Coexistence of Helicobacter pylori and Giardia duodenalis causes severe iron deficiency anaemia in an adult male: a case report.

INTRODUCTION: Iron deficiency anaemia (IDA), the most prevalent type of anaemia, is recognised as a significant global health concern that affects individuals of all ages. CASE PRESENTATION: Herein, we present a case involving an adult male coinfected with Helicobacter pylori and Giardia duodenalis, which precipitated severe IDA. RESULTS: A 24-year-old male presented with symptoms including fatigue, dizziness, headache, abdominal pain, and diarrhoea persisting for four weeks. Thorough blood tests, including complete blood counts, blood film, and iron studies, conclusively established the presence of severe IDA. Furthermore, his faecal sample was collected and subjected to analysis of common bacterial and parasitic gastrointestinal infections. Examination of upper and lower gastrointestinal pathogens indicated that the severe IDA was most likely a result of coinfection with H. pylori and G. duodenalis. The patient received treatment involving antibiotics and iron replacement therapy, which resulted in an improvement in both his symptoms and laboratory results. CONCLUSIONS: The present report provides crucial insights into the synergistic effect of concurrent H. pylori and G. duodenalis infections, highlighting their potential to induce severe IDA in infected patients.

An overview of qualitative and quantitative platelet abnormalities in schistosomiasis.

Schistosomiasis is a neglected tropical disease referring to the infection with blood parasitic trematodes of the genus Schistosoma. It impacts millions of people worldwide, primarily in low-to-middle-income countries. Patients infected with schistosomiasis often exhibit a distinct hematological profile, including anemia, eosinophilia, thrombocytopenia, and coagulopathy. Platelets, essential components of the hemostatic system, play a crucial role in the pathogenesis of schistosomiasis. Schistosomes secrete serine proteases and express ectoenzymes, such as calpain protease, alkaline phosphatase (SmAP), phosphodiesterase (SmNPP5), ATP diphosphohydrolase (SmATPDase1), serine protease Sk1, SmSP2, and Sm22.6, which can interfere with platelet normal functioning. This report provides comprehensive, up-to-date information on platelet abnormalities observed in patients with schistosomiasis, highlighting their importance in the disease progression and complications. It delves into the interactions between platelets and schistosomes, including the impact of platelet dysfunction on hemostasis and immune responses, immune-mediated platelet destruction, and the potential mechanisms by which schistosome tegumental ectoenzymes affect platelets. Furthermore, the report clarifies the relationship between platelet abnormalities and clinical manifestations such as thrombocytopenia, coagulation disorders, and the emergence of portal hypertension and gastrointestinal bleeding. Understanding the complex interplay between platelets and schistosomes is crucial for improving patient management and outcomes in schistosomiasis, particularly for those with platelet alterations. This knowledge contributes to improved diagnostic methods, innovative treatment strategies, and global efforts to control and eliminate schistosomiasis.

Comparison of in vitro growth characteristics of Cryptosporidium hominis (IdA15G1) and Cryptosporidium parvum (Iowa-IIaA17G2R1 and IIaA18G3R1).

Cryptosporidium is a major cause of diarrhoeal disease and mortality in young children in resource-poor countries, for which no vaccines or adequate therapeutic options are available. Infection in humans is primarily caused by two species: C. hominis and C. parvum. Despite C. hominis being the dominant species infecting humans in most countries, very little is known about its growth characteristics and life cycle in vitro, given that the majority of our knowledge of the in vitro development of Cryptosporidium has been based on C. parvum. In the present study, the growth and development of two C. parvum isolates (subtypes Iowa-IIaA17G2R1 and IIaA18G3R1) and one C. hominis isolate (subtype IdA15G1) in HCT-8 cells were examined and compared at 24 h and 48 h using morphological data acquired with scanning electron microscopy. Our data indicated no significant differences in the proportion of meronts or merozoites between species or subtypes at either time-point. Sexual development was observed at the 48-h time-point across both species through observations of both microgamonts and macrogamonts, with a higher frequency of macrogamont observations in C. hominis (IdA15G1) cultures at 48-h post-infection compared to both C. parvum subtypes. This corresponded to differences in the proportion of trophozoites observed at the same time point. No differences in proportion of microgamonts were observed between the three subtypes, which were rarely observed across all cultures. In summary, our data indicate that asexual development of C. hominis is similar to that of C. parvum, while sexual development is accelerated in C. hominis. This study provides new insights into differences in the in vitro growth characteristics of C. hominis when compared to C. parvum, which will facilitate our understanding of the sexual development of both species.

