ASSOCIATION OF MATERNAL PERIODONTITIS WITH LOW BIRTH WEIGHT IN NEWBORNS IN A TERTIARY CARE HOSPITAL.

BACKGROUND: Low birth weight is a major public health problem in Pakistan. So there is a need for identification of its modifiable risk factors like periodontitis which will reduce its burden on the society. The objectives of the study were to find out the association between maternal periodontitis and low birth weight in new-borns of all gestational ages delivered in a tertiary care hospital of Abbottabad as well as to see the frequency of periodontitis severity in these subjects. METHODS: A hospital-based matched case-control study was conducted among 160 postpartum mothers in Gynaecology/Obstetrics- B ward Ayub Teaching Hospital, Abbottabad. The 80 cases were mothers of low birth weight babies (< 2,500 g), the 80 controls were mothers of normal weight babies (> 2,500 g) matched with maternal age and gestational age. Data was collected through the hospital records, interview and a periodontal examination. RESULTS: Periodontitis was more in the cases than in the controls (OR: 4.167, 95% CI: 2.142-8.109, p = 0.000). On multivariate logistic regression, periodontitis was found to be a significant independent risk factor for low birth weight (aOR: 3.173, 95% CI: 1.429-7.047, p = 0.005). Other significant risk factors were educational level (aOR: 3.408, 95% CI: 1.452-7.996, p = 0.005), socioeconomic status (aOR: 3.173, 95% CI: 1.366-7.368, p = 0.007), maternal nutrition (aOR: 3.071, 95% CI: 1.392-6.778, p = 0.005) and moderate/severe anaemia (aOR: 3.035, 95% CI: 1.052-8.756, p = 0.040). CONCLUSIONS: Periodontitis is found to be a strong, independent, and clinically significant risk factor for low birth weight. So periodontal therapy should form a part of the antenatal care of the pregnant women in Abbottabad.

TRAIL based therapy: overview of mesenchymal stem cell based delivery and miRNA controlled expression of TRAIL.

Rapidly increasing number of outstanding developments in the field of TRAIL mediated signaling have revolutionized our current information about inducing and maximizing TRAIL mediated apoptosis in resistant cancer cells. Data obtained with high-throughput technologies have provided finer resolution of tumor biology and now it is known that a complex structure containing malignant cells strictly coupled with a large variety of surrounding cells constitutes the tumor stroma. Utility of mesenchymal stem cells (MSCs) as cellular vehicles has added new layers of information. There is sufficient experimental evidence substantiating efficient gene deliveries into MSCs by retroviral, lentiviral and adenoviral vectors. Moreover, there is a paradigm shift in molecular oncology and recent high impact research has shown controlled expression of TRAIL in cancer cells on insertion of complementary sequences for frequently downregulated miRNAs. In this review we have attempted to provide an overview of utility of TRAIL engineered MSCs for effective killing of tumor and potential of using miRNA response elements as rheostat like switch to control expression of TRAIL in cancer cells.