Isolation and Identification of Fungal Strains from Fresh and Smoked Fish from the Sassandra River in Côte d’Ivoire

Introduction: Fresh and smoked fish are widely consumed in Côte d'Ivoire as everywhere in West Africa. However, these foodstuffs, due to certain processing conditions, are likely to be contaminated by molds that produce dangerous mycotoxins. Objective: This study aimed to isolate and identify fungal strains contaminating fresh and smoked fish from the Sassandra River in Côte d'Ivoire. Place and Date of the Study: Sampling was carried out in various processing sites around the Sassandra River, particularly in the towns of Soubré and Guessabo. The microbiological analysis was carried out at Jean Lorougnon Guédé University in Daloa (Ivory Coast). Methods: A total of 108 samples of fresh and smoked fish were collected. Isolation and purification of fungal strains were carried out on Sabouraud medium with chloramphenicol. The identification of isolated strains was made on the basis of morphological and cultural criteria. Results: A total of 126 fungal strains were isolated, including 87 from the Guessabo samples and 39 from the Soubré samples from 54 fresh fish and 54 smoked fish. The predominant species were Aspergillus of the Glaucus group (39%), Aspergillus niger (36%) and Penicillium sp. (25%). Conclusion: This study shows that fresh and smoked fish from the Sassandra River in Côte d'Ivoire are contaminated by several strains of molds, some of which produce mycotoxins that can cause illness in consumers depending on their concentrations. It would therefore be appropriate to improve processing techniques.

Poverty related diseases amongst Malaysia’s low-income community: a review

@#Poverty, as proven by several studies, is a driving force behind poor health and hygiene practices. This review attempts to outline common communicable and non-communicable diseases that disproportionately affect Malaysia’s 2.91 million low-income households. The current study also looks into the government’s housing and healthcare programmes for this demographic to improve their health and well-being. The initial examination yielded incredibly little research on this marginalised community, with event reporting typically generalised to the Malaysian community as a whole rather than analysing disease incidences based on household income, which would better reflect povertydriven diseases. As a result, there is an acute need for more accurate information on the epidemiology of diseases among the poor in order to address this public health issue and provide conclusions that can drive policy designs.

Transtubular Transoral Approach for Irreducible Ventral Craniovertebral Junction Compressive Pathologies: Surgical Technique and Outcome

@#Introduction: To investigate the use of a tubular retractor to provide access to the craniovertebral junction (CVJ) sparing the soft palate with the aim of reducing complications associated with traditional transoral approach but yet allowing adequate decompression of the CVJ. Materials and methods: Twelve consecutive patients with severe myelopathy (JOA-score less than 11) from ventral CVJ compression were operated between 2014-2020 using a tubular retractor assisted transoral decompression. Results: All patients improved neurologically statistically (p=0.02). There were no posterior pharynx wound infections or rhinolalia. There was one case with incomplete removal of the lateral wall of odontoid and one incidental durotomy. Conclusions: A Tubular retractor provides adequate access for decompression of the ventral compression of CVJ. As the tubular retractor pushed away the uvula, soft palate and pillars of the tonsils as it docked on the posterior pharyngeal wall, the traditional complications associated with traditional transoral procedures is completely avoided.

Clinical presentation and in-hospital prognosis of lung cancer patients presenting with suspected and confirmed COVID-19

We sought to compare the clinical presentation and prognosis of patients with lung cancer and confirmed COVID-19 infection to those with negative RT-PCR SARS-CoV-2 results. We included patients with confirmed lung cancer and suspected COVID-19 who presented to the emergency department. The primary outcome was in-hospital mortality and secondary outcomes included admission to intensive care unit (ICU) or mechanical ventilation. We analyzed the characteristics according to RT-PCR results and primary outcome. We constructed a logistic regression for each RT-PCR result group to find potential predictors of the primary outcome. Among 110 individuals with confirmed lung cancer (65±9 years, 51% male), 38 patients had positive RT-PCR and 72 patients had negative RT-PCR. There was no difference between groups for any clinical characteristic or comorbidities though individuals with confirmed COVID-19 had higher functionality in the ECOG scale. Leucocytes and lymphocytes were lower in individuals with positive tests. The primary outcome occurred in 58 (53%) individuals, 37 (34%) were admitted to the ICU, and 29 (26%) required mechanical ventilation. Although mortality was similar between the two groups, individuals with confirmed COVID-19 were significantly more likely to be admitted to the ICU or receive mechanical ventilation. Only lower lymphocytes and higher CRP were significantly associated with higher mortality. The clinical presentation of COVID-19 in lung cancer is not sufficient to identify higher or lower probability groups among symptomatic individuals, the overall mortality is high irrespective of RT-PCR results, and lymphopenia on admission was associated with the diagnosis and prognosis for COVID-19.

