Impact of sleeve gastrectomy on weight loss, comorbidities of obesity, and quality of life in Saudi Arabia

Background and aim of the work: Laparoscopic sleeve gastrectomy [LSG] proved to be an effective operation for control of obesity and associated comorbidities. The aim of this study was to evaluate the impact of this operation on weight reduction, improvement of obesity comorbid diseases, and the quality of life [QoL]

Patients and method: A cross sectional web-based survey was conducted between June and October 2016. A total of 660 patients who was subjected to LSG volunteered in the survey and answered the online questionnaire which consisted of 30 items [multiple choice and short answered questions]

Results: the study involved 425male patients [64.4%] and 235 female patients [35.6%]. The mean preoperative BMI was significantly reduced from 38.6+/-9.1 kg/m2 to 28.4+/-6.9kg/m2 after a mean duration of 24+/-5.6 months following LSG. There was highly significant improvement [P< 0.001] in obesity comorbid diseases; however, the improvement was significant [P< 0.05] for improvement in sexual performance. The patient satisfaction from the weight reduction after LSG was rated as excellent by 68.2% of participants, as very good to good by 24.2% of participants, and as just accepted by 1.8%. 5.8% of patients had no changes or even gain weight after LSA [P>0.05]. 92.4% considered that their quality of life became better and would recommend the sleeve gastrectomy for other obese people who suffer from the obesity

Conclusion: laparoscopic sleeve gastrectomy is a good option for those with morbid obese patients as regard weight reduction, improvement of obesity comorbid diseases, and their quality of life

value of signal-averaged electrocardiogram and QT dispersion as predictors of arrhythmic vulnerability in patients with left ventricular hypertrophy

Left ventricular hypertrophy [LVH] predicts increased risk for ventricular arrhythmias [VAs] which probably accounts for the elevated risk of sudden cardiac death. To investigate the value of signal-averaged electrocardiogram [SAECG] and QT dispersion as noninvasive markers for ventricular arrhythmias in patients with LVH. We subjected 60 patients with LVH;30 hypertensive [group 1], 15 with hypertrophic cardiomyopathy [HCM] [group II] and 15 with valvular aortic stenosis [group III] to a complete echo-Doppler examination, 12-lead electrocardiogram and SAECG for estimation of left ventricular mass index [LVMI], detection of QT dispersion and late diastolic potentials [LDPs]. Ventricular arrhythmias were detected in 32% of patients with LVH. LDPs were detected in 17% of patients with LVH. All patients with LDPs had VAs. All VAs in patients with LDPs were of Lown grade [2] and [3], whereas most of VAs in patients without LDPs were of Lown grade [1]. Patients with LVH had significantly high QT dispersion, QTc dispersion and LVMI when compared to control subjects [P=0.04, 0.03 and 0.01, respectively]. Patients with HCM had significantly high QT dispersion, QTc dispersion and LVMI when compared to group I [P=0.02, 0.03 and 0.02, respectively] and group II [P=0.02, 0.02 and 0.04, respectively]. Significant correlation was found between LVMI and LDPs as well as QT and QTc dispersion [P=0.042 for LDPs, 0.036 for QT dispersion and 0.028 for QTc dispersion]. Of the many ECG and echocardiographic variables subjected to univariate and multivariate analysis, only three were identified as significant independent predictors of VAs: QT, QTc dispersion, LVMI and LDPs [P=0.006 and 0.04 for QT dispersion; 0.008 and 0.043 for QTc dispersion, 0.008 and 0.033 for LVMI and 0.0001 and 0.0001 for LDPs]. QT dispersion, QTc dispersion, LVMI and LDPs may be a useful adjuncts to the noninvasive assessment of patients with LVH, particularly in the prediction of sudden death

Study of left ventricular mass in patients above 60 years with isolated systolic hypertension

The study comprised 40 patients with ISH, 21 males and 19 females, their age ranged between 60-80 years [mean 65 +/- 7.25] and 20 healthy subjects of matched age and sex as a control group. This study revealed highly significant increase in left ventricular mass [LVM] and left ventricular mass Index [LVMI] in the whole test group versus control group while a non significant differences were observed in these parameters when comparing male versus female subgroups; subgroup with body mass index [BMI] >30 versus subgroup with BMI <30, and subgroup with hypertension HTN >5 years versus subgroup with HTN <5 years. A nonsignificant increase in LVM and LVMI in subgroup with mild ISH versus control, while a significant increase in these parameters was observed in subgroups with moderate and severe IS versus control and between the 3 subgroups of mild, moderate and severe ISH

genetic susceptibility and value of lipoprotein screening in offsprings of parents with premature coronary artery disease

