The sensitivity and specificity of COVID-19 rapid anti-gene test in comparison to RT-PCR test as a gold standard test.

BACKGROUND: Coronavirus disease 2019 (COVID-19) is a modern infectious disease, first identified in December 2019 in Wuhan, China. The etiology is via severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), in a pandemic manner. The study aimed to compare between RT-PCR and rapid anti-gene tests for COVID-19 with regard to sensitivity and specificity. METHODS: This is a cohort hospital-based study done during the period of July to September 2020. Both rapid anti-gene test kit (SARS-CoV-2) and RT-qPCR were used for the detection of COVID-19 in suspected cases. RESULTS: A total of 148 cases were tested using both the RT-qPCR and rapid test. Twenty-nine (19.6%) of these cases had positive results for RT-qPCR and 119 (80.4%) were negative, whereas 52 (35.1%) patients were positive to rapid anti-gene test and 96 (64.9%) of them negative. The sensitivity of the rapid test was 37.9%, the specificity was 65.5% and the accuracy was 64.44%. Rapid IgG test was positive in 47 (31.8) of cases. Although, rapid IgM test was positive in 18 (12.2%). The rapid IgG test was more sensitive than rapid IgM (Sensitivity 34.48% vs. 3.45%), but it was less specific than rapid IgM test (Specificity 68.91% vs. 85.71%). CONCLUSION: We cannot consider rapid anti-gene test alone as a diagnostic method for COVID-19. We should also conduct RT-PCR test and other investigations like imaging CT scan of chest to confirm the diagnosis. The rapid IgG test is more sensitive than rapid IgM, but it was less specific.

ACE gene polymorphism and its association with serum erythropoietin and hemoglobin in Iraqi hemodialysis patients.

PURPOSE: To evaluate the frequencies of angiotensin-converting enzyme gene polymorphism in Iraqi hemodialysis patients and to examine the association between this polymorphism and serum erythropoietin and hemoglobin levels. . METHODS: In this study, 70 chronic renal failure Iraqi patients on maintenance hemodialysis (patient group) and 20 healthy subjects (control group) were genotyped for angiotensin-converting enzyme gene polymorphism. The distribution of genotype and allele frequencies of this polymorphism in these subjects were also evaluated. . RESULTS: The distribution of angiotensin-converting enzyme genotypes between groups was similar, and the ID genotype was the most frequent, followed by DD and II genotypes ( 50% , 37% , and 13%). The control group had a nonsignificant difference in serum erythropoietin levels among different angiotensin-converting enzyme genotypes, while patients with ID and DD genotypes displayed significant elevation in serum erythropoietin with time. No significant differences in hemoglobin levels were observed in patient and control groups. A significant positive correlation was observed between serum erythropoietin and hemoglobin in the control group with different angiotensin-converting enzyme genotypes, while a nonsignificant negative correlation was observed in the patient group throughout the study. . CONCLUSIONS: Chronic kidney disease did not significantly alter angiotensin-converting enzyme genotypes, and angiotensin-converting enzyme gene polymorphism had a significant effect on serum erythropoietin levels and a non significant effect on hemoglobin levels. .

Interleukin-6 gene polymorphisms and serum erythropoietin and hemoglobin in hemodialysis Iraqi patients.

Chronic kidney disease (CKD) is characterized by elevated levels of pro-inflammatory cytokines. Interleukin-6 (IL-6) is a pleiotropic and pro-inflammatory cytokine involved in different biological activities such as hematopoiesis, inflammation, and acute-phase response. The rate of IL-6 synthesis and degradation is affected by single nucleotide polymorphisms. This study aimed to evaluate the frequencies of 174G/C IL-6 gene promoter polymorphism in Iraqi hemodialysis (HD) patient and to examine the association between the allelic variations and serum erythropoietin (EPO) and hemoglobin (Hb) levels. The frequencies of IL-6 gene polymorphism were studied in 70 chronic renal failure patients on maintenance HD (patients group) and in 20 healthy participants (control group). Genotyping of IL-6 gene was performed by conventional polymerase chain reaction-restriction fragment length polymorphism. The distribution of IL-6 genotypes between groups was similar, and GG genotype is the most frequent followed by CG and CC genotypes. Control group had a nonsignificant difference in serum EPO levels among different IL-6 genotypes, while patients with GG genotype displayed significant elevation in serum EPO with time, followed by CG and CC genotypes. No significant differences in Hb levels were observed in patients and control groups. A significant positive correlation was observed between serum EPO and Hb in control group with different IL-6 genotypes, while a nonsignificant negative correlation was observed in patients group throughout the study. CKD did not significantly alter IL-6 genotypes, and IL-6 gene polymorphism had a significant effect on serum EPO levels and a nonsignificant effect on Hb levels.

