Introduction: Clinical and laboratory markers have limited specificity and sensitivity for predicting renal disease in Systemic Lupus Erythematosus (SLE) patients. Aim of the Work: In this study we investigated whether urinary neutrophil gelatinase associated lipocalin (uNGAL) predicts active nephritis with or without history of biopsy-proven lupus nephritis (LN), also to find the correlation between uNGAL with serum creatinine level, creatinine clearance, anti-double-stranded (dsDNA) anti body and disease activity score in SLE patients. Methods: Sixty-three SLE patients based on the American College of Rheumatology (ACR) criteria in this cross sectional study were divided into two groups: patients with and without nephritis. For each group disease activity was measured by SLEDAI [1,2] and then divided to low (SLEDAI8) and high activity (SLEDAI ³8) according to Annett et al., 2003 [3]. 24 hours uNGALvalues were measured to each group. uNGAL sensitivity and specificity for identifying biopsy-proven nephritis were calculated, and a receiver operating character-istic (ROC) curve was constructed. Results: The mean±SD of 24-hours uNGAL in patients with LN was significant higher (24.61±3.44mg/24hours) compared to patients without nephritis (16.80±3.54mg/24 hours) with p-value of (p=0.000). A significant positive corre-lation was found between serum creatinine and uNGAL (r=0.324; p=0.030), while there was significant negative correlation between Creatinine clearance and uNGAL (r=–0.310; p=0.013). uNGAL had high sensitivity (82%) and moderate specificity (67%) in patients with biopsy proven LN in comparison to that of anti-dsDNA which had low sensitivity (50%) and specificity (37%) in detection of renal flare in LN patients. Conclusions: uNGAL predicts renal flare in LN patients with high sensitivity and specificity. Furthermore, uNGAL is a more sensitive and specific for renal flare in patients with a history of LN than anti-dsDNA antibody. So uNGAL may help in earlier diagnosis and treatment of LN with good outcomes in these patients.

NULL

NULL

NULL

NULL

NULL

NULL

NULL

A total of 81 patients undergoing upper endoscopy at Assiut University Hospitals were enrolled in this study. Three biopsies were taken and tested for H. pylori infection by Campylobacter like organism (CLO) test, culture and histopathology, in which H. pylori was detected in 56.7%, 72.8% and 83.8%, respectively. A patient was considered as H. pylori positive on the basis of a positive culture considering it as gold standard and this should be confirmed at least by either histopathological finding and/or CLO-test. Cytotoxic associated gene-type A (CagA) and vacuolated associated gene-A (VacA) were determined by polymerase chain reaction (PCR) in the 59 positive clinical isolates, cagA was found in 23 (39%) & vacA was found in all cases (100%), S2 & m2 were predominant (55.9% & 64.4%), respectively, followed by S1 & m1 (44.1% & 35.6%), respectively. CagA was found to be associated with peptic ulcer disease (PUD) mainly duodenal ulcer (DU) as well as gastric ulcer (GU) and gastric cancer (GC). VacA S1m1 was associated with PUD both DU & GU, while S2m2 was associated with non-ulcer diseases (NUD) mainly pangastritis. Antimicrobial sensitivity test of the 59 H. pylori isolates was done against the five most commonly used antibiotics. The most resistance was to metronidazole (91.5%), followed by amoxicillin (71.2%), tetracycline (35.6%), clarithromycin (18.6%) and the least resistance was to ciprofloxacin (8.5%). The aim of the present study was to detect the putative virulence factors cagA & vacA genes of clinical isolated H. pylori and correlated with the gastroduodenal diseases that determined clinically as well as to determine the resistance rate in H. pylori to commonly used antibiotics using disk diffusion method.

A total of 81 patients undergoing upper endoscopy at Assiut University Hospitals were enrolled in this study. Three biopsies were taken and tested for H. pylori infection by Campylobacter like organism (CLO) test, culture and histopathology, in which H. pylori was detected in 56.7%, 72.8% and 83.8%, respectively. A patient was considered as H. pylori positive on the basis of a positive culture considering it as gold standard and this should be confirmed at least by either histopathological finding and/or CLO-test. Cytotoxic associated gene-type A (CagA) and vacuolated associated gene-A (VacA) were determined by polymerase chain reaction (PCR) in the 59 positive clinical isolates, cagA was found in 23 (39%) & vacA was found in all cases (100%), S2 & m2 were predominant (55.9% & 64.4%), respectively, followed by S1 & m1 (44.1% & 35.6%), respectively. CagA was found to be associated with peptic ulcer disease (PUD) mainly duodenal ulcer (DU) as well as gastric ulcer (GU) and gastric cancer (GC). VacA S1m1 was associated with PUD both DU & GU, while S2m2 was associated with non-ulcer diseases (NUD) mainly pangastritis. Antimicrobial sensitivity test of the 59 H. pylori isolates was done against the five most commonly used antibiotics. The most resistance was to metronidazole (91.5%), followed by amoxicillin (71.2%), tetracycline (35.6%), clarithromycin (18.6%) and the least resistance was to ciprofloxacin (8.5%). The aim of the present study was to detect the putative virulence factors cagA & vacA genes of clinical isolated H. pylori and correlated with the gastroduodenal diseases that determined clinically as well as to determine the resistance rate in H. pylori to commonly used antibiotics using disk diffusion method.