Comparison between laparoscopic pylorus-preserving gastrectomy and laparoscopic distal gastrectomy for overweight patients with early gastric cancer

Purpose@#Laparoscopic pylorus-preserving gastrectomy (LPPG) has a nutritional advantage over laparoscopic distal gastrectomy (LDG), however, may be less beneficial in overweight patients in terms of weight loss. The purpose of this study was to compare LPPG and LDG in overweight patients with early gastric cancer. @*Methods@#Clinicopathologic data of overweight patients (body mass index [BMI], ≥25 kg/m2 ) who underwent LPPG (n = 63) or LDG (n = 183) in 2016–2018 were retrospectively reviewed. In the LDG group, patients with Billroth-II anastomosis were separately grouped (LDG B-II, n = 66). Changes in BMI, hemoglobin, albumin, and total protein were compared among groups. @*Results@#Changes in BMI were not significant different among groups. The LPPG group had significantly higher albumin than the LDG group at postoperative 6 months and 1 year. The LPPG group had higher total protein than the LDG group at postoperative 2 years. The LPPG group had a higher complication rate of Clavien-Dindo classification III or higher (20.6%) than the LDG group (8.2%, P = 0.007). However, after excluding pyloric stenosis, there was no significant difference among groups (LPPG vs. LDG, P = 0.290; LPPG vs. LDG B-II, P = 0.921). @*Conclusion@#LPPG and LDG groups showed similar weight loss. However, the LPPG group had higher albumin and protein levels than the LDG group of overweight patients. Thus, it is not necessary to select LDG only for weight loss. LPPG may be selected as one option due to its potential nutritional benefit when pyloric stenosis is properly managed.

Knowledge, Attitude and Practices of Saudi Pediatricians Regarding Newborn Hearing Screening in Saudi Arabia

Background: Late detection of permanent congenital and early and onset-hearing loss (PCEHL) severely affectslinguistic, cognitive, and educational development in children. Routine newborn hearing screening (NHS) hasprovided opportunities for children under the DHH category to be identified shortly after birth. Pediatricianshave the biggest role in undertaking the assessment and physical interventions on hearing among newborns.Methods: For this study, the participants who took part in the survey were Saudi pediatricians. The study designwas based on a cross-sectional approach where convenience sampling was adopted as a technique for datacollection. Questionnaires were used as the only tool for data collection. Results: From the study, the majority ofrespondents were male, registering up to 57.9%. From the survey, documenting the state of the NHS program inSaudi Arabia, it turns out that it is important to have a typical screening protocol, regarding the working nationalpolicy. Up to 47.7% of the respondents replied that hearing screening instigates parental concern and anxiety,contradicting other studies that assert the opposite. The respondents, however, articulated concerns aboutrequiring additional information on some of the particular details that are related to NHS. However, majority ofthem (44.4%) were confident in explaining the process to the parents of the newborns. Conclusion: The study canbe seen to shed light on the attitudes, existing knowledge, and practice levels amongst pediatricians in SaudiArabia. It shows that any NHS program is considered profitable if timely and appropriate referrals can be madeto ensure follow-ups.

Evaluation of Recent Surgical Updates Regarding Diagnosis and Management of Intestinal Obstruction

Background: Intestinal obstruction is a painful abdominal condition that is ultimately managed by surgical methods.Proximal intestinal obstructions usually present clinically with pain, while distal obstructions havepronounced vomiting and absolute constipation. The junior surgeon should take careful note of anamnesis, as theobstruction is mainly a clinical diagnosis. Objectives: We focus in this paper on intestinal obstruction, diagnosticapproach, and surgical interventions, and only relevant studies are discussed. Methodology: PubMed databasewas used for articles selection, and papers on intestinal obstruction and pseudo-obstruction were obtained andreviewed. Conclusion: In summary, certain factors increase the vulnerability of patients and developing intestinalobstruc-tion, most notably including adhesions, neoplasms, and abdominal herniation. Exploratory laparot-omyis indicated when patients do not improve within 48 hours of conservative therapy, or perforat-ed bowels are seenon radiography (as air-under-the-diaphragm). Colonoscopy is valuable in ruling out mechanical obstruction anddecompressing a distended bowel. Team effort is needed to avoid non-urgent operation, and to identify and treatcurrent dehydration and correct depleted electro-lytes, while also preventing systemic inflammation, ischemia,and sepsis

