Research Institute of Ophthalmology
Giza, Cairo | Egypt
Main Specialties: Biology, Infectious Disease, Medical Microbiology
Additional Specialties: Medical Parasitology
Prof. Dr. Nagwa Mostafa El-Sayed is a Professor of Medical Parasitology. She currently works as a Head of Medical Microbiology& Parasitology Department at Research Institute of Ophthalmology, Giza, Egypt. She has B.SC. in general Medicine & Surgery with very good grade with honors and Master and MD Degrees in Medical Parasitology, Faculty of Medicine, Cairo University. She does researches about Infectious Diseases and Parasitic Infections, especially those affecting the eye. She is an author in more than 35 scientific papers published in international journals. She is a member in many scientific and medical societies. She is a member in OSWD "Organization for Women in Science for the Developing World". She is a supervisor on many MD and Master Theses. She is a reviewer in many scientific international journals. She is an editorial board member of international journals. She received many national awards for the excellent medical achievements and scientific publications.
Primary Affiliation: Research Institute of Ophthalmology - Giza, Cairo , Egypt
123PubMed Central Citations
Anti-Infective Agents, 2019, 17, 130-137
Background: As natural herbs and medicinal plants extracts are widely used as alternative treatments for different parasitic diseases, some have been tested on Cryptosporidium either in vitro or in vivo. This study assessed the prophylactic and therapeutic treatments' effect of Moringa oleifera (M. oleifera) leaves methanol extract on immunosuppressed-Cryptosporidium infected mice.
Methods: The evaluation was carried out by Cryptosporidium oocysts count in fecal samples, histopathological changes in the intestinal tissues, determination of IFN-γ level in mice sera and measuring the antioxidant activity in the intestinal tissues.
Results: Prophylactic treatment by M. oleifera extract lowered Cryptosporidium oocysts shedding from immunosuppressed-infected mice although there was no complete elimination of the parasite. However, therapeutic treatment induced a significant reduction in Cryptosporidium oocysts counts by 91.8% higher than that of the drug control (nitazoxanide) group (77.2%). Histopathologically, the intestinal tissues from immunosuppressed-Cryptosporidium infected mice showed loss of brush border with severe villous atrophy and extensive necrosis. M. oleifera prophylactic treatment induced a moderate improvement of the pathological changes. However, the villi in M. oleifera therapeutic treated mice retained their normal appearance with minimal inflammatory cells. It was observed that M. oleifera extract induced a significant upregulation of IFN-γ in both prophylactic and therapeutic treated groups compared to that of the infected untreated group. In addition, M. oleifera leaves extract exhibited a significant antioxidant activity by reducing the levels of Nitric Oxide (NO) and Malondialdehyde (MDA) and increasing Superoxide Dismutase (SOD) level in the intestinal tissues compared to those of the infected and drug controls.
Conclusion: M. oleifera leaves extract has potent prophylactic and therapeutic activities against infection with Cryptosporidium.
Phytomedicine 43 (2018) 158–163
Background: Origanum majorana (O. majorana) and Foeniculum vulgare (F. vulgare) are traditionally used herbs in Egypt for treatment of several diseases including parasitic diseases. The Purpose was to determine the efficacy of O. majorana and F. vulgare aqueous extracts (AEs) on Blastocystis spp. in vitro, and to reveal their phenolic, flavonoids components and antioxidant activities through chemical analysis. Methods: The Efficacy of both plant AEs on human Peripheral Blood Mononuclear Cells (PBMCs) viability was assessed using MTT assay. Isolated Blastocystis spp. cysts from patients’ diarrhea samples were incubated with different concentrations of O. majorana and F. vulgare AEs for different incubation periods (24, 48 and 72 h) in comparison with nitazoxanide (NTZ) as a drug control. The total contents of phenolic and flavonoid compounds in the AEs and their ability to reduce DPPH were assessed. High performance liquid chromatography (HPLC) analysis for quantitative and qualitative determination of the phenolic and flavonoid contents was performed. Results: O. majorana AE at a dose of 400 μg /ml showed efficacy rates of 96% and 100% against Blastocystis parasite after 48 and 72 h, respectively, which nearly equivalent to NTZ at a dose of 500 μg/ml. F. vulgare at a dose of 250 μg/ml showed less efficacy rate of 56.4% after 48 h and increased to 70.7% after 72 h. Both extracts contain high phenolic and flavonoid compounds that possess antioxidant and free radical scavenging activities. Conclusion: O. majorana and F. vulgare AEs showed dose and time dependent anti-Blastocystis activity.
J Parasit Dis 2017 Dec 22;41(4):1020-1027. Epub 2017 May 22.
Medical Parasitology Department, Research Institute of Ophthalmology, Ministry of Scientific Research and Technology, Giza, Egypt.
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J Pediatr Infect Dis 2017;12:209–213
Journal of Pediatric Infectious Diseases
Intestinal parasitic infections (IPIs) represent a major public health problem in children worldwide, especially in the developing countries. The impact of these infections on the health status of children depends on the parasite species, the intensity and course of infection, and nutritional and immunological status of the children. Giardia lamblia, Entamoeba histolytica, Cryptosporidium parvum, Enterobius vermicularis, Hymenolepis nana, Ascaris lumbricoides, and Ancylostoma duodenale are the most frequent intestinal parasites found among children. This review discussed themain consequences resulting fromIPIs as diarrhea, anemia, malnutrition, impaired growth, and learning disabilities.
J Pediatr Infect Dis 2017;12:222–227.
J Pediatr Infect Dis
Toxocariasis, a parasitic infection, carries a major health risk in children, especially in the developing countries. Children are the most infected group because of their undeveloped immune system, their higher exposure to infection, and the frequency of reinfections depending on the factors related to their hygienic and behavioral habits. Many human infections are asymptomatic, with only eosinophilia and positive serology. However, several complications were associated with this neglected disease. These complications depend on the organs invaded by migrating Toxocara larvae, the degree of the larvae burden, and the strength of the host immune response. This review aims at giving an update on clinical manifestations, diagnosis, and treatment of toxocariasis in children. The pediatricians should merge this information into their clinical diagnosis to defeat this neglected disease by establishing the correct diagnosis and treatment.