Vitamin B12 binding to mutated human transcobalamin, in-silico study of TCN2 alanine scanning and ClinVar missense mutations/SNPs.

Many missense mutations/SNPs of the TCN2 gene (which yield Transcobalamin (TC)) were reported in the literature but no study is available about their effect on binding to vitamin B12(B12) at the structural level experimentally nor computationally. Predict the effect of TC missense mutations/SNPs on binding affinity to B12 and characterize their contacts to B12 at the structural level. TC-B12 binding energy difference from the wildtype (ΔΔGmut) was calculated for 378 alanine scanning mutations and 76 ClinVar missense mutations, repeated on two distinct X-ray structures of holoTC namely 2BB5 and 4ZRP. Destabilizing mutations then went through 100 ns molecular dynamics simulation to study their effect on TC-B12 binding at the structural level employing 2BB5 structure. Out of the studied 454 mutations (378 alanine mutations + 76 ClinVar mutations), 19 were destabilizing representing 17 amino acid locations. Mutation energy results show a neutral effect on B12 binding of several missense SNPs reported in the literature including I23V, G94S, R215W, P259R, S348F, L376S, and R399Q. Compared to the wildtype, all the destabilizing mutations have higher average RMSD-Ligand in the last 25% of the MD simulation trajectories and lower average hydrogen bond count while the other parameters vary. Previously reported TCN2 SNPs with an unknown effect on TC-B12 binding were found to have a neutral effect in the current study based on mutation energy calculations. Also, we reported 17 possible amino acids that destabilize TC-B12 binding upon mutation (four listed in ClinVar) and studied their structural effect computationally.

Point of care diagnostics for Cryptosporidium: new and emerging technologies.

PURPOSE OF REVIEW: Although Cryptosporidium detection and typing techniques have improved dramatically in recent years, relatively little research has been conducted on point of care (POC) detection and typing tools. Therefore, the main purpose of the present review is to summarize and evaluate recent and emerging POC diagnostic methods for Cryptosporidium spp. RECENT FINDINGS: Microscopy techniques such as light-emitting diode fluorescence microscopy with auramine-phenol staining (LED-AP), still have utility for (POC) diagnostics but require fluorescent microscopes and along with immunological-based techniques, suffer from lack of specificity and sensitivity. Molecular detection and typing tools offer higher sensitivity, specificity and speciation, but are currently too expensive for routine POC diagnostics. Isothermal amplification methods such as loop-mediated isothermal amplification (LAMP) or recombinase polymerase amplification (RPA) including a commercially available LAMP kit have been developed for Cryptosporidium but are prone to false positives. Clustered regularly interspaced short palindromic repeats (CRISPR)-Cas diagnostic technologies (CRISPRDx) have recently been combined with isothermal amplification to increase its specificity and sensitivity for detection and typing. Other emerging technologies including amplification-free CRISPR detection methods are currently being developed for Cryptosporidium using a smartphone to read the results. SUMMARY: Many challenges are still exist in the development of POC diagnostics for Cryptosporidium. The ideal POC tool would be able to concentrate the pathogen prior to detection and typing, which is complicated and research in this area is still very limited. In the short-term, CRISPR-powered isothermal amplification lateral flow tools offer the best opportunity for POC Cryptosporidium species and subtype detection, with a fully integrated autonomous biosensor for the long-term goal.

Association of Lung CT Findings in Coronavirus Disease 2019 (COVID-19) With Patients' Age, Body Weight, Vital Signs, and Medical Regimen.

