Latex Agglutination Research Articles

Development of a rapid diagnostic test for the detection of antibodies or antigens to Coronavirus (COVID-19)

The global health crisis caused by COVID-19 has overwhelmed both healthcare settings and economies globally. While mass population testing has improved drastically, recent reviews of existing methods have highlighted various shortcomings with these methods. The aim of this project was to investigate whether the LAA could be modified and utilised as a rapid detection test which either matched or exceeded the existing sensitivity and specificity values.   The latex agglutination assay (LAA) investigated whether the COVID-19 spike protein could be detected in samples. COVID-19-specific  IgM and IgG were used in conjunction with a series of non-specific antigens. Control or AG-containing samples were mixed with AB-microsphere complexes on glass microscope slides. Manual visualisation identified various levels of agglutination. Light microscopy and spectrophotometry at 405 nm determined that the LAA could detect at least 2.3 ng of spike protein.  The particle-counting tool of ImageJ was utilised to obtain a data set which was subjected to statistical analysis which indicated that there was a significant difference between control samples and live tests, P = 0.000102 for the spike protein assay and P = 0.254 for the non-specific assay respectively. The results obtained fell in line with a similar study conducted by Buffin et al. in 2018. The analytical methods used in this project twinned with data obtained in previous studies supports the significant difference between control values and live test values. The LAA is easier, quicker to use (results in ≤ 30 minutes) and cheaper, with potentially better sensitivity to existing methods. This could benefit high- and low-income countries alike upon further research and optimisation. 

Cerebrospinal fluid analysis: current diagnostic methods in central nervous system infectious diseases.

Cerebrospinal fluid (CSF) analysis is an important diagnostic tool for many conditions affecting the central nervous system (CNS), especially CNS infectious diseases. Despite its low specificity, CSF white blood cell counts, CSF protein levels, CSF serum glucose ratio and CSF lactate measurement are useful in differentiating infections caused by distinct groups of pathogens. CSF direct examination and cultures can identify causative organisms and antibiotic sensitivities as well. Adjunctive tests such as latex agglutination, different immunological assays and molecular reactions have great specificities and increasing sensitivities. In this article, some recent diagnostic methods applied to CSF analysis for frequent CNS infections are presented.

Evaluation of seroprevalence and associated risk factors of Toxoplasmosis in sheep and goats in District Jhang-Pakistan

Toxoplasmosis is a zoonotic infection caused by a pathogenic protozoan, Toxoplasma gondii, responsible for huge economic and health losses in developing countries. The current study was conducted to assess the seroprevalence of Toxoplasmosis and associated risk factors in sheep and goats in District Jhang, Punjab, Pakistan. Blood samples (n=400) were collected from both genders of goats (n=219) and sheep (n=181) from four Tehsils of District Jhang alongwith a comprehensive questionnaire to evaluate the risk factors associated with the disease endemicity and spread. For assessing the seroprevalence, the samples were examined using Latex agglutination test. Additional data regarding hygienic conditions, water source, gender, breed, age of animal was also collected on a predesigned questionnaire. The overall seroprevalence of Toxoplasma gondii was found 34.25% (137/400) in District Jhang. Higher seroprevalence was recorded in goats {36.52% (80/219)} as compared to sheep {31.49% (57/181)}, however, it was non-significant (p>0.05). Gender-wise seroprevalence was found 32.59% (44/135) and 35.09% (93/265) in male and female animals, respectively (p>0.05). Further, the association of Toxoplasmosis between different age groups was significantly higher in older animals having age >24 months 42.75% (62/145) than younger animals with age <12 months 26.60% (29/109) and 11-24 months 31.50% (46/146) (p<0.05). The seroprevalence was also higher 40.81% (80/196) in animals drinking water from outdoor water source than in animals drinking from indoor water source 27.94% (57/204) (p<0.05). Moreover, seroprevalence was significantly higher 43.11% (97/225) in animals kept in vicinity of cats than in absence of cats 22.85% (40/175) (p<0.05). However, reproductive status, breeds, flock size had non-significant impact on the prevalence of T. gondii. Thus, it is concluded that the presence of cats near animals, larger flock size, older age of animals, and poor hygienic conditions are main risk factors of Toxoplasmosis in sheep and goats and these could be a potential threat of infection for livestock industry and public health.