J Parasit Dis (Oct-Dec 2017) 41(4):1020–1027
Journal of Parasitic Diseases
Abstract This study evaluated the effect of Zingiber officinale (Z. officinale) ethanol extract on the viability, embryogenesis and infectivity Toxocara canis (T. canis) eggs. It was carried out both in vitro and in vivo. In the in vitro experiment, unembryonated T. canis eggs were incubated with 25, 50 and 100 mg/mL Z. officinale extract at 25 C for 6, 12, and 24 h to assess the effect of Z. officinale on their viability and for two weeks to assess the effect of Z. officinale on their embryogenesis. In vivo experiment was performed to assess the effect of Z. officinale on infectivity of T. canis eggs. Treated embryonated eggs by Z. officinale extract at concentrations of 25, 50 and 100 mg/mL for 24 h were inoculated into mice and their livers were examined for the presence of T. canis larvae on the 7th day after infection and for histopathological evaluation at 14th day post-infection. Z. officinale showed a significant ovicidal activity on T. canis eggs. The best effect was observed with 100 mg/mL concentration after 24 h with an efficacy of 98.2%. However, the treated eggs by 25, 50 mg/mL of Z. officinale extract after 24 h showed ovicidal activity by 59.22 and 82.5% respectively. Moreover, this extract effectively inhibited T. canis eggs embryogenesis by 99.64% and caused their degeneration at the concentration of 100 mg/mL after 2 weeks of treatment. However, the lower concentrations, 25 and 50 mg/ mL inhibited embryogenesis by 51.19 and 78.57% respectively. The effect of Z. officinale on the infectivity T. canis eggs was proven by the reduction of larvae recovery in the livers by 35.9, 62.8 and 89.5% in mice groups inoculated by Z. officinale treated eggs at concentrations of , 50 and 100 mg/mL respectively. Histopathologically, the liver tissues of mice infected with Z. officinale treated eggs at the concentration of 100 mg/mL appeared healthy with slight degenerative changes of hepatocytes, opposite to that recorded in the infected mice with treated eggs by the lower concentrations. In conclusion; Z. officinale extract possessed dose-dependent anti-T. canis activity on the viability, embryogenesis and infectivity of T. canis eggs.
Asian Pac J Trop Dis 2017; 7(5): 280-285
Asian Pacific Journal of Tropical Disease
Objective: To evaluate the hepatoprotective activity of Thymus vulgaris (T. vulgaris) extract against Toxoplasma gondii (T. gondii) infection in experimentally infected mice. Methods: Sixty mice were divided into six groups (Group I–Group VI). Group I was normal control (non-infected, non-treated); Group II was non-infected and treated with T. vulgaris extract (500 mg/kg); Group III was T. gondii infected-non-immunosuppressed control; Group IV consisted of infected immunosuppressed mice; Group V was infected and treated with T. vulgaris extract; Group VI consisted of infected immunosuppressed mice treated with T. vulgaris extract. Hepatoprotective effect of T. vulgaris extract was evaluated by histopathological examination of tissue sections stained with hematoxylin and eosin, determination of liver function parameters (alanine aminotransaminase, aspartate aminotransaminase and alkaline phosphates, total bilirubin, total protein concentrations) and assessment of hepatocytes genotoxicity by comet assay.Antigenotoxic effect of T. vulgaris was assessed by several comet assay parameters that were provided by the image analysis software, including % tailed cells, % of DNA in the tail, tail length, and tail moment. Results: Treatment with T. vulgaris in both Groups V and VI improved T. gondii induced pathological lesions in the infected liver that regressed to near the normal picture especially in Group V. Also, it restored the altered values of liver function parameters near to the normal levels significantly (P < 0.05) compared with Groups III and IV respectively. Regarding comet assay parameters, all of them were significantly increased (P < 0.05) after T. gondii infection (Group III) and reached the greatest values in infected immunosuppressed group (Group IV) compared to the normal controls (Group I). With treatment by T. vulgaris in Groups V and VI, there was a significant decrease (P < 0.05) in all values compared to Groups III and V respectively. The results indicated that T. vulgaris reduced DNA damage induced by T. gondii infection in liver cells. Conclusions: T. vulgaris ethanol extract exhibited notable hepatoprotective activity against T. gondii infection.
J Parasit Dis 2016 Dec 24;40(4):1459-1465. Epub 2015 Sep 24.
Rheumatology Division, Internal Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
(), an intracellular parasite, establishes a chronic infection by forming cysts preferentially in the brain. TNF-? plays an important role in controlling the infection caused by this protozoan. Thus, the blockade of TNF-? could cause reactivation of latent toxoplasmosis infection as well as increase the risk of acute toxoplasmosis. This study evaluated the effect of etanercept, a TNF-? antagonist in reactivation of latent toxoplasmosis compared to the therapeutic effect of sulfadiazine and pyrimethamine in combination on the progress of the disease. A total of 40 laboratory-bred Swiss albino mice were infected with Me49 strain of and divided into four groups: infected control group; treated group with sulfadiazine and pyrimethamine; treated group with etanercept and treated group with both etanercept and sulfadiazine and pyrimethamine. The mean number and size of tissue cysts in brain smears of mice of each group were determined and also, serum levels of TNF-? were assessed in different study groups by an enzyme linked immunosorbent assay. The results showed that the mean TNF-? level was significantly different in the treated groups compared to that in infected control group. The highest level of TNF-? was found in the infected controls. After treatment with etanercept alone or combined with sulfadiazine and pyrimethamine, it was significantly decreased. In this study, reactivation of latent toxoplasmosis was observed by a significant increase in the mean number and sizes of tissue cysts in brains of mice with established chronic toxoplasmosis after treatment with etanercept alone or combined with conventional treatment compared to both untreated chronically infected controls and infected mice treated with sulfadiazine and pyrimethamine. It was concluded that etanercept, a TNF-? antagonist may play a role in reactivation of latent toxoplasmosis. So, serological screening for toxoplasmosis might offer a valuable aid for patients treated with this drug.
