COMPARISON BETWEEN PCR STUDY AND ELISA STUDY AMONG PATIENTS WITH DIARRHEA.

Amoebic dysentery is a common infectious disease that is acquired through contaminated food and water harboring the infective stage of the parasite. Entamoeba histolytica is a parasite that is spread globally causing increasing morbidity and mortality in developing countries. To Identify the infection of Entamoeba histolytica by PCR and other lab methods among patients attending Kirkuk hospitals. Methods: The current study involved the examination of 220 fecal specimens from children under 15 years during the period of 1st January 2023 until 5th of June 2023. It involved microscopic examination of fecal samples confirmation of diagnosis with two different ELISA tests that capture E. histolytic. Also, microscopic positive samples were submitted to nucleic acid detection of E. histolytic via Real-Time PCR. The percentage of positive specimens that were tested with E. histolytica / dispar ELISA (DRG ELISA), out of 93 stool specimens, 59 (63.44%) were positive, while the remaining specimens 34 (36.56%) were negative despite being tested positive by microscopy. The DRG stool ELISA revealed sensitivity and specificity (69.28% and 97.91%) respectively and a predictive value of (97%). The sample that was the positive result with DRG ELISA was discriminated via Tech Lab E. histolytica ELISA which detects the presence of only E. histolytica alone in fecal samples. Out of 93 examined specimens, only 24 (25.81%) were positive while the remaining 69 (74.19%) were negative. DRG ELISA for E. histolytica/dispar positive results were 63.44%, while TechLab ELISA has produced 25.81% positive E. histolytica. Whereases, RT PCR results were only 20.44%. Qi square analysis was applied and yielded a significant difference v=between the method of diagnosis with P=<0.0001. Microscopy-positive Entamoeba complex is a primitive means of detection of Entamoeba complex and diagnosis should always be confirmed with superior method like ELISA or PCR.

Prescribing Patterns of Proprotein Convertase Subtilisin-Kexin Type 9 Inhibitors in Eligible Patients With Clinical Atherosclerotic Cardiovascular Disease or Heterozygous Familial Hypercholesterolemia.

Two proprotein convertase subtilisin-kexin type 9 (PCSK9) inhibitors are approved for patients with atherosclerotic cardiovascular disease or heterozygous familial hypercholesterolemia who require additional low-density lipoprotein cholesterol (LDL-C) lowering. This retrospective study sought to determine differences between eligible patients who were prescribed and those who were not prescribed a PCSK9 inhibitor. Patients from an electronic medical record database were included in the analysis, and their demographic, clinical, and treatment characteristics were evaluated. Of 368,624 PCSK9 inhibitor-eligible patients, 1,752 (<0.5%) received a PCSK9 inhibitor prescription. Patients who received a PCSK9 inhibitor were more frequently associated with a higher cardiovascular disease risk category and a higher baseline LDL-C level (139.4 vs 103.5 mg/dl; p <0.0001) compared with those who did not. Patients with a PCSK9 inhibitor prescription were significantly more likely to be on ezetimibe, alone or in combination with a statin, at baseline compared with those without (29% vs 5%; p <0.0001). The use of a PCSK9 inhibitor was very low in the 2 groups of patients identified as PCSK9 inhibitor-eligible based on the American College of Cardiology Expert Consensus Decision Pathway. In conclusion, this study demonstrates that most PCSK9 inhibitor-eligible patients do not receive a PCSK9 inhibitor prescription, highlighting that many high-risk patients could benefit from additional LDL-C lowering with a PCSK9 inhibitor.

Identification of Candida species in vaginal flora using conventional and molecular methods.

Vaginal swab samples were collected both from women with signs of acute vulvovaginal candidiasis (VVC; n=270) and from healthy controls (n=100). The microscopic examination revealed a significant difference in the proportion of positive cultures of Candida between the VVC (33%) and control (21%) groups. To determine the frequency of different species, positive cultures were analyzed using the germ tube test, CHROMagar medium, API 20 AUX System and DNA analysis. CHROMagar and API 20 AUX System tests identified 67% of samples as C. albicans. Out of these, 42% appeared to be C. dubliniensis when the specific primers in the polymerase chain reaction (PCR) were used. We observed the prevalence of Candida species isolated from the vagina in descending order as follows: C. albicans (38-39%), C. glabrata (32-33%), C. dubliniensis (28-29%) and C. tropicalis (0-1%) for both the VVC and the control group.

Therapeutic options for premature coronary artery disease.

Although cardiovascular disease is commonly recognized as a disease of the elderly, young patients are also at risk for coronary atherosclerosis, which has a devastating impact on their more active lifestyle. In identifying patients at risk for a cardiovascular event, global risk models often fail to assess family history, an important risk factor in patients with premature coronary artery disease (P-CAD). P-CAD refers to the accelerated development of coronary atherosclerosis before age 55 in men and 65 in women, which may be the result of acquired or primary causes. Acquired P-CAD is associated with an underlying medical condition or influencing factor, such as systemic lupus erythematosus or cocaine use, that directly contributes to the rapid progression of coronary atherosclerosis. It is important to evaluate young patients for acquired P-CAD because in many instances treatment may be tailored to the underlying medical condition. Most cases of P-CAD, however, are the result of primary causes involving more complex interactions among genetic, metabolic, and environmental risk factors. Patients with primary P-CAD usually have a family history of coronary disease, suggesting a strong genetic component. With the use of genome-wide association analysis, several chromosome loci have been identified as being linked to the development of coronary atherosclerosis and risk factors. The chromosome 9p21.3 locus, which is the most replicated to date, has provided some insight into the pathologic mechanism of coronary disease. The confirmation and replication of these associations through further study will lead to earlier detection of P-CAD in at-risk patients and a better understanding of the underlying pathologic mechanisms, thereby influencing the development of preventive therapies.