Validation of the North America expert consensus statement on reporting CT findings for COVID-19 in individuals with lung cancer

The aim of our study was to validate the use of the standardized Radiological Society of North America (RSNA) reporting system in individuals with known lung cancer who presented to the emergency department with suspected COVID-19. We included patients aged 18 years or older from the Cancer Institute of the State of São Paulo (ICESP) with a confirmed diagnosis of lung cancer, admitted to the emergency department and undergoing chest computed tomography (CT) for suspicion of COVID-19. Comparison between SARS-CoV2 RT-PCR across RSNA categories was performed in all patients and further stratified by diagnosis of lung cancer progression. Among 58 individuals included in the analysis (65±9 years, 43% men), 20 had positive RT-PCR. Less than a half (43%) had no new lung findings in the CT. Positive RT-PCR was present in 75% of those with typical findings according to RSNA and in only 9% when these findings were classified as atypical or negative (P<0.001). Diagnostic accuracy was even higher when stratified by the presence or absence of progressive disease (PD). Extent of pulmonary inflammatory changes was strongly associated with higher mortality, reaching a lethality of 83% in patients with >25% of lung involvement and 100% when there was >50% of lung involvement. The lung involvement score was also highly predictive of prognosis in this population as was reported for non-lung cancer individuals. Collectively, our results demonstrated that diagnostic and prognostic values of chest CT findings in COVID-19 are robust to the presence of lung abnormalities related to lung cancer.

Imaging Analysis of Onodi Cells on Cone-Beam Computed Tomography

Abstract Introduction Onodi cells are the most posterior ethmoid air cells, and extend superolaterally to the sphenoid sinus. The identification of Onodi cells is essential to because they can have some significant anatomic variations and relationships to vital adjacent structures, like the optic canal, the sphenoid sinus, and the internal carotid artery. Objective The present study aimed to assess the prevalence of Onodi cells and their position with respect to sphenoid sinus. To the authors' best knowledge, this is the first study that uses cone-beam computed tomography (CBCT) to assess the prevalence and position of Onodi cells. Methods We collected CBCT scan records from November 1st, 2016, to July 31st, 2017; the patients who fulfilled the eligibility criteria were included in the present study. The CBCT scans were reviewed by two independent observers. The descriptive statistics was performed using the Statistical Package for the Social Sciences (SPSS, SPSS, Inc., Chicago IL, US) software, version 17.0. A cross-tabulation of gender with the presence and position of Onodi cells was evaluated using the Chi-squared (χ2) test. The inter- and intraobserver agreements were evaluated using Kappa (κ) statistics. Results Onodi cells were identified in 86 (42.8%) out of 201 patients. A subgroup analysis revealed that Onodi cells were present in 45 (43.3%) female and 41 (42.3%) male patients. The position of the Onodi cells was superior with respect to the sphenoid sinus in 43 (50%) of the patients, superolateral in 36 (41.9%), and lateral to the sphenoid sinus in 7 (8.1%) of the patients. Conclusion The present study indicated a high prevalence of Onodi cells, with approximately equal distribution among males and females, and mostly superior in position in relation to the sphenoid sinus.