Objective: This study aimed to detect possible associations between lung computed tomography (CT) findings in COVID-19 and patients' age, body weight, vital signs, and medical regimen in Jordan. Methods: The present cross-sectional study enrolled 230 patients who tested positive for COVID-19 in Prince Hamza Hospital in Jordan. Demographic data, as well as major lung CT scan findings, were obtained from the hospital records of the COVID-19 patients. Results: The main observed major lung changes among the enrolled COVID-19 patients included ground-glass opacification in 47 (20.4%) patients and consolidation in 22 (9.6%) patients. A higher percentage of patients with major lung changes (24%) was observed among patients above 60 years old, while (50%) of patients with no changes in their lung findings were in the age group of 18-29 years old. Results obtained from the present study showed that only patients with major CT lung changes (9.7%) were prescribed more than three antibiotics. Additionally, 41.6 % of patients with major lung CT scan changes had either dry (31.0%) or productive (10.6%) cough at admission. Conclusion: Several factors have been identified by this study for their ability to predict lung changes. Early assessment of these predictors could help provide a prompt intervention that may enhance health outcomes and reduce the risk for further lung changes.

A review of the molecular epidemiology of Cryptosporidium spp. and Giardia duodenalis in the Middle East and North Africa (MENA) region.

Cryptosporidium spp. and Giardia duodenalis are important protozoan parasites which are associated with diarrheal diseases in humans and animals worldwide. Relatively little is known about the molecular epidemiology of Cryptosporidium spp. and Giardia duodenalis in the Middle East Countries and North Africa (MENA region). Therefore, this review aimed to inspect published genotyping and subtyping studies on Cryptosporidium spp. and Giardia duodenalis in the MENA region. These studies indicate that both anthroponotic and zoonotic transmission of Cryptosporidium occurs with the predominance of zoonotic transmission in most countries. Seven Cryptosporidium species were identified in humans (C. parvum, C. hominis, Cryptosporidium meleagridis, C. felis, Cryptosporidium muris, C. canis and C. bovis), with C. parvum by far being the most prevalent species (reported in 95.4% of the retrieved studies). Among C. parvum gp60 subtype families, IIa and IId predominated, suggesting potential zoonotic transmission. However, in four MENA countries (Lebanon, Israel, Egypt and Tunisia), C. hominis was the predominant species with five subtype families reported including Ia, Ib, Id, If and Ie, all of which are usually anthroponotically transmitted between humans. In animals, the majority of studies were conducted mainly on livestock and poultry, 15 species were identified (C. parvum, C. hominis, C. muris, Cryptosporidium cuniculus, C. andersoni, C. bovis, C. meleagridis, C. baileyi, C. erinacei, C. ryanae, C. felis, C. suis, Cryptosporidium galli, C. xiaoi and C. ubiquitum) with C. parvum (IIa and IId subtypes) the dominant species in livestock and C. meleagridis and C. baileyi the dominant species in poultry. With G. duodenalis, five assemblages (A, B, C, E and F) were identified in humans and six (A, B, C, E, D and F) in animals in MENA countries with assemblages A and B commonly reported in humans, and assemblages A and E dominant in livestock. This review also identified a major knowledge gap in the lack of Cryptosporidium spp. and Giardia duodenalis typing studies in water and food sources in the MENA region. Of the few studies conducted on water sources (including drinking and tap water), ten Cryptosporidium species and four genotypes were identified, highlighting the potential role of water as the major route of Cryptosporidium spp. transmission in the region. In addition, three G. duodenalis assemblages (A, B and E) were detected in different water sources with AI, AII and BIV being the main sub-assemblages reported. More research is required in order to better understand the molecular diversity and transmission dynamics of Cryptsporidum spp. and Giardia duodenalis in humans, animals, water and food sources in MENA region.

Molecular characterization of Entamoeba, Blastocystis and Cryptosporidium species in stool samples collected from Jordanian patients suffering from gastroenteritis.

Little is known about the prevalence of intestinal protozoa in patients suffering from diarrhea in Jordan. The present study aimed to detect and speciate Entamoeba, Blastocystis, and Cryptosporidium species in a total of 159 human patients with diarrhea from November 2014 to October 2016. The overall prevalence for the three parasites was 19.5% (31/159). Entamoeba spp. (Entamoeba. dispar and/or Entamoeba histolytica), Blastocystis hominis, and Cryptosporidium parvum subtype IIaA15G2R1 were detected in 12.6%, 6%, and 0.6 of samples, respectively. This is the first molecular study in Jordan to confirm the diagnosis of Entamoeba species and to discriminate between E. histolytica and E. dispar.

