We examined the lymphocyte subsets in peripheral blood, bone marrow and spleen of 11 patients with acute visceral leishmaniasis (VL) and 9 with chronic VL before and after 8 weeks of antileishmanial therapy. On admission, the CD4 cell count was depressed in the peripheral blood of acute and chronic VL cases as compared to the value in 10 normal control subjects. In contrast, CD4 cell counts were higher in the bone marrow in acute and chronic cases, and in splenic aspirates of chronic cases only, compared to normal values. The peripheral blood CD8 cell count, while normal in acute cases, was uniformly low in chronic cases. Counts of CD8 cells were also low in bone marrow of acute and chronic cases, as well as in splenic aspirates of chronic cases only. All these differences were significant (P < 0.05). After treatment, the CD4 cell count in the peripheral blood increased, but decreased in bone marrow and splenic aspirates. The CD8 cell count remained unaltered in the peripheral blood but increased significantly (P < 0.05) in bone marrow and spleen. The results suggest that in VL the peripheral blood picture may not reveal the actual T cell subset profile in the reticuloendothelial system. The changes in CD8 cell counts in the bone marrow and spleen seem to be independent, and are probably influenced by antileishmanial therapy.
The prevalence of CD among FDR is 9 fold higher than the general population. High prevalence of CD in presence of anemia and short stature in seropositive FDR in index study indicates need of targeted screening of this subgroup for the presence of CD.CD is unlikely in the absence of HLADQ2/DQ8.
We describe a case of bouveret's syndrome associated with carcinoma gall bladder. This is probably the second reported case of such an association. Computed tomography detected the calculus in the duodenum but endoscopy could not retrieve it. Open gastrojejunostomy and stone retrieval was done.
Background/Aim:Helicobacter pylori is implicated in various gastroduodenal diseases and many tests are available for its detection. The present study attempted to document the morphological changes in the gastric mucosa induced by H. pylori colonization and correlate them with the severity of the infection. The study also compared various diagnostic tests and evaluated the different staining methods used for H. pylori detection, especially immunohistochemical identification.Patients and Methods:One hundred and two patients with dyspepsia were included. Enzyme-linked immunosorbent assay (ELISA) for H. pylori-specific immunoglobulin G (IgG), immunoglobulin A (IgA), and immunoglobulin M (IgM) was used. Rapid urease test was performed on endoscopic biopsy and it was stained with hematoxylin and eosin (H and E), modified Giemsa, and immunohistochemical stains.Results:A significant correlation was found between the density of H. pylori and severity of gastritis. A significant correlation was observed between serology (especially when used in combination, IgG and IgA) and status of H. pylori. Immunohistochemical staining enhanced the diagnostic yield of H. pylori detection.Conclusions:Immunohistochemistry (IHC) should be used judiciously, whereas simple and economical tests like modified Giemsa should be used routinely for the detection of H. pylori. Combined ELISA (IgG and IgA) should be preferred over single ELISA. Simultaneous morphological and serological detection of H. pylori is preferable as H. pylori may not be detected on morphology alone due to its patchy distribution in the stomach.
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