Dipstick Research Articles

Association between PAHs biomarkers and kidney injury biomarkers among kitchen workers with microalbuminuria: A cross-sectional pilot study

To study the association between kidney injury biomarkers and urinary OH-PAH metabolites in kitchen workers, with microalbuminuria. A cross-sectional pilot study was conducted among 120 male kitchen workers in a mega kitchen located at Coimbatore, India. Personal and sub-clinical details of study subjects were collected using a questionnaire. Albumin, creatinine, and albumin-creatinine ratio (ACR) were measured using urine dipstick test for the determination of microalbuminuria. Urinary hydroxylated PAHs metabolites (1-NAP, 9-HF, 3-HF, 2-HF, 9-PHN, and 1-OHP) were measured using GC-MS/MS and urinary kidney biomarkers (uNGAL, uCyst-C, uKIM-1, uOPN, and uTIMP-1) were measured using Multiplex Reader. Concentrations of urinary PAHs metabolites (1-NAP, 3-HF, 2-HF, 9-PHN, and 1-OHP) and kidney biomarkers (uKIM-1, uTIMP-1, uCyst-C and uNGAL) were significantly higher among kitchen workers with MAU compared to non-kitchen workers with MAU. Urinary kidney biomarkers viz., uKIM-1, uTIMP-1, uCyst-C, uNGAL, and uOPN showed higher median concentration among the kitchen workers with MAU compared to kitchen workers without MAU. Significant positive correlation was observed for 9-HF with uKIM-1 and uTIMP-1 and 1-OHP with uKIM-1. ACR was also well correlated with urinary kidney biomarkers. ROC analysis showed higher sensitivity and specificity for uKIM-1, uCyst-C, and uNGAL as biomarkers for early prediction of acute kidney injury among kitchen workers. The PAHs exposure among kitchen workers can lead to kidney injury. This was evident from the association of OH-PAHs and kidney injury biomarkers in kitchen workers with microalbuminuria.

Clinical features and long-term outcomes of diabetic kidney disease – A prospective cohort study from China

BackgroundInformation regarding the clinical phenotypes of diabetic kidney disease (DKD) might guide better practice for clinicians. We aim to compare the clinical features and long-term outcomes of proteinuric and non-proteinuric phenotypes of DKD, based on a prospective cohort of Chinese population. MethodsAltogether 8811 Chinese participants with diabetes were included. Kidney function decline was defined as estimated glomerular filtration rate <60 mL/min·1.73 m−2. The presence of proteinuria by urine dipstick test was further divided into micro-proteinuria (trace or 1+) and overt-proteinuria (≥2+). Participants were then stratified into 5 groups: no DKD, isolated kidney function decline, isolated micro-proteinuria, isolated overt-proteinuria, and proteinuria combined with kidney function decline. Outcomes include the first occurrence of composite cardiovascular events, end-stage renal disease (ESRD), and all-cause mortality. Main findingsAfter a median follow-up of 6.9 years, there were 646 composite cardiovascular events, 31 ESRD events, and 718 deaths. Isolated kidney function decline was only associated with the higher risk of ESRD (HRs 31.33 (95% CI 3.65–269.27)). Participants of overt-proteinuria and proteinuria combined with kidney function decline phenotypes were associated with increased risk of all predefined adverse outcomes. ConclusionsProteinuric and non-proteinuric DKD phenotypes might follow different pathophysiological pathways, and result in heterogeneous clinical features and prognosis.