Percutaneous needle aspiration versus catheter drainage in treating hepatic abscess

Aim of the study: was to investigate the effectiveness of Percutaneous Needle Aspiration in comparison to continuous catheter drainage in the treatment of hepatic abscesses

Methods: A review of the scientific literature [From 1980 to October 2017] MEDLINE, EMBASE, SCOPUS, Current Contents, Cochrane Library, and Clinicaltrials.gov were searched to identify randomized controlled trials that investigated thoroughly the Percutaneous Needle Aspiration Versus Catheter Drainage in the treating of hepatic abscess and clearly met the inclusion criteria and the study primary endpoints [success rate, total resolution and mortality]. Identification of papers and data extraction were performed by independent researchers

Results: the search yielded six eligible RCTs covering 348 patients. The meta-analysis showed that outcomes in patients treated with PCD were superior to those in patients treated with PNA in terms of success rate [RR: 0.79, 95% CI=0.64-0.97; P = 0.04], days to achieve a 50% reduction in abscess cavity size [SMD: ?1.076, 95% CI 0.63-1.51; P < 0.00001] and overall clinical improvement [SMD: 0.71, 95% CI 0.35-1.09; P =0.0001]. On the other hand, no significant difference was notable in the duration of hospitalization [SMD: -0.15, 95% CI -2.03 to 1.72, P = 0.84] or procedure-related complications [RR: 0.48, 95% CI 0.13-2.58; P = 0.39]

Conclusion: The results of the present meta-analysis and systematic review indicated that PCD and PNA can be less safe and less invasive methods for the treatment of hepatic abscesses yet PCD is suggested to be more advantageous and superior to PNA

assessment of knowledge towards acute cholecystitis among general population of Albaha city

Background: Acute cholecystitis is an acute inflammation of the gallbladder, and it is the most common cause of acute pain in the right upper quadrant. It is a critical clinical problem representing up to 5% of emergency room visits

Objective: The aim of the present study was to assess the knowledge of the general population of Albaha City, Saudi Arabia towards acute cholecystitis [AC]

Methods: A representative sample of 634 subjects from both sexes, aged from 18-80 years who completed a standardized questionnaire was involved in the study

Results: Only 48 subjects had history of the disease with a prevalence rate of 7.57%. More than half of the participants [58.7%] recorded family history of AC in one of their direct relatives. Great percent of the study participants considered obesity, high cholesterol and high triglycerides responsible for increased incidence of AC [59.9%, 54.3% and 66.9%]. A high percentage of the participants [55.2%, 48.3%, 38.2%, 62.8%, 36.9% and 54.3%] did not know whether their food or habits could predispose to AC. Higher percentages considered intolerance to fatty meals, nausea and vomiting as symptoms of AC [55.5%, 48.9 %and 46.7% respectively]. Most of the participants [75.7%] did not receive any information about AC prevention. Their established information was highly or to some extent effective in changing the participants' life style [39.0% and 42.9% respectively]

Conclusion: This survey has been useful in determining the current regional knowledge towards AC among general population in Albaha city. Such study emphasizes the need for more efforts that focus on novel preventive strategies to overcome the onset of gallstones. Further much bigger collaborative national studies are recommended

Vitamin D deficiency in orthopedic patients, Riyadh, Saudi Arabia

BackgVound: Low levels of blood serum vitamin D have been connected to various musculoskeletal and non musculoskeletal conditions. Vitamin D lack shows up moderately high among different patient subpopulations, including patients with break non-union. We directed a review study to decide the pervasiveness of vitamin D lack what's more, inadequacy in an expansive populace of patients with orthopedic trauma

