Toxoplasma gondii specific IgG avidity assay: Role and implication in the confirmatory diagnosis of acute toxoplasmosis in seropositive pregnant women

This study was undertaken to apply Toxoplasma gondii specific IgG avidity test in seropositive pregnant women to differentiate acute and past infection. T. gondii specific IgG avidity test was conducted in 39 seropositive pregnant women and their pregnancy outcomes were observed later on. Out of 39 T. gondii seropositive pregnant women 33 (84%) were only IgG positive and 6 (15.4%) were both IgG-IgM positive. All the IgG positive cases (100%) and 2(33.3%) IgG-IgM positive cases had high avidity antibodies and they gave birth to healthy babies. Rest of the 4 (66.7%) IgG-IgM positive women had low avidity and 50% of them had abortion and 50% gave birth to unhealthy babies. This reveals that the seropositive mothers having high IgG avidity had past infection and no risk of congenital transmission. Seropositive mothers having low IgG avidity had acute infection and so congenital transmission occurred. Presence of T. gondii specific IgG and IgM antibody does not indicate acute infection always. IgG-IgM positive pregnant women should be further evaluated by IgG avidity assay to confirm acute infection.

Immunofluorescence pattern of antinuclear antibody and its association with autoantibody profile in systemic lupus erythematosus

Background: Antinuclear antibody (ANA) is useful in the diagnosis of systemic lupus erythematosus (SLE). Association of specific autoantibodies with the immunofluorescence pattern of ANA in SLE as noted in Western literature has been taken as reference in all over the world. However, in Bangladesh such research work or data correlating the autoantibodies and their ANA patterns is inadequate. Objective: To identify an association between immunofluorescence patterns of antinuclear antibody on HEp-2 cell and more specific antinuclear reactivities (e.g. anti-dsDNA and anti-extractable nuclear antigen) in the serum samples of SLE patients.Methods: Serum samples of 37 SLE patients who were diagnosed by ARA (American Rheumatism Association) classification criteria and laboratory tests, attending at lupus clinic of Bangabandhu Sheikh Mujib Medical University (BSMMU) during the study period of six months were subjected for ANA testing by Indirect Imrnunofluorescence (IIF) on HEp-2 cell, anti-dsDNA by ELISA and anti- extractable nuclear antigen (anti-ENA) by Dot Immunoblot. Dot blot strips were tested for anti-Sm, anti-RNP, anti-SSA/Ro, and anti-SSB/La. Results: Out of 37 SLE patients 32 (86.5%) cases were ANA positive by IIF on HEp-2 cell. ANA positive sera exhibited three fluorescence patterns such as speckled (43.7%), peripheral (34.3%) and homogenous pattern (21.8%). Peripheral pattern (100%) was strongly associated with anti-dsDNA (p<0.05) and homogenous pattern (85.7%) was also predominantly associated with anti-dsDNA (p<0.05). Speckled pattern (85.6%) was significantly associated with anti-ENA (p<0.05). Anti-dsDNA was positive in 75% of SLE cases and majority (45.8%) of which showed peripheral pattern whereas anti-ENA was positive in 48.6% cases and majority (70.5%) of which showed speckled pattern. The most commonly identified antinuclear autoreactivity was directed towards anti-RNP (22.2%) then anti-Sm (16.6%), anti-SSA (16.6%) and anti-SSB (11.1 %). Multiple anti-ENA reactivities were identified in 33.3% cases. Conclusion: Peripheral and homogenous pattern is strongly associated with anti-dsDNA therefore may be predicted that patients have active SLE and speckled pattern may predict anti-ENA (specially ribonucleoprotiens). Thus, ANA-IIF method may suffice and probably reduce the expense of detailed immunological work-up with minimal loss in diagnostic accuracy

Uncovering the Indirect Impact of Work Ethic on Engineering Students’ Productivity through Positive and Negative Organizational Behaviors and Workaholism

The main objective of this study is to investigate the mediating effects of organizational citizenship behavior (OCB), destructive deviant behaviors (DDB), constructive deviant behaviors (CDB), and workaholism (WA) in the relationship between work ethic (WE) and the productivity of engineering students. Another objective is to present a comprehensive holistic model of relationships of these organizational behaviors (OB), attitudes, and work ethic with the productivity. Structure equation modeling (SEM) and Hayes’ processes are used to analyze the hypothesized model. Data were randomly collected from 400 participants from the universities of Pakistan. The overall assessment of the model showed that WE indirectly effects productivity through mediating variables (OCB, DDB, CDB, WA). One of the implications of this finding is that education practitioners/planners should promote work ethic (considered essential for sustainable management practices by contemporary researchers also) among engineering students. This ethic will be reflected in students’ behaviors (enhanced positive behaviors/attitudes, i.e., OCB, CDB, and WA, and reduced negative behaviors i.e., DDB) which will in turn improve their productivity. The originality of this research lies in it being the first to explore the indirect effect of Islamic work ethic (IWE) on individuals’ productivity through OCB, DDB, CDB, and WA

