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1.
Total acetylcholinesterase activity (AChE) was estimated in CSF and serum of 163 cases, comprising of 64 cases of Tuberculous meningitis (TBM), 60 cases of pyogenic meningitis (PM) and 30 control in the paediatric age group. Mean CSF-AChE levels were 7.94±0.38, 9.06±0.16 and 9.80±0.30 unit/ml (Mean±S.E.) in Control, TBM and PM respectively. The respective serum AChE levels were 2.65±0.13, 3.18±0.07 and 3.93±0 0.035 units/ml. The ratio of CSF/serum-AChE in three groups were 3.09±0.137 (Mean±S.E.), 2.88±0.087, 2.98±0.092 in control, TBM and PM respectively. The values in both CSF as well as in serum in patient with TBM and in PM were significantly higher as compared to controls. However, the differences between the mean CSF-AChE and serum-AChE levels and CSF-AChE/serum-AChE were insignificant. Thus, though AChE levels are raised in meningitis, they are not helpful in differentiating TBM from PM.  相似文献   

2.
Total acetylcholinesterase (AChE) activity was estimated in cerebrospinal fluid (CSF) using colorimetric method in 64 cases with tuberculous meningitis, (TBM) (n=64), pyogenic meningitis (PM) (n=60) and in controls (n=39) of paediatric age group. Mean CSF—AChE values of both TBM and PM were significantly higher when compared with controls (p<0.001) but no significant change between TBM and PM was observed (p<0.01). It is suggested that inflammation of meninges due to the infection may attribute to a change in the function of blood brain barrier (BBB) causing higher CSF—AChE values in these diseases.  相似文献   

3.
Background  Sialic acid (SA) is a nine carbon sugar derived from mannosamine and pyruvate. High levels of sialic acid and aspartate transaminase (AST) levels in cerebrospinal fluid have been described in pyogenic meningitis (PM) compared to tubercular meningitis (TBM). Objectives  To evaluate the levels of CSF free SA in PM and TBM and to assess the correlation between CSF free SA and CSF glucose or total protein levels. Patients and Methods  A total of 122 subjects were studied and divided into children and adults. Further, these have been subdivided into controls, PM and TBM. CSF free SA was estimated by thiobarbituric acid assay of Warren and AST by Reitmann and Frankel method. Results  CSF free SA and AST levels in children and adults were significantly high in PM (p<0.001) as compared to TBM and controls. Conclusion  A very high CSF free SA and AST were found to be characteristic of PM, making them useful parameters to differentiate PM from TBM.  相似文献   

4.
Oxidative stress is implicated in the etiopathogenesis of a variety of human diseases. Therefore, in the present study, erythrocyte lipid peroxidation, percentage hemolysis, antioxidant enzymes viz., glutathione reductase, glutathione peroxidase, superoxide dismutase and plasma antioxidants viz., ceruloplasmin, vitamins A,E and C have been determined in 19 patients with tubercular meningitis (TBM) and 50 normals. Six patients who were treated with antibiotics were considered for the follow up. The statistical analysis was carried out by Mann Whitney U test and Wilcoxon rank sum test. Lipid peroxidation (P<0.02), percentage hemolysis (P<0.001) and plasma ceruloplasmin (P<0.0001) of TBM patients were significantly higher, whereas erythrocyte glutathione reductase (P<0.05) and plasma antioxidant vitamins A, E and C (P<0.01, P<0.05 respectively) were significantly lower than those of the controls. In the follow up patients the glutathione reductase and catalase levels were significantly high (P<0.05) compared to their pre-treated condition. Vitamin C and E levels have attained normal range. This study indicated that the blood antioxidant status of TBM patients which was low compared to controls improved after treatment, suggesting the role of free radicals in TBM.  相似文献   