A18702 Microalbuminuria among newly diagnosed Sudanese patients with hypertension

Objectives: To assess microalbuminuria among newly diagnosed Sudanese patients with hypertension in Ibrahim Malik Teaching Hospital hospital from February to end of March 2017 Methods: It is a Descriptive cross sectional hospital based study, conducted in Ibrahim Malik Teaching hospital which is one of the major hospitals in Khartoum that provides medical services to a wide range of population. The study Covered 60 participants. Data were entered, prepared and analyzed using SPSS version 22.0 Results: The results found that the mean age of the participants was 50.4 ± 12.6 which is younger compared to other similar studies. 73.3% of the study participants had positive microalbuminuria which is higher compared to other similar studies. Only 27.0% of the participants found to have positive dipstick test for proteinuria which indicates low sensitivity of the test and the importance of microalbuminuria test for similar cases. Most the study participants were found to be in stage 2 and 3 hypertension. However, the study didn’t show significant relationship between the stage of hypertension and the level of microalbuminuria. 90% of patients found to have normal creatinine level. Conclusion: Microalbuminuria test should be part of routine follow up test for patients with newly diagnosed hypertension. Also, if they show persistent positive results after treatment of hypertension they should receive specific management such as angiotensin converting enzyme inhibitors or angiotnsin receptor blockers.

312. Proteinuria among women in the CLIP Trials

Background The WHO recommends blood pressure (BP) and proteinuria measurement at each antenatal care (ANC) visit, but the value of proteinuria testing in normotensive women has been questioned, especially where dehydration is common. Objective We sought to determine prevalence and prognosis of baseline proteinuria in CLIP (Community Level Intervention in Pre-eclampsia, cluster randomised trials, NCT01911494). Methods In CLIP intervention clusters, women received enhanced antenatal care by trained community health care providers supported by the Piers-On-the-Move (POM) app. Each assessment included BP measurement (validated CRADLE device). The first and all hypertensive visits included proteinuria dipstick testing (visual). Progression to hypertension and adverse outcomes (not available in Nigeria) were compared by baseline proteinuria (chi-squared, p Results In 27 intervention clusters, 20,804 (64.3%) women received ⩾ 1 POM visit and delivered by trial end (India, 6102; Pakistan, 10,932; Mozambique, 4310; Nigeria, 6999). Baseline proteinuria ⩾ 1+ (assessed in >90%) was Discussion With low prevalence of baseline proteinuria and lack of strong relationships with outcomes, these data question current WHO recommendations to routinely assess proteinuria in pregnancy.

418. Improving screening for bacteriuria in pregnancy: A quality improvement project

Introduction Screening for asymptomatic bacteriuria is an essential aspect of antenatal care. Urinalysis using dipsticks is most commonly performed for the identification of proteinuria and is cheap and easy to do. However, often too much weight is put on other components of the dipstick testing for the identification or exclusion of infection. National guidelines do not advocate the use of urine dipstick in screening for infection. Objective We constructed a project to assess the current pathway in our high-risk Obstetrics clinics, the impact of collection methods on contamination rates as well as the usefulness of urine dipstick results for identification of bacteriuria. Methods We analysed patient encounters in two specific clinics from January to June 2017. We looked at urine dipsticks and cultures if they were performed. The association between dipstick data and positive cultures was then assessed. Results Of 883 patient encounters with full data available, 486 cultures were sent. There was a 18.9% contamination rate and 1.85% had significant growth of a pathogenic organism identified. The presence of protein or leucocytes did not correlate with bacteriuria, however the presence of nitrites did predict a positive culture result (PPV 0.71). Discussion There was a high contamination rate in the culture samples that were analysed. Our data support national guidelines that state that dipsticks are a poor indicator for bacteriuria. We therefore implemented some significant changes: Changed our default container for urine collection. Production of a standard operating procedure for urine sample collection. Production of a patient information leaflet for urine collection. Construction of new Trust guidelines about the investigation and treatment of bacteriuria in pregnancy. Education sessions for all staff. These above interventions and a post-implementation survey will be presented.

