Glomerular filtration rate in homozygous sickle cell disease children in steady state and healthy Nigerian children: a comparative study in north-eastern Nigeria

Background: Homozygous sickle cell disease (HSCD) is the most common inherited blood disorder of public health importance worldwide, with Sub-Saharan Africa accounting for a third of the global burden. The effect of HbS on the kidneys results in sickle cell nephropathy, which contributes to increased mortality among HbSS patients beyond third decade of life. Glomerular filtration rate (GFR) is an important renal function test for evaluating progress of sickle cell nephropathy, however, this is seldom done to HbSS patients especially in the insurgency that devastated the North-eastern part of Nigeria, where displacement of people has led to increase in diarrhoeal diseases with its complications which also contributes to renal diseases, hence the need for this study. Objective: To determine the baseline glomerular filtration rate of homozygous SCD in steady state and compare same with normal controls. Methods: This is a prospective comparative study conducted at the University of Maiduguri Teaching Hospital (UMTH). The study population consisted of age and sex matched HbSS subjects in steady state and children with haemoglobin AA genotypeaged 3-14 years. The study was conducted over a period of 6 months. Anthropometry and serum creatinine of the subjects were determined and GFR calculated using Schwartz formula. Results: Two hundred and twenty children consisting 110 HbSS and 110 controls were enrolled. This consist of 106 males and 114 females with M:F ratio of 0.9:1. Mean ages of HbSS patients and HbAA subjects were 8.2years and 7.9 years respectively. The mean GFR (SD) was 125.9 (31.9) ml/min/1.73m2 and 93.0 (16.1) ml/min/1.73m2 for the HbSS and HbAA controls, the difference between the means was significant (P<0.001). The normal GFR range for the controls was 77 to 109 ml/min/1.73m2. Sixty-seven (61%) casesand 86 (78%) controls had GFRs within normal range. There was statistically significant difference for GFRs above and below the normal range (Z-score=6.2 & -2.9, p<0.001 & p<0.004). Conclusion: About a third of HbSS children in steady state have elevated GFR, this suggests the presence of moderate renal pathology. Regular monitoring of these children will lead to improvements in management of sickle cell nephropathy and their quality of life

Incremental layer shear bond strength of low-shrinkage resin composites under different bonding conditions.

The purpose of this study was to determine the incremental shear bond strength of a silorane-based composite (Filtek Silorane) repaired with silorane or a methacrylate-based composite (Filtek Z250) under various aging conditions. Also, the incremental bond strength of the silorane-based composite was compared with that of another low-shrinkage methacrylate-based composite (Aelite LS Posterior) under fresh and aged conditions, with and without the use of an adhesive resin between successive layers. The two brands of low-shrinkage composites were compared with a microhybrid, Filtek Z250, which served as the control. Substrate discs were fabricated and second layers were adhered to them immediately, after two weeks of aging, or after four weeks of aging and with and without an adhesive resin. Shear bond strengths were measured and failure modes were evaluated. The incremental bond strength of silorane to the silorane-based composite was not significantly different from that of the methacrylate-based composite. However, repairing a silorane-based composite with a methacrylate-based composite significantly reduced the bond strength. Aelite showed a lower incremental bond strength than Z250 and silorane, but the use of an adhesive significantly improved the bond strength. The absence of an oxygen-inhibited layer did not affect the bond strength of the consecutive layers of the silorane-based composite.

Gene therapy of HSV-TK transferred by the EBV based expression vector on experimental hepatocellular carcinoma.

To study the therapeutic effects of herpes simplex virus thymidine kinase (HSV-TK) gene transferred by the EBV-based expression vector (pDR2) on experimental hepatocellular carcinoma, pDR2-TK gene was delivered into human hepatocellular carcinoma cell line SMMC-7721 by using liposome-mediated transfection technique, and then gene expression was detected by RT-PCR, and the killing effects were examined through MTT method. In the nude mice hepatoma model, the antitumor effects of pDR2-TK/GCV system was evaluated in terms of tumor growth. MTT results showed that the pDR2-TK/GCV had cytotoxic effect and about 70% SMMC-7721 cells were killed when GCV was at 1000 mumol/L. In vivo experiment showed that the tumor size in nude mice with transferred pDR2-TK gene was significantly smaller than that in control group (P < 0.01). On the 10th day the tumor in 3 mice (60%) disappeared completely after GCV treatment. It is concluded that the pDR2-TK/GCV system has marked killing effects on the experimental hepatocellular carcinoma.