Role of the quantiferon-TB gold in tube in ruling out tuberculosis in end stage renal disease patients receiving hemodialysis

It is difficult to diagnose tuberculosis [TB] in dialysis patients because of the high rate of extrapulmonary TB in these patients compared with the general population. Recently, a new diagnostic test called QuantiFERON[QFT] has been developed and shown promise as a diagnostic tool for active TB diseases and latent TB infection. The aim of the present study was to analyze the performance of QuantiFERON-TB Gold in tube [QFT-G] in end stage renal disease patients receiving hemodialysis. QuantiFERON Gold in tube [QFT-GIT] were prospectively performed in 50 end stage renal disease [ESRD] cases undergoing hemodialysis [HD], including 6 patients with active TB and evaluated the utility of this test in dialysis patients. Among 50 dialysis patients, positive QFT results occurred in 10 [20%], negative QFT results occurred in 25 [50%] and indeterminate QFT results occurred in 15 [30%]. All six active TB patients had positive QFT results, and none of the 25 patients with negative results had active TB. Among 7 patients with a history of active TB, 2 [28.5%] had positive results. Although the indeterminate rate was relatively high, no patient with an indeterminate result had active TB. Among 30 cases after excluding the patients with previous TB and indeterminate results, the sensitivity of the QFT is 100% [6 of 6] and the specificity is 91.6% [22 of 24 cases]. Our data suggest that the QFT test is a useful supplementary tool for the diagnosis of active TB even in dialysis patients. Negative and indeterminate results on this test may be used to exclude the presence of active TB

Paraoxonase 1 activity and genotyping in systemic lupus erythematosus and their relationships with cardiovascular complications

Systemic lupus erythematosus [SLE] is characterized by an enhanced risk of atherosclerosis and cardiovascular diseases [CVD]. Human serum paraoxonase 1 [PON1], an antioxidant enzyme closely associated with high density lipoprotein [HDL], has been implicated in the prevention of low density lipoprotein [LDL] oxidation, and these may provide HDL-associated protection against atherosclerosis. Our objective was to evaluate PON1 activity and genotypes in SLE patients and their relationships to cardiovascular complications and some other risk factors of cardiovascular diseases in those patients. Thirty SLE patients, subdivided into patients with CVD and without CVD, and fifteen matched healthy control subjects were studied. Laboratory investigations included lipid profile, lupus anticoagulants [LA], anticardiolipin antibodies [aCL]. PON1 activity was determined by paraoxon substrate. PON1 genotyping was conducted by PCR amplification, followed by polymorphism-specific restriction enzyme digestion and gel electrophoresis. Our study revealed that PON1 activity was significantly decreased in SLE patients groups compared to controls and in SLE patients with CVD compared to those without CVD [p<0.001]. PON1 activity was significantly negatively correlated with total cholesterol, LDL-C and LDL-C/HDL-C ratio, positively correlated with HDL-C but not significantly correlated with triglycerides, disease activity, LA or a CL antibodies. As regard PON1 192 gene polymorphism, there was significant increase in B allele frequency in SLE patients with CVD compared to those without CVD and control groups, while no significant difference was found between SLE patients without CVD and control group. As regard PON1 55 gene polymorphism, there was no significant difference in genotype distribution or allele frequency between the three groups. The Odds ratio of development of CVD in SLE patients who carry PON1 192B allele was 6 [95% CI 1.2-30.7, p<0.05]. PON1 activity determined by paraoxon substrate was significantly higher in BB and LL, intermediates in AB and LM, and lower in AA and MM genotypes

Detection of helicobacter pylori infection and upper gastrointestinal disorders among Zagazig university hospitals waste collectors: a comparative cross- sectional study

