Immunodetection and molecular determination of visceral and cutaneous Leishmania infection using patients' urine.

The diagnosis of leishmaniasis relies mainly on the use of invasive processes, to collect the biological material for detecting Leishmania parasites. Body fluids, which can be collected by non-invasive process, would greatly facilitate the leishmaniasis diagnosis. In the present study, we investigated the potency of urine immunoblotting to diagnose cutaneous and visceral leishmaniasis and we compared with routine molecular methods. A total of 80 samples, including 40 sera and their 40 corresponding urine samples were collected from 37 suspected patients with cutaneous and visceral leishmaniasis, and 3 healthy individuals (as control), in Ilam and Ardabil provinces of Iran. All sera and urine samples were analyzed, using immunoblotting. The confirmation of leishmaniasis infection was performed, using conventional and quantitative PCRs as well as by sequencing the amplicons. Among 37 suspected patients, 23 patients presented cutaneous lesions (CL) and 14 exhibited clinical symptoms reminiscent of visceral leishmaniasis (L. infantum). Among cutaneous patients, 15 were positive for zoonotic cutaneous leishmaniasis (L. major), and eight for anthroponotic cutaneous leishmaniasis (L. tropica). Molecular quantification of Leishmania parasites was performed on sera, urines and cutaneous biopsies of CL and VL patients, demonstrating that parasite load is lower in urines, compared to sera or biopsy. DNA can be detected in 20 out of 23 (86.9%) CL urine samples and in 13 out of 14 (92.8%) VL urine samples. Immunodetection analysis demonstrates that 22 out of 23 (95.6%) sera from CL patients and all patients suspected with VL are positive. For urine samples, 18 out of 23 (78.2%) urine of CL patients and 13 out of 14 (92.8%) urine of VL patients were positive, using Western blot. Therefore, immunodetection and molecular analysis using urine samples can be used as a diagnostic tool for surveying cutaneous and visceral leishmaniasis.

Determining Serum Zinc and Magnesium Levels in Hemodialysis Patients Could be Helpful for Clinicians.

Trace element determination is requested rarely for critically ill patients in Iran, due to the underestimation of the trace element determination by Iranian physicians. The aim was to compare the levels of Zn and Mg in a group of hemodialysis patients and normal individuals. This study shows that trace element determination is helpful for management of hemodialysis patients. Fifty-three hemodialysis patients and 51 control individuals were randomly analyzed for Zn and Mg serum levels. Comparison of before or after dialysis and with normal individuals was done and receiver operating characteristics (ROC) curves were plotted to evaluate the analytical sensitivity and specificity of Zn and Mg determination. Confidence interval for all statistical methods was 95 %. Zinc serum levels were decreased after hemodialysis insignificantly (P = 0.201) but Mg levels were decreased significantly (P = 0.000). Both Zn and Mg levels, before and after hemodialysis were meaningfully lower than normal controls (P < 0.05). ROC analysis showed that the area under the curve was high for Zn levels both before and after hemodialysis but it was high for Mg only before hemodialysis. Current study shows that serum Zn and Mg measurements can have clinical importance. Both before and after hemodialysis, serum Zn = 297.5 µg/L and Mg = 2.295 µg/L are proposed as cut-off values with about 90 % specificity, for monitoring of these two element in hemodialysis patients. It is suggested that clinicians consider the measurement of these trace elements for hemodialysis patients routinely or periodically as clinical chemistry tests.