Assessment of enzyme linked immunosorbent assay based diagnostic kits (Toxokit-G and Toxokit-M) for the detection of IgG and IgM antibodies to Toxoplasma gondii in human serum.

An enzyme linked immunosorbent assay (ELISA) using penicillinase was developed in the form of diagnostic kits (Toxokit-G and Toxokit-M) for the detection of IgG and IgM antibodies to Toxoplasma gondii. The performance of both the kits was compared with commercially available diagnostic kits, i.e. Enzygnost-Toxoplasmosis/IgG (Behring Co., Germany), TOXOTEK-G (Flow Lab., U.K.) and Toxoplasma IgM Microassay (Diamedix Corp., U.S.A.) by testing toxoplasma-suspected human serum samples. The results indicate a good reliability between these diagnostic kits. Toxokit-G has 86.66 and 96.05% sensitivity and specificity respectively. The main advantage of Toxokit-G is that the end result can be assessed visually without using sophisticated instruments. Toxokit-M has 100% sensitivity and specificity and test results were not affected by the presence of antitoxoplasma IgG antibodies, rheumatoid factor or antinuclear antibodies.

Chronic bronchitis: IgA and C3 in acute exacerbations.

Serum IgA, secretory IgA and serum C3 were estimated in 22 patients of chronic bronchitis with acute exacerbation. These were compared with 22 normal controls. There was no significant difference in the parameters studied. However, all patients showed a significant change in the above parameters when divided into mild, moderate and severe categories depending on the chronicity of the disease. An inverse relationship between serum C3 and secretory IgA was observed.

An outbreak of meningitis caused by Neisseria meningitidis Group A.

During a period of six months from September, 1985 to March, 1986, there were twenty seven cases of pyogenic meningitis due to Neisseria meningitidis Group A. Maximum number of cases could be diagnosed by antigen detection by latex agglutination test. The organism was sensitive to all commonly used antibiotics. The patients affected were mostly young adults. The mortality rate was eleven per cent.

Comparative evaluation of coagglutination and latex agglutination test (Rotalex kit) for detection of rota virus.

Coagglutination test was compared with commercially available latex agglutination test (Rotalex kit) for detection of rota virus in faecal samples from clinically suspected cases of viral gastroenteritis. Out of 80 test samples 16 (20%) and 20 (25.3%) were positive for rota virus antigen by Rotalex kit and coagglutination test respectively. All the 40 controls were negative for viral antigen by Rotalex kit and only one gave positive result by coagglutination test. Coagglutination test was found to be economical, sensitive and specific for screening and rapid diagnosis of Rota virus diarrhoea.

Counterimmunoelectrophoresis in the immunodiagnosis of amoebiasis.

Counterimmunoelectrophoresis (CIE) detection of antiamoebic antibodies in the patients' sera, has been carried out and correlated with the routine diagnostic microscopic examination of stool and pus samples. The clinically suspected amoebiasis cases were divided into two main groups, (i) proved positive for Entamoeba histolytica as detected by microscopic examination of samples, and (ii) negative for the parasite. A total 153 cases of intestinal amoebiasis were studied. CIE was positive in 27 of the 84 proved cases, and in 12 out of 69 unproved cases showing negative microscopy. A total of 59 cases of amoebic liver abscess (ALA) were studied, of which CIE was positive in 20 of the 30 proved cases of ALA and in 4 of the 29 unproved cases. Sera from patients with non-amoebic illness (n = 48) gave negative results with CIE. Similarly sera from normal healthy controls (NHC) (n = 100) and asymptomatic cyst passers (n = 75) were negative by CIE.

Immunoprofile of pulmonary tuberculosis-comparison with normal healthy controls.

The immunoprofile of 60 adult patients of pulmonary tuberculosis was studied and compared with 22 normal controls. The immunological parameters studied were serum protein electrophoresis, serum immunoglobulins (IgG, IgA and IgM), delayed hypersensitivity by Mantoux test, and T-cell % estimation. The mean total serum proteins and serum albumin were significantly lower, whereas mean beta and gamma globulins were elevated. Mean serum IgG and serum IgA showed a significant rise, whereas the T-cell % was significantly reduced when compared to controls. The significance of these findings is discussed.

