Validity of immunoglobulin-binding protein 1 as a biomarker for lupus nephritis.

BACKGROUND: Lupus nephritis (LN) is a major issue that adds a burden on patients with systemic lupus erythematosus (SLE). Immunoglobulin-binding protein 1 (IGBP1) is identified as a phosphoprotein that has been recently reported to be linked to the B-cell receptor complex and regulates differentiation, proliferation, apoptosis, and tolerance of B cells. Its diagnostic and/or prognostic role in LN has been highlighted only recently. OBJECTIVES: This study aims to evaluate the relation between serum IGBP1 and SLE disease activity and/or renal activity and to investigate the validity of IGBP1 as a biomarker for LN. METHODS: 96 participants were enrolled and divided into three groups: nephritis, nonnephritis, and control groups. The patients with SLE were diagnosed according to the Systemic Lupus International Collaborating Clinics classification (SLICC) criteria. The serum IGBP1 level was assayed using an enzyme-linked immunosorbent assay (ELISA). Assessments were conducted using the Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2k) and renal biopsy for LN patients. RESULTS: The nephritis and nonnephritis groups had higher IGBP1 levels than the controls; the nephritis group had the highest serum IGBP1 levels (p < .001). Significant correlations were found between IGBP1 levels and proteinuria (r = 0.568, p = .001) and renal SLEDAI (r = 0.475, p = .006) in the nephritis group; on the other hand, the correlation of serum IGBP1 levels with SLEDAI-2K was non-significant for both groups (nephritis and nonnephritis groups). The IGBP1 levels were significantly different among histopathologic classes (p < .001), with class V showing the highest level. Moreover, it showed a significant positive correlation with the pathologic activity index. Compared with renal SLEDAI for identifying active renal affection in patients with SLE, the serum IGBP1 level with a cut-off value of 547.45 ng/mL is a valid biomarker for detecting active nephritis with 93.8% sensitivity and 96.9% specificity. CONCLUSION: The serum IGBP1 levels were high in patients with LN and were positively correlated with the pathologic activity index. The serum IGBP1 level of 547.45 ng/mL is a valid biomarker for detecting active nephritis. Thus, we recommend that clinicians monitor the serum IGBP1 level of patients with SLE to detect LN.

Serum Procalcitonin as A Diagnostic and Prognostic Marker for Bacterial Community - Acquired Pneumonia.

For community acquired pneumonia (CAP), the discrimination between typical and atypical bacterial causes could influence antibiotic choice and outcome of patients. Objective of this study was to evaluate the utility of serum procalcitonin (PCT) level as a diagnostic and prognostic marker for CAP. Typical bacteria were isolated and identified by conventional methods. An indirect immunoflourescence assay was used to diagnose atypical bacteria. Serum level of PCT was measured by ELISA and clinical outcome was evaluated. Out of 240 enrolled CAP patients, 95 (39.6%) had bacterial etiology (30.8 % typical bacterial pneumonia and 8.8% atypical pneumonia). Ninety five bacterial CAP patients were divided into 3 groups; group 1 (mortality, 20.1%), group 2 (complications, 52.6 %) and group 3 (discharge, 26.3 %). Group 1 patients had the highest PCT level in serum compared to other groups with a statistically significant difference (P < 0.001). A statistically significant higher serum level of PCT was detected in typical than atypical pneumonia (P < 0.001). In conclusion, serum PCT level may serve as a diagnostic and prognostic marker in CAP.

Anti-Helicobacter pylori activity of Egyptian medicinal plants and bacteriophages

Background: Helicobacter pylori (H. pylori) is the most common cause of gastric infections worldwide. Due to antibiotic resistance and adverse effects, phytotherapy and phage therapy have been a research focus as an alternative therapy for H. pylori infection. Objectives: To assess the medicinal plant extracts and bacteriophages as a treatment of H. pylori infection. Methodology: Thirty five gastric biopsies were cultured for H. pylori isolation. Screening of medicinal plants extract efficiency was done by Disc diffusion method. Minimum inhibitory concentrations of extracts were assessed. In vivo effect of Punica granatum peel extract was tested by bacterial density and histopathology in rats. Sewage water samples were screened for H. pylori specific bacteriophages. Single plaque isolation technique was used for phage purification. Results: Ten out of 35 (28.57%) patients had positive gastric biopsy for H. pylori by culture. Four out of 10 (40%) isolates were resistant to all antibiotics. Inhibitory effect of Rosemarinus officinalis, Syzygium aromaticum, Rhus coriaria and Ammi visagna on H. pylori was detected. Punica granatum extract was the most efficient in vitro. In vivo, Punica granatum peel extract caused significant reduction of bacterial density (Pty (P<0.05) and enhanced ulcer healing. Sewage water filtrates contained 3 types ofH. pylorispecific bacteriophages. During phagepurification,phage infectivity waslost.Conclusions:Punicagranatumpeel extract revealed better in vivo activity againstH. pylorithanv standard regimen antimicrobials. Other effective plants can be beneficial inH. Pylori infection management .Loss of bacteriophage infectivity may be an obstacle to phage therapy of H. pylori

Diagnostic performance of direct latex agglutination, post-enrichment latex agglutination and culture methods in screening of group B streptococci in late pregnancy: a comparative study.