5.
Serodiagnosis by ELISA has been widely explored over the years, in the diagnosis of tuberculosis. Two ELISA systems were evaluated for detection of mycobacterial antibodies in pulmonary and extra pulmonary tuberculosis. The two test assays explored were ERBA LISA (TB IgG) test (Anda Biologicals) which uses A60 antigen complex found in the cytosol of typical and atypical mycobacteria, and SEVA TB (IgG) ELISA, which uses a 31 kDa, glycoprotein antigen purified fromM. tb H37Ra culture filtrate. Sera from 98 proven tuberculosis [pulmonary TB (48), tuberculous lymphadenopathy (30), tuberculous meningitis (15) & genitourinary TB (5)] were studied along with 32 healthy controls. The overall positivity obtained using ERBA LISA (TB IgG) test and SEVA TB (IgG) ELISA test was 72.9% and 91.6% in pulmonary tuberculosis, 43.3% and 76.6% in tuberculous lymphadenopathy respectively. The sensitivity of ERBA LISA test in tuberculous meningitis and genito-urinary TB was significantly low (26.6% & 40% respectively) compared to sensitivity obtained using SEVA TB ELISA (86.6% & 60% respectively) with overall specificity of 60% and 87.5%. Thus SEVA TB IgG ELISA test was found to be more sensitive than ERBA LISA in detecting IgG antibodies in tuberculous sera, in particular in extra pulmonary tuberculosis cases.  相似文献   

6.
Alkaline phosphatase, alanine amino transferase, aspartate amino transferase and proteins were investigated in C.S.F from cases of pyogenic and non-pyogenic meningitis and controls; ascitic fluid from patients with cirrhosis of liver, tuberculous abdomen and malignancy; and pleural fluid. Same investigations were done in the corresponding blood-sera in respect of fluids other than C.S.F. Levels of proteins were elevated by 65.7% in C.S.F. in pyogenic meningitis and 27.7% in non-pyogenic meningitis compared to controls. Levels of alkaline phosphatase were found to be increased to 57% in pyogenic meningitis with a decrease of 17.8% in the non-pyogenic type while those of ALT and AST were found to be increased by 59% and 103% respectively in the non-pyogenic type. If the levels of the 3 enzymes of fluids other than C.S.F. were compared, alkaline phosphatase levels were almost double in ascitic fluid in cirrhosis and those of ALT and AST were greater in malignancy and tuberculous pleural effusion. Both alkaline phosphatase and ALT levels were low in ascites in tuberculous abdomen with the least ALT values.  相似文献   

7.
Adenosine deaminase and C-reactive protein in CSF were assessed in 72 cases of Tubercular meningitis, 24 cases of partially treated pyogenic meningitis, 20 cases of Aseptic meningitis and 8 cases of febrile seizures. Mean Adenosine deaminase value was 12.12±3.13 IU/L for Tubercular meningitis group. It was significantly higher (p<0.001) as compared to partially treated pyogenic meningitis (5.39±2.70 IU/L) and aseptic meningitis (1.92±0.56 IU/L) groups. A combination of clinical criteria along with biochemical test of Adenosine deaminase and C-reactive protein in CSF increased the sensitivity of diagnosing Tubercular meningitis and differentiating it from other forms of meningitis at an early stage.  相似文献   

8.
Tuberculosis has, in a short span of time, become a major health problem in the third world or developing countries like India. In view of this, a retrospective study was conducted to study Adenosine deaminase activity in serum and pleural fluid in patients affected with Pulmonary Tuberculosis and other common non-tubercular chronic respiratory diseases. The study was carried out on 100 patients suffering from various pulmonary disorders, between January 2002 and August 2002. Thirty-five normal healthy individuals were included as control subjects. ADA estimation was done by sensitive colorimetric method. The study revealed that the serum ADA activity was higher in patients of tuberculous pulmonary and pleural diseases and non-tuberculous pulmonary diseases than in control subjects. The mean serum ADA activity in the patients’ group was 35.5±6.93 u/l as compared to 16.20±2.85 u/l in control group, showing a highly significant (P≪0.001) difference. ADA activity was highest in tuberculous pleuropulmonary diseases. The pleural fluid ADA activity was higher in pyogenic pleural effusion than in tuberculous pleural effusion.  相似文献   