Hospital work, involving direct patient contact and poor sanitary conditions, constitutes a major risk factor for acquisition of H. pylori infection. 1] determining the prevalence and occupational risk of, pylori infection among hospital waste collectors, 2] identifying some of its associated risk factors, 3] investigating the validity of some non-invasive tests for the diagnosis of H. pylori infection in comparison with the gold-standard invasive test, esophagogastroduodenoscopy with biopsy, 4] comparing the diagnostic performance of salivary H. pylori IgG with that of serum H. pylori IgG, and 5] determining the percentages of upper gastrointestinal [GIT] symptoms and the endoscopic findings among hospital waste collectors and assessing their relation to H. pylori infection. This comparative cross-sectional study was conducted on 78 hospital waste collectors and 78 security and administrative workers from Zagazig University Hospitals as a control group. All participants filled pre-constructed questionnaires and were subjected to H. pylori stool antigen and serum and salivary anti-H. pylori IgG tests; while only 110 workers underwent esophagogastroduodenoscopy with biopsy and rapid urease test. The results revealed absence of significant occupational risk of H. pylori infection acquisition among hospital waste collectors compared to the controls. Moreover, Male sex, smoking habit, low socioeconomic status, poor personal hygiene, and family history of upper GIT complaints were the risk factors significantly associated with active H. pylori infection. Fecal antigen test had the highest sensitivity, specificity, positive, and negative predictive values for the diagnosis of H, pylori infection compared to the other non-invasive tests. Moreover, there was a fair degree of agreement between salivary and serum H. pylori IgG tests regarding their diagnostic performance [0.34]. Also, absence of statistical significant differences between both studied groups regarding the percentages of upper gastrointestinal symptoms and different endoscopic findings was revealed. Finally, current H. pylori infection was found to be significantly associated with different types of gastritis; however, normal mucosa by endoscopy didn't exclude the presence of H, pylori infection. So, improving the overall standard of living in our country, environmental sanitation, introducing effective anti-infective sanitary regulations at work, mass screening through either stool antigen or serum IgG or salivary IgG tests to detect infected persons, and proper treatment of infected persons are mandatory

Prevalence of hepatitis C virus infection and evaluation of a health education program in El-Ghar village in Zagazig, Egypt

Hepatitis C virus [HCV] is an emerging global epidemic, some nations have been more drastically affected than others. Egypt reports the highest incidence in the world, with a prevalence rate of over 20% [global average 3%]. Despite the alarming prevalence of the disease in the country, awareness of the disease is still low. The objectives of this study were: 1-to estimate the prevalence of hepatitis C seropositivity among the study group. 2-to study some risk factors with hepatitis C, 3-to assess the effect of the health education on the knowledge and concepts about hepatitis C. This study is a combined cross sectional and an interventional educational community-based study. It was carried out at El-Ghar village in Zagazig district from November 2006 to January 2007. A multistage systematic sample included 304 households above 12 years of age, using a predesigned questionnaire for assessing some potential risk factors [medical and lifestyle behavior] and another questionnaire to assess the effect of health education on knowledge and attitude toward Hepatitis C problem. In addition, samples were collected to assess the seropositivity of HCV among the studied group. The results showed that the prevalence of seropositivity of HCV among the sample was 10.9%. The seropositivity of HCV was higher among males than females and increased sharply with age from 3.6% in those below 20 years old to 30.9% in older age [40 years or more]. Those who were illiterate and farmers had a significantly higher prevalence. According to the logistic regression model, the significant predictors of HCV infection were previous infection with schistsomiasis, those who have positive medical history, followed by those shaving at the community barber, above 40 years and male sex. A highly significant improvement in knowledge in all aspects of HCV infection and also the attitude toward HCV problem [p < 0.000] was revealed. Conclusion and recommendations: Hepatitis C is a health problem in rural areas in Zagazig district. Health education program successfully improved knowledge and attitude toward this problem. The following is recommended: 1- Introduction of health education programs about HCV infection into the established health services 2-Surviellance activities to monitor the disease trend