Potential application of small myristoylated protein-3 evaluated as recombinant antigen and a synthetic peptide containing its linear B-cell epitope for the serodiagnosis of canine visceral and human tegumentary leishmaniasis

Serological tests are important tools for the diagnosis of Leishmania infection. However, they are not effective markers to diagnose asymptomatic cases of visceral leishmaniasis (VL) and patients developing tegumentary leishmaniasis (TL), since antileishmanial antibodies can be encountered in low levels resulting in false-negative results in the serological trials. In this context, antigens able to be recognized by antibodies in sera from both VL and TL patients will be desirable to be employed in a more sensitivity and specific diagnosis of disease. In the present study, a conserved Leishmania protein, small myristoylated protein-3 (SMP-3), which was showed to be conserved in different Leishmania species and an effective vaccine candidate against Leishmania infantum infection in a murine model, was cloned and the recombinant protein was evaluated as a serological marker for the diagnosis of human TL and canine VL. In addition, a linear B cell-specific epitope (MQKDEESGEFKCEL) was identified, synthetized and also investigated as a serological marker. As antigen controls, rA2 protein and antigenic Leishmania extracts (SLA) were used. Results showed that ELISA-rSMP-3 and ELISA-Peptide presented sensitivity and specificity values higher than 90% in both diseases in humans and canids, having identified all asymptomatic cases and did not present cross-reaction with cross-reactivity diseases in both mammalian hosts. On the other hand, sensitivity and specificity values were worst when rA2 or SLA were used as antigens in humans and dogs. In conclusion, results showed the efficacy and Leishmania SMP-3 protein, employed as a recombinant antigen or a B cell epitope, for the improvement of the serodiagnosis of human TL and canine VL. This candidate can be tested in other diagnostic platforms, such as rapid immunochromatographic dipstick tests, aiming its use in epidemiological studies in remote areas where laboratories are not readily accessible for conventional assays.

Prevalence of Chronic Kidney Disease and Poor Diagnostic Accuracy of Dipstick Proteinuria in Human Immunodeficiency Virus-Infected Individuals: A Multicenter Study in Japan.

BackgroundChronic kidney disease (CKD) has become one of the common comorbid conditions affecting the human immunodeficiency virus (HIV) population. Human immunodeficiency virus-infected individuals are at increased risk of developing CKD, and they are likely to experience faster progression of renal dysfunction compared with HIV-uninfected individuals. Albuminuria represents not only kidney damage but also manifests metabolic syndrome and vascular dysfunction.MethodsWe conducted a multicenter, cross-sectional study involving 2135 HIV-infected individuals in Japan to test the prevalence of CKD and proteinuria/albuminuria. Urine sample was analyzed by both dipstick test and albumin-to-creatinine ratio (ACR) assay. Chronic kidney disease was classified according to the Kidney Disease Outcomes Quality Initiative (K/DOQI) and Kidney Disease: Improving Global Outcomes (KDIGO) guidelines. The diagnostic performance of dipstick test to detect albuminuria (ACR ≥30 mg/g) was evaluated.ResultsThe prevalence of CKD, evaluated by K/DOQI and KDIGO guidelines, was 15.8% and 20.4%, respectively. Age, total cholesterol level, prevalence of hypertension, diabetes mellitus, and hepatitis C infection tended to increase, whereas levels of hemoglobin, serum albumin, and CD4 cell count tended to decrease as CKD risk grades progressed. Proteinuria and albuminuria were present in 8.9% and 14.5% of individuals, respectively. Dipstick test ≥1+ to detect albuminuria had an overall sensitivity of 44.9% and specificity of 97.2%.ConclusionsThe KDIGO guideline may enable physicians to capture HIV-infected patients at increased risk more effectively. The sensitivity of dipstick proteinuria to detect albuminuria is so poor that it may not serve as an alternative in HIV-infected individuals.

Predictors of Symptom Duration and Bacteriuria in Uncomplicated Urinary Tract Infection

