Acute appendicitis has been reported to be present throughout the year, but some particular months are associated with higher incidences. The aim of this study was designed to review previous studies and analyze the current knowledge and controversies related to seasonal variability of acute appendicitis, to examine whether appendicitis has an annual seasonal pattern. A search of the MEDLINE databases for English language publications over the period from 1970 to 2012 was conducted. This list was extended by including also references from a recent review of appendicitis epidemiology. We selected the studies, which were published in an English-language peer-reviewed journal, did not have intervention, were conducted for at least one year and had the outcome of histologically-confirmed appendicitis and those which reported case data temporally. A total of 30 titles and abstracts were screened for eligibility. Of these, 11 studies from 8 countries conducted across from 1970 to 2012 met the selection criteria and contributed to the systematic review. A seasonal pattern of appendicitis with a mostly predominant peak is seen during the summer months in all the countries (except Nigeria and Turkey). Appendicitis is more common in summer months. The existence of a seasonal pattern in the onset of appendicitis may be due to exposure to air pollution, decreasing fiber diet and increase in the incidence of gastrointestinal infections in summer.

Future experimental and observational studies should consider how the environmental factors (infection, cold, air pollution etc.) or other triggers (dietary habit, alcohol consumption) promotes or hinders such diseases.

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Omega-3 supplementation improves lipid nephrotoxicity observed in mothers and their pups.

Background: Garlic extract can be used alongside conventional antibiotics to fight agents of nosocomial infections, prevalent in hospitals. Phonophoresis is the use of therapeutic ultrasound to increase the percutaneous absorption of pharmacologic agents. Aim of the work: To compare between the use of garlic extract with and without phonophoresis in wound healing in male albino rats. Material & methods: Twenty four male albino rats were classified into 4 equal groups. Group I included 6 rats used as the control group. Group II; 6 rats subjected to wound injury; of them 3 were sacrificed after 2weeks (subgroup-IIa) and the other 3 rats were sacrificed after 3 weeks (subgroup IIb). Group III (Garlic-extract treated) included 6 rats subjected to wound injury and received garlic extract gel daily. Of them, 3 rats and were sacrificed after 2weeks of treatment (subgroup-IIIa). The other 3 rats were sacrificed after 3 weeks of teatment (subgroup-IIIb). Group IV (Garlic extract /Phonophoresis, both) 6 rats subjected to wound injury and received garlic extract gel daily together with phonophoresis 3 times/week. Of which, 3 rats sacrificed after 2 weeks (subgroup-IVa) and 3 rats were sacrificed after 3 weeks (subgroup-IVb). The wound surface areas were measured. Skin sections were processed for histological, immunohistochemical and morphometric studies. Results: Examination of skin sections in the wound group (group II) showed wide separation of edges and few hair follicles with reduced thickness and desquamated keratin. In group III and group IV, there was marked regeneration of the epidermis and dermis. With significant increase in hair follicles number in group IV compared to group III. Multiple immunostained CD44 +ve cells were detected in group IV. Conclusion: Both garlic and phonophoresis helped wound healing but Garlic extract/phonophoresis combination revealed faster and better (i.e., more complete wound) healing compared to garlic extract application without phonophoresis.

Purpose: This study aims to histologically compare the median nerve in the arm, forearm, and wrist, to help understand how cervical radiculopathy in a double crush phenomenon causes distal nerve dysfunction at the carpal tunnel and median nerve with concurrent absence of symptoms at the forearm.Methods: The study was performed on 12 fresh cadaveric upper limbs free from any injury or operation. Male cadavers in the age range of 35–40 years were used. The dissection of the median nerve and the histological examination of the specimens from the arm, forearm, and wrist were conducted to evaluate variations in the epineurium thickness (μm), perineurium thickness (μm), number of fascicles per nerve trunk, area percent of myelin covering, and area percent of neurolemmal sheath.Results: Morphometric and statistical results of the cadaveric median nerve trunk revealed that the mean epineurium and perineurium thickness measured in H&E-stained sections in the forearm were significantly greater than those in the arm and wrist specimens. Further, the mean percent area of the myelin covering in the forearm was significantly lower than that in the arm and wrist specimens in the sections stained with osmium oxide (p < 0.001). There were, however, no significant differences in the neurolemmal sheath among the arm, forearm, and wrist specimens in the silver-stained sections.Conclusion: The histological differences explained the high concomitant occurrence of carpal tunnel syndrome (CTS) and cervical radiculopathy and the concurrent absence of symptoms at the forearm. Hence, we suggest cautious evaluation of patients with upper limb symptoms, since the management of these conditions requires a different approach.

Background and objectives The X-linked bleeding disorder, hemophilia A, is caused by defective production of factor VIII (FVIII). Hemophilic patients require regular FVIII infusions. Recombinant factor replacement poses the safest line of therapy. However, its main drawbacks are high expenses and the higher liability for formation of inhibitors. Recent studies confirmed the ability of bone marrow-derived stem cells to secrete FVIII. This study aims to generate bioscaffold from decellularized liver and subsequently seed it with trans-differentiated human stem cells into hepatic-like cells. This scaffold can then be implanted intraperitoneally or subcutaneously to provide FVIII. Methods After generation of the bioscaffold, seeding of discoid scaffolds with trans-differentiated human hepatocyte-like cells was performed. Then, the generated organoid was implanted into peritoneal cavity or subcutaneous tissue of experimental rats. Results Serum human FVIII was significantly increased in rats subjected to subcutaneous implantation compared intraperitoneal implantation. Immunostaining for detecting Cytokeratin 19 and human anti-globulin confirmed the presence of mature human hepatocytes that were significantly increased in subcutaneous implanted scaffold compared to the intraperitoneal one. Conclusion Implantation of decellularized bioscaffold seeded with trans-differentiated stem cells in rats was successful to establish production of FVIII. Subcutaneous implantation showed higher FVIII levels than intraperitoneal implantation.

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