9.
Pleural effusion is one of the commonest presentations of tuberculosis, the clinical manifestations being typically abrupt resembling bacterial pneumonia. Since delayed hypersensitivity is the underlying immune response, bacterial load is very low. Owing to these facts, tuberculous pleurisy as an extra-pulmonary disease poses a diagnostic dilemma. The conventional bacteriological methods rarely detect Mycobacterium tuberculosis in pleural fluid and are of limited use in diagnosis of tuberculous pleurisy. We evaluated the efficacy of polymerase chain reaction (PCR) in the diagnosis of tuberculous pleurisy by targeting the gene segment coding for MPB64 protein specific forMycobacterium tuberculosis. Based on the clinical criteria, 82 patients with lymphocytic exudative pleural effusion were included in the study. Patients were analyzed in two groups; one group consisting of 48 patients of tubercular pleural effusion confimed by various diagnostic procedures and another group of 34 patients comprising of non-tubercular pleural effusion. There were no false positive results by PCR and the specificity worked out to be 100%. Twenty two patients tested positive for Mantoux with a sensitivity of 45%. ZN-staining for AFB was found in samples from 15 patients (20% sensitivity). ADA was positive for 28 patients with a sensitivity of 53%. PCR was positive for 32/48 patients (67% sensitivity). Thus, PCR was found to be more sensitive than any other conventional method in diagnosis of clinically suspected tubercular pleurisy.  相似文献   

10.
Serum ceruloplasmin is one of the most commonly used screening tests for Wilson’s disease. However immunological assays for ceruloplasmin are not recommended for diagnosis and management of Wilson’s disease through calculation of free copper index. Enzymatic methods using non-physiological substrates have toxicity and stability problems, making them difficult to automate. Ferroxidase assays may be a satisfactory alternative for measuring serum ceruloplasmin. The o-dianisidine hydrochloride manual method for estimation of serum ceruloplasmin enzyme activity was compared with an automated method using the ferroxidase activity of ceruloplasmin in measurement in a double blind study in 91 consecutive patients screened for Wilson’s disease. The o-dianisidine and ferroxidase methods both successfully identified 7 patients with Wilson’s disease. Values for these 7 patients in the o-dianisidine and ferroxidase methods were median 5.0 (range 0–16.0 U/L) and median 45.0 (range 4–166 U/L) respectively. There were 7 other positive values (<62 U/L) with the o-diansidine method and 2 (<200 U/L) with the ferroxidase method, where WD was not confirmed. ROC curves for both methods showed area under the curve of 0.998 for o-dianisidine and 0.997 for ferroxidase. Using literature cut off values of 62 U/L and 200 U/L respectively both methods had 100% sensitivity and specificity was 91.7% (o-dianisidine) and 97.6% (ferroxidase). For the o-dianisidine assay, specificity was improved to 98.8% using a cut off of 22.5 U/L. In the 84 persons (46 adults and 38 children) in whom the diagnosis of Wilson’s disease was not established, the mean value for ceruloplasmin activity by the o-dianisidine and ferroxidase methods was 124.7 ± 48.7 U/L and 571.4 ± 168.1 U/L respectively. There were no significant differences between sex or age of patients (p > 0.29). In a subsequent evaluation with 372 specimens, the Pearson correlation coefficient between the assays was 0.908, p < 0.01, slope 4.06, intercept 265.8, with the manual assay as the x-axis. The ferroxidase assay is a suitable replacement for the o-dianisidine assay in detecting patients with Wilson’s disease.  相似文献   