BACKGROUND: Group B streptococcus (GBS) is one of the main causes of neonatal sepsis. PURPOSE: Evaluation of the diagnostic performance of direct latex agglutination test (DLA), post-enrichment latex agglutination (LA) test, and direct culture on chromogenic media in rapid identification of GBS carrier in pregnant women in comparison with the conventional post-enrichment CDC-recommended culture method and further to estimate GBS carriage prevalence and its antimicrobial susceptibility. METHODS: Two hundred pregnant women at gestational age (35-37 weeks) were enrolled. Three low vaginal swabs were obtained from each participant. One swab was directly inoculated into Strep B Select (SBS) agar. The second swab was inoculated in enrichment Lim broth for immunological antigen detection by post-enrichment latex agglutination (5 h and 24 h) and subculture for bacteriological detection. The third swab was used for immunological detection of GBS antigen by direct latex agglutination. The isolated GBS was subjected to antimicrobial susceptibility testing. RESULTS: Among 200 pregnant women, 47 (23.5%) were GBS carriers. Considering post-enrichment subculture on SBS medium as a gold standard, the sensitivities for post-enrichment 5 h and 24 h LA were 66% and 95.7%, respectively. However, direct cultivation of the vaginal swabs on SBS medium and DLA recorded 83% and 4.3%, respectively, for sensitivity. All GBS isolates (100%) were sensitive to penicillin G, ampicillin, ceftriaxone, and vancomycin. In contrast, 21.3% and 12.8% of isolated GBS were resistant to erythromycin and clindamycin, respectively. CONCLUSION: Group B streptococcal antigen detection by latex agglutination after 5 h enrichment is a reliable, easy, and relatively rapid method for screening of GBS carriage in pregnant woman not in labor. Latex agglutination after 18-24 h enrichment can be used alternative to standard subculture method for screening GBS carriage.

Physicochemical properties of some bottled water brands in Alexandria Governorate, Egypt.

BACKGROUND: Many people use bottled water instead of tap water for many reasons such as taste, ease of carrying, and thinking that it is safer than tap water. Irrespective of the reason, bottled water consumption has been steadily growing in the world for the past 30 years. In Egypt, this is still increasing to reach 3.8 l/person/day, despite its high price compared with tap water. OBJECTIVE: The purpose of this study was to evaluate the physicochemical quality of some bottled water brands and to compare the quality with that reported on manufacture's labeling, Egyptian, and International standards. MATERIALS AND METHODS: Fourteen bottled water brands were selected from the local markets of Alexandria city. Three bottles from each brand were randomly sampled, making a total sample size of 42 bottles. Sampling occurred between July 2012 and September 2012. Each bottle was analyzed for its physicochemical parameter and the average was calculated for each brand. The results obtained were compared with the Egyptian standard for bottled water, Food and Drug Administration (FDA), and with bottled water labels. RESULTS: In all bottles in the study, pH values ranged between 7.21 and 8.23, conductivity ranged between 195 and 675 µs/cm, and total dissolved solids, sulfate, chloride, and fluoride were within the range specified by the FDA. Calcium concentrations ranged between 2.7373 and 29.2183 mg/l, magnesium concentrations ranged between 5.7886 and 17.6633 mg/l, sodium between 14.5 and 205.8 mg/l, and potassium between 6.5 and 29.8 mg/l. For heavy metals such as iron, zinc, copper, and manganese, all of them were in conformity with the Egyptian standards and FDA, but nickel concentration in 11 brands was higher than the Egyptian standards. Twelve brands were higher than the Egyptian standards in cadmium concentration, but on comparison with FDA there were only five brands exceeding limits. Lead concentrations were out of range for all brands. On comparison with the labeled values, the quality of bottled water was not complying with labeled values. CONCLUSION: Physicochemical parameters in all bottled water examined brands were consistent with the Egyptian Standard and FDA, except for total dissolved solids, nickel, cadmium, and lead. Statistical analysis showed that there was significant difference (P<0.05) in all parameters tested between different brands. Values on the bottled water labels were not in agreement with analytical results.