Cryptosporidium infection in humans and animals from Iraq: A review.

The apicomplexan parasite Cryptosporidium causes serious diarrheal disease in humans and animals worldwide. The present review summarizes epidemiological and molecular studies as well as the clinical disease burden of natural Cryptosporidium infections in humans and animals from Iraq. Retrieved reports regarding cryptosporidiosis in Iraq indicated that the disease is highly prevalent in humans and animals, but the results extracted from these reports are confusing and mostly employed traditional methodologies for the detection of Cryptosporidium infective stage, the oocysts, in clinical samples. Many screened surveys represent point prevalence studies, which described diarrhea in infants and children due to cryptosporidiosis; however, other pathogens causing diarrhea were not excluded. High prevalence of Cryptosporidium oocysts was recovered from many studies from different environmental matrices in different parts of Iraq including drinking tap water, which facilitates its transmission to humans and animals. Reports on molecular characterization of different Cryptosporidium species which exist in Iraq are few but both Cryptosporidium hominis and Cryptosporidium parvum were detected in humans and the latter was more prevalent in isolates from cattle, sheep, goats and birds. A national study on adequate numbers of samples from different hosts and environmental matrices, and employing advanced diagnostic methodologies is required to precisely detect the epidemiological situation of cryptosporidiosis in Iraq. Furthermore, molecular genotyping studies are required to be conducted in Iraq to characterize the species and subtypes of Cryptosporidium infecting humans and animals especially during outbreaks. Therefore, Cryptosporidium parasite should be included in the routine diagnosis and surveillance system of infectious diseases in Iraq and should be regarded as an important public health problem of concern.

Iron deposition and atrophy in cerebral grey matter and their possible association with serum iron in relapsing-remitting multiple sclerosis.

PURPOSE: The present study was carried out to investigate any possible linkage between cerebral grey matter volumetric, iron changes, white matter's lesions load and serum iron levels in a group of relapsing-remitting multiple sclerosis (RRMS) patients. MATERIALS AND METHODS: Sixty-five RRMS patients along with thirty-four age-matched healthy controls (HCs) were recruited. Serum samples were isolated from blood samples which were collected in vacutainer plain tubes individually from both groups. Both groups were scanned at 1.5 T magnetic resonance imaging (MRI) using the following 3D sequences; T1-weighted gradient echo (MPRAGE), T2*-weighted gradient echo and T2-weighted fluid-attenuated inversion recovery (FLAIR). RESULTS: Significant differences were observed between the RRMS patients and HCs for cortical and deep grey matter (dGM) volumes where cortical and dGM volumes in RRMS patient were significantly smaller than those in HCs. While iron deposition in the cortex, putamen (PT) and globus pallidus (GP) of RRMS patients were significantly higher than those of HCs, iron levels in thalamus (TH) and serum were significantly lower in RRMS compared to those in HCs. Except for T2 lesion load, none of volumetric measures showed any association with patients' disability status. Cerebral grey matter's iron changes did not show any association with those of serum. CONCLUSION: Smaller cortical and subcortical grey matter volumes in RRMS patients compared to HCs were detected. None of the volumetric measures showed any association with patients' disability status. RRMS patients showed increased iron levels in the PT, GP and cortex and decreased levels in the TH and serum.

Cryptosporidiosis among Hemodialysis Patients in Jordan: First Preliminary Screening Surveillance.