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Trop Med Infect Dis, 2016, 1, 7.
Tropical Medicine and Infectious Disease
Abstract: Toxoplasmosis may present as a severe disease among some Egyptian patients with chronic liver disease (CLD) due to their impaired immune system, changing the course of the disease. The classical diagnosis of toxoplasmosis by serological tests is inadequate for such patients. This study was performed to highlight the role of real-time quantitative PCR (qrtPCR) test in the accurate diagnosis of toxoplasmosis among Egyptian patients with CLD. Seventy patients with CLD and 50 healthy controls were enrolled in this study. All were subjected to full clinical examinations, abdominal ultrasonography, and biochemical analysis of liver enzymes and they were investigated for markers of hepatitis B virus (HBV) and hepatitis C virus (HCV). In addition, Toxoplasma gondii (T. gondii) parasitemia was determined using qrtPCR. The results showed that T. gondii parasitemia was positive in 30% of CLD patients with highly statistically significant (p < 0.001) compared with the control group (6%). Co-infection in both T. gondii/HBV and T. gondii/HCV was 33.3% and 31.4%, respectively, with a highly significant association between T. gondii parasitemia and HCV viral load. Moreover, the results showed a significant increase of liver enzymes in the serum of patients positive for T. gondii compared with negative patients. An association between T. gondii infection and CLD was observed, and further studies will be needed to define the mechanism of this association.
Asian Pacific Journal of Tropical Disease
Objective: To ascertain a relationship between Toxoplasma gondii (T. gondii) infection and rheumatoid arthritis (RA) disease among Egyptian patients.
Methods: One hundred RA patients and 50 healthy subjects participated in this study. The patients were classified into three groups, namely GI, G2 and G3. Patients in G1 were recently diagnosed with RA with the disease duration of less than one year (prior treatment); G2 included RA patients receiving anti-tumor necrosis factor agents and RA patients in G3 received disease modifying anti-rheumatic drugs (methotrexate, antimalarial, corticosteroids). Serum samples of all participants were examined for the presence of anti-Toxoplasma immunoglobulin G (IgG) antibodies and positive samples were further analyzed for anti- Toxoplasma IgM antibodies to detect the possibility of reactivation of latent toxoplasmosis. Also, the association between Toxoplasma seropositivity and clinical, laboratory and radiological features of these patients were determined.
Results: There was a significantly higher percentage of T. gondii IgG positivity in RA patients (54%) than in the controls (32%). At the same time, 20.40% of T. gondii IgG positive patients had anti-T. gondii IgM antibodies with a statistically significant difference as comparing to T. gondii IgG positive controls. Out of T. gondii seropositive patients, 20.37% had a lower IgG level with a mean titer of (65.3 ± 17.7) IU/mL, 46.29% had moderate level with a mean titer of (184.2 ± 60.0) IU/mL and 33.33% had higher level with a mean titer of (404.3 ± 50.0) IU/ mL. A positive correlation was found between disease activity and Toxoplasma seropositivity. T. gondii seropositive RA patients had longer disease duration, longer time morning stiffness, higher numbers of tender and swollen joints and also increase in disease severity markers (erythrocyte sedimentation rate, C-reactive protein, disease activity score 28, anti-cyclic citrullinated peptide anti-bodies, rheumatoid factor) than T. gondii seronegative patients. As regards radiological findings, Larsen score was found significantly higher in T. gondii seropositive RA patients.
Conclusions: The positive correlation between T. gondii infection and RA disease among Egyptian patients indicated the need to improve awareness of this parasitic infection and its management in this risk group.
J Parasit Dis 2016 Sep 30;40(3):922-9. Epub 2014 Oct 30.
Clinical Pathology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
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Parasitol Res 2016 Jul 20;115(7):2863-71. Epub 2016 Apr 20.
Parasitology Department, Faculty of Medicine, Benha University, Benha, 13518, Egypt.
The current work was undertaken to investigate the potential effectiveness of Thymus vulgaris ethanolic extract (TVE) against Toxoplasma gondii infection in chronic experimental toxoplasmosis. To evaluate prophylactic effects, mice received 500 mg/kg TVE for 5 days before they were infected by an avirulent Me49 T. gondii strain. To investigate the therapeutic effects of the extract postinfection, daily treatment with TVE was initiated at 6 weeks postinfection and continued for 10 days. The following groups of animals were used as controls: uninfected/non-treated, infected/non-treated, and infected/treated with a combination of pyrimethamine and sulfadiazine. Brain cyst count and histopathological changes using H&E and Feulgen stains were used to evaluate the efficacy of TVE. The mean number of brain cysts was significantly decreased by 24 % in mice treated prophylactically with TVE. TVE also significantly reduced the mean number of brain cysts when administered to animals already chronically infected with T. gondii. The effect of TVE was comparable to that of treatment with a mixture of sulfadiazine and pyrimethamine (46 and 51 % reduction, respectively). Moreover, considerable amelioration of the pathological lesions in the brain and retina was observed. The results demonstrate the potential efficacy of T. vulgaris as a new natural therapeutic and prophylactic agent for use in the treatment of chronic toxoplasmosis.
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Asian Pac J Trop Dis 2016; 6(4): 260-264
Asian Pacific Journal of Tropical Disease
Objective: To determine the value of voluntary blood donors screening in diagnosing asymptomatic toxoplasmosis in an attempt to reduce the risk of this infection in Egyptian immunocompromised recipients.
Methods: Serum samples from 300 healthy voluntary blood donors were analyzed for anti- Toxoplasma antibodies [immunoglobulin G (IgG) and immunoglobulin M (IgM)] using ELISA and detection of Toxoplasma gondii (T. gondii) parasitemia was done by real-time quantitative PCR (qrtPCR).
