Yet, surveillance and follow-up measures detected asymptomatic microfilaraemic cases among the at risk population. The present work aimed to evaluate and compare tile diagnostic value of filarial immunoassays currently used in clinical as well as research institutions in Egypt regarding their sensitivity, specificity and reliability. Accordingly, Dirofilaria immitis adult crude antigen was evaluated as a capture molecule for anti-human filarial antibodies in serum of patients with occult as well as overt infections. A comparative study was done on a total of 82 subjects. Serum samples from all subjects were tested for the presence of anti-fliarial antibodies, utilizing reagents currently used for the diagnosis of lymphatic filariasis in Egypt. Tile commercially available Dirofilaria immitis adult crude antigen was used to detect serum IgG by indirect ELISA, lgG4 ELISA, Dot-ELISA and dipstick ELISA techniques. Among 18 microfilaraemic cases, indirect ELISA, IgG4 ELISA, Dot-ELISA and dipstick ELISA techniques were positive in 61.1%, 100%. 77.8% and 77, respectively. Corresponding figures among 20 symptomatic amicrofilaraemic cases were 95%, 0%. 85% and 80% with 75%, 95.5%, 88.6% and 88.6% specificity, respectively. Although IgG4 ELISA was more sensitive and specific in detection of microfilaraemic asymptomatic group than other ELISA techniques, Dot ELISA was found to be relatively more sensitive than other techniques among all groups of patients examined. The use of Dirofilaria immitis adult worm crude antigen in ELISA tests revealed an acceptable degree of sensitivity and specificity, in addition to its commercial availability. It is a reliable reagent with high immunodiagnostic potential

Evaluation of fibrosis sero-markers versus liver biopsy in Egyptian patients with hepatitis C and/or NASH and/or schistosomiasis

Although liver biopsy is acknowledged as the gold standard for evaluating fibrosis, it is occasionally prone to sampling error and complications. Is to correlate an index of biochemical markers with histological features of fibrosis in patients with chronic hepatitis C virus [HCV] and/or non alcoholic steatohepatitis [NASH] with or without schistosomiasis in order to reduce the use of liver biopsy. Fifty-six patients [n-56] attending tropical medicine clinics in Kasr El-Aini and Beni Suef Faculty of Medicine were enrolled and classified into 3 groups according to the histopathological findings of their liver biopsy. Stool and urine analysis were done to exclude passage of Schistosoma ova, in addition to liver biopsy, abdominal ultrasonography, and testing of their sera for fibrosis biomarkers [Apolipoprotein Al, Haptoglobin, Alpha-2-Macroglobulin, and Ganima-glutamyl transpeptidase [GGT]]. Patients with history of contact with canal water [35 patients] were screened for Schistosoma mansoni infection by detecting anti-Schistosoma IgG antibodies and circulating Schistosoma soluble egg antigen using indirect ELISA and sandwich ELISA techniques, respectively. Forty-three [43%] of group I [HCV] and 40% of group II [HCV and NASH] had advanced fibrosis [F3 and F4]. Out of the 35 patients with positive history of canal water contact 25 [71.4%] were antibody positive; Schistosoma antigen was detected in only 5 patients [14.3%], with no statistically significant differences in the level of fibrosis seromarkers from other patients. Alpha-2-macroglobulin was found to be a reliable predictor of fibrosis. Haptoglobin was negatively related to the degree of hepatic fibrosis in groups I and II and significantly directly correlated in group III [NASH]. By regression analysis, haptoglobin can be a good predictor for fibrosis in group Ill. Apolipoprotein Al had insignificant negative correlation to the stage of fibrosis in groups I and II. GGT was positively correlated to the degree of hepatic fibrosis in groups I, II and III. AST/platelet ratio index [APRI] proved significantly directly correlated with fibrosis stage and grade of inflammation of the studied patients. Co-infection with schistosomiasis in patients with HCV and/or NASH gave no statistically significant differenceinfibrosis staging in all groups.Alpha-2-macroglobulin, haptoglobin and apolipoprotein Al, besides APRI index and modified APRI index proved to be significant predictors of hepatic fibrosis

Serological detection of Toxoplasma gondii in chronic renal failure patients and renal transplant recipients