Few studies have reported the incidence of cryptosporidiosis among hemodialysis patients worldwide. Currently many molecular and immunological assays have been developed for the sensitive diagnosis of cryptosporidiosis, but still, the microscopic detection of the parasitic infective stage (oocysts) in stool specimens using modified acid stain is regarded as a reliable sensitive technique which is widely used in many clinical labs. In the present study, a total of 133 stool samples were collected from hemodialysis patients and were screened for Cryptosporidium oocyst using formalin-ether concentration and modified acid-fast staining technique. Clinical and demographic data were also collected and analyzed. Cryptosporidium oocysts were recovered in 15/133 (11%) of the investigated hemodialysis patients. The age of patients ranged from 25 to 80 years (mean: 57.84 ± 12.22). Most of the Cryptosporidium-positive cases were recovered from males (73.7%) residing in rural villages in Irbid city (86.6%). The most repeatedly reported symptoms in the Cryptosporidium-positive patients were gastrointestinal symptoms, including diarrhea (15%), nausea (24%), abdominal pain (23%) and bloating (17%), in addition to general fatigue (32%) and weight loss (19%). No statistically significant associations for certain clinical symptoms or risk factors were found. The present study is the first preliminary study in Jordan that provided a brief screening for the incidence of cryptosporidiosis among hemodialysis patients.

Association of Breastfeeding Duration with Susceptibility to Allergy, Influenza, and Methylation Status of TLR1 Gene.

Background and Objectives: This study aimed to investigate the possible association between exclusive breastfeeding duration during early infancy and susceptibility to allergy and influenza in adulthood. Furthermore, we also investigated the association of breastfeeding duration with DNA methylation at two sites in the promoter of the toll-like receptor-1 (TLR1) gene, as well as the association between DNA methylation of the toll-like receptor-1 (TLR1) gene and susceptibility to different diseases. Materials and Methods: Blood samples were collected from 100 adults and classified into two groups according to breastfeeding duration (<6 months and ≥6 months) during infancy. Subjects were asked to complete a questionnaire on their susceptibilities to different diseases and sign a consent form separately. Fifty-three samples underwent DNA extraction, and the DNA samples were divided into two aliquots, one of which was treated with bisulfite reagent. The promoter region of the TLR1 gene was then amplified by polymerase chain reaction (PCR) and sequenced. Results: We found a significant association between increased breastfeeding duration and a reduction in susceptibility to influenza and allergy, as well asa significant reduction in DNA methylation within the promoter of the TLR1 gene. No association was found between DNA methylation and susceptibility to different diseases. Conclusions: The findings demonstrate the significance of increased breastfeeding duration for improved health outcomes at the gene level.

Subcutaneous and visceral fat volumes measured by MRI and their relationships with nutrient intakes among adults.

BACKGROUND AND OBJECTIVES: Types and amounts of nutrients may influence the volume of subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT). This study targeted to investigate the relationship between SAT and VAT volumes and macro- and micronutrients intake among adults. METHODS AND STUDY DESIGN: Data were collected via a private face-to-face interview, in which diet history was obtained using validated quantitative food frequency questionnaire. The different fat volumes were assessed using magnetic resonance imaging (MRI) scanning. RESULTS: Participants with the lowest VAT volume had the highest intake of saturated fats, monounsaturated fatty acids and omega-3 and omega-6 fatty acids (p<0.05). VAT volume was significantly associated with the highest level of total energy and energy from carbohydrate consumption among participants while significantly associated with the lowest energy intake from fat among participants (p=0.013). There was a significant relationship with the highest consumption of total carbohydrate, soluble fiber, and insoluble fiber and VAT volume (p<0.05). Participants in the highest VAT volume had significantly the highest intake of vitamin A, ß- carotene, and copper. CONCLUSIONS: This study underscores the importance of quantifying depot-specific body fat and highlights the unique responsiveness of various fat depots to dietary intake.

Seroprevalence of cystic echinococcosis in a high-risk area (Al-Mafraq Governorate) in Jordan, using indirect hemagglutination test.

Hydatid disease (HD) is a zoonotic disease of humans and animals which is caused by infection with the larval stages of the taeniid cestodes of the genus Echinococcus. HD is endemic in many countries of the Middle East, including Jordan. The seroprevalence rate of HD in areas of elevated risk in Jordan has not previously been investigated using indirect haemagglutination (IHA) testing. In the present study, 512 blood samples were collected from recruited outpatients from an internal medicine clinic in Al-Mafraq Governmental Hospital in Jordan. Each participant signed a consent form and completed a questionnaire. The presence of antibodies specific for E. granulosus antigens was detected using an IHA test. Statistical analysis was performed by SPSS software using the Chi-square test. In all, 4.1% of the study participants were seropositive for E. granulosus IgG antibodies. There was a significant correlation between unexplained weight loss among seropositive patients (P = 0.018). Seropositivity was significantly higher in patients who slaughtered sheep inside their houses (P = 0.023). HD seroprevalence did not correlate with gender (P = 0.433), age (P = 0.880), residency status (P = 0.938), or educational level (P = 0.808). The vast majority (75.2%) of participants reported no prior knowledge about HD, and 99.8% were not aware about the etiology of the disease.

