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G F Araj

Publications and source records attributed to G F Araj.

At least 37 records · Page 2Linked to original sources
PubMed1997

Post immunization Hib antigen detection in the CSF of a patient with meningococcal meningitis.

We report a case of meningococcal meningitis where the cerebrospinal fluid was negative for Neisseria meningitidis but positive for Haemophilus influenzae type b by rapid antigen detection test. We believe that this was due to prior immunization with Haemophilus influenzae type b vaccine. We recommend caution in interpretation of the rapid antigen detection tests especially in patients who had been vaccinated against organisms screened by these tests.

Antigens, Bacterial↗
PubMed1997

Drug resistance among Mycobacterium tuberculosis isolates in Lebanon.

OBJECTIVE: To determine the prevalence and patterns of drug resistance among Mycobacterium tuberculosis isolates recovered from tuberculosis (TB) cases in Lebanon. DESIGN: A total of 96 isolates were collected from the same number of TB cases between October 1994 and December 1995. These isolates were obtained from cases with newly diagnosed (81.3%) and previously treated (18.7%) cases of TB, and tested against isoniazid (INH), rifampicin (RIF), streptomycin (STM) and ethambutol (ETH), using the BACTEC-TB susceptibility procedure and system. RESULTS: The male to female ratio was 2:1 and the mean ages of males and females were almost similar, 34.1 and 32.7 years, respectively. Resistance to one or more drugs was found in 25 of 96 (26%) isolates. The overall percentages of single drug resistance against INH, RIF, STM and ETH were 23.9%, 12.5%, 7.3% and 3.1%, respectively. These percentages were higher, for all drugs, in isolates recovered from previously treated compared to new cases of TB: INH (50% vs 17.9%), RIF (33.3% vs 7.7%), STM (22.2% vs 3.8%) and ETH (11.1% vs 1.3%). Of the 25 resistant isolates, 11 were resistant to one drug only (10 to INH and 1 to STM), 10 were resistant to two drugs (7 to INH and RIF, 2 to INH and STM, 1 to STM and RIF), 2 were resistant to three drugs (1 to INH, RIF and ETH, 1 to INH, RIF and STM) and 2 were resistant to the four tested drugs. CONCLUSION: These data show that M. tuberculosis isolates in Lebanon have high rates of single and multidrug resistance, and speaks for the need to establish surveillance and monitoring programs in this country as part of the global effort to control TB.

Adult↗
PubMed1996

Seroprevalence of brucella antibodies among persons in high-risk occupation in Lebanon.

Prevalence of brucella-specific antibodies was measured in 597 persons in high-risk occupations living in 10 regions of Lebanon using the standard agglutination test (SAT), anti-human globulin (Coombs') test (AHGT) and enzyme-linked immunosorbent assay (ELISA) for measuring immunoglobulin G (IgG), IgM and IgA. The study population consisted of butchers (54%), farmers (35%), laboratory technicians (8%), abbatoir workers (2%) and veterinarians (1%), with 82% males and 18% females. The overall seroprevalence based on SAT and AHGT titres of > or = 80 was 1.7% and 15%, respectively, but seroprevalence varied by region from 0-5% in SAT and from 3.4-34% for AHGT. The overall seroprevalence based on ELISA IgG (OD > or = 0.6), IgM (OD > or = 0.6) and IgA (OD > or = 0.3) was 57, 61 and 26%, respectively. The highest seroprevalence was noted in Biqaa (34%), Kisrwan (24%), Shouf (21%), Sidon (16%) and Aley (12%) regions. Nineteen percent of those surveyed reported symptoms that could be associated with brucellosis. We conclude that exposure to brucellosis is high among persons in high-risk occupations from all surveyed regions in Lebanon. Such findings should be used to design control measures especially now that the 17 years of civil strife is over.

Antibodies, Bacterial↗
PubMed1996

Prevalence and etiology of intestinal parasites in Lebanon.

