Evaluation of gram-chromotrope kinyoun staining technique: its effectiveness in detecting microsporidial spores in fecal specimens

This study was conducted to evaluate the modification of the usual Gram-chromotrope staining technique developed in-house known as Gram-chromotrope Kinyoun (GCK) in comparison with the Weber Modified Trichrome (WMT) staining technique; as the reference technique. Two hundred and ninety fecal specimens received by the Microbiology Diagnostic Laboratory of Hospital Universiti Kebangsaan Malaysia were examined for the presence of microsporidial spores. The sensitivity and specificity of GCK compared to the reference technique were 98% and 98.3%, respectively. The positive and negative predictive values were 92.5% and 99.6%, respectively. The agreement between the reference technique and the GCK staining technique was statistically significant by Kappa statistics (K = 0.941, P < 0.001). It is concluded that the GCK staining technique has high sensitivity and specificity in the detection of microsporidial spores in fecal specimens. Hence, it is recommended to be used in the diagnosis of intestinal microsporidiosis.     

Essential tremor: choosing the right management plan for your patient

Essential tremor is a common neurologic problem seen widely at all levels of patient care. It should be differentiated from secondary causes of tremor and Parkinson disease. It can be managed with commonly used drugs. However, severe, resistant, or atypical cases should be referred to a specialist for evaluation and the possible use of botulinum toxin or deep brain stimulation.     

Effect of Hawthorn (Crataegus aronia syn. Azarolus (L)) on platelet function in albino Wistar rats

Objective

This study was designed to investigate the possible antiplatelet effect of aqueous whole-plant C. aronia syn: Azarolus (L) extract using Wistar albino rats as a model.

Materials and methods

Forty-two male albino Wistar rats weighing 200 to 250 g were divided into seven groups with six rats in each group. Group 1 served as the control and received equal volumes of distilled water. Groups 2-6 served as the experimental groups and were given C. aronia extract at doses of 100, 200, 500, 1,000, and 2,000 mg/kg, while group 7 served as a positive control and was given aspirin (25 mg/kg). All the doses were administered orally once a day and the treatment was continued for seven days. In all groups, at the end of the experimental procedure, blood samples were obtained for platelet function measurements, including PFA-100, thromboxane B2 levels, platelet count, and haematocrit. The bleeding time was determined using a modified tail cutting method described previously.

Results

The aqueous C. aronia syn. Azarolus (L) extract significantly altered the bleeding time and the closure time, as determined by the PFA-100 and thromboxane B2 levels, suggesting significant platelet function inhibition. These effects were observed with C. aronia doses between 100 - 500 mg/kg, which yielded thromboxane B2 levels of 1,000 mg/kg, whereas the higher dose (2,000 mg/kg) produced opposite effects on these parameters.

Conclusion

C. aronia syn. Azarolus (L) aqueous extract has antiplatelet effects in Wistar albino rats.     

Chlorhexidine controlled-release profile after EDTA root surface etching: an in vivo study

Background: The main objective of the present study was to quantify chlorhexidine (CHX) release after the use of CHX‐EDTA root surface treatment as a local‐delivery antimicrobial vehicle. Methods: Twenty non‐smoking patients clinically diagnosed as having moderate‐to‐severe chronic periodontitis were selected to participate in this study. After cause‐related therapy, one site in every patient received defect overfill with CHX gel 2% (20 sites). In addition, twenty contralateral sites received defect fill of CHX gel after 3 minutes of 24% EDTA gel root surface etching (20 sites). Gingival crevicular fluid samples were collected at 1, 3, 7, and 14 days post‐therapy. Results: The CHX‐EDTA group showed statistically significantly higher levels of CHX than those of the control group at 1, 3, and 7 days. At 14 days, the CHX‐EDTA group showed 0.8 mg/mL values. Conclusion: The use of CHX‐EDTA root surface treatment as a local‐delivery antimicrobial improves CHX substantivity.     

Predictors of a sustained virological response in patients with genotype 4 chronic hepatitis C

Objectives: To determine the clinical, biological, virological and histological predictive factors associated with a sustained virological response (SVR) to combined interferon therapy among Egyptian patients infected by genotype 4 hepatitis C virus (HCV). Patients and Methods: Individual data from 250 patients with genotype 4 chronic hepatitis C, treated with different regimens of combined interferon, were analysed. The primary end point was SVR defined as undetectable HCV RNA by polymerase chain reaction (PCR) 24 weeks after the end of treatment. Multivariate logistic regression analysis was performed to select the independent prognostic parameters associated with SVR. Results: A sustained virological response was achieved among 137/250 (54.8%) patients. Baseline factors independently and negatively associated with SVR were serum α‐fetoprotein (AFP) level (above 0.3 upper limit of normal) [odds ratio (OR)=0.5, 95% confidence interval (CI): 0.2–0.8], severe fibrosis (Metavir score >F2) (OR=0.4, 95% CI: 0.2–0.8), presence of steatosis (OR=0.5, 95% CI: 0.3–0.97) and standard interferon treatment (OR=0.4, 95% CI: 0.2–0.8). Conclusions: Among genotype 4 chronic hepatitis C patients, severe fibrosis, severe steatosis, treatment with standard interferon and a high serum AFP level were all negatively associated with SVR. Pretreatment serum AFP level should be considered in the routine assessment of factors predictive of a treatment response.