Prevalence and antimicrobial susceptibility of Escherichia coli O157:H7 in raw cow’s milk in Gojo and Shukute towns, central Ethiopia

Escherichia coli O157:H7 is one of the most important emerging foodborne pathogens and cause life-threatening disease condition in consumers worldwide. A cross-sectional study was carried out from February 2020 to August 2020 in Gojo and Shukute towns, Jeldu district, West Shewa Zone, Oromia region, Ethiopia to isolate and identify E. coli O157:H7 from raw cow’s milk samples and determine antimicrobial susceptibility of the isolates. A total of 262 milk samples (127 from Gojo and 135 from Shukute towns) were collected from dairy cows (126 from udder, 115 from milking bucket) and 21 from collection tanks and examined bacteriologically. The isolates were tested with a series of biochemical tests followed by a latex agglutination test for identification and confirmation of E. coli O157:H7. The antimicrobial susceptibility profile of the isolated E. coli O157:H7 was performed using the Kirby-Bauer disk diffusion method. The study revealed 1.5% (95% Confidence interval [CI]: 0.4–3.8%) of the collected raw milk was contaminated with E. coli O157:H7. The isolates showed 100% susceptibility to azithromycin, norfloxacin, nitrofurantoin, amikacin, chloramphenicol, tetracycline, and trimethoprim-sulfamethoxazole. In contrast, the isolates showed 75% and 100% resistance to ampicillin and cefotaxime, respectively. In conclusion, the consumption of raw milk may constitute a public health hazard due to contamination with E. coli O157:H7. Farmers and farmworkers should be trained on milk hygiene and proper milk handling practices.

Serum Amyloid A Concentrations of Healthy and Clinically Diseased Japanese Black Breeding Cattle-Preliminary Measurements for Determining the Cut-Off Concentrations.

The present study aimed to compare serum amyloid A (SAA) concentrations of Japanese Black (JB) breeding cows in both clinically normal and diseased cows diagnosed by veterinarians using modified latex agglutination turbidimetric immunoassay (LATIA) to determine the cut-off values for healthy and diseased JB cows. For the comparison, a total of 289 serum samples of healthy cows without any clinical symptoms intended for the metabolic profile test and 66 serums from diseased cows clinically diagnosed by veterinarians were measured for the SAA concentrations. A significant difference (p-value = 6.68 × 10−29) was observed in the mean SAA concentrations between the healthy (2.8 ± 3.2 mg/L) and diseased (54.8 ± 76.8 mg/L) groups, and the median concentrations of the healthy and diseased groups were 1.5 mg/L and 31.2 mg/L, respectively. Finally, the cut-off SAA concentrations at each probability were 2.9 mg/L (p = 0.05), 5.7 mg/L (p = 0.1), 13.7 mg/L (p = 0.5), and 21.8 mg/L (p = 0.9), respectively, and 6.5 mg/L (p = 0.122) based on evaluation performed using the receiver operating characteristic curve. The results indicated that, with the practical application of the obtained cut-off value, the measurement of SAA concentrations for JB breeding cows with LATIA could be potentially beneficial in the early evaluation of inflammatory diseases in JB breeding cows and possibly useful in the prevention of not only metabolic diseases but also non-nutritional diseases during the perinatal period of JB breeding cows.

Development of SERS-based immunoassay for the detection of cryptococcosis biomarker.

The surface-enhanced Raman scattering (SERS) technique has displayed a broad application prospect in disease diagnosis owing to its high sensitivity, fast responsiveness, and high specificity. In this study, we developed a SERS-based immunoassay for the detection of cryptococcal capsular polysaccharide (glucuronoxylomannan, GXM), which is an important biomarker of cryptococcosis. The coupled localized surface plasmon resonance effect between magnetic SERS substrates and SERS tags gave rise to an enhanced Raman signal upon the formation of sandwich complexes, which contributes to the sensitive and specific detection of GXM. As a result, the developed method provided a lower limit of detection (1.25ng/mL) than conventional methods, such as latex agglutination, lateral flow assay, and enzyme-linked immunosorbent assay. Additionally, a recovery experiment was performed to detect GXM in human serum, which also validated the potential advantages of a SERS-based immunoassay in the clinical diagnosis of cryptococcosis.

