Progressive cardiotoxicity following treatment with doxorubicin-based chemotherapy in patients with non-Hodgkin's lymphoma (NHL) may lead to late onset cardiomyopathy. So, early prediction of toxicity can lead to prevention of heart failure in these patients. The aim of this work was to investigate the role of H-FABP as an early diagnostic marker of anthracycline-induced cardiac toxicity together with brain natriuretic peptide (BNP) as an indication of ventricular dysfunction in such patients. Our study was conducted on 40 NHL patients who received 6 cycles of a doxorubicin containing chemotherapy protocol (CHOP), not exceeding the total allowed dose of doxorubicin (500 mg/m2). Ten healthy controls were included in our study. Human heart-type fatty acid-binding protein (H-FABP) was assessed 24 hours after the first cycle of CHOP. Plasma levels of BNP were estimated both before starting chemotherapy and after the last cycle of CHOP. Resting echocardiography was also performed before and at the end of chemotherapy cycles. The ejection fraction (EF) of 8 of our patients decreased below 50% at the end of the sixth cycle. Elevated levels of both H-FABP and BNP were found in all patients wth EF below 50% and both markers showed a positive correlation with each other. We concluded that H-FABP may serve as a reliable early marker for prediction of cardiomyopathy induced by doxorubicin. Thus, in patients with elevated H-FABP, alternative treatment modalities with no cardiac toxicity may be considered in order to prevent subsequent heart failure in these patients.

Background: A rising threat of the rapid spread of acquired metallo (3 -lactamases (MBLs) among Gram Negative Bacilli (GNB) is a matter of public health concern worldwide. Hence, detection of MBLs producing clinical isolates via an accurate and cost effective technique is necessary to prevent their dissemination as well as regulation of antimicrobial stewardship policy. This study aimed to detect MBLs in Carbapenem Resistant Gram Negative Bacilli (CRGNB) using two phenotypic tests; Combined Disc Test (CDT) and Double Disc Synergy Test (DDST). Methods:We conducted a prospective study on 130 GNB isolates recovered from different clinical specimens collected from different patients. Isolates were identified then antibiotic susceptibility profile was determined by VITEK® 2 compact system. GNB which showed resistance to meropenem were screened for MBLs production by CDT and DDST.Results: Out of 36 CRGNB isolates, 23 isolates (63.9%) were MBLs positive by CDT, and 20 (55.6%) by DDST. With almost perfect agreement between CDT and DDST. Conclusion:Our study validates two phenotypic methods (CDT and DDST) for the detection of MBLs production, making them highly applicable to routine clinical laboratories.

Background: The frequency of fungal infections of the lung has increased particularly in immunocompromised patients. Early diagnosis and treatment is important to start antifungal therapy and to avoid unnecessary use of toxic antifungal agents. This study aimed to identify the common fungal species causing pulmonary infection in immunocompromised patients and their in vitro antifungal sensitivity pattern in Assiut University Hospitals (AUH). Subjects and Methods:This was a hospital based descriptive study conducted on 135 patients admitted at different Intensive Care Units (ICUs) and Oncology Department at Assiut University Hospitals (AUH). Collected respiratory specimens were subjected to direct microscopic examination and inoculation on Sabouraud Dextrose Agar (SDA). Identification of isolated yeasts was done using phenotypic methods including chromogenic media (Brilliance Candida agar and CHROMagar Candida differential media), germ tube test, cornmeal agar and API candida while mould isolates identification was mainly dependent on macroscopic and microscopic features. Some isolates had confirmed using rRNA gene sequencing. In vitro antifungal susceptibility testing was done using disc diffusion method.Results: In this study 80/135 (59.3%) of collected samples were positive for fungal infection. The most common fungal pathogens isolated were Candida and Aspergillus species. In vitro sensitivity test showed that the yeast isolates had the highest sensitivity to Nystatin (90.9%) followed by Amphotericin B (80.3%) while for mould isolates, the highest sensitivity was to Voriconazole (71.4%) followed by Amphotericin B (57.1%). Conclusion:Pulmonary fungal infection appears to be an important problem in immunocomprimised patients with Candida albicans was the most commonly isolated yeast from various clinical specimens; also the increase in the resistance especially to azoles is a major concern.

Background: Tuberculosis (TB) has been a major health problem in developing countries.Rapid diagnosis of Mycobacterium tuberculosis infection plays a critical role in controlling the spread of tuberculosis. Conventional methods may take up to several weeks or longer to produce results. This study aimed to compare different methods like culture on Bio F-M media, automated BacT/ ALERT MP bottles, and urine lipoarabinomnnan by ELISA. Subjects and Methods:This study was done on 100 patients suspected to have tuberculosis, cases divided into two groups: (Group A): 68 clinically suspected pulmonary TB cases. (Group B): 32 clinically suspected extrapulmonary TB cases. All samples from Group A and B were subjected to direct staining by Zeihl-Neelsen stain, culture of the samples on Lowenstein Jensen media, Bio FM media and automated BacT/ALERT MP bottles and detection of urine lipoarabinomannan by ELISA.Results: In suspected pulmonary tuberculosis cases the sensitivity and specificity of Bio FM were 87.2%, 100% respectively, sensitivity and specificity of BacT/ALERT MP were 74.4%, 100% respectively, sensitivity and specificity of urine lipoarabinomannan were 20.5%, 96.9% respectively and in suspected extrapulmonary tuberculosis cases were the sensitivity and specificity of Bio FM were 87.5%, 100% respectively, sensitivity and specificity of BacT/ALERT MP were 50%, 100% respectively, sensitivity and specificity of urine lipoarabinomannan were 12.5%, 100% respectively. Conclusion:The sensitivity of both solid (Lowenstein Jensen) and liquid (Bio FM) media were the same and better than BacT/ALERT MP. Bio FM media and BacT/ALERT MP show shorter time than Lowenstein Jensen for detection of mycobacterial growth. Detection of urine lipoarabinomannan by ELISA is insensitive for the diagnosis of TB.