A CPFR Readiness Assessment Model

The retail industry is a pioneer in developing new supply chain practices arising from the fact that the environment is characterized by intense competition and the need to achieve supply chain cost savings. An initiative launched by the Voluntary Interindustry Commerce and Standards Committee (VICS) introduced a concept known as the Collaborative Planning, Forecasting and Replenishment (CPFR). The objective is to integrate business and supply chain processes and provide better visibility and create and effective supply chains. This research develops a CPFR Readiness Assessment Model, which enables organizations to understand their readiness in implementing CPFR. This model can provide an initial assessment of the supply chain and propose development initiatives that will assist organizations to move towards a more effective CPFR process. Through identification of key CPFR activities, the model enables organizations to view the required tasks for executing an effective CPFR process. It also provides an insight into the level of commitment required and the specialization necessary to advance through the various stages of CPFR. Furthermore, the model also suggests a `Path-of-Progress\u27 to guide organizations through a systematic CPFR development process through proper utilization of resources

Diagnostic significance of pleural fluid adenosine deaminase activity in tuberculous pleurisy

Diagnosis of tuberculous pleural effusion (TPE) is difficult because of its non-specific clinical presentation and insufficient efficiency of conventional diagnostic methods. The study was carried out to evaluate the utility of adenosine deaminase (ADA) activity in pleural fluid for the diagnosis of TPE. ADA activity was measured in pleural fluid of 103 pleural effusion patients by colorimetric method using a commercial ADA assay kit. The diagnosis of TPE was made from pleural fluid examinations (including cytology, biochemistry, and bacteriology) and pleural biopsy. Patient with negative result of this methods were diagnosed by response of empirical treatment. Out of 130 cases, 62 (61.1%) had TPE and the remaining 41 (39.8%) had pleural effusion due to non tuberculous diseases. There was statistically significant difference (p < 0.001) between the mean of pleural fluid ADA levels (70.82±22.54 U/L) in TPE group and (30.07±22.93 U/L) in non-TPE group. Of 62 TPE cases, microscopy for AFB and culture for M.tuberculosis in pleural fluid revealed positivity in 9.6% and 22.5% cases respectively, and biopsy of pleura showed typical epithelioid granuloma in only 43.5% cases. The cut-off value of ADA for diagnosing TPE was 40 U/L using a ROC curve, with a sensitivity of 94% and specificity of 88%. Positive and negative predictive value of ADA assay were 92% and 90% respectively. The overall test accuracy was 90%. Pleural fluid ADA assay is therefore a simple, rapid, highly sensitive and specific adjunct test for diagnosis of TPE. Ibrahim Med. Coll. J. 2011; 5(1): 1-

Phenotypic detection of metallo-β-lactamase among the clinical isolates of imipenem resistant Pseudomonas and Acinetobacter in tertiary care hospitals of Dhaka city

The rapid spread of Metallo-b-lactamase (MBL) producing Gram negative bacilli represents a matter of great concern worldwide. The study analyzed the occurrence of MBL production in carbapenem resistant Pseudomonas and Acinetobacter isolates over one year period. A total of 132 Pseudomonas and 76 Acinetobacter isolates were obtained from two tertiary care hospitals of Dhaka city. A total of 53 Pseudomonas and 29 Acinetobacter isolates were selected because of their resistance to carbapenem specially imipenem (IPM). Screening for MBL production was performed in these isolates by IPM-EDTA microdilution MIC method. 44 (83%) IPM resistant Pseudomonas and 19 (65.5%) Acinetobacter isolates were MBL producer by IPM-EDTA microdilution MIC method. These results suggest that MBL producing Pseudomonas and Acinetobacter isolates are emerging in our country and it is essential to screen carbapenem resistant isolates for MBL production. Ibrahim Med. Coll. J. 2010; 4(2): 63-6

Simple screening tests for the detection of metallo-β-lactamase (MBL) production in clinical isolates of Pseudomonas and Acinetobacter