As there are no studies done on the prevalence of intestinal parasites in Lebanon since 1967, this study was undertaken to reveal the current patterns of intestinal parasitic infestations in Lebanese patients from two geographic regions: Beirut and Tripoli. Analysis was based on 33,253 stool specimens examined at the American University of Beirut Medical Center (AUH) and 11,611 specimens examined at the Islamic Hospital (IH) in Tripoli over five and three years, respectively. The prevalence of intestinal parasites at AUH and IH were 8.47% and 45.35%, respectively (overall 18%). The prevalence in males vs females was almost the same; being 8.23% vs 8.74%, and 44.67% vs 45.88%, at AUH and IH, respectively. Multiple infections were noted in 8.8% and 3.5% of stool specimens at AUH and IH, respectively. Although 18 different types of parasites were encountered, the most common pathogenic parasites found at AUH vs IH were: Giardia lamblia (20.7% vs 10.5% of parasites found), Entamoeba histolytica (19.41% vs 1.25%), Taenia spp. (6.03% vs 4.08%) and Ascaris lumbricoides (2.09% vs 46.97%). The overall yearly or monthly prevalence of parasites recovered from both hospitals did not show clear seasonal patterns. Compared to developed countries, Lebanon still suffers from a high prevalence and a wide spectrum of intestinal parasites.

Animals↗
PubMed1995

Cryptococcal meningitis and confusional psychosis. A case report and literature review.

A previously healthy and immuno-competent 22-year-old man presented in confusional psychosis. Cryptococcal meningitis was later found to be the underlying cause as proven by culturing Cryptococcus neoformans serotype A from the cerebrospinal fluid. Combined antifungal therapy with amphotericin B and 5-fluorocytosine resulted in sustained improvement of all mental and physical functions. Cryptococcosis has rarely been reported from the Middle East. This represents the second case from Kuwait.

Adult↗
PubMed1995

Hepatitis C virus : prevalence in Lebanese blood donors and brief overview of the disease.

Hepatitis C virus (HCV) is recognized as the major cause of non-A, non-B hepatitis. Its prevalence in different patient populations and blood donors has been reported worldwide but not yet from Lebanon. This study was performed to determine the prevalence of HCV antibodies in 536 random Lebanese blood donors using three enzyme immunoassay kits: ETI-AB-HCVK (Sorin, Biomedica, Italy), UBI HCV EIA (Organon Teknika, Netherlands) and ORTHO HCV 2.0 ELISA (Ortho Diagnostic Systems, USA). The latter was also used as an arbitrator test. Though ETI-AB-HCVK and UBI HCV EIA kits gave higher initial positive results (5.8% and 3.7%, respectively) than ORTHO HCV 2.0 ELISA (1.1%), the over all prevalence of HCV antibody in these blood donors was 0.7%. A brief review of the HCV virus, its epidemiology, clinical features and diagnostic aspects is also presented. A similar testing approach was carried out on additional 3643 blood donors. Confirmatory testing based on CHIRON*RIBA*HCV 2.0 strip immunoblot assay (Ortho) revealed that the HCV antibody seroprevalence in random Lebanese blood donors is 0.11% and not 0.7% as found by ELISAs alone.

Blood Donors↗
PubMed1994

Antimicrobial susceptibility patterns of bacterial isolates at the American University Medical Center in Lebanon.

In Lebanon, knowledge of the prevailing pattern of bacterial resistance to antimicrobial agents has been limited, particularly because of 15 years of civil strife. Thus, the current study was conducted to determine the antimicrobial susceptibility patterns of nonselected bacterial isolates recovered from recent clinical specimens, using the standardized disk agar diffusion technique. A total of 5216 isolates (1443 Gram positive and 3773 Gram negative) were examined. Over 92% of Staphylococcus aureus and coagulase-negative staphylococci (CNS) were resistant to penicillins. Methicillin resistance was more frequently noted among CNS (28%) compared with S. aureus (18%). For the pneumococci, 27% of the isolates were resistant to penicillin G. High but variable rates of multidrug resistance were encountered among Acinetobacter spp., Pseudomonas spp., Serratia spp., Citrobacter spp., and Enterobacter spp. Ampicillin resistance was detected in 65% of Escherichia coli and in 20% of Haemophilus influenzae isolates. Although one resistant Salmonella typhi strain was observed, 17% of other Salmonella spp. and 60% of Shigella spp. proved to be resistant to ampicillin, chloramphenicol, and cotrimoxazole. Among Vibrio cholerae isolates, high resistance to tetracycline (71%) and trimethoprim-sulfamethoxazole (94%) was observed. The overall antimicrobial resistance rates in Lebanon seem to fall between figures reported from the Arabian Gulf countries (higher) and those from medical centers in the United States (lower).