Objective: To identify baseline predictors of symptom duration after empirical treatment for uncomplicated urinary tract infection (UTI) and significant bacteriuria in a cohort of women treated for UTI.Design: Prospective single-centre cohort study.Setting: Outpatient clinic in Norway.Patients: From September 2010 to November 2011, 441 women aged 16–55 years with symptoms of uncomplicated UTI were included.Results: Dipstick findings of leukocyte esterase 1 + (incidence rate ratio (IRR) 1.93, 95% confidence interval (CI) 1.23–3.01, p < 0.01) and microbe resistant to mecillinam treatment (IRR 1.41, 95% CI 1.07–1.89, p = 0.02) predicted longer symptom duration. More pronounced symptoms did not predict longer symptom duration (IRR 1.18, 95% CI 0.94–1.46, p = 0.15) or significant bacteriuria (odds ratio [OR] 1.16, 95% CI 0.72–1.88, p = 0.54). Leukocyte esterase 2 + (OR 2.51, 95% CI 0.92–6.83, p = 0.07) or 3 + (OR 2.40, 95% CI 0.88–6.05, p = 0.09) and nitrite positive urine dipstick test (OR 3.22, 95% CI 1.58–7.01, p = <0.01) were associated with bacteriuria.Conclusion: More pronounced symptoms did not correlate with significant bacteriuria or symptom duration after empirical treatment for acute cystitis. One might reconsider the current practice of treating uncomplicated UTI based on symptoms alone.Key PointsTreatment strategies for milder infectious diseases must consider ways of reducing antibiotic consumption to decelerate the increase in antibiotic resistance. Our findings suggest that more emphasis should be put on urine dipstick results and bacteriological findings in the clinical setting. One might reconsider the current practice of treating uncomplicated UTIs based on symptoms alone.

Prevalence of antibodies against visceralizing Leishmania spp. in brown rats from Grenada, West Indies.

Background and Aim:Leishmania spp. are known to cause disease in man and animals. Rats are considered important reservoir hosts and transmission takes place through the bite of female sand fly, Phlebotomus spp. To the best of our knowledge, there is no published information on Leishmania infection in rats in Grenada. This study was conducted to estimate the antibodies for visceralizing Leishmania spp. (VL) in rats (Rattus norvegicus) from Grenada.Materials and Methods:A total of 146 brown rats (R. norvegicus) were trapped live from two parishes (St. George and St. David) in Grenada. Following anesthesia, blood was collected from the heart through thoracic puncture. The serum was collected after the centrifugation of blood. Serum was tested for antibodies to VL. with a commercially available immunochromatographic dipstick test which is licensed for use in animals and humans.Results:The seroprevalence of antibodies against Leishmania spp. was found in 34 of 146 rats (23.3%; CI 95% from 16.70 to 30.99). No significant differences were found between sexes and young or adults. The prevalence between parishes (St. George and St. David) was also not significant.Conclusion:The results show that rats (R. norvegicus) in Grenada are exposed to Leishmania spp. The rats could play an important role in the transmission of leishmaniasis to humans and other animals in Grenada.

Abstract P311: Static Urine Osmolality With Elevated First Trimester Urine Copeptin in Human Preeclampsia

We have previously shown that maternal plasma copeptin (CPP), as a marker of vasopressin, is highly predictive of preeclampsia (PE) in the first trimester and remains elevated throughout pregnancy. Furthermore, in maternal urine samples we demonstrated that CPP was also significantly elevated in the first trimester in women who later developed PE. Because a urine dipstick test could be easily used in the clinic, we sought to validate this finding in a new and expanded cohort of samples and to determine whether these changes persist throughout pregnancy. In addition, to begin to address the mechanism for this difference, we also assessed urine osmolality to further probe renal function. In a case-control study (IRB# 2015038355), banked maternal urine samples and clinical data from each trimester from women who developed PE (N=117) and controls (N=593) were obtained from the University of Iowa Maternal Fetal Tissue Bank (MFTB) (IRB# 200910784). CPP concentrations were measured by ELISA. Osmolality was determined by freezing point depression. Differences between groups were detected by Chi square, Student’s T Test, or ANOVA as appropriate. Using a validation cohort and a different ELISA (USCN vs Phoenix Pharmaceuticals), we validated our earlier findings. We again find a significant increase in the concentration of urine CPP in the first trimester in women who developed preeclampsia compared to women who did not (0.304 ± 0.03 vs 0.223 ± 0.01 pg/ml, P =0.03). No significant differences in copeptin were observed in urine CPP in the 2nd and 3rd trimesters from PE and control women (2 nd tri: 0.205 ± 0.04 vs 0.213 ± 0.02; 3 rd tri: 0.290 ± 0.03 vs 0.336 ± 0.02 pg/ml P &gt;0.05 in 2 nd and 3 rd trimesters). In this cohort, we did not detect differences in urine osmolality between preeclamptics and controls in any trimester (1 st tri: 606.09 ± 50.16 vs 604.28 ± 16.72; 2 nd tri 582.10 ± 36.30 vs 596.96 ± 16.98; 3 rd tri: 479.63 ± 58.81 vs 583.75 ± 19.61 mOsm/kg H 2 O). We conclude that (i) PE is associated with increased maternal urinary CPP in the 1st trimester, (ii) this increase does not correlate with expected increases in urine osmolality. Future work will focus on understanding the mechanisms involved in the elevation in urinary CPP such as early immunologic changes or renal concentrating responses.