There are no standard methods for the detection of metallo-b-lactamase (MBL) production in gram negative organism in routine microbiology practice. The present study was undertaken to evaluate the screening tests like double disk synergy test (DDST) and disk potentiation test (DPT) using ceftazidime (CAZ) and imipenem (IPM) disks with chelating agents like EDTA, 2-mercaptopropionic acid (2-MPA). A total of 132 Pseudomonas and 76 Acinetobacter isolates were obtained from Bangabandhu Sheikh Mujib Medical University (BSMMU) and Bangladesh Institute of Research and Rehabilitation for Diabetes, Endocrine and Metabolic Disorders (BIRDEM) hospitals of Dhaka city. A total of 53 and 29 IPM resistant Pseudomonas and Acinetobacter isolates were selected. EDTA-IPM microdilution minimum inhibitory concentration (EDTA-IPM MIC) method detected MBL in 44 (83%) IPM resistant Pseudomonas and 19 (65.5%) Acinetobacter isolates. DDST with CAZ-0.1M EDTA and CAZ-2-MPA detected MBL in 73.6% and 67.9% of IPM resistant Pseudomonas and 55.2% and 48.3% of Acinetobacter isolates respectively. The detection rate was 67.9% and 66.1% in Pseudomonas and 51.7% and 44.8% in Acinetobacter isolates by EDTA-IPM and IPM-2-MPA methods respectively. In comparison to DDST, DPT with CAZ-0.1M EDTA showed higher sensitivity (89.7% ) and specificity (100%) for detection of MBL in Pseudomonas and Acinetobacter. The results showed that simple screening tests like DPT with 0.1M EDTA was able to detect MBL producing Pseudomonas and Acinetobacter from clinical samples with high sensitivity and specificity. Ibrahim Med. Coll. J. 2010; 4(1): 26-3

Isolation and Identification of Polioviruses from Stool Specimens of Suspected Cases

Background: To study the isolation and identification of polioviruses from the stool specimen of suspected cases of poliomyelitis (polio). Methods : In this descriptive study two poliovirus-sensitive cell lines of human origin HEp-2, and RD were used for poliovirus isolation. Two hundred and two samples of stool specimen were processed according to the WHO recommendations. Supernatant of stool specimen were inoculated on HEp-2, and RD for poliovirus culture, and incubated at 36oC. Cultures were initially set up in growth medium supplemented with serum. After the formation of a confluent monolayer from the cells, cultures were changed to maintenance medium, designed to maintain cultures in healthy state without stimulating growth. The tubes were incubated , and put in racks at inclined angle of 5o , with line (blue for HEp-2, and black for RD cell line) of tube in upper position. Cultures were daily examined for color change from pinkish to yellow, and for appearance of cytopathic effects (CPEs) under the inverted microscope for 10-14 days before discarding as negative. The yellowish coloration indicated the absence of poliovirus while no color change was indicative of presence of poliovirus, and presence of characteristic CPEs production of poliovirus i.e. rounding of cells, and detachment of cells from culture tubes. Tubes showing CPEs were stored at -20oC. Identification of poliovirus isolates was done by mixing the diluted isolates samples, with equal volumes of a set of antisera of known poliovirus serotypes. The antiserum/ poliovirus mixture was incubated for 2 hr to allow binding of antibodies to poliovirus. Afterwards the mixtures were inoculated into cell culture tubes, and examined daily for CPEs. Prevention of the development of CPEs by the specific antiserum, indicated the identity of the poliovirus serotype. The identification of both isolates from RD as well as Hep-2 cell cultures, was carried on as poliovirus susceptibility of these two lines varies.Results: Majority of cases(38.1%) were of 3-12 months, followed by 13-24 months (34.6%). Male to female ratio was 1.4:1.0. Among the suspected cases, 94% were vaccinated, while about 2% were partially vaccinated. Poliovirus was isolated from 28.2% stool specimens of suspected cases of polio. The poliovirus type 1 was found 75.4%, one of the most common among positive cases. 35% cases were found from Punjab and 28% from KPKConclusion: Most prevalent type of poliovirus is type-1, and the maximum number of polio is found in the province Punjab. The most vulnerable age group for polio was 3-12 months, and the target age less than 5 years, that covered the percentage of total number of cases upto 99%. Moreover, 94.06% cases of polio were unvaccinated

Isolation and Identification of Polioviruses from Stool Specimens of Suspected Cases

