Abu Naser Ibne Sattar

Meningitis caused by Mycobacterium tuberculosis remains an important cause of morbidity and mortality worldwide, and presents particular challenges in terms of diagnosis and management. The prevalence of TB meningitis remains largely underestimated due to nonspecific clinical manifestation. At early stages diagnosis is largely based on microscopy and culture which are often less sensitive and time consuming. This study was aimed to evaluate the diagnostic potentials of urinary polymerase chain reaction (PCR) by using TRC4 and IS6110 primers. Further the results were also compared by culture on Lowenstein-Jensen (LJ) media and AFB smear by Zeihl-Nelson (ZN) staining. A total of 20 CSF samples were studied from clinically suspected cases of tubercular meningitis. All the samples were processed for conventional ZN staining, TB culture on LJ media and TB-PCR by IS6110 and TRC4 primers by standard protocols. Of the total 20 samples, 12 cases were diagnostically positive TB meningitis samples among which bacteriological test was positive in only 1(8.33%) cases. PCR assay detected MTb in 10(83.33%) patients by TRC4 primers and in 8 (66.67%) patients by IS6110 primers. Since some strains of MTB may lack the IS6110 element in their genomeusing TRC4 primer instead of IS6110 is superior in diagnosing tubercular meningitis by PCR assay.

Helicobacter pylori colonize the gastric mucosa, related with different gastro-duodenal diseases and the clinical outcome linked to these diseases has been associated with pathogen virulence genes and their polymorphism. The aim of the study is to detect Helicobacter pyloricagA gene and to investigate the distribution of their genotypes in the patients with gastroduodenal symptoms. Total 51 patients were enrolled in the study on the basis of clinical and endoscopic findings. Written informed consent was obtained from each patient prior to the endoscopic procedure and collection of gastric biopsy specimens. Histopathological examination was done for detection of H. pylori in tissue specimens. The H. pylori histopathology positive specimens are considered as Helicobacter pylori positive and PCR were done for cagA detection and the positive specimens further tested by RFLP to detect the cagA polymorphism. Among the histopathology positive H. pylori cases 90% were positive for cagA gene by PCR and almost 100% cagA were β genotype by PCR-RFLP. No α genotype of cagA was found. Mean age of the patients were 46.9 ± 14.2 years starting from 22to 76 years. Out of 51 patients 39(76.47%) were male and 23.52% were female. According to the age group distribution, 22 (43.13%) were in 41-60 years age group and 39.21%and 17.64% were in 20-40 years and 61-80 years age group respectively. Among the 09 cagA positive cases 55.6% are in the 41-60 years age group and most (66.6%) of the cagA positive cases found in male patients. Significant percentage (33.3 and 50) of cagA was found among the patients suffering from melena and hematemesis. The result of the present study by PCR-RFLP pattern analysis revealed only β genotype for H. pylori cagA positive strains, which were typical genotypes in strains from Western countries. Therefore, it seems that the evaluation of genetic diversity in H. pylori-associated cagA gene can be attributable to the colonial relationship and epidemiology of H. pylori in defined population.