11.
Humoral immune response against PPD derived A60 antigen was evaluated by quantification of serum A60 antibodies in thrity healthy adults not exposed to tuberculosis (Group 1), in twenty seven healthy adults exposed to tuberculosis patients i.e. staff working in wards of tuberculosis hospital for one to thirty years (group 2), in twenty five pulmonary tuberculosis patients admitted to the Institute for Chest Diseases, Hyderabad (Group 3) and in sixty neurotuberculosis patients admitted to Neurosurgery department of our institute (Group 4). Highly significant elevation of A60 antibodies was observed in pulmonary tuberculosis patients (p<0.01) compared to healthy adult groups. A significant elevation in serum was also observed in case of neurotuberculosis group compared to both healthy groups (p<0.01). A test on A60 antibodies in serum gavv a sensitivity of 100%, specificity of 96.6%, positive predictive value of 81% and negative predictive value of 100% for pulmonary tuberculosis, whereas a sensitivity of 58%, positive predictive value of 79% and negative predictive value of 75% were noted for neurotuberculosis patients. Results of A60 antibodies in ten cerebrospinal fluids (CSF) obtained from non tuberculosis patients and thirty two CSF from patients of neurotuberculosis did not show significant elevation of antibodies. However the ninetyfive percentile value of CSF A60 antibodies was higher in neurotuberculosis (7.4 U/ml) group compared to nontuberculous group (3.8 U/ml) and the test showed a good positive predictive value (83%), very low negative predictive value (25%) and low sensitivity (63%). Serum A60 antibody assay appears to be a good serological marker available today for pulmonary tuberculosis and a supportive marker for neurotuberculosis.  相似文献   

12.
Heat stable fraction (HSF) of alkaline phosphatase (ALP) was evaluated as an adjunct to CA 125 as a tumour marker for epithelial ovarian cancer in a follow-up study. In our study group 63.4% of patients had elevated HSF levels (≥10U/L) and 93.3% had elevated CA 125 levels (>35U/mL). The sensitivity of CA 125 and HSF was 93.3% and 63.3% respectively. The decline in the activity of HSF, over the pre-op levels was highly significant after the first (p=0.001) chemotherapy cycle and significant after the second and third cycles (p<0.029). Thereafter, HSF activity was almost undetectable. The decrease in CA 125 levels over the pre-op levels was significant after the first, second, third (p<0.001) and fourth (p<0.034) chemotherapy cycle. HSF can be used alone or as an adjunct to CA 125 in screening and monitoring patients of ovarian carcinoma especially in remote areas where sophisticated facilities are not available and in patients in which CA 125 levels are not raised preoperatively.  相似文献   

13.
Serum Adenosine Deaminase (ADA) activity was studied in 20 control cases and 32 patients with carcinoma breast. In control group the ADA activity ranged from 13–94 IU/L with a mean of 43.75±21.55 IU/L while in patients of carcinoma breast it was 16–95 IU/L with a mean of 47.46±22.54 IU/L, but these values were not statistically different. The ADA activity was also compared with other parameters in patients of carcinoma breast but the difference was not statistically significant in the various parameters like duration of disease, menopausal status, tumor size, hemoglobin level, total leucocyte count, absolute lymphocyte count, total serum proteins, serum albumin, histological grade of tumor and lymphocytic infiltration. The only significant difference in ADA activity was when N1 status of lymph node was compared with N2 status of lymph node.  相似文献   

14.
Load voltage waveforms corresponding to symmetrical phase-angle triggering and integral-cycle triggering in single-phase thyristor circuits, and also the waveform due to half-wave rectification, are all discrete forms of amplitude modulation. In each case the modulated output voltage is obtained from a sinusoidal (supply) carrier signal by use of a rectangular modulating function, dependent on thyristor switching.The use of amplitude modulation (AM) techniques for frequency conversion in high power applications is subject to certain severe restrictions of performance. These restrictions can be largely overcome by the use of phase modulation (PM) methods which involve two channels of AM in each electrical supply line.Appropriate waveforms may be realised by the use of controlled switching of thyristors. These are arranged in combinations of inverse-parallel connected pairs forming subtractor modulators. Certain thyristor commutation problems arise in PM systems at high power levels. These problems can be overcome by producing so-called AM/PM waveforms that combine the separate advantages of AM and PM systems.  相似文献   

