Increased gallstone formation after sleeve gastrectomy and the preventive role of ursodeoxycholic acid.

BACKGROUND AND STUDY AIMS: To investigate the incidence of gallstone formation, and the use of Ursodeoxycholic Acid (UDCA), weight loss and serum lipid profile changes following obesity surgery. PATIENTS AND METHODS: Patients who underwent bariatric surgery due to obesity were retrospectively reviewed and divided into 2 groups for their prophylactic UDCA use. Patients who had a previous gallbladder pathology and ones who did not have a preoperative ultrasonography (US) were excluded. The patients who have returned to our clinic for a control ultrasound between 6 and 18 months following the surgery were included in this study, but only if they did not have any gall bladder pathology demonstrated with an US prior to surgery. Body mass index (BMI) and lipid profile measurements were also recorded. RESULTS: Of the 108 patients who had undergone obesity surgery, it is reported that 42 (38.9%) were given UDCA as a preventative medication, and 66 (61.1%) were not prescribed any preventative medications. During the ultrasound controls in the postoperative period between 6 and 18 months after surgery, gallbladder stones were seen in 42 patients (38.9%) and biliary sludge development was detected in 5 patients (4.6%). A total of 47 patients (43.5%) developed gallbladder pathology. Fewer patients who took UDCA developed gallstones when compared with the patients who did not take UDCA (10% vs 33%). Also, there is a correlation between BMI loss rate and the frequency of gallstone development. Though the decrease in triglyceride (TG) levels was higher in patients with gallstone development, this decrease was not statistically significant. CONCLUSIONS: Stone or sludge development in the gallbladder due to rapid weight loss after obesity surgery is quite common. However, we observed that the gallstone development decreased significantly with the prophylactic use of UDCA in patients who had undergone obesity surgery.

Contaminated tooth brushes-potential threat to oral and general health.

BACKGROUND: Tooth brushing is most common method of maintaining oral hygiene. In removing plaque and other soft debris from the teeth, tooth brushes become contaminated with bacteria, blood, saliva and oral debris. These contaminated tooth brushes can be a source of infection. AIMS AND OBJECTIVES: The aim of the present study was to evaluate the presence of microorganisms in the tooth brushes and to investigate the effect of disinfectants such as chlorhexidine gluconate, sodium hypochlorite and water to decontaminate them. MATERIALS AND METHODS: Twenty-one children were asked to brush their teeth for 5 days with a tooth brush. The tooth brushes were put in Robertson's Cooked Meat broth and were observed for growth of Streptococcal microorganisms. These tooth brushes were then placed in disinfectants such as 0.2% chlorhexidine gluconate (Group I), 1% sodium hypochlorite (Group II) and water (Group III) for 24 hrs and then cultured again. Reduction of growth of microorganisms was seen in Group I, Group II and remnants of growth seen in Group III. CONCLUSION: We conclude that the use of disinfectant for a tooth brush is a must for every individual at least at regular intervals.