Prevalence of psychiatric morbidity (depression) and its effect on drug compliance among patients attending diabetic outpatient clinic

Background: Depression, a common mental disorder characterized by persistent unhappiness and lack of interest in daily activities, is one of the major important public health problems that are often comorbid with other chronic diseases like diabetes and can worsen the effect of the disease outcomes. Depression alone and/or as a comorbidity with diabetes is a common condition in the community. Aim of the study: To identify the prevalence of Depression among Type 2 Diabetes Mellitus patients and relationship between Depression and its effect on Drug Compliance among Type 2 Diabetes Mellitus patients, to determine the severity of Depression among Type 2 Diabetes Mellitus patients and the extent to which it affects Drug compliance. Materials and methods: The study was to be conducted in Rajah Muthiah Medical College and Hospital, Chidambaram in the year 2018-2019. A hundred patients with diagnosis of T2DM attending Diabetic OPD above 20 years of age were randomly selected. The Hamilton rating scale for depression by Hamilton is the most widely used rating scale to assess the symptoms of depression. The Ham-D is an observer-rated scale consisting of 17-21 items. Ratings are based on clinical interview. The items are rated on either a 0 to 4 spectrum or a 0 to 2 spectrum. The HAM-D also relies quite heavily on the clinical interviewing skills and the experience of rater in evaluating individuals with depressive illness. The strength of HAM-D is its excellent validation/research base, K.H. Mohamed Ibrahim, R. Gandhi Babu, M. Senthil Velan. Prevalence of psychiatric morbidity (depression) and its effect on drug compliance among patients attending diabetic outpatient clinic. IAIM, 2019; 6(11): 19-28. Page 20 and case of administration. Its use is limited in individuals who have psychiatric disorders other than primary depression. Results: Analyzing with HAMD score, 40 had no depression, mild depression in 24 cases, moderate depression in 21 cases, severe depression in 15 cases. MAQ score scale- low adherence in 41 cases, medium adherence in 37 cases, high adherence in 22 cases. MMAQ score scale and HAMD scorelow adherence with no depression were 9 cases (22.5%) mild depression were 6 cases (25%) moderate were 11(52.4%) severe depression were 15 cases (100%). MMAQ score scale and HAMD score - medium adherence with no depression were 23 cases (57.5%) mild depression were 9 cases (37.5%) moderate were 5(23.8%) severe depression were not seen. MMAQ score scale and HAMD score - Medium adherence with no depression were 8 cases (20%) Mild depression were 9 cases (37.5%) Moderate were 5(23.8%) severe depression was not seen. Pearson Chi-Square = 35.344**, p<0.001. Conclusion: Further, there was a significant association between the depression in Type 2 diabetes patients and medication adherence, where patients with depression had poor medication adherence as compared to those without depression and severity of depression correlates with worse adherence to diabetic medications

Prevalence of Dental Developmental Anomalies in Patients Attending a Faculty of Dentistry in Ajman, United Arab Emirates

Objective: To determine the prevalence of dental developmental anomalies among patients visiting the dental clinics at Ajman University, United Arab Emirates. Material and Methods: This retrospective study consisted of 425 digital panoramic radiographs. The study sample included people in the United Arab Emirates who have visited the outpatient dental clinics at the Faculty of Dentistry, at Ajman University. These OPGs have been evaluated for the presence of dental anomalies such as: Macrodontia, Microdontia, Talon cusp, Taurodontism, Dilaceration, Ectopic Eruption, Supernumerary teeth or roots, Fusion, Gemination, and Concrescense. Results: 80.7% had at least 1 anomaly, with the maximum of 5 anomalies presented in 1.2% of the sample. Dilacerations were the most commonly identified anomaly (61.4%), followed by missing third molars (22.8%), and Ectopic Eruption (15.5%) where (12.9%) of this anomaly has affected the maxillary canines. Hypercementosis (10.2%) followed by Microdontia (4.6%), which was mostly seen in the Upper laterals. Taurodontism accounted for (4.1%), Macrodontia (2.3%) and Talon cusp (2.3%). Gemination, Dens Invaginatus, and Concrescence were separately present in 1.1%, each one, of the cases observed. Conclusion: Variations in data and results among different studies suggest the impact of racial, genetic and environmental factors. The high frequency of dental anomalies emphasize the need of early detection and diagnosis which can be achieved through radiographic imaging, this would aid in further awareness to minimize any means of complexity in dental problems.

