BackgroundHemorrhoid is one of the most common surgical diseases occurring in the anorectal region. In this study, we evaluated the effect of ischiorectal fossa block on alleviating post hemorrhoidectomy pain.MethodsIn this study, 90 patients suffering from hemorrhoids were evaluated. They were randomly divided into 3 groups. The first group had no block, the second group an ischiorectal block with placebo (normal saline), and the third group a preemptive ischiorectal block with bupivacaine. Postoperative variables such as pain intensity, pethidine consumption, nausea, and vomiting were compared between the groups.ResultsThe postoperative pain score in group 1 was 8.5 ± 1.3 and 8.1 ± 0.9 (P = NS) in group 2. The post operative analgesic demand was 3.1 ± 1.5 and 3.3 ± 1.8 hours in groups 1 and 2, respectively (P = NS). The post operative pain score and analgesic demand were 4.2 ± 2.1 and 9.3 ± 2.7 hours, respectively, in group 3 (P < 0.0001).ConclusionsPreemptive ischiorectal block reduces the posthemorrhoidectomy pain and opioid demand.

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In vitro follicular culture systems provide optimal culture models for research about the physiology of the ovary and support the clinical practices to achieve competent mature oocytes for in vitro fertilization. In vitro maturation of preantral follicles makes it possible to study the effects of therapeutic agents on various conditions or disorders of the ovary. Nowadays, preventive bioflavonoids against cancer, hypercholesterolemia, fatty liver, or a variety of toxic agents are in focus. The aim of this study was to design and investigate the impacts of different concentrations of hesperidin, a glycoside flavonoid, on the in vitro preantral follicle growth and maturation in the three-dimensional (3D) culture system which was made with sodium alginate. Preantral follicles (n = 1363) were mechanically isolated from immature mice ovaries, then, after capsulating, they were randomly divided into four groups: the control group received no concentration of hesperidin, and three experimental groups were supplemented with 10, 22.5, and 50 µmol/L of hesperidin. All groups were cultured for 12 days. At the end of the culture period, the percentage of survival rate, antrum formation, obtained metaphase II oocytes, and the secretion of 17β-estradiol and progesterone were significantly higher in the group Hesp 50 (50 µmol/L hesperidin). Moreover, the mean average of follicular diameter cultured in the group Hesp 50 was also increased and the mRNA expression levels of PCNA, FSH-R, and Bcl-2 genes were higher, while Bax mRNA expression was significantly reduced compared with the other groups. Follicles cultured in the presence of 50 µmol/L of hesperidin had a higher fertilization rate and embryo development. Adding hesperidin at the concentration of 50 µmol/L to the culture medium resulted in higher follicular growth and maturation and increased the rate of in vitro fertilization and embryo development. Impact statement It has been stated that hesperidin has many pharmacological effects, such as anti-inflammatory and antioxidant effects, antimicrobial activity, and anti-carcinogenic activity; but hesperidin and its derivatives have been under investigation as anti-fertility factors for a very long time. However, our results show that hesperidin can improve mice follicular growth and maturation during in vitro 3D culture. Hesperidin as an antioxidant factor could enhance the mRNA expression levels of two important genes involved in folliculogenesis, PCNA, and FSH-R. Our results prove for the first time that hesperidin not only has deleterious effects on follicular development but can also increase rates of in vitro fertilization and embryo development.

There is little about the incidence, mortality and risk factors of Esophageal cancer (EC) in the world. Therefore, the purpose of this study was to determine the incidence rate, mortality and EC risk factors in the world. This review study was conducted on published English research by January 2017 with the search in by March 2018 by searching in the databases of PubMed, Scopus, and Science Direct with the keywords "esophagus cancer," "epidemiology," "incidence," "mortality," "risk factor," " world." Based on the findings of this study, the geographical distribution of the EC differs according to subtitles, as AC is more prevalent in developed countries, while SCC is more prevalent in countries in Africa and East Asia. The most important risk factors for EC are the low intake of vegetables and fruits, drinking drinks and hot liquids, reducing the intake of nutritional supplements such as selenium and zinc, smoking, excessive consumption of alcohol, past medical history, obesity and exposure to some environmental factors. According to the findings, it seems that the main cause of EC- is an undesirable lifestyle. Therefore, it is possible to improve the lifestyle and inform the community about EC risk factors and healthy lifestyle education.