Neurocryptococcosis and leptomeningeal carcinomatosis in metastatic prostate adenocarcinoma: differential diagnoses or overlapping symptoms?

Acute headaches with red flags in patients with cancer may indicate metastasis or infection. This report describes a case of acute headache with red flags in a patient with metastatic prostate adenocarcinoma who presented a positive latex fixation test without pleocytosis in cerebrospinal fluid (CSF) analysis. Antifungal treatment was initiated based on the test's high accuracy combined with the patient’s clinical condition and radiological impression of infectious meningitis, although we could not exclude associated secondary neoplastic involvement. Clinical improvement was first observed on D4 of treatment. On D14, CSF examination revealed therapeutic efficacy but positive oncotic cytology. The patient subsequently had new episodes of headache with warning signs and magnetic resonance imaging showed leptomeningeal carcinomatosis. Although neurocryptococcosis and leptomeningeal carcinomatosis are rare neurological complications, they may coexist with overlapping symptoms.

Clinical efficacy and tolerability of 1.5 g/day oral amoxicillin therapy without probenecid for the treatment of syphilis

ObjectivesIntramuscular benzathine penicillin G is not available in certain countries. In a previous report, 3 g/day amoxicillin with probenecid was shown to be effective in treating syphilis in patients with...

Study of type 2 diabetes patients and its association between obesity and glycated hemoglobin

Background: Obesity plays a central role in the pathophysiology of both T2D and its macrovascular complications. The present study was conducted to assess correlation between obesity and glycated hemoglobin in type 2 diabetes patients. Materials and Methods: 94 type II DM patients of both genders were included. Anthropometric measurements such as weight, height and BMI (kg/m2) was calculated. The waist circumference (WC) was measured. Patients were classified as Normal BMI: 18.0-22.9 kg/m2, Overweight: 23.0-24.9 kg/m2, Obesity: >25 kg/m2. Fasting plasma glucose was analyzed by glucose oxidase method and HbA1c by Latex agglutination inhibition assay. Results: There were 23 normal, 30 overweight and 41 obese patients. The difference was significant (P

Rectovaginal Colonization with Serotypes of Group B Streptococci with Reduced Penicillin Susceptibility among Pregnant Women in León, Nicaragua.

Group B Streptococci (GBS) are important causes of neonatal sepsis and meningitis globally. To elucidate the potential benefits of maternal GBS vaccines, data is needed on the epidemiology of maternal GBS rectovaginal colonization, distribution of serotypes, and resistance to intrapartum antibiotic prophylaxis (IAP). We collected rectal and vaginal samples from 305 pregnant women in León, Nicaragua between 35 and 40 weeks gestation. Samples were cultured for GBS and confirmed using latex agglutination. GBS isolates underwent serotyping by quantitative polymerase chain reaction, and antimicrobial susceptibility testing by disk diffusion and microdilution following Clinical Laboratory Standard Institute guidelines. Sixty-three women (20.7%) were colonized with GBS in either the rectum or the vagina. Of 91 GBS isolates collected from positive cultures, most were serotypes II (28.6%), Ia (27.5%), and III (20.9%). Most GBS isolates (52.9%) were resistant to penicillin, the first-line prophylactic antibiotic. Penicillin resistance was highly correlated with resistance to vancomycin, ceftriaxone, and meropenem. The results of our study suggest that one-fifth of pregnant women in the urban area of León, Nicaragua are colonized with GBS and risk transmitting GBS to their offspring during labor. High resistance to commonly available antibiotics in the region suggests that prophylactic maternal GBS vaccination would be an effective alternative to IAP.

Genomic analysis of virulence factors and antimicrobial resistance of group B Streptococcus isolated from pregnant women in northeastern Mexico.

