Evaluation of serological test in the diagnosis of Helicobacter pylori and risk factors associated with the infection

Background: Serological testing has been widely used for the diagnosis of H. pylori. This study aimed to evaluate the serological test and to determine the sensitivity and specificity of the test in the diagnosis of H. pylori. The study also aimed to address if there are risk factors like blood grouping, Smoking, Age, gender, and residence of the patients associated with H. pylori infection.Methods: A prospective cross‑sectional study was performed among 100 symptomatic patients attending Dr. Suliman dispensary, Elnehoud city in west Kordofan state-Sudan, from March to September 2016. H. pylori were detected on plasma by using Healgen immunochromatography test cards from Xiamen Boson Biotech Co., Ltd (China), and identified from a stool by using monoclonal antigen detection from the same trademarked company. Data for the risk factors associated with the infection were assessed in a participant interview.Results: The serological test showed significant differences when compared to the stool antigen test p-value = 0.000. The statistical analysis showed moderate sensitivity and high specificity of the serological test compared to the stool antigen detection test. The study also showed that smoking [odds ratio (OR): 1.20, 95% confidence interval (CI): (1.24-4.02) and blood grouping (OR: 1.10, 95% CI: (1.08-1.60) were risk factors for H. pylori infection.Conclusions: The serological test showed high specificity and moderate sensitivity in comparison to the stool antigen test. The increased risk of H. pylori infection associated with smoking and blood grouping

Comparative analysis of chromogenic vs clot based CDC modified, Nijmegen-Bethesda assay for detection of factor viii inhibitor titre

Background:-Inhibitors to infused factor VIII are the most significant complication of hemophilia treatment. These inhibitors are usually IgG antibodies, that react with FVIII in a time and temperature dependent manner. Coagulation factor VIII inhibitors can be detected by Chromogenic, clot based and immunological assays. However, there is lack of consensus as to what constitutes a positive inhibitor, including the appropriate cut-off for inhibitor measurement The main objective of this study is to compare the sensitivity and specificity of chromogenic Nijmegen Bethesda assay (CNBA) with Centre for disease control modified Nijmegen Bethesda (CDC-NBA) assay against the Reference control method (RCM).Materials and Methods: The Coagulometer used for inhibitor titre  quantification is Sysmex CS-5100. APTT reagent used isPathromtin SL supplied by seimensSeimens. All data were expressed as Mean ± SD. Statistical formulae were used for sensitivity and specificity calculations. Unpaired students t test was used whereever necessary and a P value of <0.05 is considered as statistical significanceResults: A total of 150 cases were tested for inhibitor titre using CNBA vs CDC-NBA. For low titre Inhibitor (<2 NBU), CNBA has 92% and 86% and CDC-NBA has 80 and 60% sensitivity and specificity respectively. These results show that CDC-NBA shows false positive results at low inhibitor titre. For High titre Inhibitor ( >2 NBU) CNBA has 88% and 80% and CDC-NBA has 85 and 70 % sensitivity and specificity respectively.Conclusion :- These results shows that CNBA is more sensitive and specific than CDC-NBA at both low and high inhibitor titre. Moreover chromogenic assays can differentiate factor specific inhibitor from nonspecific inhibitors like lupus anticoagulant and unfractionated heparin therapy.Keywords: Hemophilia, Bethesda assay, ELISA, Factor VIII, Inhibitor, Mixing studyAbbrevations: APLA- Antiphospholipid antibody syndrome, CDC:NBA- Centers for Disease Control and Prevention - Nijmegen-BethesdaAssay, CNBA:- chromogenic Nijmegen Bethesda assa

Effect of HbF Level among Different Severity of Sickle Cell Disease

Background: Fetal hemoglobin (HbF) can inhibit the deoxygenation induced polymerization of sickle hemoglobin (HbS) that drives the Pathophysiology of sickle cell disease. The aim of this study was to determine fetal Hb level in Sudanese sickle cell disease patients as well as to find out the effect of fetal hemoglobin level on different severity groups. Materials and Methods: This was descriptive cross sectional study included 100 Patients with sickle cell disease diagnosed by Positive sickling test and Hemoglobin electrophoresis. The Patients were attended Sudan sickle cell anemia center (SSCAC), Elobied-Sudan during September 2015 – July 2016. Clinical history was obtained to perform the severity of the disease according to Hedo et al. scoring. Fetal hemoglobin was estimated by Betke's method. Data were analyzed using SPSS software computer program version 21. Results: The mean of HbF level among the studied population was 7.6%. The descriptive analysis showed that, the mean level of HbF in 38 (38%) patients with mild disease was 7.7%, while in 54 (54%) patients with moderate disease the mean level of HbF was 7.6% and the last 8(8%) patients with severe disease showed HbF level 7%. There was no statistical significant differences observed when HbF level was less than 10% (P value = 0.146), while the statistical significant differences was observed among patients with HbF level more than10% (P value = 0.03). Conclusion: The study concluded that Hb F level has no effect in severity of the disease among studied sickle cell patients, unless HbF level more than 10%