Tuberculous and brucellosis meningitis differential diagnosis

PubMedID: 25801665SummaryBackground The Thwaites and Lancet scoring systems have been used in the rapid diagnosis of tuberculous meningitis (TBM). However, brucellar meningoencephalitis (BME) has similar characteristics with TBM. The ultimate aim of this study is to infer data to see if BME should be included in the differential diagnosis of TBM when these two systems suggest the presence of TBM. Method BME and TBM patients from 35 tertiary hospitals were included in this study. Overall 294 adult patients with BME and 190 patients with TBM were enrolled. All patients involved in the study had microbiological confirmation for either TBM or BME. Finally, the Thwaites and Lancet scoring systems were assessed in both groups. Results The Thwaites scoring system more frequently predicted BME cases (n = 292, 99.3%) compared to the TBM group (n = 182, 95.8%) (P = 0.017). According to the Lancet scoring system, the mean scores for BME and TBM were 9.43 ± 1.71 and 11.45 ± 3.01, respectively (P < 0.001). In addition, TBM cases were classified into "probable" category more significantly compared to BME cases, and BME cases were categorized into the "possible" category more frequently. Conclusions When the Thwaites or Lancet scoring systems indicate TBM, brucellar etiology should also be taken into consideration particularly in endemic countries. © 2015 Elsevier Ltd. All rights reserved

Association of paraoxonase activity and atherosclerosis in patients with chronic hepatitis B

Background: The hepatitis B virus is a significant pathogen that causes cirrhosis, and hepatocellular cancer as a result of the damage it causes to liver cells. Its infection affects more than 400 million people globally. Although there is an effective vaccine and treatment methods, almost 1, 000, 000 people die every year. Objective: To investigate paraoxonase and arylesterase activities along with oxidative status parameters and serum lipid levels, and to find out if there is any increased susceptibility to atherogenesis. Methods: Thirty-four subjects with chronic hepatitis B and 39 healthy subjects as control were enrolled in the study. Age, body mass index and gender, Serum Triglycerides (TG), High-density Lipoprotein (HDL) and Low-Density lipoprotein (LDL) levels, serum paraoxonase-1 and arylesterase activities were determined. Oxidative and antioxidative statuses were evaluated by measuring serum-free sulfhydryl groups, lipid hydroperoxide levels, total antioxidant capacity, total oxidant status, and oxidative stress index. Results: Serum TG and LDL levels were higher while serum HDL levels were lower in patients with chronic hepatitis B than in controls but the differences did not reach statistical significance. Serum paraoxonase-1 and arylesterase activities, plasma free sulfhydryl groups, and total antioxidant capacity were significantly lower in patients than in controls (p=0.018, p=0.005, p<0.001, p=0.037 respectively), while lipid hydroperoxide, total oxidant status, and oxidative stress index were significantly higher (for all p<0.001). Conclusion: The diminution in the paraoxonase-1 and arylesterase activities could contribute to the accelerated development of atherosclerosis in patients with chronic hepatitis B

Evaluation of oxidative status in patients with Fasciola hepatica infection

Background: F. hepatica infection is rare and mostly subclinical. Migration of juvenile forms of F. hepatica into the host&rsquo;s liver is accompanied by an inflammatory reaction followed by fibrosis and cirrhosis. Objective: The aim of this study was to evaluate oxidative status by using a novel automated method in patients with Fasciola hepatica. Methods: Twenty two patients with a diagnosis of F. hepatica and 26 healthy volunteers were enrolled in the study. Their Total antioxidant capacity status (TAC), total oxidant status (TOS) and catalase were measured in them and oxidative stress index (OSI) was calculated. These measurements were also taken for the control group and the values were compared. Results: Plasma levels of total TOS and OSI were significantly increased in patients as compared with healthy controls (P&lt;0.001, P&lt;0.001, P=0.001, P=0.008) respectively. In contrast, TAC level was significantly lower in patients as compared with controls (p&lt;0.05). There was no significant difference between the catalase results of the two groups (p&gt;0.05). Conclusion: Total oxidative status and OSI were increased and total antioxidative status capacity was decreased in patients with F. hepatica infeciton. A high oxidative stress occurs during F. hepatica infection, which may cause severe damage in both the liver.Keywords: Fasciola hepatica, total antioxidant capacity, total oxidative status, oxidative stress inde

Evaluation of oxidative status in patients with Fasciola hepatica infection

Background: F. hepatica infection is rare and mostly subclinical. Migration of juvenile forms of F. hepatica into the host’s liver is accompanied by an inflammatory reaction followed by fibrosis and cirrhosis. Objective: The aim of this study was to evaluate oxidative status by using a novel automated method in patients with Fasciola hepatica. Methods: Twenty two patients with a diagnosis of F. hepatica and 26 healthy volunteers were enrolled in the study. Their Total antioxidant capacity status (TAC), total oxidant status (TOS) and catalase were measured in them and oxidative stress index (OSI) was calculated. These measurements were also taken for the control group and the values were compared. Results: Plasma levels of total TOS and OSI were significantly increased in patients as compared with healthy controls (P<0.001, P<0.001, P=0.001, P=0.008) respectively. In contrast, TAC level was significantly lower in patients as compared with controls (p<0.05). There was no significant difference between the catalase results of the two groups (p>0.05). Conclusion: Total oxidative status and OSI were increased and total antioxidative status capacity was decreased in patients with F. hepatica infeciton. A high oxidative stress occurs during F. hepatica infection, which may cause severe damage in both the liver