MTHFR C677T, PT G20120A and FV Leiden as Risk Factors for Thrombosis in Egyptian Pediatric ALL Patients

Thrombosis is a well-known side effect associated with Acute Lymphoblastic Leukemia (ALL) treatment leading to significant morbidity rates. Thrombosis occurrence in ALL patients seems to be due to the interaction between the disease, the therapy and the possible inherited genetic defects affecting the hemostatic balance. In this study we aimed to assess the prevalence of prothrombotic defects- FV Leiden, MTHFR (Methylene Tetra Hydrofolate Reductase enzyme) C677T & prothrombin (PT) G20210A mutations in Egyptian pediatric ALL patients and its impact on the risk of thrombosis onset as well as to evaluate the impact of the presence of single versus multiple prothrombotic mutations on thrombosis. Sixty three pediatric ALL patients with thrombotic event treated with ALL protocol adopted from SJCRH (Saint Jude Cancer Research Hospital) study XV at the Children\u27s Cancer Hospital in Egypt (CCHE) and 63 matched ALL control patients were enrolled in the study. Restriction fragment polymorphism technique was used to assess the prevalence of the FV Leiden and MTHFR C677T while Allele specific PCR was used for Prothrombin G20210A. Our results showed that MTHFR C677T prevalence between the ALL patients with and without thrombosis was 65% and 38.1% respectively p value = 0.002. The FV Leiden prevalence between the ALL patients with and without thrombosis was 17.5% and 15.9 % respectively p value= 0.81. While the prothrombin G20210A prevalence was 3.2% in both groups. In addition, patients who were older than 10 years or on SR/HR treatment protocol or in induction treatment phase were also at high risk of thrombosis. The presence of MTHFR C677T polymorphism can increase the risk of thrombosis 3 folds more than those patients who didn\u27t have the polymorphism, while FV Leiden and PT G20210A didn\u27t affect the thrombosis risk. Having more than one mutation didn’t show a significant effect on increasing the risk of thrombus incidence (p= 0.087). We concluded that MTHFR C677T is important risk factor for thrombosis in Egyptian pediatric ALL patients. These results may help in the prediction of the thrombosis susceptibility for ALL patients and a prophylaxis therapy may be considered before having the thrombosis. To the best of our knowledge these findings regarding the thrombosis risk factors in Egyptian pediatric ALL patients are first to be reported

Comparative analysis of canal transportation using reciproc blue and wavo one gold in simulated root canals using different kinematics

Objective: The purpose of the current study was to assess and compare the shaping ability of WaveOne Gold and Reciproc Blue in reciprocation and counter clock wise rotation using standardized resin blocks and to assess time required to reach full working length. Methodology: A total of 52 curved canals in clear resin blocks with 30° angle of curvature and 16mm canal length were used in this study. The blocks were divided into 4 groups according to the instrument and motion utilized into: Reciproc Blue/Reciprocation (RB/R) group, Reciproc Blue/counter clock wise rotation (RB/CCW) group, WaveOne gold/Reciprocation (WG/R) and WaveOne gold/Counter clock wise rotation (WO/RCR). Standardized digital images were taken prior and post instrumentation. Then, Adobe Photoshop was used to superimpose post and pre-instrumentation images to evaluate the degree of canal transportation. Digital chronometer was used to record the time required for canal preparation. One-way ANOVA followed by Tukey post hoc test was used to compare between more than two groups in non-related samples. Results: No statistically significant difference was noted among all groups at the apical and middle thirds levels. As for the preparation time, both groups; RB/R and RB/CCW recorded significantly longer time than groups; WG/R and WG/CCW (P \u3c 0.001). Conclusions: The use of single-file in counter clock wise rotation showed favourable results in terms of avoiding canal transportation and preparation time

Circulating MCP-1 level and 2518 gene polymorphism as a marker of nephropathy development in Egyptian patients

Objective: Monocyte chemoattractant protein-1 (MCP-1) is a member of CC chemokine that plays an important role in the recruitment of monocytes/macrophages into renal tubulointerstitium. A biallelic A/G polymorphism at position 2518 in the MCP-1 gene was found to regulateMCP-1 expression. MCP-1 and its A/G gene polymorphism have been implicated in the pathogenesis of some renal diseases. The aim of this study was to evaluate the role of circulating MCP-1 level and the relevance of functional genetic variations of MCP-1 as early predictors of the development of glomerulonephropathy (GN) in Egyptian patients.Methods: This is a case control study that was conducted in 50 GN patients, 20 non-GN cases and 20 ethnically matched healthy controls. MCP-1 serum level was detected by ELISA technique, while genotyping of polymorphisms in the MCP-1 genes was performed using a polymerasechain reaction (PCR) followed by restriction fragment length polymorphism (RFLP)detection.Results: High MCP-1 circulating levels and subsequently MCP-1 2518G polymorphism are associated with the developing of nephropathy  irrespective to the underlying etiology. MCP-1 serum level was significantly high when compared with healthy controls (P = 0.0007) and non-GN cases (P = 0.01). There was predominance of A allele at 2518 of MCP-1 gene in healthy controls (87.5%) and non-GN cases (77.5%). The frequency of the 2518G MCP-1 polymorphism was significantly higher in GN patients than in healthy controls (

A rare case of posterior uterine rupture with neonatal survival during trial of vaginal birth after cesarean section

Posterior wall uterine rupture is a rare complication. Trial of vaginal birth after cesarean section (CS) is a predisposing factor especially when associated with augmentation of labor. Here we report a case of intrapartum uterine rupture during the second stage of labor in a multiparous woman trying vaginal birth after previous CS. Emergency laparotomy was done and the baby was saved. Repair of the site of the rupture in layers with complete hemostasis was achieved

Physical evaluation of a new pulp capping material developed from portland cement

Background: This study examined the effects of addition of 10% and 25% by weight calcium hydroxide on the physicochemical properties of Portland cement associated with 20% bismuth oxide in order to develop a new pulp capping material. Material and Methods: The solubility, pH value, setting time, compressive strength, and push out bond strength of modified Portland were evaluated and compared to those of mineral trioxide aggregate (MTA) and Portland cement containing 20% bismuth oxide. Results: The statistical analysis was performed with ANOVA and Duncan’s post-hoc test. The results show that the strength properties and push out bond strength of Portland cement were adversely affected by addition of calcium hydroxide especially with a ratio of 25 wt%, however, the setting time and pH were not affected. MTA showed a statistically significant lower setting time than other cements (P≤0.001). Portland cement with bismuth oxide and Port Cal I showed a statistically significant higher Push out Bond strength than MTA and Port Cal II (P=0.001). Conclusions: Taking the setting time, push out bond strength and pH value into account, addition of 10 wt% calcium hydroxide to Portland cement associated with 20% bismuth oxide produces a new pulp capping material with acceptable physical and adhesive properties. Further studies are recommended to test this cement biologically as a new pulp capping material