Helicobacter pylori stool antigen test: evaluation of diagnostic accuracy in Egyptian patients with dyspepsia

Thirty-six H. pylori infected patients [proved by positive Grams stained film, rapid urease test, culture and histopathology] as well as ten non-infected patients selected among 120 Egyptian patients presenting with dyspepsia were included in the present study. There was no statistically significant difference between H. pylori positive and negative patients concerning their presenting symptoms. The endoscopic examination revealed that gastritis was more prevalent in H. pylori infected patients. A significant relation was found between the complaint of regurgitation and the endoscopic finding of hiatus hernia as well as between the complaints of heart burn and epigastric pain on one hand and the endoscopic detection of gastritis on the other hand. The histopathological examination of gastric biopsies revealed that gastritis in its moderate degree was more prevalent in H. pylori infected patients than in the controls. Stool specimens collected from 36 H. pylori positive patients and 10 ten non-infected controls were examined by an enzyme immunoassay for the detection of H. pylori antigens [Premier Platinum HpSA]. The HpSA test was positive in 35 out of the 36 H. pylori infected patients and in 2 out of the 10 non-infected cases. The sensitivity and specificity of the test were 97.2% and 80%, respectively. The overall accuracy rate was 93.5%. The positive and negative predictive values for HpSA test were 94.6% and 89%, respectively

Cellular immune response in acute hepatitis B leading to chronic carrier state

Immunological studies among jaundiced patients revealed significant changes in T-helper and T-suppressor cells among chronic HBV cases from the acute and control groups. The chronic cases revealed a highly significant decrease in interleukin-2R expression but their low interferon-gamma values were statistically nonsignificant from the control group. The acute cases recorded the highest interleukin-2R and interferon-gamma values. Lymphocyte blastogenesis assay in response to different mitogens and antigens produced two groups: responders [acute cases] and nonresponders [chronic cases]. The responders revealed more intact specific and nonspecific cellular immune responses. Neither group differed with regard to their proliferative response to HBsAg, but vigorous response to HBcAg was a significant feature of the responders

Clostridium difficile isolation trials and prevalence rate in post antibiotic and non-antibiotic related diarrhoea

100 fecal specimens collected from 50 normal adults as control and 25 of each post antibiotic and antibiotic unrelated diarrhea were processed for isolation of C. difficile and deduction of its prevalence rate. Different isolation trials were resorted to as direct plating, ethanolic shock treatment and Robertson's cooked meat enrichment. Egg yolk supplemented cycloserine cefoxitin fructose agar and columbia blood agar were used for direct and indirect inoculation. They were incubated anaerobically and for different periods. C. difficile prevalence rate was 2% in the control group, 16% in post antibiotic diarrhea and 8% in miscellaneous diarrhea patients. All isolated strains of C. difficile grew from ethanolic shock treated stools and exclusively into egg yolk CCFA medium. Out of positive ethanolic shock treated stools 57.1% needed 5 days of anaerobic incubation onto egg yolk CCFA medium to grow the organism compared to 42.8% only which needed 48 hours. Moreover, 71.4% of C. difficile grew after enrichment into cooked meat medium for 48 hours prior to plating onto selective medium whereas 28.5% only could be isolated by direct plating of ethanolic shock treated stools onto the same medium

Prevalence of endocervical genital mycoplasmas and chlamydia trachomatis in infertile, abortive and pregnant women in Alexandria

Several isolation studies have been carried out in several parts of the world, but none in our country, to determine the incidence of genital mycoplasma colonization in different sites and in various defined groups in attempts to study the role of these organisms in reproductive failure with more precision. Similarly, this study was designed to subject 300 endocervical specimens obtained from Egyptian females in the fertile age [100 represented the infertile group, 100 the abortive group and 100 pregnant women, the control group] to culture procedures for isolation of genital mycoplasmas and Chlamydia trachomatis. Preliminary studies were performed by growing st and ard strains of genital mycoplasmas on several system media before the selection of the most appropriate ones, i.e. Difco PPLO broth and agar supplemented with gamma globulin free horse serum for isolation of Chlamydia trachomatis were inoculated into cycloheximide treated McCoy cell line and were further propagated. The results of this isolation study revealed that the differences in the frequency of isolation of both genital mycoplasmas between each of the test groups [30% for the infertile group and 35% for the abortive] and the control group [12%] were statistically significant while the differences in frequency of isolation of Chlamydia trachomatis between the same groups [7% and 5%, respectively] and the control group [3%] were not. This study also revealed a higher frequency of isolation of U urealyticum than M hominis from all groups examined. Out of the 15 cases positive for Chlamydia trachomatis 9 were also positive for genital mycoplasmas [60%]. This was a relatively high rate of association not commonly encountered in Gynecology and Obstetric Departments but probably expected in VD clinics

study of the association of schistosomal bladder cancer and HLA typing

Schistosomal bladder being the commonest solid malignant tumour in Egypt and being different from the transitional cell carcinoma of the bladder stimulated the present study to establish any association which may be present between it and HLA types. HLA typing was performed in 40 patients using the two stage lymphocytotoxicity method. Antisera supplied were used to define any of the 23 antigens at the HLA, A and B loci. Two control groups were included in our study the first was normal free controls and the second control group was schistosomal patients without any evidences of bladder cancer. The results of the present study showed absence of any association between schistosomal bladder cancer and any of the different 23 HLA antigens used

Immunological study on cigarette smokers Part I effect of smoking on the serum immunoglobulin levels

Twenty asymptomatic apparently healthy adult male smokers, 20 to 60 of age, ranging from mild to heavy smokers were compared with 10 apparently healthy non-smokers of the same sex and age range as regards serum immunoglobulin levels. The results obtained revealed a significant increase, in serum IgE level in smokers compared to non-smokers irrespective of the extent of smoking. Serum IgG and IgM levels declined with smoking and this decline was statistically significant in heavy smokers for IgG and in moderate and heavy smokers as well as in smokers in general for IgM. Serum IgA ana IgD levels showed no significant changes

Mycological and immunological studies of tinea capitis in Alexandria

This work represents mycological and immunological studies of Tinea capitis in Alexandria. T. violaceum was isolated from 57% of cases, T. Schoenleinii from 15%, M. canis from 15%, M. audouini from 7%, T. mentagrophytes from 2%, M gypseum from 2%, T. tonsurans from 2% and T. rubrum from 1%. Only 15% of the cases gave a positive trichophytin test reaction. An increase in IgG and IgM but not in IgA was detected in all patients studied and the results were discussed

Asymptomatic bacteriuria in pregnancy

Mid-stream urine specimens of 150 pregnant women, in different trimesters of pregnancy and without manifestations or previous history of urinary tract infection, were subjected to microscopic examination, culture, bacterial colony count and antibiotic sensitivity tests. A positive urinary culture was found in 17 percent of cases and a bacterial colony count more than 10[5]/ml was revealed in four percent of the investigated specimens. Six strains of bacteria, namely, Esch. Coli, Klebsiella, Staph. aureus, Staph. albus, Streptococcus Viridans and Streptococcus faecalis were isolated from the infected urine specimens. The asymptomatic bacteriuria was found to be more common during the third trimester of pregnancy and in those cases with four pregnancies or more. The antibiotic sensitivity pattern was determined and the results were discussed