Group B Streptococcus (GBS) causes infections in women during pregnancy and puerperium and invasive infections in newborns. The genes lmb, cylE, scpB, and hvgA are involved with increased virulence of GBS, and hypervirulent clones have been identified in different regions. In addition, increasing resistance of GBS to macrolides and lincosamides has been reported, so knowing the patterns of antibiotic resistance may be necessary to prevent and treat GBS infections. This study aimed to identify virulence genes and antibiotic resistance associated with GBS colonization in pregnant women from northeastern Mexico. Pregnant women with 35-37 weeks of gestation underwent recto-vaginal swabbing. One swab was inoculated into Todd-Hewitt broth supplemented with gentamicin and nalidixic acid, a second swab was inoculated into LIM enrichment broth, and a third swab was submerged into a transport medium. All samples were subcultured onto blood agar. After overnight incubation, suggestive colonies with or without hemolysis were analyzed to confirm GBS identification by Gram staining, catalase test, hippurate hydrolysis, CAMP test, and incubation in a chromogenic medium. We used latex agglutination to confirm and serotype GBS isolates. Antibiotic resistance patterns were assessed by Vitek 2 and disk diffusion. Periumbilical, rectal and nasopharyngeal swabs were collected from some newborns of colonized mothers. All colonized women and their newborns were followed up for three months to assess the development of disease attributable to GBS. Draft genomes of all GBS isolates were obtained by whole-genome sequencing. In addition, bioinformatic analysis to identify genes encoding capsular polysaccharides and virulence factors was performed using BRIG, while antibiotic resistance genes were identified using the CARD database. We found 17 GBS colonized women out of 1154 pregnant women (1.47%). None of the six newborns sampled were colonized, and no complications due to GBS were detected in pregnant women or newborns. Three isolates were serotype I, 5 serotype II, 3 serotype III, 4 serotype IV, and 2 serotype V. Ten distinct virulence gene profiles were identified, being scpB, lmb, fbsA, acp, PI-1, PI-2a, cylE the most common (3/14, 21%). The virulence genes identified were scpB, lmb, cylE, PI-1, fbsA, PI-2a, acp, fbsB, PI-2b, and hvgA. We identified resistance to tetracycline in 65% (11/17) of the isolates, intermediate susceptibility to clindamycin in 41% (7/17), and reduced susceptibility to ampicillin in 23.5% (4/17). The tetM gene associated to tetracyclines resistance was found in 79% (11/14) and the mel and mefA genes associated to macrolides resistance in 7% (1/14). The low prevalence of colonization and the non-occurrence of mother-to-child transmission suggest that the intentional search for GBS colonization in this population is not justified. Our results also suggest that risk factors should guide the use of intrapartum antibiotic prophylaxis. The detection of strains with genes coding virulence factors means that clones with pathogenic potential circulates in this region. On the other hand, the identification of decreased susceptibility to antibiotics from different antimicrobial categories shows the importance of adequately knowing the resistance patterns to prevent and to treat GBS perinatal infection.

High Occurrence Among Calves and Close Phylogenetic Relationships With Human Viruses Warrants Close Surveillance of Rotaviruses in Kuwaiti Dairy Farms.

Rotavirus, one of the main pathogens causing morbidity and mortality in neonatal dairy calves worldwide, is responsible for 30–44% of cattle deaths. It is considered to be the most common etiologic agent of diarrhea in neonatal dairy calves and children, the dominant type being group A. Two hundred seventy animals from 27 farms from 2 regions of Kuwait were tested for the presence of Rotavirus serogroup A (RVA) using latex agglutination test (LAT) and reverse transcription–polymerase chain (RT-PCR) testing. RVA non-structural proteins NSP1-2, NSP4-5 and capsid protein genes VP1-7 were characterized by next generation sequencing. LAT was positive in 15.56% of the animals, and RT-PCR in 28.89%. Using RT-PCR as a reference method, LAT was 100% specific but only 83.33% sensitive. ANOVA analysis showed correlation only with the location of the farms but no significant correlation with the age and sex of the animals. Although there was a tendency of clustering of RVA positive animals, it did not reach statistical significance (p = 0.035 for LAT). The phylogenetic analysis showed that Kuwaiti isolates of group A rotavirus clustered with human rotaviruses. Taken together, it seems that rotavirus was present in most of the dairy farms in Kuwait. The high occurrence of the virus in calves in Kuwaiti dairy farms and the close phylogenetic affinity with human isolates warrants urgent action to minimize and control its spread between calves in farms.

