Laparoscopic versus open adhesiolysis in patients with bowel obstruction

Background: Adhesions are bands of scar tissue that form between organs. In the abdomen, they form after an abdominal surgery or after a bout of intra-abdominal infection [i.e., pelvic inflammatory disease, diverticulitis]. More than 95% of patients who undergo abdominal surgery develop adhesions; these are nearly inevitably part of the body's healing process. Though most adhesions are asymptomatic, some can cause bowel obstructions, infertility, and chronic pain

Objectives: Concerning whether patients with chronic pelvic pain benefit from laparoscopic adhesiolysis or whether any appearing advantage is a placebo effect

Materials and Methods: This review was conducted using a comprehensive search of MEDLINE, PubMed, EMBASE, Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials from January 1, 1990, through October 31, 2017

Results: The spectrum of treatments for a small-bowel obstruction ranges from conservative management with bowel rest to surgical intervention, sometimes involving bowel resection. The caveat with regard to surgical treatment is that while surgery may be required to release symptomatic adhesions, postoperative reformation of these adhesions is common. Debate continues as to whether laparoscopic adhesiolysis yields added benefit in terms of decreasing postoperative adhesion reformation; however, promising results have been obtained with Open approach

Conclusion: Laparotomy with open adhesiolysis has been the treatment of choice for acute complete bowel obstructions. Patients who have partial obstructions, with some enteric contents traversing the obstruction, might similarly require surgery if nonoperative measures fail

Public awareness of systemic lupus erythematosus in Al-Dammam city in Saudi Arabia

Background: Systemic lupus erythematosus [SLE] is an autoimmune disease where the body's immune system attacks its own healthy tissue. It can affect many organs such as skin, joints, brain, kidneys and other organs

Objectives: to evaluate the knowledge toward Systemic Lupus Erythematosus [SLE] among citizens in Al-Dammam city

Methods: a questionnaire-based quantitative cross-sectional study which focuses on determining the knowledge of Systemic lupus erythematosus in Al-Dammam city

Results: 240 participants filled the surveys, 130 participants [54%] have no idea about SLE. The majority of respondents had no clear idea regarding treatment and complications of the disease. 32% respondents had idea that SLE is more prevalent among females. In fact, this disorder is reported more prevalent in women

Conclusion: this study indicated that the public have low awareness with some misconception regarding the SLE. The awareness campaigns are needed to increase the awareness about SLE which will be helpful to educate the public about its symptoms and methods of treatments

Post-operative anticipation of outcome after cholecystectomy

Background: A substantial group of patients with gallstone disease experience negative outcome after surgical removal of the gallbladder [cholecystectomy]. Early identification of these patients is important

Purpose: The purpose of the study was to recognize predictors [trait anxiety and clinical symptoms] of negative symptomatic outcomes at 5 weeks after cholecystectomy

Materials and Methods: Consecutive patients [n=66], 18-60 years, with symptomatic gallstone disease, completed symptom checklists and the state-trait anxiety inventory preoperatively and at 6 weeks after cholecystectomy. Results: High trait anxiety was the only predictor of persistence of biliary symptoms at 6 weeks after cholecystectomy [OR=6.79]

Conclusion: In addition to clinical symptoms, high trait anxiety is a predictor of negative symptomatic outcome at 6 weeks after cholecystectomy. Trait anxiety should be evaluated to aim at a patient-tailored approach in gallstone disease

change in mitral regurgitation severity after trans-catheter aortic valve implantation

Mitral regurgitation [MR] is a frequent finding in patients with aortic stenosis [AS]. The objective of this study is to assess the change in MR severity following transcatheter aortic valve implantation [TAVI]. MR changes were assessed by comparing transthoracic echocardiography before and after the procedure. The prosthetic aortic valve was successfully implanted in 65 patients. The number of patients with pre-procedure MR was reduced from 58 [85.3%] to 43 [63.2%] [p < 0.001]. Vena contracta width was decreased from 0.47 +/- 0.28 to 0.25 +/- 0.21, [p = 0.043]. About 59.4% [19/32] of those who had moderate to severe MR and 85.7% [12/14] of those with severe MR experienced a significant improvement in MR after the procedure [p < 0.001]. Improvement in MR was independent of prosthetic valve type with 54.2% in CoreValve and 43.9% in Edwards SAPIEN, p = 0.424; valve sizes were 25.8 +/- 1.9 in those who improved vs. 25.0 +/- 1.9 mm in those who did not improve, p = 0.105; femoral approach was 51.2% and apical approach was 41.7%, p = 0.457; MR etiology was 48.1% in organic and 48.6% in functional, p = 0.968; and operative risk was 50.0% in EuroScore >20 and 48.6% in EuroScore <20, p = 0.356. TAVI is associated with a significant improvement in MR, especially in severe types. The lack of influence of MR improvement by the etiology of MR, the type of valve implanted, and the operative risk need to be confirmed in a larger multi-center study

Saudi oncology society and Saudi urology association combined clinical management guidelines for urothelial urinary bladder cancer

In this report, updated guidelines for the evaluation, medical, and surgical management of transitional cell carcinoma of the urinary bladder are resented. They are categorized according the stage of the disease using the TNM staging system 7[th] edition. The recommendations are presented with supporting level of evidence

Saudi oncology society and Saudi urology association combined clinical management guidelines for prostate cancer

In this report, updated guidelines for the evaluation, medical, and surgical management of prostate cancer are presented. They are categorized according the stage of the disease using the tumor node metastasis staging system 7[th] edition. The recommendations are presented with supporting evidence level

Saudi oncology society and Saudi urology association combined clinical management guidelines for renal cell carcinoma

In this report, updated guidelines for the evaluation, medical and surgical management of renal cell carcinoma are presented. They are categorized according the stage of the disease using the tumor node metastasis staging system 7[th] edition. The recommendations are presented with supporting evidence level

Saudi oncology society and Saudi urology association combined clinical management guidelines for testicular germ cell tumors

In this report, updated guidelines for the evaluation, medical, and surgical management of germ cell tumor of testes are resented. They are categorized according the stage of the disease using the tumor-node-metastasis staging system 7[th] edition. The recommendations are presented with supporting level of evidence