ABSTRACT
OBJECTIVE: To identify neglected aspects of primary health care activities and propose effective strategies for better health promotion in Pakistan. METHOD: An observation study was carried out from March-July, 1998 in a low-medium income group in Karachi West in a primary health care set-up. RESULTS: Seventy-three percent of female clients were influenced by the advice of male members of the family, 22% followed the directions of elderly female member, 5% availed health services on their own will. CONCLUSION: The Pakistani female community is influenced strongly by the male members of the family in almost all health related activities.
Subject(s)
Family , Health Promotion , Female , Humans , Male , PakistanABSTRACT
The commercial PCR test Amplicor was compared with the 32-kDa PCR for detection of Mycobacterium tuberculosis from 76 sputum specimens from Egyptian patients. Both tests performed with rather equal efficacy (resolved sensitivity of 88.9% for both tests; specificity of 98.0% for Amplicor and 93.9% for 32-kDa PCR). PCR was found to be useful in detection of auramine fluorescent stain-positive, culture-negative specimens.
Subject(s)
Mycobacterium tuberculosis/genetics , Mycobacterium tuberculosis/isolation & purification , Polymerase Chain Reaction/methods , Sputum/microbiology , DNA, Bacterial/genetics , DNA, Bacterial/isolation & purification , Egypt , Evaluation Studies as Topic , Humans , Polymerase Chain Reaction/statistics & numerical data , Sensitivity and Specificity , Tuberculosis, Pulmonary/diagnosis , Tuberculosis, Pulmonary/microbiologyABSTRACT
One hundred forty-eight urine specimens were collected from 47 renal transplant and dialysis patients and screened for the detection of cytomegalovirus (CMV). Diagnosis of CMV infection was suggested in 17 out of 47 patients (36.2%) by more than one of the five methods used. DNA hybridisation assay (DNA HA) using 32P-labelled probe detected CMV DNA in 15 (31.9%) of 47 patients, whereas virus isolation on conventional tube cell cultures (CTC), immunofluorescence incorporating monoclonal antibodies on centrifugation vial cultures (IF), complement fixation test (CFT), and electron microscopy (EM) yielded positive results in only nine (19.2%), 12 (25.2%), 11 (23.4%), and one (2.1%) of 47 patients, respectively. The significance of these results obtained by DNA HA lies not only in the apparent increase in number of patients diagnosed, but also in both early and rapid detection of CMV DNA. More importantly, the DNA HA is highly specific in that it correlates accurately with clinical and laboratory data characteristic of CMV disease. In respect of clinically manifest CMV disease, the specificity of DNA HA, CTC, IF, CFT, and EM was 87.5, 43.7, 56.3, 43.7, and 6.3%, respectively. These advantages of DNA HA make it the test of choice for early diagnosis of CMV infections in immunosuppressed patients.
Subject(s)
Cytomegalovirus Infections/diagnosis , DNA, Viral/analysis , Kidney Transplantation , Postoperative Complications/microbiology , Renal Dialysis/adverse effects , Complement Fixation Tests , Cytomegalovirus/genetics , Cytomegalovirus/isolation & purification , Cytomegalovirus/ultrastructure , Cytomegalovirus Infections/urine , DNA Probes , Female , Fluorescent Antibody Technique , Humans , Male , Microscopy, Electron , Nucleic Acid Hybridization , Retrospective Studies , Sensitivity and SpecificityABSTRACT
A 32P-labelled Hind III-0 DNA fragment (nine Kilobases; Kb) from human cytomegalovirus AD-169 (HCMV) was used in slot-blot hybridisation assay for the detection of HCMV in clinical samples. The results obtained with DNA hybridisation assay (DNA HA) were compared with virus isolation using conventional tube cell culture (CTC) and centrifugation vial culture (CVC), immunofluorescence (IF), and complement fixation test (CFT). Of 15 CTC-positive samples, 13 were positive with DNA HA (sensitivity 86.7%). Also, 14 additional samples were DNA HA-positive but CTC-negative. CVC and/or IF confirmed the diagnosis in nine of 14; the remaining five samples were from three patients who showed fourfold rising antibody titre by CFT. Although DNA HA using 32P-labelled probes is relatively cumbersome and expensive, it is a valuable test for quantitation of viral shedding in patients with HCMV infections who may benefit from antiviral therapy.
Subject(s)
Cytomegalovirus Infections/diagnosis , Cytomegalovirus/isolation & purification , DNA Probes , DNA, Viral/analysis , Nucleic Acid Hybridization , Cells, Cultured , Complement Fixation Tests , Fluorescent Antibody Technique , Humans , Phosphorus Radioisotopes , Sensitivity and SpecificityABSTRACT
A total of 157 clinical specimens was inoculated into shell vials and conventional tube cell cultures containing confluent monolayers of human embryonic lung fibroblasts (HELF). Of 31 clinical cytomegalovirus (CMV) isolates, 30 specimens (96.8%) were positive by the immunofluorescence method on centrifugation vial cultures (CVC-IF), whereas the cytopathic effects (CPE) of CMV were detected in only 14 specimens (45.2%) in conventional tube cell cultures (CCC), P less than 0.001 and in 22 specimens (70.9%) in centrifugation vial cultures (CVC-P), P less than 0.1. Significantly more fluorescent foci were detected in centrifugation cultures inoculated with sonicated urine samples (P less than 0.001). CVC-P is more sensitive than CCC for the diagnosis of CMV (P less than 0.05), and a highly significant difference was observed when we compared the mean day to initial detection of CPE (P less than 0.001). For optimal detection of CMV, both CVC-IF and CVC-P should be used for the laboratory diagnosis of this virus infection.
Subject(s)
Antibodies, Monoclonal , Antigens, Viral/analysis , Cytomegalovirus/immunology , Immediate-Early Proteins , Centrifugation , Evaluation Studies as Topic , Humans , SonicationABSTRACT
Conventional tube cell culture has been recognised as the most sensitive technique available for human cytomegalovirus (HCMV) detection. Low-speed centrifugation of specimen inocula onto cell culture monolayers has been shown to increase the efficiency of infection with the AD 169 strain of HCMV. Therefore a centrifugal force of 900g for 1 hour at 37 degrees C was used to enhance the detection of HCMV cytopathic effect (CPE) in shell vials that contained circular coverslips with a monolayer of human embryonic lung (HEL) fibroblasts. Of 195 specimens, HCMV CPE was detected in 18 specimens (9.02%) on shell vial culture assay, whereas conventional tube cell culture was positive in only 13 specimens (6.6%). The shell vial culture assay was significantly more sensitive (P less than 0.05). Furthermore the development of the cytopathic effect on shell vial culture assay was significantly earlier (P less than 0.01) and more extensive. Urine samples were sonicated and the results obtained with immunofluorescence using human immune serum demonstrated that sonication increased both the intensity of fluorescence and number of fluorescent foci of HCMV-infected cells and also decreased the non-specific fluorescence of the background.