Detection, genotyping, and phylogenetic analysis of Leishmania isolates collected from infected Jordanian residents and Syrian refugees who suffered from cutaneous leishmaniasis.

Leishmania is a parasitic protozoan which is transmitted to humans through the bite of an infected female Phlebotomus and Lutzomyia sand flies. Cutaneous leishmaniasis (CL), caused by Leishmania major and L. tropica, is an endemic disease in many areas of Jordan and considered as a major public health problem. The political instability in the Syrian Arab Republic has resulted in the immigration of large number of refugees into Jordan where most of them resided in camps near the Syrian borders. Therefore, the main objective of the present study was to inspect Leishmania species/genotypes which are responsible for CL infections among Syrian refugees and compare them with the recovered species/genotypes isolated from Jordanian patients. Three molecular-based assays (ITS1-PCR-RFLP, Nested ITS1-5.8S rDNA PCR, and Kinetoplast DNA PCR) followed by sequencing and phylogenetic analysis were undertaken and compared for their efficiency to confirm CL diagnosis and genotype the infecting Leishmania species. Thereafter, the evolutionary relationships among various Leishmania isolates from Syrian and Jordanian CL patients were elucidated. Results from the present study indicated that 20 and 9 out of the inspected 66 patients (39 Jordanian and 27 Syrian) were infected with L. major and L. tropica respectively. ITS1-PCR RFLP typing proved to be more sensitive in the detection of Leishmania species (positive in 44% of the isolates) compared to both ITS1-5.8S rDNA gene and Kinetoplast DNA PCR which were successful in identifying Leishmania species only in 23% and 33% of the isolates respectively. Sequencing and phylogenetic analysis of ITS1 and ITS1-5.8S rDNA genes revealed high levels of heterogeneity among the sequenced isolates. One sample typed as L. tropica from Jordanian patient showed high similarity with L. tropica sample isolated from a Syrian patient in a Lebanon refugee camp; therefore, the need for comprehensive studies to confirm if any new L. tropica strains might be introduced to Jordan by Syrian refugees is urgently indicated. These observations highlighted the need for further studies to clarify the risk status of species and strains which might be introduced from Syria to Jordan.

Giardia: an under-reported foodborne parasite.

Foodborne zoonotic pathogens are a serious public health issue and result in significant global economic losses. Despite their importance to public health, epidemiological data on foodborne diseases including giardiasis caused by the enteric parasite, Giardia duodenalis, are lacking. This parasite is estimated to cause ∼28.2 million cases of diarrhoea each year due to contamination of food, but very few foodborne outbreaks have been documented due to the limitations of current detection as well as surveillance methods. The current method for the recovery of Giardia cysts from food matrices using immunomagnetic separation requires further standardisation and cost reduction before it can be widely used. It also should incorporate downstream molecular procedures for genotyping, and traceback and viability analyses. Foodborne giardiasis can be potentially controlled through improvements in national disease surveillance systems and the establishment of Hazard Analysis and Critical Control Point interventions across the food chain. Studies are needed to assess the true prevalence and public health impact of foodborne giardiasis.

Spatial and temporal characteristics of cancer in the period from 2004 to 2013 in the Hashemite Kingdom of Jordan.