Osteoradionecrosis in Subaxial Cervical Spine - a Rare and Devastating Complication: A Case Report

Osteoradionecrosis, a rare complication of radiation therapy, is a slow progression disease which affects the surrounding structures of spinal components. It essentially weakens the soft tissue and bony configuration and can cause nerve impingement or cord compression. We describe a patient who underwent radiotherapy for thyroid cancer and presented with cervical kyphosis with anterolisthesis of C3/C4 and C4/C5 some 32 years later. We explore the role of anterior and posterior fusion, as well as hyperbaric oxygen therapy in promoting healing.

Cone-beam computed tomography analysis of accessory maxillary ostium and Haller cells: Prevalence and clinical significance

PURPOSE: This study aimed to evaluate the prevalence of Haller cells and accessory maxillary ostium (AMO) in cone-beam computed tomography (CBCT) images, and to analyze the relationships among Haller cells, AMO, and maxillary sinusitis. MATERIALS AND METHODS: Volumetric CBCT scans from 201 patients were retrieved from our institution's Digital Imaging and Communications in Medicine archive folder. Two observers evaluated the presence of Haller cells, AMO, and maxillary sinusitis in the CBCT scans. RESULTS: AMO was observed in 114 patients, of whom 27 (23.7%) had AMO exclusively on the right side, 26 (22.8%) only on the left side, and 61 (53.5%) bilaterally. Haller cells were identified in 73 (36.3%) patients. In 24 (32.9%) they were present exclusively on the right side, in 17 (23.3%) they were only present on the left side, and in 32 (43.8%) they were located bilaterally. Of the 73 (36.3%) patients with Haller cells, maxillary sinusitis was also present in 50 (68.5%). On using chi-square test, a significant association was observed between AMO and maxillary sinusitis in the presence of Haller cells. CONCLUSION: Our results showed AMO and Haller cells to be associated with maxillary sinusitis. This study provides evidence for the usefulness of CBCT in imaging the bony anatomy of the sinonasal complex with significantly higher precision and a smaller radiation dose.

Assessing the Lebanese population for their knowledge, attitudes and practices of antibiotic usage

Antibiotic-resistant bacteria has become a global phenomenon, mainly due to the inappropriate use of antibiotics. There are no studies in Lebanon to assess the public's knowledge, attitudes and practices [KAP] of antibiotic usage. A cross-sectional study was carried out using a self-administered questionnaire completed by a random convenience sample of 500 people. Nearly half of the respondents [46.1%] demonstrated moderate knowledge levels, while 40.6% demonstrated moderate attitudes. Although 80.2% knew that antibiotics are anti-bacterial, 73.5% did not know that antibiotics are not anti-viral. Moreover, 68.3% of respondents reported consuming antibiotics 1-3 times per year, while 22.4% consumed antibiotics on their own accord. Approximately 66.7% realized that abusing antibiotics could lead to resistance. Participant knowledge and attitudes were significantly associated with monthly family income, educational level, place of residency, having medical insurance, working in the health sector or having a relative working in the health sector. Nation-wide awareness campaigns targeting susceptible demographics should be initiated

Comparative histological study of human adult cervical and lumbar intervertebral discs and its relation to functions and diseases

The intervertebral discs are the major structural links between adjacent vertebrae. They serve to allow greater movement and compression between vertebral bodies. However, there is regional difference in disc structure and pathology relative to different mechanical stresses and load bearing. Comparing the histological structure of human cervical and lumbar intervertebral discs at adult age to analyze the extent of variations in structure between these regions and its relation to their functions and diseases. [12] IVDs: [4] C3C4, [4] L4L5 and [4] L5S1 and adjacent bony vertebrae were removed from each of 12 adult male and female humans at autopsy. The discs and vertebrae were processed for paraffin sections and stained by haematoxylin and eosin, trichrome, orcein and safranin stains. Histomorphometric study and statistical analysis were conducted. L4-L5, L5-S1 IVDs presented less collagen and more elastic fibers in posterior region of annulus fibrosus than anterior region, peripheral regions were thicker than central one of lumbar end plate. The annulus fibrosus invading nucleus pulposus and dividing it but at cervical level invading without dividing it. Safranin reaction was positive and much higher in cervical than in lumbar annulus fibrosus. The reaction was much higher in lumbar than in cervical nucleus pulposus. There are significant differences in collagen, elastic fibers and heights of cervical and lumbar discs. There are histological differences of human adult intervertebral discs in cervical and lumber regions which may affect their mechanical and physiologic functions and provide a better understanding of the external factors causing spinal disorders and enable the best method to be applied to the patients both at the diagnosis and the treatment stage