Results: Frequency of T. gondii infection in 300 healthy blood donors was 101 (33.67%), 10 (3.33%), 18 (6.00%) by ELISA IgG, IgM and qrtPCR, respectively. It was found that 8 of 18 (44.4%) donor samples positive by qrtPCR contained IgM anti-T. gondii, conversely 8 of 10 (80%) IgM-positive samples were positive for T. gondii DNA. There was a highly significant increase in detection of recent Toxoplasma infection using PCR over IgM ELISA by 55.6%. At the same time, T. gondii parasitemia was detected in 11 of 101 (10.90%) donor samples positive by IgG ELISA and in 7 of 199 (3.50%) negative donor samples for anti-T. gondii IgG antibodies. On the other hand, the negative results obtained by both qrtPCR and ELISA in 192 (64%) subjects ruled out the infection in those donors.
Conclusions: It might be appropriate to include the screening of blood and blood products for T. gondii in the pre-transfusion blood testing schedule in Egypt. Also, molecular screening should be carried out on the blood being transfused to immunocompromised patients.
Indian J Ophthalmol 2015 Dec;63(12):881-7
Department of Medical Parasitology, Research Institute of Ophthalmology, Giza, Egypt.
Ocular lesions are frequently associated with different parasitic infections. The classes of infection include protozoa, nematodes, cestodes, and ectoparasites. Ocular parasitic infections can manifest in any part of the eye; the disease manifestations are frequently characterized as either posterior or anterior eye disease. Parasite-induced lesions may be due to damage directly caused by the parasite, indirect pathology caused by toxic products or the immune response initiated by infectious parasitism. This review characterized the parasite-induced lesions in the posterior segment of the eye. Prompt diagnosis and early treatment of these lesions can reduce ocular morbidity. The method of the literature search was conducted on PubMed, Elsevier Scopus database, and Google Scholar with no limitation on the year of publication databases. It was limited to English articles published for ocular lesions in clinical studies and was focused on parasitic infections of the eye.
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Aperito J Bacteriol Virol Parasitol
Autoimmune Diseases and Therapeutic Approaches Open Access
The association between Schistosomes infection and autoimmunity has been studied extensively in the medical literature. Schistosomiasis might induce autoimmune activity by several mechanisms: molecular mimicry, production of pathogenic autoantibodies, polyclonal activation of B cells, altered self antigens. It has documented the protective effect of Schistosomes infection against immune-mediated diseases such as type 1 insulin-dependent diabetes mellitus, multiple sclerosis, and Crohn’s disease. This protective effect mediated by Th2 immune response with production of IL-10 which able to inhibit the production of pro-inflammatory mediators such as interferon-γ (IFN-γ), tumor necrosis factor (TNF-α) and nitric oxide and mediate the control of autoimmune disease. Additionally, autoimmune mechanisms might have a role in the pathogenesis of schistosomiasis inducing granulomatous inflammation, glomerulonephritis and visceral fibrosis.
Aperito Journal of Bacteriology, Virology and Parasitology
A number of parasitic diseases have been reported to be transmitted by blood transfusion, including malaria, leishmaniasis, Chagas' disease, babesiosis, toxoplasmosis and filariasis. Majority of blood banks do not screen donor blood samples for these potentially pathogenic parasites, this poses great risk to the recipients of blood, especially immunocompromised patients and those who need regular, frequent and multiple transfusions. Transfusion-transmitted parasitic infections depend on several factors; asymptomatic parasitemia individual qualifies as a blood donor, the ability of the parasite to survive on stored donated blood, and the infected blood is transfused in a sufficient dose to a susceptible patient.
Parasitol Res 2015 Mar 28;114(3):823-30. Epub 2014 Oct 28.
Medical Parasitology Department, Research Institute of Ophthalmology, 2 El-Ahram St, P.O. Box: 90, Giza, 12556, Egypt,
Acanthamoeba is one of the most common free-living amoebae. It is widespread in the environment and can infect humans causing keratitis. Delayed diagnosis or misdiagnosis leads to extensive corneal inflammation and profound visual loss. Therefore, accurate and rapid diagnosis of Acanthamoeba keratitis is essential for successful treatment and good prognosis. This study was designed to use different staining techniques to facilitate the identification of Acanthamoeba cysts. Acanthamoeba cysts were isolated by cultivation of either corneal scraping specimens or tap water samples onto non-nutrient agar plates seeded with Escherichia coli. Subcultures were done from positive cultures until unique cysts were isolated. Acanthamoeba cysts were stained temporarily using iodine, eosin, methylene blue, and calcofluor white (CFW) stains and as permanent slides after processing for mounting using modified trichrome, Gimenez and Giemsa staining. These stains were compared on the basis of staining quality including clarity of morphological details, differentiation between cytoplasm and nuclei, color and contrast, and also other characteristics of the staining techniques, including ease of handling, time taken for the procedure, and cost effectiveness. The cysts of Acanthamoeba were recognized in the form of double-walled cysts: the outer wall (ectocyst) that was being differentiated from the variably stained surrounding background and the inner wall (endocyst) that was sometimes stellated, polygonal, round, or oval and visualized as separate from the spherical, sometimes irregular, outline of the ectocyst. Regarding the temporary stains, it was found that they were efficient for visualizing the morphological details of Acanthamoeba cysts. In CFW staining, Acanthamoeba cysts appeared as bluish-white or turquoise oval halos although the internal detail was not evident. On the other hand, the results of permanent-stained slides showed the most consistent stain for identification of Acanthamoeba cysts was modified trichrome followed by Gimenez stain and lastly Giemsa stain that gave poor visibility of Acanthamoeba cysts due to the intense staining background and monochrome staining of parasite. In the present study, multi-attribute ranking of the used staining techniques showed the highest rank for iodine stain (92 %) followed by eosin stain (84 %), Gimenez stain (76 %), methylene blue (72 %), CFW (64 %), modified trichrome (56 %), and the least was Giemsa stain (44 %). In conclusion, the staining techniques enhance the overall visibility of Acanthamoeba cysts.
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J Parasit Dis 2015 Mar 3;39(1):7-12. Epub 2013 Sep 3.