Predictive Value of Urinary Trypsinogen-2 Dipstick for Early Diagnosis of Acute Pancreatitis in Emergency Medicine

AbstractBackground: Acute pancreatitis is a grave condition that requires fast and accurate diagnosis to save lives and prevent complications. In this study, we evaluated the fast and bedside urinary trypsinogen-2dipstick test in the diagnosis of acute pancreatitis.Aim of Work: This study was designed to evaluate the predictive value of the rapid urinary trypsinogen-2 test strip in acute pancreatitis, in comparison with serum amylase and serum lipase in Emergency Department at Tanta University Hospital.Subjects and Methods: Thirty-five (35) patients with acute pancreatitis (Group I) and thirty-four (34) patients with other causes of acute abdomen (Group II) were included in the study.Full history taking, clinical examination, and laboratory investigations including urine analysis and serum levels of creatinine, random glucose, lipid profile, total and direct bilirubin, albumin, liver enzymes, total calcium, amylase, and lipase were undertaken.In addition, radiological examinations, using abdomi-nopelvic ultrasonography, computed tomography of the abdo-men and conventional X-ray when appropriate were under-taken.Urinary trypsinogen-2 was tested using dipstick.Results: We found that the most common cause of acute pancreatitis was gall stone obstructive pancreatitis (76.47%), serum amylase and lipase were elevated in (91.18% and 88.24% respectively) in acute pancreatitis.While urinary trypsinogen-2 dipstick test was positive in 100% of patients with acute pancreatitis.The specificity of serum amylase, serum lipase and urinary trypsinogen-2 in diagnosis of acute pancreatitis was (76.47%, 88.24% and 100% respectively).Conclusion: Urinary trypsinogen-2 dipstick test is a promising fast and easy test performed in the effort of diagnosis of acute pancreatitis. Further studies on large number of patients are mandatory to confirm the findings in this study.

Detecting Anti-IIa and Anti-Xa Direct Oral Anticoagulant (DOAC) Agents in Urine using a DOAC Dipstick.

The assessment of the anticoagulant effect of direct oral anticoagulants (DOACs) can be important for rapid medical decision-making, especially in patients needing immediate management. An assay that screens for the absence or presence of a DOAC would help accelerate treatment in these situations. Chromogenic and coagulation methods have several limitations, including limited accuracy, long turnaround time, and their need of specialized laboratories. Oral factor Xa and thrombin inhibitors are also eliminated by the kidneys and can be detected in patient urine samples using a single, rapid, sensitive, and patient-specific qualitative assay. In these tests, the presence or absence of a DOAC in urine can be identified by visually observing specific colors after a few minutes. Several studies have demonstrated the robustness and repeatability of these assays. The specific colors of the test strip also detect creatinine in the urine, which shows whether DOAC excretion is reduced, thus suggesting renal impairment. Persons with amblyopia may use a specific reader. Current indications for using the DOAC Dipstick test include emergency medical situations with severe bleeding and thrombotic events or before urgent major surgical interventions to accelerate medical decision-making.

