الفهرس 
BC AND MANAGEMENTOnly 14 pages are availabe for public view
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Abstract
Budd–Chiari syndrome is a heterogeneous group of
disorders characterized by hepatic venous outflow
obstruction at the level of the hepatic venules, the large hepatic
veins, the inferior vena cava till its junction with the right
atrium (Valla, 2008).
The classic triad of abdominal pain, ascites, and
hepatomegaly is observed in the vast majority of patients with
Budd-Chiari syndrome, but it is nonspecific (Goel et al., 2015).
Warfarin was introduced into clinical practice in the
1950s, and has been the most widely prescribed oral anticoagulant for prevention and treatment of thrombotic diseases
despite its significant side effects as (bleeding tendency, drug
drug interaction).
Vitamin K epoxide reductase complex subunit1
(VKORC1), a membrane protein located in hepatocytes, has an
important role in the anabolism of vitamin K, which is essential
for blood coagulation
All included patients were subjected to:
History taking, full clinical examination, throbmpophilia
work up [Fvlm-MTHFR-factor 2-anti thrombin 3-protein c/sCD55/CD59-jak2-ANA with titre-anti DNA-lupus
anticoagulant-anticardiolipin igG/igM-viral markers] Screening to be under warfarin therapy as the single
anticoagulant therapy with maximum dose (10ml) Mutation
detection for VKORC1 was performed for all enrolled
subjects regarding the issue that the pharmacodynamic
mechanism of warfarin resistance relied on or VKORC1
polymorphism
PT, PTT and INR were used to monitor effectiveness of
warfarine every 3 days.
The PT and PTT was be determined using standard Kits
according to the manufacturer‘s instruction.
All procedures were be approved by an Ethics Committee
(El demerdash hospital Ain hams university, and
participants’consent was be obtained. 2.AIM/ OBJECTIVES
This study was designed to evaluate effect of the allelic
frequency of the VKORC1 (G1639A) polymorphic genes by
real time PCR on response of Egyptian patients with Budd–
Chiari syndrome or PVT to Warfarin.
Methodology:
Patients and Methods
Type of Study: A cross sectional study.
Study Setting: Budd chiarri study group clinic..tropical
medicine department in Ain shams university hospitals
Study Period: 6 months.
Study Populationo Inclusion Criteria:
Egyptian Patients diagnosed with Budd–Chiari syndrome
and/or benign portal vein thrombosis.
Including males and females above 18 years old till 60
years old.
o Exclusion Criteria:
All patients not on vitamin k antagonist oral long acting
anticoagulant (all patients not on warfarine) -patients below 18
years old and above 55years old-patients wih malignant portal
vein thrombosis.
Sampling Method: We will include 50 cases with budd
chiarri syndrome and/ or benign P.V.T. presenting in Budd
chiarri study group clinic. tropical medicine department in
ain shams university hospitals.
Sample Size: 50 patients [Budd–Chiari and/or benign
P.V.T.].
Study Procedures: All patients will be subjected to the
following: History taking, full clinical examination,
throbmpophilia work up[Fvlm-MTHFR-factor 2-anti
thrombin 3-protein c/s-CD55/CD59-jak2-ANA with titreanti DNA-lupus anticoagulant-anticardiolipin igG/igM-viral
markers].
o Screening to be under warfarin therapy as the single
anticoagulant therapy with maximum dose (10ml) Mutation detection for VKORC1 will be performed for
all enrolled subjects regarding the issue that the
pharmacodynamic mechanism of warfarin resistance
relies on or VKORC1 polymorphism.
o PT, PTT and INR are used to monitor effectiveness of
warfarine every 3 days.
o The PT and PTT will be determined using standard Kits
according to the manufacturer‘s instruction.
o All procedures will be approved by an Ethics Committee
(El demerdash hospital Ain Shams University, and
participants’consent will be obtained.