ABSTRACT
Background: obesity nowadays is associated with comorbidities that double folded the mortality as cancer, cardiovascular disease, and diabetes. And weight loss by dietary changes and exercise usually does not achieve the desired weight loss goals. As such, bariatric surgery has become the treatment of choice for obesity and co-morbidities. Body contouring and specially abdominoplasty after bariatric surgery is a component in the treatment of the obese patient and is well accepted by patients, despite the extensive scarring with all of the surgical procedures. There is evidence that post-bariatric surgery patients who have subsequent body contouring surgery maintain their weight loss
Aim of the Work: to compare between formal and modern mini-abdominoplasty after laparocopic sleeve gastrectomy
Patients and Methods: this comparative study included two groups of thirty patients each, group I consisted of patients with redundancy at the ventral part of the abdomen after weight loss stabilization at BMI 30 for more than 6 months post laparoscopic sleeve gastrectomy, where formal, traditional, abdominoplasty was done to them. While group II consisted of patients with redundancy at the ventral part of the abdomen after weight loss stabilization at BMI 30 for more than 6 months post laparoscopic sleeve gastrectomy, where modern mini-abdominoplasty was done to them
Results: as regarding Flank fullness post Abdominoplasty Group I resolved the flank fullness except for 10 while Group II 20 cases still with flank fullness, therefore there was statistical significant difference between the two groups as [p value] = 0.009823. As regarding upper abdominal wall bulge condition resolved successfully in 27 cases from group I and only 10 from Group II, therefore there was statistical significant difference between the two groups as [p value] = 0.000006
Conclusion: abdominoplasty gives the patient seeking weight loss the encouragement and well to lose more weight and improve his psychological state, traditional abdominoplasty provide a comprehensive treatment of abdominal wall redundancy, even in the most severe cases, the patients get both functioning and cosmetic improvement. Mini-abdominoplasty is less effective, not appropriate method to treat patients with lipodystrophy of the trunk and fullness of the flanks post laparoscopic sleeve gastrectomy and bariatric surgeries
ABSTRACT
This method was applied to perform a comparative study of optical purity of some generic solid pharmaceutical products of esomeprazole [capsules, tablets] manufactured locally and in some neighbouring countries for the determination the percentage of R enantiomer. A product of under license company was used for comparison of the results. The study was performed by using a validated HPLC method on chiral column Nucleocel Alpha S and a mixture ethanol: hexane [70:30, v/v] as a mobile phase, the flow rate was 0.65 ml/min, and the detection was carried out using UV detector at 302nm. The temperature of column was set at 25[degree]C. The study showed that some samples were not polluted with R enantiomer, while the others contained this enantiomer in the range of 0.1-2.24%
Subject(s)
Chromatography, High Pressure Liquid , Optical Phenomena , Omeprazole/chemical synthesis , Chemistry, PharmaceuticalABSTRACT
Bile duct injury is one of the most serious complications of cholecystectomy. Proper diagnosis and appropriate treatment of bile duct injury are paramount in preventing life-threatening complications of cholangitis, biliary cirrhosis, portal hypertension, end stage liver disease and death. Sixty patients with postcholecystectomy bile duct injury were managed in Ain- Shams University Hospitals during the period from April 2003 till January 2007. The age of the patients ranged from 28 to 65 years [average 35 years]. The patients were assessed clinically, then by full laboratory investigations. Abdominal ultrasonography was performed as the first radiological investigation to diagnose biliary leakage and/or intrahepatic biliary radicle dilatation. Then MRCP was done to identify the nature and the type of the lesion. The initial goal of the treatment was to control sepsis by broad spectrum antibiotics, to aspirate bile by U/S or CT guided drainage, and to decompress the biliary tree by ERCP and stent insertion [in patients with distal bile duct or minor bile duct leaks: 30 patients = 50%] or by PTC and stenting [in patients with proximal bile duct leaks or total occlusion of the major bile ducts: 30 patients = 50%]. Patients with cystic duct or minor bile duct leaks [10 patients = 16.7%] were adequately treated by the above mentioned protocol without further complications. While patients with major bile ducts leaks or occlusion [50 patients = 83.3%] required delayed reconstruction by Roux-en-y hepaticojejunostomy after 6-8 weeks. These patients were followed up for 6-36 months [average 18 months]. 47 patients [94%] showed favorable postoperative results with no further complications. Three patients [6%] showed postoperative stricture of the anastomosis which responded to PTC pneumatic balloon dilatation. The control of sepsis and the ongoing bile leak is the primary goal of the initial management of bile duct injury. A delayed elective reconstruction of major biliary injuries following cholecystectomy, is associated with less complications compared to acute repair under suboptimal circumstances