Predictive value of the urinary dipstick test in the management of patients with urinary tract infection-associated symptoms in primary care in Indonesia: a cross-sectional study

ObjectiveTo assess the test characteristics of a urine dipstick test in predicting a positive urine culture in an outpatient setting in Indonesia.DesignCross-sectional study.SettingTwo outpatient clinics in Medan, Indonesia.Participants616 consecutively enrolled...

Pre-transplant Proteinuria is a Risk Factor for Worsening Renal Function in Heart Transplant Candidates

Background Proteinuria has recently emerged as an independent risk factor for post-implant renal failure and mortality in patients undergoing continuous-flow left ventricular assist device implantation. Impact of proteinuria on heart transplant outcomes remains unknown. We hypothesized that end-stage heart failure patients with proteinuria have increased risk of renal failure and mortality following cardiac transplantation. Methods Patients who underwent orthotopic heart transplantation (OHT) at a major academic center between 2000 and 2016 were retrospectively reviewed. Urine protein was qualitatively assessed by dipstick test. Patients were categorized into proteinuria (≥ trace) or no proteinuria groups. Groups were comparatively analyzed for baseline recipient and donor characteristics. Outcomes measures included freedom from post-transplant renal failure which was defined as serum creatinine ≥ 2.5 mg/dL, and post-transplant patient survival. Results 195 out of 656 (26.7%) patients had evidence of proteinuria (≥ trace) at the time of cardiac transplantation. Of these, 93 (12.7%) had trace, 72 (9.8%) had 1+, 30 (4.1%) had 2+ or greater proteinuria. Patients with proteinuria (≥ trace) were younger (53.7 ± 12.3 vs. 50.6 ± 13.4 years, p=0.005), had higher serum creatinine (1.46 ± 0.78 vs. 1.32 ± 0.55 mg/dL, p=0.037), and lower serum albumin (3.81 ± 0.57 vs. 4.00 ± 0.52 g/dL, p Conclusions One in every four patients undergoing cardiac transplantation have evidence for proteinuria. Proteinuria is a risk factor for worsening renal function following cardiac transplantation but does not have a significant impact on post-transplant mortality. Proteinuria should be routinely assessed in transplant recipients and taken under consideration for individualization of immunosuppressive management in order to achieve optimal patient outcomes.

ACCURACY OF THE URINE DIPSTICK VERSUS CULTURE TEST FOR DETECTING ASYMPTOMATIC BACTERIURIA IN PREGNANCY IN KENYA; A RETHINK OF THE TESTING STRATEGY?

Background: The quantitative urine culture, the “gold standard” test for detection of asymptomatic bacteriuria (ASB), is time consuming, expensive, requires special equipment and trained personnel thus limiting its routine use in low-resource settings. Although the dipstick test is cheaper, easier to perform and interpret, its accuracy and role in detecting ASB in pregnancy in this setting has not been evaluated. Methodology: This was a cross-sectional study of pregnant women without symptoms of urinary tract infection, who were receiving routine antenatal care at Kenyatta National Hospital, in Nairobi Kenya. Clean catch, mid-stream urine specimens from 132 eligible participants were subjected to concurrent dipstick urinalysis and bacteriologic culture. Markers of ASB in urine dipstick (presence of either or both leucocyte esterase (LE) and nitrites) were compared with culture. Accuracy of urine dipstick, as measured from the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (PLR) and negative likelihood ratio (NLR) in detecting ASB was estimated using culture as the “gold standard.” Results: Out of 320 women screened, 132 (41%) were eligible. Prevalence of ASB was 6.9%. Sensitivity, specificity, PPV and NPV were 66.7%, 74.4%, 16.2% and 96.8% respectively for LE; 44.4%, 97.5%, 57.1% and 95.9% respectively for nitrite; 22.2%, 100%, 100% and 94.5% for either LE or nitrite; and 88.9%, 71.9%, 19% and 98.9% for both LE and nitrite respectively. The PLR and NLR for LE was 2.61 and 0.45 whereas that of nitrite was 17.76 and 0.37 respectively. Conclusion: A negative urine dipstick test rules out ASB in pregnancy and the need for routine culture. Positive dipstick test has low accuracy in detecting ASB in pregnancy and requires confirmatory testing with culture. This would avoid exposing pregnant women to unnecessary antibiotics and their side effects.

