[Show abstract][Hide abstract] ABSTRACT: Introduction: Tuberculous meningitis is a medical emergency that low sensitivity of CSF smear staining and mycobacterial culture make its diagnosis difficult, so there is an urgent need for rapid, accurate and reliable laboratory test. The aim of this study was comparing the sensitivity and specificity of CSF adenosine deaminase (ADA) level with Polymerase Chain Reaction (PCR) test in the diagnosis of tuberculous meningitis (TBM). Methods and Materials: In the period between January 2007 and January 2008 we had 49 patients with primary diagnosis of TBM in Bou-Ali University hospital. After committing and using the definite and probable TB as a golden standard, the final diagnosis for 29 of them was TBM. Results: Our study showed that the sensitivity and specificity of CSF-ADA level in comparison with PCR results in diagnosis of TBM with a 6.5 IU/L cut-off were 100% and 85% respectively. Our study showed that selecting a 6.5 IU/L cut-off with respect to the PCR results of the patients makes a reasonable sensitivity and specificity for CSF-ADA test in TBM diagnosis. Conclusion: Our study emphasized that CSF-ADA level measurement can be used as a good, rapid and reliable laboratory test for diagnosing tuberculous meningitis.
Iranian Journal of Child Neurology 01/2010; 8:651-658.
[Show abstract][Hide abstract] ABSTRACT: Mycobacterium tuberculosis H(37)Rv is a highly successful pathogen and its success fully relies on its ability to utilize macrophages for its replication and, more importantly, the macrophage should remain viable to host the Mycobacterium. Despite the fact that these phagocytes are usually very effective in internalizing and clearing most of the bacteria, M. tuberculosis H(37)Rv has evolved a number of very effective survival strategies, including: (a) the inhibition of phagosome-lysosome fusion; (b) the inhibition of phagosome acidification; (c) the recruitment and retention of tryptophan-aspartate containing coat protein on phagosomes to prevent their delivery to lysosomes; and (d) the expression of members of the host-induced repetitive glycine-rich protein family of proteins. However, the mechanisms by which M. tuberculosis H(37)Rv enters the host cell, circumvents host defenses and spreads to neighboring cell are not completely understood. Therefore, a better understanding of host-pathogen interaction is essential if the global tuberculosis pandemic is ever to be controlled. This review addresses some of the pathogenic strategies of the M. tuberculosis H(37)Rv that aids in its survival and pathogenicity.
[Show abstract][Hide abstract] ABSTRACT: Serum ferroxidase and albumin levels were determined in 98 patients of tubercuiosis, of whom 49 were freshly diagnosed, sputum positive (group-I) & 49 were completely treated patients (group-II). Forty nine age and sex matched healthy individuals were taken as controls. Mean±SD of serum ferroxidase and albumin levels in controls, group-I and group-II was found to be 864.35±106.35 IU/L & 3.91±0.234 g/dL, 1603.76±222.65 IU/L & 3.24±0.518 g/dL and 1001.78±201.63 IU/L & 3.82±0.43 g/dL, respectively. Serum ferroxidase in group I was significantly higher as compared to controls and group-II (p<0.01). The decreased levels of serum albumin in group I, as compared to control and group-II was statistically significant (p<0.01). Serum ferroxidase: albumin ratio (Ferroxidase in International Unit per gram of albumin) in group I (50.47±10.36 IU/g) was significantly higher than controls (22.22±3.3 IU/g), (p<0.001) while in group II it was significantly lower (26.72±7.18 IU/g, p<0.001) than group-I and close to control values. Serum ferroxidase: albumin ratio (IU/g) can therefore be incorporated as a surrogate marker to assist in diagnosis and prognosis of pulmonary tuberculosis.
Indian Journal of Clinical Biochemistry 09/2007; 22(2):106-8.
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