Serum Krebs von den Lungen-6 concentrations reflect severity of anti-melanoma differentiation-associated protein 5 antibody positive dermatomyositis associated interstitial lung disease.

Rapidly progressive interstitial lung disease (RP-ILD) is a major complication of anti-melanoma differentiation-associated protein 5 antibody positive dermatomyositis (anti-MDA5+DM) with a high mortality rate. The aim of the study is to determine whether serum Krebs von den Lungen-6 (KL-6) could be a prognostic biomarker to predict RP-ILD and prognosis in anti-MDA5+DM patients. A total of 21 anti-MDA5+DM patients with RP-ILD and 20 anti-MDA5+DM patients without RP-ILD were retrospectively included in this study. Serum KL-6 concentration (pg/mL) was measured using the latex agglutination test. Serum KL-6 level was higher in RP-ILD patients than those in non-RR-ILD patients (1195.61±872.93 vs. 452.6±465.51 pg/mL, p=0.002). The best cut-off value of KL-6 serum level was 500.9 pg/mL using ROC curve (AUC area = 0.7976, p=0.0011). KL-6 >500.9 pg/mL was an independent risk factor for RP-ILD using multivariate analysis (OR=56.38, 95% CI 5.51-577.504, p=0.001). Serum KL-6 concentrations were significantly higher in dead patients than those in the survivor group (1209.34±840.55 vs. 592.41±667.76, p=0.0033), and higher KL-6 concentration was also an independent risk factor for all-cause death after adjusting confounders (OR = 21.94, 95% CI 3.3-145.73, p=0.001). Anti-MDA5+DM patients with higher KL-6 level displayed a significantly decreased one-year survival rate, as compared with lower KL-6 level (36.36% vs. 89.47%, p=0.0008). The serum KL-6 levels reflect severity of lung injury and serve as a clinically useful biomarker in detection and monitoring RP-ILD progression in anti-MDA5+DM patients.

Role of C-reactive Protein, Leucocyte and Neutrophil Count in Diagnosis of Acute Appendicitis

Introduction: Acute appendicitis is the most common cause of surgical acute abdomen and appendicectomy is the most commonly done surgery. Accurate preoperative diagnosis can reduce negative appendicectomy rate. Objective: To evaluate the diagnostic accuracy of C-reactive protein (CRP), total leucocyte count (TLC) and neutrophil count in patients operated after clinical diagnosis of acute appendicitis. Materials and Methods: This cross-sectional observational study was conducted among 100 patients at Combined Military Hospital, Dhaka from August 2012 to January 2013. Serum CRP level was measured by latex agglutination method which is a qualitative test and level of 6 mg / L was considered positive. TLC and neutrophil count were estimated by processing blood sample through automated haematology analyzer. TLC level of 10.5 x 109/L and differential count of neutrophil more than 75% were considered elevated. Results: Out of 100 cases the mean age of the patients was 21.7 years and 65 patients were male and 35 patients were female with male to female ratio 1.85:1. Majority cases (54%) were in the age group of 11-20 years. Clinical diagnosis was correct in 93% cases and negative appendicectomy rate was 07% (p<0.001). Appendix was found mostly inflamed (83%) and gangrenous (10%). CRP was highly sensitive (84.9%) and specific (85.7%) with diagnostic accuracy of 85%. TLC was also found equally sensitive and specific with diagnostic accuracy of 83%. Overall diagnostic accuracy of neutrophil was 76%. Conclusion: Diagnosis of acute appendicitis is essentially clinical supported by simple laboratory investigations like TLC and neutrophill count. Elevated levels of CRP, TLC and neutrophill count are helpful in confirming a suspected diagnosis of acute appendicitis. Appendicitis is very unlikely if the CRP, TLC and neutrophill counts are normal. JAFMC Bangladesh. Vol 17, No 1 (June) 2021: 26-29

Incidence of Vaginal Colonization of Group B Streptococci among Pregnant Women Attending a Tertiary Care Hospital – Chennai, India