Pediatric Department, Faculty of Medicine, Ain-Shams University, Cairo, Egypt.
Patients with chronic liver diseases (CLD) are often highly susceptible to parasitic infection due to a depressed immune system. The objective of this study was to detect the most commonly intestinal parasites found among Egyptian children with CLD. The present study was conducted on 50 children with CLD of different etiology (25 were having different intestinal symptoms, 25 without intestinal symptoms) and 50 non-CLD children with gastrointestinal complaints served as controls. All cases were subjected to stool examination and investigated by liver function tests. Also, anthropometric measurements were taken for all children including weight and height. It was found that the most commonly intestinal protozoa identified in the patients with CLD in order of frequency were: Entamoeba histolytica/Entamoeba dispar (16 %), Giardia lamblia (14 %), Blastocystis hominis (14 %), Cryptosporidium parvum (10 %), E. histolytica and G. lamblia (2 %), E. histolytica and B. hominis (2 %), G. lamblia and B. hominis (2 %), B. hominis and Entamoeba coli (2 %), Microsporidium (2 %) and no cases were found infected with Strongyloides stercoralis. As compared to the controls, the observed incidence of these organisms in CLD patients was significantly higher (p < 0.045) as regards stool examination by unstained techniques while, there was no significant difference between both groups as regards stool examination by stained techniques (p < 0.478). In addition, this study showed that the weight and height of studied patients were affected by parasitic infection while, there was no significant correlation between parasitic infection and liver function tests. In conclusion, chronic liver diseases affect the immunity of the patients as shown in significant increase in the incidence of intestinal parasites in cases compared to controls.
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Aperito Journal of Ophthalmology
Keratitis is painful inflammation and swelling of the cornea, the transparent domelike portion of the eyeball in front of the iris and the pupil. It can be classified by its location, severity, and cause. If keratitis only involves the surface (epithelial) layer of the cornea, it is called superficial keratitis. If it affects the deeper layers of the cornea (the corneal stroma), it is called stromal keratitis or interstitial keratitis. Often there is inflammation of both the cornea and the conjunctiva, the mucous membrane that lines the inside of the eyelid and covers the sclera. In this case, the condition is called keratoconjunctivitis. Bacteria, viruses, fungi, and parasitic organisms may infect the cornea, causing infectious or microbial keratitis. The unique structure of the human eye as well as exposure of the eye directly to the environment renders it vulnerable to these microorganisms. These pathogens infect the eye either by direct introduction through trauma or surgery, by extension from infected adjacent tissues, or by hematogenous dissemination to the eye. The main parasites that cause keratitis include: Acanthamoeba spp., Mirosporidia spp., Onchocerca volvulus. Other parasites that rarely or uncommonly affect the cornea include; Leishmania spp., Mansonella ozzardi, Thelazia and Gnathostoma spp. The symptoms vary, but may include redness, pain, decreased vision, light sensitivity, or a frank opacity within the cornea. It has been almost very difficult to be differentiated between the parasitic keratitis and that caused by other pathogens. Therefore, the timely identification and treatment of the involved microorganisms are paramount. The aim of this article is to summarize up-to-date information about corneal involvement by some parasitic infections in an attempt helping the ophthalmologist integrate this information into their clinical diagnosis to tailor appropriate therapies
Aperito J Bacteriol Virol Parasitol 2014Dec 28, 1: 2
Aperito Journal of Bacteriology, Virology and Parasitology
The treatment of Toxoplasma gondii (T. gondii) infection accentuates the problem of the limited effectiveness of the available anti-parasitic agents and their side effects and also, the potential appearance of resistant Toxoplasma strains. Thus, the search of the newer and more effective drugs is needed. This study aimed to review the efficacy of some herbal plants extracts on T. gondii infection, in an attempt to overcome the side effects of hazardous drugs. It was found that many herbal plants extracts exhibit anti-Toxoplasma activity including Nigella sativa, Zingiber officinale, Myrrh, Piper nigrum, Capsicum frutescens, Curcuma longa, Azadirachta indica (neem) and Melia azedarach. However, their efficacies in human toxoplasmosis remain to be confirmed in clinical trials. The use of such medicinal plants extracts has a more beneficial effect in prophylaxis as well as treatment of this protozoan infection through being safer, acceptable, affordable, culturally compatible, widely available at low cost and suitable for treatment of chronic toxoplasmosis.
Parasitol Res 2014 Sep 21;113(9):3267-72. Epub 2014 Jun 21.
Parasitology Department, Research Institute of Ophthalmology, Giza, Egypt,
This study evaluated the performance of direct amplification of Acanthamoeba-DNA bypassing DNA extraction in the diagnosis of Acanthamoeba keratitis in clinically suspected cases in comparison to direct microscopic examination and in vitro culture. Corneal scrapings were collected from 110 patients who were clinically suspected to have Acanthamoeba keratitis, 63 contact lens wearers (CLW), and 47 non-contact lens wearers (NCLW). Taken samples were subjected to direct microscopic examination, cultivation onto the non-nutrient agar plate surface seeded with Escherichia coli, and PCR amplification. The diagnostic performance of these methods was statistically compared. The results showed that Acanthamoeba infection was detected in 21 (19.1%) of clinically suspected cases (110); 17 (81%) of them were CLW and the remaining 4 (19%) positive cases were NCLW. Regarding the used diagnostic methods, it was found that direct amplification of Acanthamoeba DNA bypassing nucleic acid extraction was superior to microscopy and culture in which 21 cases (19.1%) were positive for Acanthamoeba by PCR compared to 19 positive cases by culture (17.3%) and one case (0.9%) by direct smear. The difference in detection rates between culture and direct smear was highly statistically significant (P?=?0.001). On the other hand, there was no significant difference in detection rates between culture and PCR (P?=?0.86). On using culture as the gold standard, PCR showed three false-positive samples that were negative by culture and one false-negative sample that was positive by culture. At the same time, direct smear showed 18 false-negative samples. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of PCR were 94.7, 96.7, 85.7, 98.9, and 96.4, respectively, while those of direct smear were 5.3, 100, 100, 83.5, and 83.6, respectively. In conclusion, direct amplification of Acanthamoeba-DNA bypassing DNA extraction is a reliable, specific, sensitive method in the diagnosis of Acanthamoeba keratitis in clinically suspected cases. It should set up in ophthalmological centers as an easy diagnostic tool.