Pattern of Blood Transfusion Request and Utilization at a Nigerian University Teaching Hospital

Introduction: Provision of adequate safe blood is challenging in developing countries due to paucity of voluntary blood donors; poor facilities for storage and blood component preparation as well as inappropriate blood ordering and utilization. Appraisal of pattern of blood transfusion requests and utilization helps highlight shortcomings that could be addressed toward judicious use of blood. Aims: To determine the pattern of blood transfusion requests and utilization at a Nigerian Teaching Hospital. Materials and Methods: Blood request forms and cross-match worksheets at the blood bank of Usmanu Danfodiyo University Teaching Hospital (UDUTH) Sokoto were analyzed over a 3-month period. Number of blood units requested; cross-matched; or transfused and the cross-match to transfusion ratio (CTR) for clinical units were computed. Results: Of the 1703 units of blood requested for 986 patients; 94.42 (1608) were cross-matched but only 34.51 (555) were transfused giving a CTR of 2.90 for the hospital. The CTR for the various clinical units were: O and G - 3.40; Surgery - 3.11; Trauma center - 2.74; Emergency - 2.61; Medicine - 2.02; and Pediatrics - 1.97. Conclusions: The overall CTR of the hospital is high indicating suboptimal transfusion practice. Introducing transfusion guidelines and type and screen with abbreviated cross-match method can help toward apt requisition and utilization of blood thereby reducing wastages

Community pharmacist impacts on self-medication management among Rural dwellers, kwara state central, nigeria.

The role of pharmacist has not only advanced from traditional medication dispensing but also to direct patient care and pharmaceutical interventions aiming at enhancing the populace wellbeing. Objective: The objective of this research was to assess the impact of rural community pharmacist on drug self-medications and disease prevalence among rural settings in the Kwara State Central, Nigeria. . Method: This study was conducted between September, 2011 and February, 2013 in eight rural communities on 730 respondents, following a six-week pilot study on 50 respondents. Respondents aged 30 years and over and regular clients of the community pharmacy were included into the study. Self-medications were assessed using pre-tested and validated questionnaire. Pharmaceutical interventions were carried out on the respondents by the clinical pharmacist at every two months for eighteen months. Descriptive statistics and regression analysis were for the computation of the data. Results: Male respondents were one third of the population studied, while female had the highest percentage of 69.9%. Respondents between the age of 40 and 50 years dominated with 42.3% and majority (88.1%) of the rural residents were illiterates. Farming was the core livelihood of the respondents and survived on less than ten thousand naira Nigeria money ($63) per month. Among the combinations of drugs abused by the respondents, the regimen containing combination of (prednisolone, diclofenac and paracetamol) had the highest users. The least used combination was (Ibuprofen, Diclofenac plus Prednisolone). These combinations were taken two times daily by the majority participants. The most common reasons given for self-medications were osteoarthritis (31.1%), poverty (17.4%), general body pain (14.3%), lack of health facilities (4.6%), ignorance (4.3%) among others. The intervention offered by the pharmacist had reduced the mean systolic blood pressure significantly (p<0.05) from 161mmhg to 129 mmhg and diastolic blood pressure from 104mmhg at baseline to 86 mmhg. Post-intervention evaluation revealed the impact of the pharmacist, as the respondents with dyspepsia at baseline significantly (p<0.05) reduced from 220 to 53 participants. Conclusion: Pharmacist interventions on self-medication of drugs greatly enhanced patient healthcare in the rural communities.

