ABSTRACT
BACKGROUND/OBJECTIVE: Tuberculous pleurisy is a diagnostic challenge due to its nonspecific clinical presentation, paucibacillary nature of the effusion together with the inefficiency of conventional laboratory methods motivating the evaluation of variable diagnostic strategies. METHODS: Using thoracoscopy, the pleural cavity of 50 patients with undiagnosed exudative pleural effusion were fully examined and biopsy specimens of affected parietal pleura were taken under direct vision. Pleural fluid and biopsy specimen were subjected to microscopic examination (direct and after cytocentrifugation), culture, PCR, and histopathological examination. RESULTS: The pleural biopsy specimens proved to have a higher detection rate of tubercle bacilli than pleural fluid. Also, cytocentrifugation improved the sensitivity of microscopic detection for both pleural fluid and biopsy specimens. CONCLUSION: The combination of microbiological results and histopathology examination of the pleural biopsy specimens is essential for the diagnosis of tuberculous pleurisy, as microbiological examination of pleural biopsy specimens has proved to have a higher detection rate than pleural fluid examination.
Subject(s)
Bacteriological Techniques/methods , Clinical Laboratory Techniques/methods , Histocytochemistry/methods , Tuberculosis, Pleural/diagnosis , Adult , Aged , Aged, 80 and over , Biopsy , Female , Humans , Male , Middle Aged , Thoracoscopy , Time FactorsABSTRACT
Introduction and study aim : Egypt has the highest prevalence of hepatitis C in the world estimated about 15. There are several host and viral factors that aid in predicting response to treatment; Hepcidine hormone is being investigated as one of these host factors. The aim of the work is to assess the serum concentration of hepcidin in chronic hepatitis C patients and evaluate any possible association with the viral load during therapy.Patients and methods: This study was carried on 35 chronic HCV patients on peg IFN/ Ribavirin therapy and 15 chronic HCV patients not on therapy as a control group.Hepcidin hormone levels were measured in sera of patients before starting therapy (base line) then at 12 and 24 weeks during therapy. RT PCR was used to asses response to ongoing therapy.Results: The level of hepcidin in all cases was low before starting therapy and it showed a significant increase during the course of therapy. This rise was detected earlier in responding cases. A negative correlation was found between baseline hepcidin level and baseline viral load of the responding cases. Conclusion: Chronic HCV infection is associated with reduced level of serum hepcidin hormone. The reduced serum hepcidin in chronic HCV patients is fully reversible after IFN/RBV therapy. Initial rise in serum hepcidin concentration might have a potential for being used as one of the indicators of patient response to therapy