15.
Pleural tuberculosis accounts for nearly 20% of Extra pulmonary tuberculosis. Adenosine deaminase, commonly used biomarker for the diagnosis, is non specific and there is paucity of literature on its correlation with conventional or newer methods for the diagnosis of extra pulmonary forms of TB. The aim of the study was to assess diagnostic potential of T cell function markers [interferon (IFN-γ), interleukin (IL-2) and IFN-γ/IL-2 ratio]; macrophage activation marker [neopterin]; and oxidative stress markers [protein carbonyl and malondialdehyde (MDA)] in pleural tuberculosis. 26 pleural TB cases diagnosed on the basis of suggestive chest X-ray and raised serum ADA levels and healthy controls were included in the study. Pleural fluid specimens were subjected to Zeihl Neelsen staining and culture on Lowenstein Jensen medium. Serum IFN-γ, IL-2, neopterin and protein carbonyl levels detection were done by ELISA and MDA levels were determined by measuring the thiobarbituric acid reactive substances. Median serum levels of IFN-γ, IL-2, IFN-γ/IL-2 ratio, neopterin, protein carbonyl and MDA were significantly different between cases and controls. Levels of all biomarkers except IL-2 were significantly higher in cases with contact history. Mean levels of ADA and ESR were 46.27 U/L and 46.62 mm/hr in PTB cases. AUC for IFN-γ, IL-2, IFN-γ/IL-2 ratio, neopterin, protein carbonyl and MDA were significantly discriminative for cases and controls. IFN-γ/IL-2 ratio was best discriminatory biomarker with highest area under ROC curve. Though no correlation was seen between ADA and any of the six biomarkers, ESR levels correlated significantly with all biomarkers except IL-2 by spearman’s correlation coefficient. Though all the circulating biomarkers under study provide useful supportive evidence for the diagnosis of PTB, further studies involving diverse control groups particularly non-PTB effusion are needed to validate these results.  相似文献   

16.
Serum adenosine deaminase (ADA), 5′ nucleotidase (5′NT) and malondialdehyde (MDA) were estimated in patients with acute infective hepatitis (AIH) along with the routine parameters of liver disease. Present study is done to evaluate these special parameters in patients with clinical history of AIH and to assess the utility of these parameters as diagnostic/ prognostic indices of liver function and to correlate special parameters with routine live function tests (LFT). ADA, 5′NT and MDA along with routine LFT was estimated in 25 patients with AIH and 25 samples from healthy voluntary blood donars served as the control group. Routine LFT was estimated by standard clinical chemistry procedures on dade behring analyser and ADA, 5′NT and MDA were estimated by berthlot reaction, fiske and subbarao method and thiobarbituric acid method respectively. Statistical analysis showed that serum ADA, 5′NT and MDA were significantly higher in patients as compared with the controls. There was a significant positive correlation between ADA and total bilirubin and MDA and total bilirubin. Hence we can conclude that these tests would be more sensitive to diagnose the patients with AIH and that the raised bilirubin levels could be looked upon, as a protective mechanism which the liver has evolved in order to combat oxidative stress.  相似文献   