Effect of Plasma Storage on Prothrombin Time and Activated Partial Thromboplastin Time at a Nigerian Public Laboratory

Background: Prothrombin time (PT) and activated partial thromboplastin time (APTT) are the tests used in the investigation and monitoring of hemostatic disorders. Plasma is used to perform these tests immediately or stored for later use. The time and storage temperature have been shown to affect the results of these tests. Thus; all coagulation laboratories need guidelines for plasma storage to ensure reliable results. Objective: To determine the effect of varying storage times and temperatures on plasma PT and APTT. Materials and Methods: PT and APTT were run on plasma from 40 healthy adults using a semi-automated coagulometer. PT and APTT were measured at 0; 4; 6; and 24 h on samples stored at room temperature; refrigerated samples; and frozen samples. The values at 0 h were compared with the values at 4; 6; and 24 h. Results: PT and APTT values were within the reference ranges at 0 h. For refrigerated plasma; PT values at 4 h were within normal; but at 6 and 24 h; they were significantly deranged (P 0.05). PT was significantly different at 4; 6; and 24 h for both room temperature and frozen plasma (P 0.05). The APTT showed significant differences between 0 h value and values at 4; 6; and 24 h for all the varying temperature conditions. Conclusion: For reliable PT and APTT results; samples should be processed and run immediately after collection. However; plasma for PT can be stored at 2o-4oC for only 4 h

Morphology of Colorectal Carcinoma among Nigerians: A 30-Year Review

Background: The incidence of colorectal carcinoma has been on the increase in the developing countries; including Nigeria; as a result of change in diet and adoption of western lifestyle. Objectives: The aim of this review is to highlight the prevalence; age and sex distribution; anatomical location; and morphological characteristics of colorectal carcinomas in Ilorin; Nigeria. Materials and Methods: This is a retrospective study of all cases of histologically diagnosed colorectal carcinoma in the University of Ilorin Teaching Hospital; Ilorin; Nigeria; over a 30-year period (January 1979-December 2008); using the departmental record and histological slides of the cases. Result: A total of 241 cases of colorectal carcinoma were reported; 144 cases (60) in males and 96 cases (40) in females with a male: female ratio of 1.5:1. The peak age of occurrence for males was between 51 and 60 years; while that of the females was between 41 and 50 years. The malignancy was found in the rectum in 60.2of the cases; while the least affected site is the descending colon (1.2). The exophytic occluding masses were found in 82.2of the cases; and the most common histological type is adenocarcinoma (77.2) with well-; moderately; and poorly differentiated forms constituting 52.3; 32.8; and 14.9respectively. Of the 241 cases that were seen over the last 30 years; 93 cases (38.6) were seen in the last 5 years. Conclusion: Colorectal carcinoma is no longer a rare disease in Nigeria. The surge in the incidence reported in the last 5 years in this center calls for a pragmatic action in its control; with emphasize on colonoscopic screening for those with family history; and possibly making digital rectal examination a mandatory aspect of clinical examination; because most colorectal carcinomas are within the reach of examining finger

Percutaneous endoscopic colostomy: a new technique for the treatment of recurrent sigmoid volvulus

Sigmoid volvulus is a common cause of large bowel obstruction in western countries and Africa. It accounts for 25% of the patients admitted to the hospital for large bowel obstruction. The acute management of sigmoid volvulus is sigmoidoscopic decompression. However, the recurrence rate can be as high as 60% in some series. Recurrent sigmoid volvulus in elderly patients who are not fit for definitive surgery is difficult to manage. The percutaneous endoscopic placement of two percuatneous endoscopic colostomy for the colon from over-distending. In our opinion, this aspect is key to its success as it keeps the sigmoid colon deflated until adhesions form between the colon and the abdominal wall

Closed percutaneous pleural biopsy. A lost art in the new era

To assess the association between size and number of biopsy specimens obtained by percutaneous closed pleural biopsy, with overall diagnostic yield in general, and histopathological evidence of tuberculosis pleurisy, in particular. One hundred and forty-three patients, with a high index of clinically having tuberculous pleurisy, were referred to the respiratory division of Mubarak Al-Kabeer Hospital in Kuwait during a 9-year period [January 1999 to December 2007]. All subjects with exudative lymphocytic predominant effusion underwent percutaneous closed pleural biopsy, looking for tuberculous granulomas. The clinical diagnosis and pathological characteristics [number and size of biopsy samples] were analyzed. Overall diagnostic yield of percutaneous closed pleural biopsy in all cases was noticed to be 52%. The larger biopsy sample size of 3 mm and more, and the higher number of specimens [>/= 4] were significantly associated with an increased diagnostic yield for tuberculous pleurisy [p=0.007 and 0.047]. Obtaining 4 or more biopsy samples, and larger specimens of 3mm and more for histopathological evaluation, through percutaneous pleural biopsy, results in a better diagnostic yield for tuberculous pleurisy