SUMMARY:There are some medications and procedures that can be used to accelerate the healing of skin wounds. Some studies have demonstrated improvement of burn wound healing with honey treatment. In other hand, based on traditional medicine have improved wound healing with animal oil. This study was done to compare the efficacy of animal oil and honey in accelerating healing of full thickness wound of skin in mice. In this experimental study 36 male NMRI mice were subjected to full-thickness skin wounds under general anesthesia. Animals were randomly allocated to receive either single daily applications of placebo, animal oil and honey (n=12 for each group) respectively. On 4 th , 7th and 10th days, four mice from each group were sacrificed using an overdose of anesthetic. Macroscopic and Microscopic characteristic of wounds were studied pathologically and histologically. The findings of this study showed that formation of granulation tissue, density and activation of fibroblasts, keratinization in surface of wound and thickness of basement membrane and epidermis in Honey treatment group was more than animal oil group. Honey more than animal oil decreased inflammation, edema and dehiscence of wound in mice. The wound healing rate in honey group was higher than in animal oil group (p<0.05). This study showed that honey more than animal oil accelerates healing of full thickness wound of skin in mice.

This study, to the best of our knowledge, showed for the first time that intraperitoneal administration of carbamazepine at clinically comparable doses during organogenesis can induce several eye malformations in mice. The implication of these results needs to be considered when carbamazepine is administered during human pregnancy.

IntroductionThe aim of the study was to study a nanoliposomal anti-PCSK9 vaccine as a novel approach for cholesterol lowering via PCSK9 inhibition.Material and methodsAn immunogenic peptide construct termed immunogenic fused PCSK9-tetanus (IFPT) was displayed on the surface of liposome nanoparticles (L-IFPT) and mixed into alum adjuvant (L-IFPTA+). The manufactured vaccine formulations IFPT, L-IFPT, L-IFPTA+, IFPTA+, and free nanoliposomes were subcutaneously injected four times with bi-weekly intervals in C57BL/6 mice on a severe atherogenic protocol.ResultsAmong the formulations, L-IFPTA+ vaccine was found to elicit the highest IgG response against PCSK9 peptide. The induced PCSK9 antibodies inhibited PCSK9-LDLR interaction through binding to PCSK9 in vaccinated mice. Liver low-density lipoprotein receptor (LDLR) protein was increased in vaccinated mice. L-IFPTA+, L-IFPT and IFPTA+ vaccines reduced total cholesterol by up to –38.13 ±3.8% (p = 0.006), –23 ±4.1% (p = 0.027) and –19.12 ±3% (p = 0.038), and low-density lipoprotein cholesterol (LDL-C) by up to –57 ±7.7% (p = 0.0003), –41.67 ±4.2% (p = 0.03) and –36.11 ±5% (p = 0.02) in hypercholesterolemic mice, respectively, versus control mice after 8 weeks. Long-term assessment indicated that the vaccine formulations could stimulate a long-lasting humoral immune response against PCSK9 peptide, which was associated with a marked reduction of total cholesterol in L-IFPTA+, L-IFPT and IFPTA+ vaccine groups by up to –82.5 ±7.3% (p = 0.002), –70.54 ±6.2% (p = 0.013) and –72.02 ±8.7% (p = 0.004), respectively, and LDL-C by up to –88.14 ±5.6% (p = 0.002), –55.92 ±8.3% (p = 0.003) and 54.81 ±9.3% (p = 0.003), respectively, versus the pre-vaccination time point adjusted to the control group. Anti-inflammatory Th2 cells and IL-4 cytokine were considerably increased in splenocytes of vaccinated mice.ConclusionsL-IFPTA+ vaccine can induce long-lasting, functional and safe PCSK9-specific antibodies in hypercholesterolemic C57BL/6 mice, providing a long-term protective impact on dyslipidemia and atherosclerosis.