Streptococcus agalactiae or Group B Streptococcus (GBS) is an important pathogen, which can cause serious illness and sometimes death especially in newborns, pregnant women and in people with compromised immune system. The major risk factor for neonatal disease is vaginal colonization of GBS during pregnancy and delivery. 1) To study the incidence of vaginal colonization of Group B Streptococcus (GBS) among pregnant women. 2) To compare the efficacy of sheep blood agar vs selective medium like HiCHROME Strep B Selective agar (HIMEDIA) in the isolation of GBS. Vaginal swabs were collected from 150 antenatal women at 35-37 weeks of gestation or at any gestational age if additional risk factors were present. The swabs were cultured on non-selective medium like Blood agar and a chromogenic medium (HiCHROME Strep B Agar, HiMedia). GBS was identified by standard microbiological techniques. Bluish, purple-colored colonies were confirmed as GBS by CAMP test and latex agglutination test. Only 3 out of 150 women (2%) of the screened antenatal women were colonized with GBS. Incidence was quite low, compared to the literature from the West. All the 3 babies born to the three women colonized with GBS were healthy with no indication of invasive GBS disease. The chromogenic medium supported the growth of Group B Streptococcus and Enterococcus spp. only and was a useful selective medium for isolation of GBS.

Invitro susceptibility of Imipenem by E-test in different conditions of Methicillin resistant Staphylococcus aureus

MRSA infections have been confined to health care centres for decades, which is recognised as one of the major pathogen in Hospital as well as community settings. MRSA infections are associated with high morbidity and mortality. However, nowadays MRSA infections are increasingly seen in young healthy individuals with no exposure to health care centres, ie;CA-MRSA infections are seen increasingly. 50% to 70% of Staphylococcus aureus isolates submitted to area labs are methicillin resistant. MRSA is a major threat to patient safety. There are antibiotics that can kill MRSA germs. MRSA are resistant to most of the beta lactam antibiotics, not only to beta lactam but also to several other agents which is used for treatment. Imipenem is the most important antibiotic of Carbapenem, it is bactericidal for most aerobic and anaerobic pathogenic bacteria except MRSA. But in several studies its action against MRSA was shown. Here in this study, invitro susceptibility testing indicated that Imipenem is active against MRSA at different conditions, ie; at a physiological pH 7.4 & pH 5.5 an abscess condition and at two temperature 370c and 300c .Since the methicillin resistance is enhanced at 300c, the MIC of Imipenem detected at two temperature. Imipenem has a low molecular weight so it has a better penetration effect, than vancomycin and Daptomycin which is used for the treatment of MRSA. In, invitro study Imipenem spread in the medium more rapidly, and kill bacteria. So in MIC testing by Epsilometri test there is wide zone will be seen. Imipenem is the most important antibiotic of Carbapenem, it is bactericidal. To detect the in-vitro susceptibility of Imipenem by E test in different conditions of Methicillin Resistant Staphylococcus aureus. Malabar Institute of Medical Sciences, Calicut; Randomized controlled trial. Sample collection, Confirmation of MRSA by latex agglutination and cefoxitin e-test, detection of MIC of Imipenem by E-test at different conditions of MRSA, Detection of combination effect of Imipenem and Daptomycin against MRSA by E-test. paired sample t test

Synthesis of colored siloxane somonomers for use in immunodiagnostics

The article presents approaches to the preparation of copolymers of polymethylmethacrylate using azo dyes, as well as data obtained as a result of a number of reactions to obtain methacryloxy-functionalized dyes and their copolymerization with methyl methacrylate. Synthesis of such polymer particles can be useful in the field of medicine — immunodiagnostics, latex agglutination reaction, flow cytometry, microspheric multiplex analysis.

Autonomic neuropathy in Rheumatoid Arthritis: Relationship with seropositivity of Rheumatoid factor and disease activity