Methods: The review incorporated all patients who were over age 18 years, had no hazard components for vitamin D inadequacy and was dealt with for an intense break at a Level 1 injury focus

Results: Between April 2016 and October 2016, 100 injury patients had recorded serum 25-hydroxyvitamin D levels. The general commonness of joined vitamin D inadequacy/deficiency was 77%; commonness of vitamin D inadequacy alone was 39%. There were no actually critical [P < .05] age or sex contrasts among the populace. There did not seem, by all accounts, to be a regular distinction. Vitamin D inadequacy and deficiency in intense orthopedic injury, patients showed up extremely normal

Assist examination is expected to completely comprehend the clinical noteworthiness

Conclusion: The Pervasiveness of low serum levels of vitamin D among patients experiencing orthopedic trauma is extremely normal. Given the significance of vitamin D in musculoskeletal wellbeing, such low levels may adversely affect tolerant results

Bariatric surgery to treat obesity among adults

Background: bariatric surgery is one of the few effective treatments for morbid obesity, yet little information about weight outcomes after surgery in this demographic are available. We determined the effectiveness of bariatric surgery in reducing weight and body mass index [BMI] in adults

Materials and Methods: adults from 18 to 30 years old who had undertaken gastric bypass or adjustable gastric band surgery between May 2013 and November 2016 and who had complete follow-up data available were included in the present analysis. Mean weight and BMI before and one year after surgery were compared

Results: among 35 adults, Mean BMI and weight, and z-scores and percentile transformations were all significantly lower after surgery for the entire sample [P < 0.001]. Gastric bypass surgery presented significantly better weight loss outcomes for all anthropometric measures versus adjustable gastric band surgery [P < 0.05]. No perioperative complications were reported. Two patients who stopped taking supplements as prescribed experienced iron-deficiency anaemia within the year following surgery

Conclusions: our results show that bariatric surgery can markedly reduce weight among a predominantly adult patient's sample, and gastric bypass procedure in particular. These findings indicate that bariatric surgery has the potential to be safe and effective in substantially reducing weight in a group of adults who are at particularly high risk for obesity-related health consequences

Barriers and challenges in adopting Saudi telemedicine network: the perceptions of decision makers of health care facilities in Saudi Arabia

Despite emerging evidence about the benefits of telemedicine, there are still many barriers and challenges to its adoption. Its adoption is often cited as a failed project because 75% of them are abandoned or 'failed outright' and this percentage increases to 90% in developing countries. The literature has clarified that there is neither one-size-fit-all framework nor best-practice solution for all ICT innovations or for all countries. Barriers and challenges in adopting and implementing one ICT innovation in a given country/organisation may not be similar - not for the same ICT innovation in another country/organisation nor for another ICT innovation in the same country/organisation. To the best of our knowledge, no comprehensive scientific study has investigated these challenges and barriers in all Healthcare Facilities [HCFs] across the Kingdom of Saudi Arabia [KSA]. This research, which is undertaken based on the Saudi Telemedicine Network roadmap and in collaboration with the Saudi Ministry of Health [MOH], is aimed at identifying the principle predictive challenges and barriers in the context of the KSA, and understanding the perspective of the decision makers of each HCF type, sector, and location. Three theories are used to underpin this research: the Unified Theory of Acceptance and Use of Technology [UTAUT], the Technology-Organisation-Environment [TOE] theoretical framework, and the Evaluating Telemedicine Systems Success Model [ETSSM]. This study applies a three-sequential-phase approach by using three mixed methods [i.e., literature review, interviews, and questionnaires] in order to utilise the source triangulation and the data comparison analysis technique. The findings of this study show that the top three influential barriers to adopt and implement telemedicine by the HCF decision makers are: [i] the availability of adequate sustainable financial support to implement, operate, and maintain the telemedicine system, [ii] ensuring conformity of telemedicine services with core mission, vision, needs and constraints of the HCF, and [iii] the reimbursement for telemedicine services