Chronic bronchitis. IV--Antibody titres to bacterial antigens during acute exacerbations.

In 49 patients of chronic bronchitis with acute exacerbation, serum antibody titres were estimated against the respective pathogen isolated and cultured from sputum of individual patients. Antibody titres to Klebsiella and Staphylococcus coagulase positive organisms were found in 28 and 25 patients respectively. Paired serum samples from 21 patients showed rising antibody titres in 17 of them, whereas the antibody titres fell in the remaining 4 patients. Notably, only 2 patients demonstrated a four fold rise or fall in the antibody titres. The significance of these findings is discussed.

Detection of HSV-2 antigen in carcinoma cervix and premalignant conditions by immuno-cytochemistry.

One hundred and twelve cases of cervical pathology (58 paraffin sections and 54 cervical smears) were assessed by PAP technique and 30 cases by indirect immunofluorescent technique. Forty-two normal cervical smears from the age matched controls were stained by indirect immuno-fluorescent technique. HSV-2 antigen was detected by PAP method in 86 out of 112 cases (78.57%) i.e. 50/55 squamous cell carcinoma, 13/13 carcinoma in situ, 11/15 severe dysplasia, 3/4 moderate dysplasia and 9/16 mild dysplasia. The amount of antigen was maximum in squamous cell carcinoma and decreased in carcinoma in situ, severe, moderate and mild dysplasia in descending order. Three cases of adenocarcinoma cervix were negative. Only one case out of 42 controls was positive. HSV-2 antigen was detected by an indirect IF technique in 8/9 squamous cell carcinoma, 2/3 carcinoma in situ, 3/7 dysplasia, O/1 adenocarcinoma and 4/10 inflammatory cases. The above findings support the association between HSV-2 and squamous cell carcinoma cervix, as well as carcinoma in situ which is statistically significant.

Gastric colonization and pneumonia in intubated critically ill patients receiving stress ulcer prophylaxis: a randomized, controlled trial.

OBJECTIVE: To study the effects of pharmacologically increasing gastric pH on gastric colonization and the development of pneumonia in intubated critically ill patients. DESIGN: Randomized, controlled trial. SETTING: Medical ICU in a university hospital. PATIENTS: Thirty-four tracheotomized patients with tetanus. INTERVENTIONS: Sixteen patients received iv ranitidine to increase gastric pH greater than 4 (ranitidine group), while 18 patients received no prophylaxis for upper gastrointestinal bleeding (control group). MEASUREMENTS AND MAIN RESULTS: Mean gastric pH was higher in the ranitidine group (median 4.7, range 3.6 to 6.1) than in the control group (median 2.1, range 1.2 to 4.9; p less than .05). Gastric colonization occurred in 15 (94%) of 16 patients who received ranitidine, 2 days (median; range 1 to 5) after intubation; gastric colonization also occurred in all control patients (median 4 days, range 1 to 9; p less than .05). Pneumonia occurred in 13 (81%) of 16 patients who received ranitidine, 3 days (median, range 1 to 5) after intubation and in nine (50%) of 18 control patients (p less than .01) 5 days after tracheal intubation (median, range 3 to 14; p less than .01). Prior gastric colonization by the pathogen that caused pneumonia was demonstrable in nine (56%) of 16 patients who received ranitidine vs. eight (44%) of 18 control patients (p greater than .05). The risk for developing pneumonia in the ranitidine-treated group was highest in the first 4 days after tracheal intubation. There was no difference in the frequency of upper gastrointestinal hemorrhage in the two groups. CONCLUSIONS: Pharmacologically increasing gastric pH increases the risk for developing pneumonia in intubated critically ill patients. The pneumonia occurs earlier than in untreated control patients.