In a study to uncover any genetic susceptibility to develop premature coronary artery disease [PCAD], serum total cholesterol [TC], triglycerides [TG], high density lipoprotein cholesterol [HDLc], low density lipoprotein cholesterol [LDLc], lipoprotein [a] [LP [a]] and apo [B], were determined in 106 members of 20 families of parents with PCAD, and 40 individuals of 10 normal families. The aim is to identify children at increased risk of developing PCAD. The results revealed highly significant increase of LP [a] among diseased parents and their offsprings, tendency of change in the other types of lipoproteins and significant only in TC and LDLc among offsprings, and autosomal mode of inheritance in LP[a] and recessive in TC and LDLc

Interpretation of Argyrophilic nucleolar organizer regions[AgNORS] count in cervical smears

The AgNOR staining technique for nucleolar organizer regions [AgNORs] was applied to 50 cervical smears of suspicious cases. The mean numbers of AgNORs in normal cervical cells were: superficial cells [2.3], intermediate cells [2.6], basal cells [2.5] and endocervical cells [2.4]. The mean number of AgNORs dots in mild dysplastic cells was [2.8] and of moderate, severe dysplastic cells were [3.6], [4.1], respectively, while in malignant cells was [4.0]. The AgNOR stain is useful in the differentiation between normal, dysplastic and malignant cells. No significant difference between mean number of AgNORs dots in normal and mild dysplastic cells, also between severe dysplastic and malignant cells

effect of iron deficiency anemia on placental weight and ratio

Placental weight and placental ratio [placental weight/birth weight] were determined in 500 women delivered in Obstetrics and Gynecology Department, Tanta University Hospital. Half of them with normal hemoglobin and mean corpuscular volume and 250 women with iron deficiency anemia [Hb <11 g/dl and MCV <80 fl]. It was observed that placental weight and ratio increased significantly in anemic group. The importance of this discordance of placental weight and birth weight was discussed

Toxoplasmosis gondii and dilated cardiomyopathy; serological and echocardiographic study

The present study comprised 50 patients [36 males and 14 females, 10 - 70 years old] and 15 normal subjects of matched age and sex as control group. They were clinically diagnosed as cases of advanced idiopathic dilated cardiomyopathy [DCM]. It was shown that the incidence of toxoplasmosis seropositivity was 14/50 [28%] in these patients, 5/14 [35.7%] with IgM seropositivity and 9/14 [64.3%] with IgG seropositivity. There was no relation between the toxoplasmosis serological profile [i.e. the magnitude or the type of antibody] and the studied echocardiographic parameters

Vasodilators: a possible new line of therapy for recurrent aphtous stomatitis

Numerous therapeutic regimens have been used for the treatment of RAS, but permanent remission have not been obtained by any modality. Therapy was chiefly symptomatic and supportive. The present work suggested a new line of therapy for RAS, which proved markedly effective in shortening the healing period as well as prolongation of the relapse free period. Systemic and local nitrites as well as nifedipine can be used to fulfill that purpose

serum magnesium level in ischemic heart disease and relathionship to cardiac complications

To evaluate the serum magnesium [Mg] levels in patients with ischemic heart disease [IHD], eighty five patients with IHD were selected from patients of coronary care unit in Mansoura University Hospital 52 with chronic IHD without myocardial infraction [MI] and 33 cases with acute MI 25 cases out of the 52 patients with chronic IDH were presented by arrhythmias and remaining 27 patients had no arrhythmias-On the other hand 16 cases with acute MI were presented by arrhythmias and remaining 17 patients were non arrhythmic. In the present study the mean serum Mg levels in patients with IHD- with and without AMI; patients with chronic IHD and patients with acute MI were significantly lower [p<0.001] than the level in normal controls. There was in significant decrease in mean serum Mg in subgroup with arrhythmias when compared to those without arrhythmias [p>0.05], however a insignificant decrease [p<0.001] was observed in patients with IHD [with and without MI] patients with chronic IHD develop left ventricular failure [LVF] when compared to those who escape this complication in the same group. Also there was significant hypomagnesemia in patients without acute MI who complicated by premature ventricular contraction [PVCs] when compared to normal controls from the present study we can conclude that hypomagnesemia- in addition to hypokalemia - is a predisposing factor to dangerous complication in patients with IHD and the addition of Mg to the conventional therapy can reduce the incidence of complications in these patients

P-wave changes in bilharzial patients with chronic obstructive pulmonary disease

55 patients with C.O.P.D. including 18 with bilharzial hepatosplenomegaly and 7 patients with bilharzial cor-pulmonale together with 10 normal control individuals were the material of the present study. P.E.F.R. was taken as the criterion of the presence of C.O.P.D. and changes of arterial blood gases as criteria to score the severity of C.O.P.D. P-Wave changes known to score the severity of C.O.P.D. [axis and amplitude] were assessed. The presence of associating hepatosplenic bilharziasis with or without bilharzial cor-pulmonale in patients with C.O.P.D. having matching severity were found to changes the incidence of P-Wave axis and amplitude changes in C.O.P.D. This leads to the conclusion that the P-Wave changes taken as criteria for screening the severity of C.O.P.D. are no longer valid in the presence of associating hepatosplenic bilharziasis with or without bilharzial cor-pulmonale in patients with C.O.P.D