Histological, immunohistochemical and quantitative analysis of collagen in patients with direct inguinal hernia

Abnormal collagen metabolism is thought to play an important role in the development of abdominal hernia. This is underlined by detection of altered collagen metabolism and structural changes of the tissues in patients with inguinal hernia. Was to study collagen synthesis defect in patients with direct inguinal hernia. Specimens were obtained from skin, transversalis fascia and sacs from forty two adult male patients with direct inguinal hernia and from 30 control adult patients without hernia during appendectomy. Sections from the specimens were stained with haematoxylin and eosin and Masson's trichrome stains, for light microscope. Furthermore, immunohistochemical study for collagen type III and histological quantitative analysis of total collagen were done. Other specimens were processed for electron microscopic study. Histological study of the tissues of patients with direct inguinal hernia revealed that the collagen fibers appeared loosely packed, widely separated and there was decrease in bundle formation. The immunohistochemical study showed an increase in type III collagen fibrils in comparison to that of controls. Also, there was a significant decrease in the amount of total collagen content compared to the control group. The electron microscopic study revealed degenerative changes in the fibroblasts associated with loosely packed collagen fibrils. These changes were detected in all studied tissues. We concluded that the substitution of collagen type I by collagen type III that has less tensile strength predisposes to development of direct inguinal hernia. We also concluded that inguinal hernia may be a local manifestation of a systemic disorder of collagen metabolism

Histological study of the effects of extensive freeze injury on the rabbit aorta

Cryopreservation of blood vessels has become one of the key techniques to make up the limited sources of fresh blood vessels. But cryopreservation methods do not adequately preserve complex natural or engineered multicellular tisses. When lesions are produced by localized freezing of the aorta, necrosis is present throughout the full thickness of the tunica media of tunica media as well as in the endothelium. The response of the vessel wall varies according to the extent of endothelial denudation and the period of freeze injury. From this point of view, this study was designed to investigate the histological effects of extensive freeze injury on the rabbit aorta. The abdominal aorta of twenty-five adult male rabbits were used in this study. Five normal adult male rabbits were used as a control [group I]. The remaining twenty rabbit aorta were exposed to extensive freeze injury by a 12-mm aluminium bar, cooled down to the temperature of liquid nitrogen and placed on the exterior of the abdominal aorta [infrarenal segment] for I min. Freeze injury was done at 1, 3, 14 days and one month [5 rabbits / time point], corresponding to groups II, III, IV, V respectively, the aortae were excised, fixed by buffered formol saline 10%, paraffin sections were prepared and stained by haematoxylin and eosin [H. and E.] to demonestrate the general architecture of the aorta, orceinfor elastic fibers demonstration in the wall of the aorta and masson's trichrome to illustrate the collagen fibers and smooth muscle cells [SMC] in the whole aortic wall. Group II showed injured surface with desquamated denuded endothelium covered with blood elements in a single layer. The internal elastic fibers were damaged at injury site. Group III showed regenerating endothelium at the edge of the injury zone. Proliferating intimal cells was observed. Group IV showed thickened and elevated intima at the injury zone with migrating smooth muscle cells from the media to the intima. Smooth muscle cells populated the subendothelial space of the injured zone under the regenerated endothelium. Group V showed the tunica media had an area of smooth muscle cells destruction with cellular debris and homogenous smooth degeneration. The intima showed full restoration of endothelial monolayer in the zone of injury. After extensive freeze injury, complete re-endothelialization of the denuded surface and SMC regeneration in the subendothelial space occured, resulting in endothelial myointimal thickening. On the other hand, irreversible changes in the smooth muscle cells of the tunica media were noticed