17.
Tuberculosis remains major health problem in India and developing countries Immunodiagnosis has important role in screening, diagnosis and management of tuberculosis. SEVA TB ES-31 antigen has shown potential in detecting tuberculous IgG antibody in earlier studies from our laboratory. In the present study we have analysedSEVA TB ES-31 antigen specific immunoglobulinsIgM, IgA and IgG in clinically and bacteriologically confirmed pulmonary tuberculosis cases to determine the usefulness of specific immunoglobulin class in the diagnosis of patients attending the hospital. Of the 30 cases of pulmonary tuberculosis 25 (83.3%) were positive for IgG, 19 (63.3%) for IgM and 16 (53.3%) for IgA. On combining IgG and IgM positivity, sensitivity was increased to 93.3%. While combining IgG and IgA positivity, sensitivity increased to 90%. However specificity was decreased to 66.6% and 70% for both of these combinations respectively. It could be envisaged from this study that IgG antibody detection against ES-31 antigen showed acceptable sensitivity (83.3%) and specificity (86.6%) compared to IgM or IgA alone or in combination. When immune responses were analysed according to degree of sputum positivity, IgG response was observed to be predominant in all grades, compared to IgM or IgA antibody. The addition of IgM or IgA as an adjunct test increases the sensitivity but at the cost of specificity. Hence the detection of IgG alone is more useful compared to IgM or IgA assay, in detecting tuberculosis disease cases coming to the hospital.  相似文献   

18.
There was increase in erythrocyte lipid peroxidation and adenosine deaminase (ADA) activity in red blood cells (RBC's), white blood cells (WBC's) and plasma, in 30 patients of confirmed diabetes mellitus, 10 each of insulin dependent diabetes mellitus (IDDM or type I), non-insulin dependent diabetes mellitus (NIDDM or type II) and diabetes with ketoacidosis when compared with 20 healthy individuals (controls). Glycosylated hemoglobin A1c%, plasma free fatty acid (FFA) and glycerol levels were also elevated in all the cases when compared with controls. The increase was more in diabetic ketoacidosis group. Significant positive correlations were seen between erythrocyte lipid peroxidation and ADA activities in RBC's, WBC's and plasma. It is suggested that decreased tissue adenosine levels due to increase in ADA activity, is related to the severity of hyperglycemia and lipid peroxidation in diabetes mellitus.  相似文献   

19.
The study was aimed at presence of specific IgE antibody levelsinvitro to the identified antigen. Based on positive skin test with Gynandropsis gynandra and elevated levels of total IgE (>325 IU/ml) 104 patients were selected. Healthy, asymptomatic individuals (25) with low total IgE (<325 IU/ml) were included as controls. The mean OD values by ELISA for specific IgE were 0.67±0.21, 0.57±0.18 and 0.56±0.18 with whole pollen antigen, 46-37 kD fraction and 36-32 kD fraction, respectively. The specificity and sensitivity between skin test positivity with whole pollen antigen verses fraction with mol.wt 46-37 kD was 90% and 90% and for fraction with mol.wt 36-32 kD was found to be 81.1% and 89.4%. The clusters with molecular weights 46-37 kD and 36-32 kD may be useful inin vitro diagnostic test. Fractions within these clusters need to be identified for a higher specificity.  相似文献   

20.
A mycobacterial excretory-secretory protein fraction ESAS-7 purified by 50% ammonium sulphate precipitation followed by SDS-PAGE fractionation was evaluated by penicillinase enzyme linked immuno-sorbent assay (ELISA) for its sensitivity and specificity in the diagnosis of pulmonary tuberculosis. At a “cut off” serum dilution of 600, 38 (90%) of 42 sera from bacteriologically confirmed tuberculosis cases, 15 (100%) of 15 sera from bacteriogically negative but anti tubercular therapy (ATT) responded cases, 3 (7%) of 43 sera from normal healthy subjects and 4 (8%) of 48 sera from non tuberculous disease control cases gave positive reaction for tubercular antibody to ESAS-7 antigen fraction containing predominantly 33-kDa protein with a sensitivity of 90% in bacteriologically confirmed cases and specificity of 92%. Further, this diagnostic assay using the ESAS-7 antigen is more sensitive requiring as little as one nanogram antigen per test compared to use of 100 nanogram EST-6 antigen reported earlier. Thus use of ESAS-7 antigen for antibody detection has good diagnostic potential with improved specificity in pulmonary tuberculosis.  相似文献   

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