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Int J Ophthalmol 2014 18;7(3):431-6. Epub 2014 Jun 18.
Department of Basic Science, Biophysics and Laser Science Unit, Research Institute of Ophthalmology, Giza 12556, Egypt.
Aim: To detect whether Toxoplasma gondii (T. gondii) infection of mice can induce retinal DNA damage.
Methods: A total of 20 laboratory-bred male Swiss albino mice were used and divided into four groups: control group (non-infected animals); T. gondii infected group; immunosuppressed infected group; and infected group treated with sulfadiazine and pyrimethamine. Mice eyes were collected 6wk post infection and retinas were obtained. Each retina was immediately processed for comet assay and the frequency of tailed nuclei (DNA damage) was calculated. In addition, retinal DNA damage was revealed by various comet assay parameters that were provided by the image analysis software including tail length, percentage of DNA in the tail, percentage of tailed cells and tail moment.
Results: The obtained results showed that T. gondii infection induced a statistically significant increase in the frequency of tailed nuclei, tail length, percentage of DNA in the tail, and tail moment in mice retinal cells compared to the control group (which showed some degree of DNA damage). In immunosuppressed infected group, retinal DNA damage was severing and there was significant increase in various comet assay parameters compared to both control and infected groups. After treatment with sulfadiazine and pyrimethamine, retinal DNA damage decreased and all comet assay parameters showed a statistical significant decrease compared to infected groups.
Conclusion: T. gondii infection can induce DNA damage in mice retinal cells.
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Infect Dis Clin Pract 2012;20: 394-399
Infectious Diseases in Clinical Practice
Background: Toxoplasma gondii is an intracellular parasite that in most individuals can persist in multiple tissues where the latent stage of the parasite is mainly found in the central nervous system. Schizophrenia is a serious neuropsychiatric disease of uncertain etiology, and recent studies have focused on T. gondii as a possible causal factor in schizophrenia. Soluble intercellular adhesion molecule 1 (sICAM-1), which represents a circulating form of ICAM-1, has been implicated in the development of many diseases.
Aim: The present study aimed to investigate the frequency of T. gondii infection among schizophrenia patients and to determine the usefulness of sICAM-1 as an indicator of Toxoplasma role in the etiopathogenesis of schizophrenia.
Methods: Sixty patients with schizophrenia, 30 with depressive disorder, and 20 healthy volunteers were subjected to determination of antiYT. gondii immunoglobulin G (IgG) antibody seropositivity and sICAM-1 serum level using commercially available enzyme-linked immunosorbent assay kits.
Results: The results showed that the seropositivity rate of antiYT. gondii IgG antibodies among schizophrenia patients (56.7%) was higher than among patients with depressive disorder (40%); despite this, the difference was not statistically significant. It was significantly higher in schizophrenia patients than in the healthy volunteers group (30%). Regarding the serum level of sICAM-1, it was significantly higher in the antiYT. gondii IgGYseropositive schizophrenia subgroup compared with those of the seropositive healthy volunteers and seropositive depressive disorder subgroups. Moreover, there was a significantly higher level of sICAM-1 in the seropositive schizophrenia subgroup compared with that of the seronegative schizophrenia subgroup. Concerning the seropositive depressive disorder subgroup, there was a significantly higher level of sICAM-1 compared with that of the seronegative depressive disorder subgroup.
Conclusions: These statistically significant results support the association between T. gondii infection and schizophrenia and suggest the usefulness of sICAM-1 as an indicator for the possible role of Toxoplasma among other factors in the etiopathogenesis of schizophrenia.
PUJ; 2012, 5(1): 59-66
Parasitologists United Journal
Background: Malaria diagnosis depending on clinical conditions is often unreliable due to the inconsistent signs and symptoms of malaria, leading to over-diagnosis and over-treatment. Correct diagnosis is important for effective management of malaria cases and to reduce wastage of costly drugs.
Objective: This study was conducted to detect malaria infection in patients complaining of fever of unknown origin, highly suspected clinically to be due to malaria. OptiMAL rapid antigen test and polymerase chain reaction (PCR) were used in comparison with microscopy.
Subjects, Material and Methods: A total of 120 expatriate patients attending King Faisal specialized hospital, Taif, KSA, complaining of fever of unknown origin were screened for malaria parasites by microscopy of Giemsa-stained blood smears, OptiMAL rapid antigen test and genus specific PCR. The diagnostic performance of these methods was statistically compared.
Results: Out of 120 clinically suspected cases, 54 (45%) were positive for Plasmodium infection by using microscopy, and of these 45 (83.3%) were infected by P. vivax, 6 (11.1%) by P. falciparum, 1 (1.9%) by P. malariae and 2 (3.7%) were mixed infections (P. vivax and P. falciparum). Correspondingly, OptiMAL test and PCR detected malaria infection in 51(42.5%), and 56(46.7%) patients respectively. The differences in detection rates of these diagnostic tests were not statistically significant (P>0.05). Using direct microscopy as gold standard, OptiMAL test showed 5 false-positive samples that were negative by microscopy and 8 false-negative samples that were positive by microscopy. At the same time, PCR showed 3 false-positive and one false-negative results. PCR showed a higher sensitivity (98.1%), specificity (95.5%), positive predictive value (94.6%), negative predictive value (98.4%) and diagnostic accuracy (96.6%) than OptiMAL test (85.1%, 92.4%, 90.1%, 88.4%, 89.1%, respectively).
Conclusion: Consideration of fever alone as a presumptive prompt diagnosis for anti-malarial treatment would result in huge over-treatment. The use of OptiMAL test and/or PCR assay is a valuable complement to microscopy because these methods help expand the coverage of parasite-based diagnosis and minimize exclusive clinical diagnosis.