Toxoplasma gondii antibodies were detected in 78 patients with renal disease by ELISA. Patients were classified according to the renal status; chronic renal failure patients not on haemodialysis [G1=19], chronic renal failure patients on regular haemodialysis [G2=30], renal transplant recipient [G3=29] and 13 normal controls. Anti-Toxoplasma IgG and IgM antibodies were 36.8% and 10.5% in renal failure patients not on haemodialysis, 56.7% and 16.7% in patients on regular haemodialysis and 69% and 24.1% in renal transplant recipients versus 23.1% and 0% in controls with statistical significant difference for Toxoplasma IgG antibodies only. Anti-Toxoplasma IgG antibodies levels of G3 were lower than that of Gl. It was observed that the more the exposure to dialysis, the more the risk of toxoplasmosis. It was found that 85.71% of renal transplant recipient seropositive cases for anti-Toxoplasma IgM antibodies were detected in one year post-transplantation and 14.28% of cases after the first year of transplantation

Risk factors predisposing to toxoplasmosis in chronic renal failure patients and renal transplant recipients

This work evaluated risk factors predisposing to toxoplasmosis in chronic renal failure patients and renal transplant recipients. The present study included 91 cases classified according to their renal status into four groups; control group, renal failure patients not on haemodialysis, renal failure patients on regular haemodialysis and renal transplant recipients group. The age groups [<20] and [30-] had the highest positivity for anti-Toxoplasrna IgG and IgM antibodies in comparison to the other age groups. The results showed no sex difference in positivity rate for anti-Toxoplasma IgG and IgM in groups. There was no significant difference between groups regarding risk factors for contracting toxoplasmosis, clinical presentation suggestive of toxoplasmosis and diabetes mellitus. There was significant difference between all groups as regarding intake of immunosuppressiye drugs and blood transfusion

effects of royal jelly on wound healing in healthy diabetic subjects

Wound healing was evaluated in diabetic and non diabetic patients before and after the application of royal jelly by clinical, histopathological and histochemical methods. For this purpose 10 diabetics with diabetic ulcers and 10 non diabetics with ulcers [traumatic and varicose ulcers] were collected from the out patient clinic, Monira General Hospital. Every patient was evaluated clinically and by some laboratory tests as fasting blood sugar, post prandial blood sugar, serum creatinine, and plasma protein electrophoresis. Skin biopsy from the edge of every ulcer was taken before and after the application of royal jelly for 7 consecutive days stained with routine Hx and E. for histopathological examination and stained histochemically for fibroblastic and vascular activity of alkaline phosphatase. It was found that after royal jelly application the non diabetic ulcers showed marked clinical improvement evidenced by regression, diminution in size, disappearance of pus from the infected ulcers, the decrease in depth, and the appearance of healthy red granulation tissue. While the diabetic ulcers showed some clinical improvement [39.9%] but less marked than that observed in non diabetics [68.9%].Histopathological evidence of healing after royal jelly application was noted in diabetics, the vascularity was markedly decreased, and so the inflammatory infiltrate. Fibroblasts were increased in number, with decreased formation of collagen. In non diabetics the histopathological evidence of healing of the ulcers was more marked, and the appearance of increased number of fibroblasts was associated with the formation of collagen and fibrous tissue. Alkaline phosphatase activity in diabetics showed no change after royal jelly application, while in non diabetics the alkaline phosphatase activity of fibroblasts and blood vessels was increased. In this study the local application of royal jelly appears to enhance the process of wound healing

Serum magnesium zinc and copper in acute myocardial infarction

Serum levels of magnesium, zinc and copper were measured in 20 patients with AMI [Acute myocardial infarction]. This group was subdivided into: 10 patients with uncomplicated AMI. 10 patients with AMI complicated with arrythmia, and compared with 10 patients with myocardial ischemia, and 10 healthy controls. Serum levels of magnesium and zinc were found to be statistically decreased in patients with AMI as compared with ischemic and healthy controls. While serum level of copper showed a significant elevation in AMI patients as compared with ischemic, and healthy controls. Also the mean serum magnesium and zinc levels were lower in patients of AMI complicated with arrythmia compared with uncomplicated patients, but this lowering is statistically insignificant. While the mean serum copper level was higher in cases of AMI complicated with arrythmia compared with uncomplicated cases but this elevation is statistically insignificant. From these results we can conclude that measurement of serum level of magnesium, zinc and copper in cases of AMI has a diagnostic as well as prognostic significance