Malnutrition, inflamation and atherosclerosis (MIA syndrome) in patients with end stage renal disease on maintenance hemodialysis (a single centre experience).

BACKGROUND: Inflammation and malnutrition play an important role in endothelial dysfunction, atherosclerosis and excessive cardiovascular morbidity and mortality in ESRD patients AIM OF THE STUDY: The primary objective is to determine the prevalence of inflammation, malnutrition and atherosclerosis in patients on maintenance haemodialysis. Secondary objective was to determine the association for atherosclerosis with inflammation and malnutrition. PATIENT AND METHODS: One hundred and one adult patients with end stage renal disease on maintenance haemodialysis who are met with the exclusion criteria were enrolled in this cross sectional study from haemodialysis unit of Baghdad teaching hospital over the period of July/2015 - June 2016. All patients were thoroughly examined and many variables were evaluated (age, gender, blood pressure, diabetes mellitus, serum lipid profile, smoking habits, serum albumin, CRP, calcium, Phosphate, Parathyroid hormone and haemoglobin measurements). All patients underwent a carotid Doppler ultrasound study. RESULTS: Atherosclerosis was present in 65.3%: 58.4% of patients had malnutrition and 43.6% had inflammation. The association for atherosclerosis and high CRP and low serum albumin is strong and independent of other atherosclerosis risk factors. There is significant inverse and independent correlation between CRP and albumin. CONCLUSION: Inflammation (high serum CRP) and malnutrition (low serum albumin) in patients on haemodialysis are significantly associated with carotid atherosclerosis. Inflammation was more prevalent in the malnourished patients than in those with normal nutritional status.

Prediction of autonomic neuropathy in chronic kidney disease (stage 5) Iraqi patients (case control study).

BACKGROUND: The presence of autonomic neuropathy in association with end stage chronic kidney disease have not yet been established. An extending studies need to evaluate the presence of autonomic neuropathy in different stages of chronic kidney disease. OBJECTIVES: To estimate the prevalence rate of autonomic neuropathy in stage 5 chronic kidney disease. METHODS: 35 patients with end stage CKD were selected (patient group), compared with 100 person had CKD of different stages other than stage 5 CKD (control group). A sequence of questionnaires (6 questions) were applied to both groups, followed by testing for postural hypotension using as a complementary test for ANP with the cold immersion test. Any subject failed to show an increment in BP was labeled as having test positive and hence having ANP. RESULTS: The distribution of ANP according to the questionnaire was higher in the patient's group than the controls (p<0.0001). Postural hypotension was more in patients versus the control (p 0.026). The Cold immersion test was positive in 23 subject in patients (65.7%) than the control only 11 subject (11%), (p<0.0001).

Delayed Graft Function in Living-Donor Kidney Transplant: A Middle Eastern Perspective.

With an increased incidence of living-donor kidney transplants, in response to increasing unmet needs for renal transplant, a clear understanding of determinants of posttransplant outcomes is essential. The importance of delayed graft function in deceased-donor kidney transplant is now part of conventional medical wisdom, due to the large amount of evidence focused on this aspect. However, the same is not true for living-donor kidney transplant, partly due to lack of evidence on this crucial clinical question and partly due to lack of awareness about this issue. The current review aims to highlight the importance of delayed graft function as a crucial determinant of outcomes in living-donor kidney transplant. An exhaustive search of online medical databases was performed with appropriate search criteria to collect evidence about delayed graft function after living-donor kidney transplant, with a special focus on studies from the Middle East. Data on incidence, impact, risk factors, and possible prevention modalities of delayed graft function in patients undergoing living-donor kidney transplant are presented. A key finding of this review is that contemporary incidence rates reported from the Middle East are comparatively higher than those reported from outside the region. Although in absolute terms the incidence is lower than deceased donor kidney transplant, the effects of delayed graft function on graft rejection and graft and patient survival are sufficiently large to warrant the formulation of specific treatment protocols. Key to formulating prevention and treatment strategies is identifying discrete risk factors for delayed graft function. Although this evidence is scant, an overview has been provided. Further studies examining different aspects of delayed graft function incidence after living-donor kidney transplant are urgently needed to address a so far little known clinical question.