Background: Autonomic neuropathy (AN) has been recognized as a strong predictor of sudden cardiac death in Rheumatoid Arthritis (RA). Autonomic neuropathy may be assessed by five cardiovascular reflex tests. Objective: To find out the prevalence and severity of AN in RA and also to assess the correlation of inflammatory markers, disease severity and serological factor, Rheumatoid factor (RF) with autonomic reflex test parameters. Method: This cross sectional study was conducted on sixty (60) female RA patients, age range 18-50 years enrolled from the Out- Patient Department of Rheumatology Wing, Department of Medicine, of Bangabandhu Sheikh Mujib Medical University (BSMMU). Age matched 30 apparently healthy females were control. Cardiac autonomic reactivity was assessed by five cardiovascular reflex tests as described by Ewing include heart rate response to standing, deep breathing, valsalva maneuver and blood pressure response to standing and sustained hand grip. Inflammatory activity in RA was assessed by serum rheumatoid factor (RF)level which was estimated by the latex agglutination test ,C-reactive protein(CRP) and ESR and marker of disease activity was assessed by Disease activity score(DAS- 28 score) value. For statistical analysis, independent sample ‘t’ test chi-square test, pearson correlation coefficient test, spearman correlation test were used. Results: Among 60 RA patients, 43 (71.6%) patients were RF positive. Frequency of AN in RA patients was significantly higher (p< 0.001) compared to control. AN was detected in 78% of RA patients. Among the RA patients 17.38% showed severe,13.04% showed definite, 54.35% showed early involvement and 17.38% showed evidence of atypical pattern of AN. In addition, valsalva ratio and difference between maximum and minimum heart rate during deep breathing showed significant(p<0.05) negative correlation with autoantibody Rheumatoid factor(RF) whereas no significant correlation of autonomic nerve reactivity parameters with DAS- 28, CRP and ESR were found. Conclusion: Autonomic neuropathy was associated with RA. Autonomic neuropathy may be related to the presence of autoantibody RF in RA patients. J Bngladesh Soc Physiol 2021;16(1): 70-76

Direct tube coagulase testing on blood cultures in suspected staphylococcal bacteraemia

Background: Staphylococci are common isolates from blood cultures, appearing as Gram positive cocci (GPC) in clusters. The most clinically important species, Staphylococcus aureus, is identified by a positive tube coagulase or latex agglutination from plate culture, whereas less virulent species are mostly negative. This initial distinction may influence clinical management, but can take up to 48 hours. We proposed tube coagulase testing directly on blood culture broth at the time of flagging, which may reduce the time to reporting coagulase activity by 12 or more hours.

RF AND ANTI-CCPANTIBODY TESTS- A COMPARATIVE STUDY IN THE DIAGNOSIS OF RHEUMATOID ARTHRITIS IN A TERTIARY CARE HOSPITAL

INTRODUCTION: Rheumatoid arthritis (RA) is autoimmune disease associated with chronic inammation of joints causing deformities and functional impairment. Diagnosis primarily depends on clinical manifestations because of lack of suitable diagnostic tests. Rheumatoid factor (RF) is an autoantibody specic for Fc portion of human IgG. RF has low specicity as high false positive results are common in general population. Anti CCP antibody is also useful marker to diagnose rheumatoid arthritis and included in one of the criteria of American College of Rheumatology (ACR) /European League against Rheumatism (EULAR) classication of RA. Thus the present study was planned to compare the diagnostic utility of RF and Anti CCP antibody test in Rheumatoid arthritis patients in a Tertiary Care Hospital. AIM & OBJECTIVE: To compare the diagnostic utility of RF and Anti CCP antibody test in Rheumatoid arthritis patients. Material & METHODS: A total of 200 samples were taken from clinically suspected RA patients over a period of one year.RF was determined by latex agglutination method (SPAN DIAGNOSTICS Ltd.) and Anti CCP antibody by ECLIA (e-Cobas analyzer). The tests were performed as per manufacturer's instructions. RESULTS & DISCUSSION: Out of total 200 samples tested, Both RF and Anti CCP Antibody was positive in 100cases(50%). Only RF positivity was seen in 104(52%) and only Anti CCP antibody was positive in 140 (70%). We found Anti –CCP Sensitivity, Specicity,Positive predictive value,Negative predictive value result as 73.52% , 93.75%, 96.10%, 62.50% respectively.In present study combination of Anti CCPantibody and Rheumatoid factor together have shown positive predictive value for Rheumatoid Arthritis patients which lack specic signs and symptoms related to diagnosis of RA. Conclusion: Anti CCP antibody test and RF can be used concomitantly to diagnose Rheumatoid arthritis and can be used in clinical settings so that appropriate management can be initiated to decrease future morbidity.