Background: To study the isolation and identification of polioviruses from the stool specimen of suspected cases of poliomyelitis (polio). Methods : In this descriptive study two poliovirus-sensitive cell lines of human origin HEp-2, and RD were used for poliovirus isolation. Two hundred and two samples of stool specimen were processed according to the WHO recommendations. Supernatant of stool specimen were inoculated on HEp-2, and RD for poliovirus culture, and incubated at 36oC. Cultures were initially set up in growth medium supplemented with serum. After the formation of a confluent monolayer from the cells, cultures were changed to maintenance medium, designed to maintain cultures in healthy state without stimulating growth. The tubes were incubated , and put in racks at inclined angle of 5o , with line (blue for HEp-2, and black for RD cell line) of tube in upper position. Cultures were daily examined for color change from pinkish to yellow, and for appearance of cytopathic effects (CPEs) under the inverted microscope for 10-14 days before discarding as negative. The yellowish coloration indicated the absence of poliovirus while no color change was indicative of presence of poliovirus, and presence of characteristic CPEs production of poliovirus i.e. rounding of cells, and detachment of cells from culture tubes. Tubes showing CPEs were stored at -20oC. Identification of poliovirus isolates was done by mixing the diluted isolates samples, with equal volumes of a set of antisera of known poliovirus serotypes. The antiserum/ poliovirus mixture was incubated for 2 hr to allow binding of antibodies to poliovirus. Afterwards the mixtures were inoculated into cell culture tubes, and examined daily for CPEs. Prevention of the development of CPEs by the specific antiserum, indicated the identity of the poliovirus serotype. The identification of both isolates from RD as well as Hep-2 cell cultures, was carried on as poliovirus susceptibility of these two lines varies.Results: Majority of cases(38.1%) were of 3-12 months, followed by 13-24 months (34.6%). Male to female ratio was 1.4:1.0. Among the suspected cases, 94% were vaccinated, while about 2% were partially vaccinated. Poliovirus was isolated from 28.2% stool specimens of suspected cases of polio. The poliovirus type 1 was found 75.4%, one of the most common among positive cases. 35% cases were found from Punjab and 28% from KPKConclusion: Most prevalent type of poliovirus is type-1, and the maximum number of polio is found in the province Punjab. The most vulnerable age group for polio was 3-12 months, and the target age less than 5 years, that covered the percentage of total number of cases upto 99%. Moreover, 94.06% cases of polio were unvaccinated

Immunofluorescence pattern of antinuclear antibody and its association with autoantibody profile in systemic lupus erythematosus

Background: Antinuclear antibody (ANA) is useful in the diagnosis of systemic lupus erythematosus (SLE). Association of specific autoantibodies with the immunofluorescence pattern of ANA in SLE as noted in Western literature has been taken as reference in all over the world. However, in Bangladesh such research work or data correlating the autoantibodies and their ANA patterns is inadequate. Objective: To identify an association between immunofluorescence patterns of antinuclear antibody on HEp-2 cell and more specific antinuclear reactivities (e.g. anti-dsDNA and anti-extractable nuclear antigen) in the serum samples of SLE patients. Methods: Serum samples of 37 SLE patients who were diagnosed by ARA (American Rheumatism Association) classification criteria and laboratory tests, attending at lupus clinic of Bangabandhu Sheikh Mujib Medical University (BSMMU) during the study period of six months were subjected for ANA testing by Indirect Imrnunofluorescence (IIF) on HEp-2 cell, anti-dsDNA by ELISA and anti- extractable nuclear antigen (anti-ENA) by Dot Immunoblot. Dot blot strips were tested for anti-Sm, anti-RNP, anti-SSA/Ro, and anti-SSB/La. Results: Out of 37 SLE patients 32 (86.5%) cases were ANA positive by IIF on HEp-2 cell. ANA positive sera exhibited three fluorescence patterns such as speckled (43.7%), peripheral (34.3%) and homogenous pattern (21.8%). Peripheral pattern (100%) was strongly associated with anti-dsDNA (p<0.05) and homogenous pattern (85.7%) was also predominantly associated with anti-dsDNA (p<0.05). Speckled pattern (85.6%) was significantly associated with anti-ENA (p<0.05). Anti-dsDNA was positive in 75% of SLE cases and majority (45.8%) of which showed peripheral pattern whereas anti-ENA was positive in 48.6% cases and majority (70.5%) of which showed speckled pattern. The most commonly identified antinuclear autoreactivity was directed towards anti-RNP (22.2%) then anti-Sm (16.6%), anti-SSA (16.6%) and anti-SSB (11.1 %). Multiple anti-ENA reactivities were identified in 33.3% cases. Conclusion: Peripheral and homogenous pattern is strongly associated with anti-dsDNA therefore may be predicted that patients have active SLE and speckled pattern may predict anti-ENA (specially ribonucleoprotiens). Thus, ANA-IIF method may suffice and probably reduce the expense of detailed immunological work-up with minimal loss in diagnostic accuracy