Vitamin D Receptor (VDR) Gene Polymorphisms (<Emphasis Type="Italic">Fok</Emphasis>I, <Emphasis Type="Italic">Bsm</Emphasis>I) and their Relation to Vitamin D Status in Pediatrics βeta Thalassemia Major

Vitamin D is critical for calcium, phosphate homeostasis and for mineralization of the skeleton, especially during periods of rapid growth. Vitamin D Deficiency leads to rickets (in children) and osteomalacia (in adults). Expression and activation of the vitamin D receptor (VDR) are necessary for the effects of vitamin D, in which several single nucleotide polymorphisms have been identified especially (FokI, BsmI). In this study serum 25 (OH) vitamin D3 levels were estimated by Enzyme Linked Immunosorbent Assay [ELISA], VDR (FokI, BsmI) gene polymorphisms were analyzed by polymerase chain reaction-restriction fragment length polymorphism assay [PCR–RFLP].Serum levels of calcium, phosphorus, alkaline phosphatase and ferritin were determined in 50 Pediatrics beta thalassemia major patients and 60 controls. Patients had significantly lower serum calcium (p < 0.001) lower serum vitamin D3 (p < 0.001) with elevated levels of phosphorus (p < 0.001) and alkaline phosphatase than controls (p = 0.04). Of the patients studied, 60 % had vitamin D deficiency (<20 ng/ml), 20 % had vitamin D insufficiency (21–30 ng/ml) and 20 % had sufficient vitamin D status (>30 ng/ml). Patients harboring mutant (Ff,ff) and wild (BB) genotypes were associated with lower serum calcium (p = 0.08, 0.02) respectively, lower vitamin D3 levels (p < 0.001, 0.01) respectively. They were also suffering from more bony complications although the difference was not statistically significant (p > 0.05). In conclusion, these results suggest that the VDR (FokI, BsmI) gene polymorphisms influence vitamin D status, (Ff,ff), BB genotypes had lower vitamin D levels, so they might influence risk of development of bone diseases in beta thalassemia major.     

Formulation of re-dispersible dry o/w emulsions using cellulose nanocrystals decorated with metal/metal oxide nanoparticles

This study describes for the first time the preparation of re-dispersible surfactant-free dry eicosane oil emulsion using cellulose nanocrystals (CNCs) using the freeze-drying technique. Surface properties of CNCs constitute a critical point for the stability of o/w emulsions and thus can affect both the droplet size and dispersion properties of the emulsion. Therefore, surface modification of CNCs was performed to understand its effect on the size of the obtained re-dispersible dry o/w eicosane emulsion. Decoration of the CNC surface with metal and metal oxide nanoparticles was conducted through the available alcoholic groups of glycosidic units of CNC, which played a dual role in reducing and stabilizing nanoparticles. Of these nanoparticles, silver (AgNPs), gold (AuNPs), copper oxide (CuO-NPs), and iron oxide (Fe₃O₄-NPs) nanoparticles were prepared via a facile route using alkali activated CNCs. Thorough characterizations pertaining to the as-prepared nanoparticles and their re-dispersible dry eicosane o/w emulsions were investigated using UV-vis spectroscopy, TEM, XRD, particle size, zeta potential, and STEM. Results confirmed the ability of CNCs to stabilize and/or reduce the formed nanoparticles with different sizes and shapes. These nanoparticles showed different shapes and surface charges accompanied by individual morphologies, reflecting on the stability of the re-dispersed dry eicosane emulsions with droplet sizes varying from 1.25 to 0.5 μm.

Schematic diagram for the detailed preparation of dry eicosane o/w emulsions.     

Exposure of Skin Homografts from Related Living Donors to Radiotherapy and Its Effects on Acute Rejection and Wound Healing in Children with Deep Burns: A Randomized Controlled Trial

Background  The ideal skin substitute should be more similar to normal skin function while causing fewer reactions. The purpose of this study was to assess the effect of radiotherapy on minimizing acute rejection and enhancing wound healing in children with deep burns. Patients and Methods  A prospective randomized control study included 34 children admitted to the burn unit with deep burns under the age of 12 years. Through the tomotherapy device, a skin homograft from a related living donor was exposed to a local dose of radiotherapy of 500 centigray (cGy). It was immediately used for coverage of the prepared bed after the irradiation was completed. Results  The mean values of the laboratory parameters (ESR, CRP, IL-6, and TNF) for all burn patients in the study showed a significant difference, with p  < 0.001. The mean ± standard deviation (SD) of the time from homograft coverage to the appearance of rejection was 9.62 ± 1.45 in group 1 and 14.35 ± 2.8 in group 2, with p  < 0.001 (highly significant difference), indicating that exposure to radiotherapy can reduce graft rejection. Conclusions  The exposure of skin homografts from related living donors to a local low dose of radiotherapy can reduce a graft''s ability to initiate inflammatory and immunological reactions, thereby minimizing rejection of a graft and enhancing epithelialization in children with deep second- and third-degree burns.     

Evaluation of Wound Healing Following Surgical Extractions Using the IPR Scale

ObjectiveTo monitor wound healing following surgical extraction of wisdom teeth using the novel Inflammatory Proliferative Remodeling (IPR) Scale.MethodsA prospective study design was used. Participants included 94 otherwise healthy adult patients undergoing surgical extraction of a wisdom tooth at a tertiary medical centre from June 2018 to June 2019. The IPR Scale was completed by two resident surgeons in oral and maxillofacial surgery at three time points after the procedure, corresponding to the three phases of wound healing. Mean subscale and total scores were calculated. Patients graded their preoperative anxiety, intraoperative pain, and pain during follow-up on a 10 cm visual analog scale, and the findings were correlated with the IPR Scale scores.ResultsMean IPR total score (range 0–16) was excellent (14.43 ± 1.45). Mean scores by healing phase were as follows: inflammatory 6.35 ± 1.34 (range 0–8); proliferation, 4.56 ± 0.8 (range 0–5); remodeling, 2.83 ± 0.51 (range 0–3). There was a positive correlation between mean preoperative anxiety level (5.9 ± 3.6) and intraoperative pain perception (2.4 ± 2.4; P = 0.65) and a negative correlation between mean preoperative anxiety level and IPR Scale scores for each healing phase. Two cases were complicated by abscesses which resolved with treatment.ConclusionThe IPR Scale is a promising tool for the effective evaluation of the wound healing process following wisdom tooth extractions. Relaxation methods and behavioural adaptation might help to lower patient anxiety and thereby improve oral wound healing.