Drug Resistance, Microbial↗
PubMed1993

Bacterial meningitis with normal cerebrospinal fluid findings. Report of a case and review of the literature.

Bacterial meningitis presenting with normal initial CSF findings is rare and could be confusing to the physicians. Such an entity was observed in this first case report from Lebanon on an 8-month-old female febrile infant whose initial CSF studies were normal despite the culture yielding Streptococcus pneumoniae. Thus, this case emphasizes the need that physicians should start antimicrobial therapy, pending culture results, whenever bacterial meningitis is clinically suspected, even if initial CSF investigation of cellular, protein, sugar and gram-strain results do not reveal abnormal findings. In addition, repeat lumbar puncture should be considered in all febrile patients having clinical features suggestive of this diagnosis.

Age Factors↗
PubMed1990

Specific IgE response in patients with brucellosis.

In the search to find discriminative serological markers to differentiate between patients with acute brucellosis and those with chronic brucellosis, an enzyme-linked immunosorbent assay (ELISA) was used to determine and compare the brucella-specific IgE response in 80 sera from patients with acute brucellosis, 37 sera from patients with chronic brucellosis, 26 sera from patients with positive blood cultures for bacteria other than brucella and 51 sera from healthy controls. The IgE findings were compared to brucella-specific IgG, IgM, IgA and IgG1-4 demonstrated by ELISA, and to microagglutination test (MAT) results. Elevated (positive) antibrucella IgE titres were detected in 89 and 81% of sera from patients with acute and chronic brucellosis respectively. The predominant antibodies found in patients with acute brucellosis were of the IgG, IgM, IgA, IgE, IgG1 and IgG3 types while in chronic brucellosis IgG, IgA, IgE and IgG4 were found. Although IgE can be detected in patients with brucellosis, it does not discriminate between the acute and chronic stages of the disease.

Acute Disease↗
PubMed1990

Neurological complications of brucella spondylitis.

Twenty-two patients with brucella spondylitis and neurobrucellosis were studied during a 2-year period. The diagnosis was based on history of exposure, compatible signs and symptoms, high antibody titre and/or positive culture of a clinical specimen(s). Spondylitis was confirmed by plain radiographs, bone scan, CT and in some cases by histology. Neurobrucellosis was confirmed by CSF examination and culture, myelography, NCV, EMG and CT head. The spondylitis was early in 4 cases, chronic active in 12, smouldering "partially healed" in 3 and healed in 3 cases. Of these, 15 patients (68%) had neurological complications of various types. Plain radiographs were not a good index of activity of spondylitis. Tc99 bone scan was not specific and it remained positive long after the completion of therapy. CT was superior in revealing details of bone destruction, soft tissue swelling and entrapment of nerve roots and cord. The 3 modalities were complementary. Spondylitis is commonly associated with neurobrucellosis and symptoms of one may over shadow those of the other and in some cases neurobrucellosis may be subclinical. In all cases of spondylitis, a thorough search for neurobrucellosis should be made and vice versa. Prolonged treatment with a combination of 3 anti-brucella drugs is recommended and prolonged follow-up is necessary.

Adolescent↗
PubMed1990

Brucella arthritis: a study of 96 cases in Kuwait.

Of 400 patients with brucellosis, 104 (26%) had arthritis, of whom 96 could be followed up. The systemic disease in the 96 patients was acute in 54 (56%), subacute in 24 (25%), and chronic in 18 (19%). The main presenting symptoms were joint pain, fever, sweating, and easy fatigability. The joints most commonly affected were the sacroiliac joint (26%) and knee (25%) followed by hip (18%) and spine (8%). There was no particular pattern of joint affection in relation to age. Joint effusion occurred in 32/104 (30%) of cases, predominantly (94%) in the acute group. Culture of synovial fluid was negative in all, and analysis of synovial fluid for cellular profile, glucose, and protein content was not particularly helpful in diagnosis. Plain radiographs did not show major pathological changes. Among the laboratory tests, including haematological and liver function tests, the brucella enzyme linked immunosorbent assay (ELISA) was the most reliable in the diagnosis of disease, using serum and synovial fluid specimens. Treatment with a combination of streptomycin plus tetracyclines or rifampicin resulted in an excellent cure rate and resolution of arthritis without sequelae or mortality. Thus brucellosis should be considered in the differential diagnosis of arthritis, especially in areas in which the disease is endemic.

Arthritis, Infectious↗