Validity of leukocyte esterase reagent (LER) strip in diagnosing infectious pleural effusion

Background: Pleural fluid sampling and analysis are essential to confirm an infection. In a resource-limited health care setting or if biochemistries of the aspirated fluid are not available on an emergency basis, urine reagent strips applied to pleural fluid may expedite diagnostic information. Present study was aimed to evaluate the effectiveness of leukocyte esterase reagent (LER) strip in diagnosing infectious pleural effusion and to correlate the reaction of LER strip with various stages of infectious effusions.Methods: A prospective longitudinal study was conducted in the medical ward of Government Mohan Kumaramangalam Medical College Hospital for a period of one year. Pleural effusion patients with associated immuno-compromised conditions like diabetes mellitus, patients on steroids, HIV reactive patients, chronic obstructive lung disease were included for the study. A totalof 84 patients were included for the study. Exploratory thoracocentesis was done with an 8 mm needle and pleural fluid was obtained and sent for cell count and biochemical testing. The pleural fluid was also tested using the leukocyte esterase reagent strip. The results were recorded as 0, 1+, 2+, 3+ based on the density of violet colour.Results: The leukocyte esterase reagent strip test showed totally negative results in all patients with transudative pleural effusion and also in patients with tuberculous pleural effusion, whereas among patients with infectious pleural effusion other than tuberculosis LER strip test showed negative to only 15% of the patients and for remaining it ranged from 1+ to 3+. The validity of leukocyte esterase strip test was tested in comparison with the gold standard culture test. The accuracy of LER strip test was found to be 88.6%, and the sensitivity and specificity was 90.2% and 66.2% respectively.Conclusions: Reagent strips may speed up the bedside diagnosis of infectious effusions. However, where access to standard biochemical pleural fluid analysis is not available this dipstick tests would add value to the management of the patients.

Trace Albumin in the Urine Dipstick Test is Associated with Coronary Artery Calcification in Korean Adults

Background/Aims: Albuminuria is a risk factor for coronary artery calcification (CAC) and cardiovascular disease (CVD). Although the urine dipstick test is widely used to screen albuminuria, little is known about the association between low-grade urine dipstick albumin and CAC. The aim of this study is to investigate the relationship between the trace of urine dipstick albumin and CAC in Korean adults. Methods: This cross-sectional study analyzed 45,006 participants without previous CVD, who underwent coronary computed tomography and urine dipstick test from 2012 to 2014 as part of a health examination program in Korea. CAC was defined as coronary artery calcium score > 100. Participants were divided into 3 groups based on urine dipstick albumin results as follows: negative (–), trace (±), and positive (+1 to +4). Results: The numbers of participants with CAC were 800 (2.0%), 111 (2.8%), and 33 (4.9%) for the negative, trace, and positive groups respectively. Based on multivariate analysis, albuminuria determined with urine dipstick test was associated with CAC after adjustment for various cardiovascular risk factors. Compared with the negative group, the OR for CAC was 1.62 (1.08–2.42) in the positive group and 1.34 (1.07–1.66) in the trace group. Conclusion: Even a trace level of albumin in the urine dipstick test was associated with subclinical CAC in Korean adults. Low-grade dipstick albuminuria should not be overlooked.