Keywords: Malaria, Diagnosis, Microscopic Examination, PCR, OptiMAL test.
Parasitol Res 2012 May 7;110(5):1985-92. Epub 2011 Dec 7.
Parasitology Department, Research Institute of Ophthalmology, Giza, Egypt.
Acanthamoeba castellanii causes amoebic keratitis which is a painful sight-threatening disease of the eyes. Its eradication is difficult because the amoebas encyst making it highly resistant to anti-amoebic drugs, but several medicinal plants have proven to be more effective than the usual therapy. This study aimed to evaluate the in vitro amoebicidal activity of ethanol extracts of Arachis hypogaea L. (peanut), Curcuma longa L. (turmeric), and Pancratium maritimum L. (sea daffodil) on A. castellanii cysts. Acanthamoeba were isolated from keratitic patients, cultivated on 1.5% non-nutrient agar, and then incubated with different concentrations of plant extracts which were further evaluated for their cysticidal activity. The results showed that all extracts had significant inhibitory effect on the multiplication of Acanthamoeba cysts as compared to the drug control (chlorhexidine) and non-treated control, and the inhibition was time and dose dependent. The ethanol extract of A. hypogaea had a remarkable cysticidal effect with minimal inhibitory concentration (MIC) of 100 mg/ml in all incubation periods, while the concentrations of 10 and 1 mg/ml were able to completely inhibit growth after 48 and 72 h, respectively. The concentrations 0.1 and 0.01 mg/ml failed to completely inhibit the cyst growth, but showed growth reduction by 64.4-82.6% in all incubation periods. C. longa had a MIC of 1 g and 100 mg/ml after 48 and 72 h, respectively, while the concentrations 10, 1, and 0.1 mg/ml caused growth reduction by 60-90.3% in all incubation periods. P. maritimum had a MIC of 200 mg/ml after 72 h, while the 20-, 2-, 0.2-, and 0.02-mg/ml concentrations showed growth reduction by 34-94.3% in all incubation periods. All extracts seemed to be more effective than chlorhexidine which caused only growth reduction by 55.3-80.2% in all incubation periods and failed to completely inhibit the cyst growth. In conclusion, ethanol extracts of A. hypogaea, C. longa, and P. maritimum could be considered a new natural agent against the Acanthamoeba cyst.
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Journal of Molecular Pathophysiology
Rawal Med J 2012;37:155-160
Rawal Medical Journal
Objective: To investigate the seropositivity rate for anti-Toxocara IgG antibodies in patients with schizophrenia and to assess its association with schizophrenia along with some risk factors for toxocariasis, eosinophilia and the presence of other intestinal parasites.
Methods: Serological examination of 90 schizophrenic patients and 45 healthy controls was carried out by using commercial Toxocara canis IgG ELISA kit for the detection of anti-Toxocara antibodies. Also, eosinophils in peripheral blood and the presence of other intestinal parasites were investigated.
Results: Seropositivity for T. canis was detected in 21 (23.3%) out of 90 schizophrenic patients and in one subject (2.2%) of 45 healthy controls (p<0.01). When seropositive and seronegative schizophrenic patients were compared with respect to sex, residence, owning dogs /cats, history of geophagia, there was no significant differences between them (p>0.05). In contrast, when they were compared with respect to raw food intake and personal hygiene, the differences were statistically significant (p<0.05). Eosinophilia in peripheral blood was detected in 61.9% of seropositive schizophrenic patients and in 24.6% of seronegative schizophrenic patients (p<0.01). Of 21 schizophrenic patients with positive serology, 47.6% had at least one intestinal parasite comparing to 20.3% in patients with negative serology (p< 0.05).
Conclusion: There might be a causal relationship between toxocariasis and schizophrenia. Either Toxocara may be a possible etiologic agent of schizophrenia or the schizophrenic patients may be at high risk for Toxocara infection.
Egypt J Med Sci. 2011 June 32 (1) : 327-338
THE EGYPTIAN JOURNAL OF MEDICAL SCIENCES
Diagnosis of Blastocystis is routinely performed by microscopy, staining or culture. However, these methods are time consuming and rely on an experienced technician and subsequent observation of intact organisms. Recently, a new ELISA assay based on the detection of B. hominis antigen in stool samples is available which do not require the observation of intact organisms. So, the present study was conducted to detect B. hominis in stool specimens using different diagnostic methods; direct smear test, modified trichrome staining and copro-antigen detection ELISA comparing to in vitro culture and the diagnostic performance of these tests was statistically compared. A total of 170 stool samples submitted for parasitological analysis to the family health center in 10th of Ramadan city, El-Sharkyia Governorate– Egypt were evaluated. Our results showed that out of 170 examined stool specimens, Blastocystis was detected in 58 (34.1%) of them. On using culture, 51 (30%) stool specimens were identified as positive for this parasite. While, direct wet mount, trichrome staining, and antigen detection ELISA identified 25 (14.7%), 34 (20%) and 45 (26.5%) samples as positive respectively. Comparing to in vitro culture, coproELISA showed the best diagnostic results for sensitivity (88.2%), specificity (100%), positive predictive value (100%), negative predictive value ( 95.2%) and diagnostic accuracy (96.5%). Followed by trichrome staining with 52.9% sensitivity, 94.1% specificity, 79.4% positive predictive value, 82.3 % negative predictive value and 81.7% diagnostic accuracy. Lastly, direct wet mount with 35.3% sensitivity, 94.1% specificity, 72% positive predictive value, 77.2% negative predictive value and 76.4% diagnostic accuracy. Also, there was a significant increase of B. hominis detection using in vitro culture over wet mount and modified trichrome staining by 64.7% and 47.1% (P<0.001, P<0.05) respectively. While, the difference between culture and ELISA in the detection of positive specimens was not significant (P >0.05). In conclusion, ELISA may be useful alternative to parasitological methods. Also, the combination of different diagnostic techniques might detect a high percentage of positive cases.