Cancer in Jordan is a major public health problem and the second leading cause of death after heart disease. This study aimed at studying the spatial and temporal characteristics of cancer in Jordan and its 12 governorates for the period 2004-2013 to establish a baseline for future research and identification of cancer risk factors paving the way for developing a cancer control plan in the country. Numerical and graphical summaries, time-series additive seasonal decomposition, the method of least squares, and spacetime scan statistics were applied in a geographic information systems environment. Although the results indicate that the cancer incidence in Jordan is comparatively low, it is increasing over time. In the 10-year study period, a total of 44,741 cases was reported with a mean annual crude incidence rate of 68.4 cases/100,000, mean annual age-adjusted incidence rate of 111.9 cases/100,000, and a monthly rate increase of 1.2 (cases/100,000)/month. This study also revealed that the spatial and temporal characteristics of cancer vary among the governorates. Amman, which includes the capital city and hosts more than one-third of the population of the country, reported 61.0% of the total number of cases. Amman also reported the highest annual crude incidence rate (105.3 cases/100,000), the highest annual age-adjusted incidence rate (160.6 cases/100,000), and the highest rate of increase (0.7 (cases/100,000)/month) forming a high-rate cluster. Excluding the three governorates Amman, Balqa, and Ma'daba, low-rate clusters were found with regard to the remaining governorates. All governorates, except Irbid and Mafraq, showed significant rates of increase of cancer incidence. However, no clear seasonality pattern with respect to cancer incidence was discerned.

Comparison of ELISA, nested PCR and sequencing and a novel qPCR for detection of Giardia isolates from Jordan.

Little is known about the prevalence of Giardia duodenalis in human patients in Jordan and all previous studies have used direct microscopy, which lacks sensitivity. The present study developed a novel quantitative PCR (qPCR) assay at the ß-giardin (bg) locus and evaluated its use as a frontline test for the diagnosis of giardiasis in comparison with a commercially available ELISA using nested PCR and sequencing of the glutamate dehydrogenase (gdh) locus (gdh nPCR) as the gold standard. A total of 96 human faecal samples were collected from 96 patients suffering from diarrhoea from 5 regions of Jordan and were screened using the ELISA and qPCR. The analytical specificity of the bg qPCR assay revealed no cross-reactions with other genera and detected all the Giardia isolates tested. Analytical sensitivity was 1 Giardia cyst per µl of DNA extract. The overall prevalence of Giardia was 64.6%. The clinical sensitivity and specificity of the bg qPCR was 89.9% and 82.9% respectively compared to 76.5 and 68.0% for the ELISA. This study is the first to compare three different methods (ELISA, bg qPCR, nested PCR and sequencing at the gdh locus) to diagnose Jordanian patients suffering from giardiasis and to analyze their demographic data.

Cystic echinococcosis in Jordan: A review of causative species, previous studies, serological and radiological diagnosis.

Cystic echinococcosis (CE)/hydatidosis is a zoonotic disease which occur in human and herbivore animals as a result of infection with the larval stage of the taeniid cestode Echinococcus granulosus sensu lato (s. l.). In human, CE is a serious public health concern in many parts of the world including Jordan. The present review will cover CE causative agent: E. granulosus species/genotypes; life cycle of E. granulosus parasite, all published previous studies on CE in Jordan (humans, intermediate hosts, definitive host) as well as its diagnostic methods in human.

Relationship of serum leptin with some biochemical, anthropometric parameters and abdominal fat volumes as measured by magnetic resonance imaging.

AIMS: To measure the level of leptin in volunteers and correlate it with several anthropometric, biochemical variables and abdominal fat volumes. METHODS: The level of leptin was investigated in 167 disease-free volunteers. Serum levels of IL-6, adiponectin, and resistin, blood lipid profile (cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglyceride (TG) were determined. Waist circumference (WC) was measured using tape and magnetic resonance imaging (MRI) images. RESULTS: All measured anthropometric (BMI, WC measured by tape and MRI) and biochemical variables (adiponectin, resistin, cholesterol, HDL, LDL and TG); and abdominal fats showed a significant (p<0.05) difference between participants with abnormal serum leptin levels and those with normal leptin levels. A higher percentage of participants with abnormal serum leptin were obese males while participants with normal leptin levels were either overweight or normal weight females. A significant (p <0.05) positive correlation was detected between serum leptin concentration and WC, BMI, subcutaneous fat, visceral fat, total abdominal fat, and resistin. A moderate association was found between serum leptin concentration and the inflammatory cytokine IL-6. CONCLUSION: Abnormal serum leptin, was detected in obese male individuals which may be considered as an important indicator for the development of cardiovascular diseases and type 2 diabetes.