ABSTRACT
AIM: Genital tuberculosis (GTB) is a potent contributor to irreversible damage to the reproductive system and infertility in females. As no gold standard diagnostic tool is yet available, clinical suspicion and relatively insensitive approaches such as histopathology, laparoscopy and hysterosalpingogram are currently critical determinants in the diagnosis of GTB. Although a polymerase chain reaction (PCR)-based assay using endometrial tissue seems promising, sampling does require an invasive procedure. OBJECTIVE: We hypothesized that menstrual blood may provide an alternate non-invasive source of samples for PCR-based GTB diagnosis. METHODS: We enrolled 195 women with primary infertility in whom GTB was suspected. We obtained ethics committee approval from our institution and written informed consent from subjects. Endometrial tissue and menstrual blood was collected from the subjects and culture, histopathology, and multiplex PCR with both sample type was performed for each subject. RESULTS: The sensitivity and specificity of multiplex PCR was, respectively, 90.2 and 86.1% for menstrual blood, 95.8 and 84.3% for endometrial tissue, and 64.8 and 93.2% for histopathology staining. CONCLUSIONS: A strong clinical suspicion aided with multiplex PCR using menstrual blood may significantly reduce the diagnostic dilemma for GTB diagnosis in a non-invasive, sensitive, rapid, and cost-effective manner.
Subject(s)
DNA, Bacterial/genetics , Infertility, Female/diagnosis , Multiplex Polymerase Chain Reaction/methods , Mycobacterium tuberculosis/genetics , Tuberculosis, Female Genital/diagnosis , Adult , Asymptomatic Diseases , Bacterial Typing Techniques/methods , Cohort Studies , DNA Primers/chemical synthesis , DNA Primers/metabolism , DNA, Bacterial/isolation & purification , Endometrium/surgery , Female , Humans , Infertility, Female/complications , Infertility, Female/microbiology , Infertility, Female/pathology , Laparoscopy , Menstruation/blood , Mycobacterium tuberculosis/classification , Mycobacterium tuberculosis/isolation & purification , Tuberculosis, Female Genital/complications , Tuberculosis, Female Genital/microbiology , Tuberculosis, Female Genital/pathologyABSTRACT
OBJECTIVES: Psoriasis (PsO) is a common chronic T cell-mediated inflammatory disorder traditionally thought to manifest in the skin and joints (psoriatic arthritis, PsA). Recently, it has been shown that these patients have an increased risk for myocardial infarction and this was greater with increasing severity of psoriasis. Patients with psoriasis have reported to have cardiometabolic disturbances including obesity, insulin resistance, and dyslipidemia. This constellation of risk factors, referred to as the metabolic syndrome, increases the risk for atherosclerotic cardiovascular disease (ASCVD) and type 2 diabetes mellitus. The aim of this study was to determine the prevalence of metabolic syndrome in PsA. METHODS: In our study, we examined the records of 105 patients with PsA to determine the prevalence of metabolic syndrome in PsA. This was a retrospective analysis of the Sacramento Veterans Affairs database. RESULTS: Our results demonstrated an increased prevalence of the metabolic syndrome in patients with PsA (61/105 patients or 58.1%) compared to the 35.2 % reported for the Third National Health and Nutrition Examination Survery (NHANES III) data. CONCLUSIONS: Thus, patients with PsA have a very high prevalence of metabolic syndrome, which predisposes them to an increased risk of both diabetes and ASCVD.