Antidiabetic Effect of Baker’s Yeast in Alloxan Induced Diabetic Rats

Diabetes Mellitus is the most important public health problem in developed countries. It often leads to lethal complications if left untreated. Presently, no oral hypoglycemic agent or combination drug therapy exists to treat diabetes without toxicity or side effects. Insulin treatment also may lead to serious hypoglycemia and a reduction in its action by time. Therefore, the hypoglycemic effects of baker’s yeast, which is considered a safe food were investigated. Diabetes was induced by intraperitoneal injection of Alloxan monohydrate at dose of 150mg/kg. After 14 days, rats with positive glucose urine dip stick were used for the study and oral yeast for another 14 days was started at a dose of 200mg/day and compared with oral Glibenclamide at dose of 0.5mg/kg. The blood glucose was increased significantly in the untreated Alloxan induced diabetic up to 229.8±22mg/dl, rats p &lt;0.001, as well as in the Glibenclamide treated diabetic rats up to190.6± 26 mg/dl, p &lt;0.05 as compared to the control normal group (74.8±5.7mg/dl). It was found that the administration of yeast significantly decreases the blood glucose up to 85.2± 5.9, p≤ 0.001. While no statistically significant decrease in the Glibenclamide treated group. The result showed that brewer's yeast has blood glucose lowering effect in diabetic model

Detection of Drugs of Abuse among Drivers in Fayoum City/ Egypt

Background: There is growing interest in the part played by drugs in traffic accidents all over the world and in how to explore sufficient measures to decrease their rate. The aim of the study is to identify types of substance of abuse among drivers in Fayoum city.Aim of the work: To identify types of substance of abuse among drivers in Fayoum city. Methods: The current study was done on 200 drivers in Fayoum city. The screened drugs were cannabis, benzodiazepine, morphine and tramadol. All samples are screened by dip stick to detect studied types of drugs at forensic lab.at Fayoum University and positive samples were confirmed by gas chromatography (G.C) at poisoning center, Ain shams university. Results: The present study showed that 21.5% (n=43) of study group were drug abusers, 11.5% (n=23) were Tramadol abusers, 6.5% (n=13) of drivers were tetrahydrocannabinol (THC) abusers, and 3.5 % (n=7) THC and Tramadol abusers, on the other hand no one was morphine or benzodiazepine abusers. The present study demonstrated that among tramadol samples 34 samples were positive by dip stick, versus 30 samples were positive by G.C. The current study showed that among THC samples 22 samples were positive by dip stick versus 20 samples only were positive by G.C. Conclusion: about one fourth of the drivers were drug abusers. Tramadol and THC were the commonly abused drugs while there were no abusers for morphine and benzodiazepine. Recommendations: Drug screening should be added to all forms of basic toxicological screening especially to those involved in acts of violence and traffic accidents and for all drivers applying for license.Also using dip stick to check for drug abuse among drivers in check points being easy and rapid method with high accuracy

Treatable causes of fever among children under five years in a seasonal malaria transmission area in Burkina Faso

BackgroundFever remains a major public health problem. In Burkina Faso, more than half of febrile children are considered not to be infected by malaria. This study prospectively assessed probable (treatable) causes of fever in Burkinabe children.MethodsA prospective study was conducted among febrile children (≥37.5 °C) under 5 years of age presenting at four health facilities and one referral hospital in rural Burkina Faso. From each participant, blood was collected for malaria microscopy and culture, urine for dipstick testing and culturing if tested positive for leucocytes and nitrite, stool for rotavirus/adenovirus testing, culture and parasitology, and a nasopharyngeal swab for culture.ResultsIn total 684 febrile children were included in the study. Plasmodium falciparum malaria was found in 49.7% (340/684) of the participants and non-malaria infections in 49.1% (336/684) of children. The non-nalaria infections included gastro-intestinal infections (37.0%), common bacterial pathogens of nasopharynx (24.3%), bacterial bloodstream infections (6.0%) and urinary tract infections (1.8%). Nearly 45% (154/340) of the malaria infected children were co-infected with non-nalaria infections, but only 3.2% (11/340) of these co-infections could be considered as a possible alternative cause of fever. In contrast, in the malaria microscopy negative children 18.0% (62/344) of the infections could be the probable cause of the fever. Pathogens were not isolated from 23.7% (162/684) of the febrile cases.ConclusionsMalaria remains the most common pathogen found in febrile children in Burkina Faso. However, a relative high number of febrile children had non-malaria infections. The correct diagnosis of these non-malaria fevers is a major concern, and there is an urgent need to develop more point-of-care diagnostic tests and capacities to identify and treat the causes of these fevers.