Enzyme linked immunosorbent assay (ELISA) has now gained wide acclaim in the immunodiagnosis of infectious diseases. ELISA is continuously evolving with newer and sensitive formulations being added to it. The basic tenets of ELISA are discussed. The role of ELISA in two important issues facing us today, namely tuberculosis and human immunodeficiency virus infection are reviewed.
Prevalence of antibodies to hepatitis C virus (anti-HCV antibody) was ascertained in different subsets of hospitalized patients. Anti-HCV antibody testing was done using a third generation test The anti-HCV positivity in the sera of 308 tuberculosis patients, who had been given streptomycin, was 12.3 per cent It was 7.1 percent among 84 cardiac patients undergoing invasive cardiac procedures, 15.6 per cent in 77 patients on haemodialysis and 41.2 per cent patients with surgical jaundice. It is surmised that hospitalization, particularly parenteral therapy and invasive procedures during hospitalization, puts patients at higher risk of contracting HCV infecticn.
We studied bc(a-2 microglobulin (β-2Μ) levels in 44 HTV infected subjects belonging to 3 clinical stages as well as in 25 healthy controls. The method used was a competition enzyme immunoassay. In this study, levels of β2-Μ were measured in two groups of HIV infected individuals, the asymptomatic and those with progressive and advanced disease, in order to affirm its role as a surrogate prognostic marker. It was found that mean p-2M levels were 1.28 mg/L in the controls (normal range 0-2.4 mg/L), 11.41 mg/L in the HIV infected subjects, 2.69 mg/L in the asymptomatic HIV infected, 12.14 mg/L in those with persistent generalized lymphadenopathy (PGL) and 39.29 mg/L in the patients with acquired immunodeficiency syndrome. It was concluded that β-2Μ levels were significantly higher in the HIV infected as compared to the controls. Further, the levels were much higher in the IIIV infected with progressive disease/PGL and highest in those who had developed AIDS. β-2Μ is an important surrogate serological marker useful in prognostication of disease process in the HIV infected. Advantages of measuring B-2M levels over p24 antigen detection and CD4 counts were highlighted.
MJAFI1997; 53: 251-252
ABSTRACfEighteen rectal biopsies of eleven patients were histologically diagnosed as solitary rectal ulcer (SRU) during a period ofthree years. Their clinical and sigmoidoscopic features were analysed. Correct clinical diagnosis ofSRU was made in only two out ofeleven cases, the rest were diagnosed after sigmoidoscopy and biopsy. Presenting features were protean predominated by an altered bowel habit or bleeding per rectum. Sigmoidoscopically the location of the lesion varied from 6 to 12 em from the anal verge. Anterior rectal wall was more commonly affected (10 out ofll cases). Single rectal ulcer was found in 7 patients, other 4 showing multiple ulcers or polypoidal non-ulcerative lesions. Three patients required multiple biopsies. Prominent histological findings were obliteration oflamina propria by fibromuscular strands, splaying and hypertrophy of muscularis musosae as well as infiltrate in both these layers. The necessity ofbiopsy to diagnose SRU is stressed. MJAFI 1995; 51 : 17-20
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