Egypt J Med Sci 31 (2) December 2010: 1089-1102
THE EGYPTIAN JOURNAL OF MEDICAL SCIENCES
Cryptosporidium parvum is an opportunistic parasite capable of causing diarrhea that is self-limiting in immunocompetent individuals and life -threatening in immunocompromised patients. The present study was designed to compare the sensitivity and practicability of copro-antigen assays; RidaQuick Cryptosporidium strip test and enzyme linked immuno-sorbent assay (ELISA) with Kinyoun acid fast stain in diagnosing of cryptosporidiosis among diarrheic patients. Stool samples were collected from 108 diarrheic patients and also from 36 control subjects without diarrhea; a part was stained by Kinyoun acid fast stain and the other part was stored at -20°C for RidaQuick Cryptosporidium strip test and copro-antigen ELISA. The results revealed a significant association between Cryptosporidium infection and diarrhea (P < 0.05) as Cryptosporidium was detected in 18 (16.7%) of diarrheic patients while none of the control subjects was found to be infected with Cryptosporidium by any of the techniques. Also, the frequency of cryptosporidiosis in immunocompromised patients (14.8%) was significantly higher than in immunocompetent patients with diarrhea (1.9%) (P < 0.05). Detection rate of Cryptosporidium infection was 10.2% by Kinyoun acid fast stain, 13.9% by RidaQuick Cryptosporidium strip test and 15.7% by ELISA. Based on the true positive samples (18) that were positive by at least any two techniques, sensitivity of Kinyoun acid fast stain, RidaQuick Cryptosporidium strip test and copro-ELISA was 61.1% (11/18), 83.3% (15/18) and 94.4% (17/18) respectively. Based on the result of Kinyoun acid fast stain, the sensitivity, specificity and diagnostic accuracy of ELISA were 90.9%, 92.8%, 92.6%, while those of RidaQuick were 72.7%, 92.8%, 90.7% respectively. Compared to the result of ELISA, RidaQuick Cryptosporidium assay gave 82.3% sensitivity, 98.9% specificity and 96.2% diagnostic accuracy. In conclusion, the findings showed that the copro-antigen immunoassays are more sensitive compared to the staining technique and should be considered as the choice methods for the diagnosis of cryptosporidiosis in patients who have had diarrhea for a long-period of time.
Egypt J Med Sci 30 (2) December 2009: 1229-1243
THE EGYPTIAN JOURNAL OF MEDICAL SCIENCES
The present study aimed to evaluate the in vitro effects of ethanol extracts of Ocimum basilicum (sweet basil) and Thymus vulgaris (thyme) for anti-Blastocystis hominis activity. Four different concentrations of each extract were used, 0.5, 1, 1.5, 2 mg /ml for O. basilicum and 0.5, 1, 2, 4 mg/ml for T. vulgaris. Metronidazole was used as a drug control at a concentration of 50 ,g /ml. Isolated B. hominis cysts from stool samples were incubated with different concentrations of the plants extracts at 37°C for different incubation periods (24, 48, 72 and 96 hr). The results showed that the ethanol extract of O. basilicum had a significant anti-B. hominis effect with minimal inhibitory concentration (MIC) of 2 mg/ml in all incubation periods, while the concentration of 1.5 mg/ml completely inhibited the growth of cysts after 72hr. On the other hand, the concentrations of 0.5 and 1 mg/ml failed to inhibit the cysts growth completely, but showed growth reduction by 51.5 – 86.3 % in all incubation periods. Regarding to T. vulgaris ethanol extract, it had a MIC of 4 mg/ml in all incubation periods, while the concentration of 2 mg/ml completely inhibited cysts growth after 48 hr. On the other hand, the concentrations of 0.5 and 1 mg/ml caused growth reduction by 68 -95% in all incubation periods. It was found that both extracts had significant inhibitory effects on the multiplication of B. hominis cysts comparing to non-treated control (NTC) and the inhibition was time and dose dependent (P<0.001), while no significant difference was found between the inhibitory effects of these extracts and drug control; metronidazole (P >0.05). In conclusion, O. basilicum and T. vulgaris ethanol extracts have a potent anti-B. hominis activity and could be used as sources for new anti-B. hominis drugs
EC Microbiology 14.8 (2018): 429.
Visceral larva migrans (VLM), a clinical syndrome occurs with invasion of sensitive organs by larval stages of the nematodes Toxocara canis or Toxocara cati, the common roundworms of dogs and cats, respectively. Humans acquire the disease by ingestion of embryonated eggs from contaminated raw vegetables, contaminated water sources or via geophagia and also, by eating raw meat from intermediate or paratenic hosts (chicken, rabbit and lamb), that contain encapsulated larvae. The degree and type of clinical disease manifestations depend on the organs invaded by the migrating larvae, the degree of the larvae burden, and the strength of the host immune response . The liver is the visceral organ most commonly affected in VLM. The larvae reach the liver parenchyma through the portal circulation. The pathologic effects are caused by mechanical injury to the tissues by the migrating larvae, the toxic products or the immunologic response to the parasite. Many pathological findings are observed along the migratory routes including track like necrosis and hemorrhages, microscopic abscess, diffuse eosinophilic infiltration and the larvae persisting in the liver cause granulomatous reactions . The clinical disease typically manifests as hepatitis, abdominal pain, fever, hepatomegaly and splenomegaly. Laboratory findings include hypergamma-globulinaemia and leucocytosis with marked eosinophilia. On computed tomography, hepatic lesions are typically ill-defined, low attenuating nodules that have sometimes been confused with metastatic cancer . Granulomas can be visualized using ultrasound. The routine diagnosis is based on immunological tests and the method of choice is the enzyme-linked immunosorbent assay (ELISA) using the excretory- secretory antigens of infective larvae of T. canis [4,5]. The choice drug available for VLM treatment is albendazole. It was observed that albendazole reduced Toxocara larval burden in the liver by inducing degenerative changes in the tegument and intestinal cells and decreased energy production required for the survival of Toxocara larvae . Better awareness among physicians, pediatricians, would be the first step to defeat this neglected disease.