Procoagulant versus anticoagulant factors in cirrhotic patients

Liver cirrhosis leads to decreased production of clotting factors that are generally all produced in the liver except factor VIII and von Willebrand factor. However, cirrhotic patients are not protected from thrombosis. The present study aimed to assess the procoagulant and anticoagulant factors in cirrhotic patients with and without bleeding and/or thrombotic events. A total of 102 adult subjects were enroled: 51 cirrhotic patients and 51 healthy controls. After full history taking with special attention given to thromboembolic and haemorrhagic events, platelet count, serum albumin, bilirubin, international normalised ratio [INR], PT, partial thromboplastin time [PTT], hepatitis B surface antigen [HBsAg], hepatitis B core [HBc] antibodies, hepatitis C virus [HCV] antibodies, factor VIII, protein C, Protac-induced coagulation inhibition percentage [PICI%] assay and abdominal ultrasound were performed for patients and controls. Upper gastrointestinal endoscopy was conducted for the patients. Compared with control subjects, factor VIII and factor VIII/protein C were significantly higher, while protein C and PICI% were significantly lower among patients. Patients with liver cirrhosis may have a tendency for bleeding or thrombosis according to the balance of coagulant and anticoagulant status. PICI%, the assay that evaluated the functionality of the protein C anticoagulant system, was significantly lower in patients compared to control subjects. Accordingly, low PICI% and high factor VIII/protein C ratio can be taken as an index of hypercoagulability in cirrhotic patients

Delayed eruption of permanent teeth due to presence of a dentigerous cyst, report of a case

Saudi female patients, her age was 9 years, came to the pedodontic clinic complaining from tilting of teeth as well as swelling above the chin area. The case was diagnosed as solitary non kerato detigerous cust; extended from the lower border of the mandible to the alveolar bone vertically and from the permanent canine area on the left side to the first premolar area on the right side, leading to expansion of the labilal plate of bone, as well as verticall impaction of the lower left and right permanent canine, horizontal impaction of the lower permanent right lateral, tiliting of the lower central incisors. Marsupialization was performed, the size of the cystic cavity started to decrease from the 5th month from starting the marsupilization upto 2 years, end with enculeation of the cystic wall, at the 26th month from starting the marsupilization the impacted teeth had erupted in the oral cavity. Intercaptive orthodontic treatment was performed by usind lower fixed 4x2 edgewise appliance, for upwrighting he teeth, closing the spaces, treatment of the anterior open bite. At the end of the 54th month all the teeth were in normal position and the roots were in favorable positions, and the appliance was removed. Some corrective orthodontic measures will be done a a later date