Nephrotoxic effects of celecoxib on adult male albino rats

Nonsteroidal anti-inflammatory drugs are widely used for a variety of indications, including acute pain, arthritic pain, and headache. The long-term use of these agents is often limited by unwanted adverse effects, such as gastritis and renal dysfunction. In an effort to decrease the adverse effects while retaining pain-relieving properties, the selective cyclo-oxygenase [COX]-2 inhibitors were developed. The aim of the present study was to evaluate the nephrotoxic hazards of celecoxib and also to evaluate the extent of recovery that occur after discontinuation of this drug during a follow up period .The study was conducted on 50 adult male albino rats weighing approximately [150-200 gm] and divided into 3 groups; group I [negative control group]: consisted of 15 rats, each rat was given no medications to evaluate the basic parameters; group II [positive control group [Gum acacia group]]: consisted of 15 rats, each rat was gavaged with 2 mL of Gum acacia suspension once daily for 6 weeks and group III [celecoxib group]: consisted of 20 rats, each rat was gavaged with 14,4 mg celecoxib/rat once daily for 6 weeks. Twenty four hours after the last dose of celecoxib, 15 rats from each control group and 10 rats from the celecoxib group were used. The kidneys of the rats of these groups were investigated histopathologically by light microscope and biochemically by measuring blood urea nitrogen and serum creatinine, sodium and potassium levels. The remaining rats of celecoxib group were left for another 6 weeks without drug, administration for follow up. At the end of this period the. rats were examined as mentioned above. The main findings of the present study were as follow: group 1 [negative control group], and group II [positive control group], showed no abnormal findings without a statistically significant difference between them so we used the results of the negative control group to compare it with those of celecoxib group. As regard biochemical changes, there was an increase in blood urea nitrogen and serum creatinine, sodium and potassium levels in the rats of celecoxib group with a statistically significant difference when compared with the negative control group [P<0.001]. Six weeks after discontinuation of celecoxib administration, the above mentioned biochemical changes improved and showed a statistically significant difference when compared with the results obtained 24 hours after the last dose of celecoxib, but the level of improvement didn't reach to the control level and gave a significant difference when compared with the negative control group. This means that, these parameters improved but didn't return to the level' of the control, which was supported by the histopathological results. As regard histopathological study of celecoxib group, microscopical examination of the kidneys showed severe affection of the kidneys in the form of renal papillary necrosis and acute and chronic tubulo-interstitial nephritis with interstitial oedema and inflammatory cell infiltrate. After 6 weeks of follow-up, histopathological examination of the kidney in the celecoxib group showed incomplete recovery. It could, be concluded that celecoxib is nephrotoxic and its toxic effects were partially reversible after its discontinuation

impact of LH level on day one of ovarian stimulation and duration of stimulation on the outcome of ICSI cycles using the long agonist protocol

To assess the effect of LH level on day 1 of ovarian stimulation in down regulated women on the outcome of ICSI cycles. Moreover, there was a study of a possible effect of altering the timing of HCG administration on pregnancy rates in these cycles. Prospective randomized controlled study. Private centre. 115 patients undergoing ICSI. In all patients, the long luteal down regulation protocol was used. After downregulation confirmation by ultrasound and estradiol < 50 pg/mI, LH was measured before starting controlled ovarian hyperstimulation [COH]. Then, according to timing of HCG administration, patients were randomely divided into two groups, group A: HCG administered when at least 3 follicles > or = 17 mm and group B HCG administered when at least 3 follicles > 19 mm. Regarding LH level on day 1 of COH, receiver-operating characteristic [ROC] analysis was used to estimate any possible cutoff value as a predictor of pregnancy. The ROC curve revealed a value of 2.5 IU/L, [with an area under curve ROCAUC 0.705, 95% CI: 0.607-0.803] above this value, there was significant decrease in clinical pregnancy rates. Furthermore, delay the timing of HCG administration, in group B did significantly decreased pregnancy rates [61.4% and 38.6% respectively in group A and B]. In long agonist protocol, LH value > 2.5 IU/L after down- regulation is a poor prognostic value. So, prolongation of down regulation could be considered. Moreover, earlier administration of HCG is associated with higher pregnancy rates