Ramadan Fasting Increases Socialization in Patients Who Underwent Sleeve Gastrectomy: An Observational Study.

PURPOSE: The prevalence of obesity is increasing along with the number of sleeve gastrectomies. Patients' mental health and social life, along with their physical health, should be considered. Their cultural and religious values are an important part of treatment. Fasting is an important act of worship in all religions. Ramadan fasting is one of the five pillars of Islam. In this study, we aimed to investigate the effect of Ramadan fasting on quality of life in patients who underwent sleeve gastrectomy. MATERIALS AND METHODS: Data regarding the demographic characteristics, weight, the time elapsed after surgery, and the amount of liquid and solid food consumed during fasting were collected with two surveys, one of which was carried out at the beginning and the other at the end of Ramadan. In addition, the SF-36 health survey questionnaire was administered to evaluate the impact of Ramadan fasting on patients' quality of life. RESULTS: Fifty-one people participated in the first survey, but the second survey included 19 of them. While the median weight of the patients was 86.52 ± 17.78 kg before fasting, the median weight after 25 days of fasting was 83.31 ± 17.06 kg. A significant decrease was observed in weight after 25 days of fasting (p < 0.001). A comparison of the SF-36 scores for quality of life revealed a significant increase in the social functioning (p = 0.032). CONCLUSION: Ramadan fasting caused significant weight loss in patients who underwent sleeve gastrectomy. Besides, it did not adversely affect the quality of life, but rather increased social functioning.

The effects of L-carnitine and N-acetylcysteine on carbontetrachloride induced acute liver damage in rats.

AIM: To investigate the effects of L-carnitine (LCAR) and N-acetylcysteine (NAC) on carbon tetrachloride (CCl4)-induced acute liver damage in rats. MATERIAL AND METHODS: Totally, 40 rats in 5 groups were included in the study. The first group was the control group. Group 2 received CCl4 (2 ml/kg). Group 3 was given CCl4 + NAC (150 mg/kg). The rats in the Group 4 were administered CCl4 + LCAR (100 mg/kg), and the rats in the Group 5 were given CCl4 + NAC + LCAR. Both CCl4 and the treatment protocols were administered via intraperitoneal route for 10 days. Tissue oxidative stress and antioxidant markers were investigated in liver tissue and serum liver enzymes were measured. RESULTS: The levels of blood liver enzymes (ALT and AST) increased significantly in the Group 2. However, they decreased markedly in all treatment groups. While malondialdehyde and myeloperoxidase levels in the liver tissue samples increased significantly in the 2nd group, those levels were determined to be decreased significantly in all treatment groups. When the liver tissue antioxidant levels were evaluated; reduced glutathione and catalase decreased markedly in the 2nd group, but increased following the administration of NAC and LCAR. The activities of liver tissue superoxide dismutase did not differ significantly among the groups. In the histopathologic evaluation of liver tissues, on the other hand, diffuse hepatosteatosis was observed in all groups except the control group and there was no significant difference among the groups from the point of steatosis. CONCLUSION: LCAR and NAC were concluded to have beneficial effects on the acute liver damage induced by CCl4 administration (Tab. 1, Fig. 5, Ref. 52). Text in PDF www.elis.sk.

Liver transplantation following blunt liver trauma.

Due to developing medical technology worldwide, an increasing number of liver transplantations are performed for various indications. Liver transplantation has a limited but important role in specific life-threatening liver trauma cases, when initial therapeutic options fail to control the bleeding or when liver failure ensues. Herein we have reported a patient who required liver transplantation at 18 days after blunt liver trauma with acute liver failure. This case report suggested that liver transplantation is a potential treatment modality for a selected group of patients including pedratric cases who experience acute or subacute liver failure secondary to blunt trauma.

Cilostazol and diltiazem attenuate cyclosporine-induced nephrotoxicity in rats.

AIM: Cyclosporine (CsA), an important agent used in organ transplantation to prevent rejection, displays nephrotoxicity as the most important side effect limiting usage. In this study, we sought to evaluate the effects of cilostazol and diltiazem to counter the nephrotoxicity induced by the calcineurin inhibitor CsA. MATERIALS AND METHODS: Animals were randomly divided into seven groups, each consisting of eight animals: sham, controls, cilostazol, diltiazem, CsA, CsA plus diltiazem, and CsA plus cilostazol treatment. At the end of a 60-minute ischemic period, we administered the drugs after reperfusion for 7 days thereafter. CsA (10 mg/kg/d) was intraperitoneally for 7 days; cilostazol (10 mg/kg/d) orally by catheter for 7 days; diltiazem (5 mg/kg/d) intraperitoneally for 7 days. At the end of the 7-day treatment period, blood and tissue samples were harvested for biochemical, and serological evaluation. RESULTS: Ischemia-reperfusion injury significantly increased malondialdehyde (MDA) levels as well as decreased catalase (CAT) activities and superoxide dysmutase (SOD) content. The lowest MDA mean level was observed in the diltiazem and, the highest in the control group. The lowest CAT mean levels were noted in the CsA and diltiazem groups with highest CAT content was in the CsA and cilostazol groups. The lowest SOD mean level occurred in the sham group; the highest, in the CsA group. CONCLUSION: Cilostazol and especially diltiazem were effective to mitigate renal ischemia-reperfusion injury.

The protective effects of ketamine and propofol in obstructive jaundice: an experimental study.

OBJECTIVE: In this study, we investigated the protective effects of frequently used intravenous anesthetics (ketamine, propofol, thiopental, and fentanyl) in oxidative stress in a rat liver model of obstructive jaundice. MATERIALS AND METHODS: Thirty-two Wistar albino rats were divided into four groups in a randomized fashion. All rats were subjected to laparotomy, common bile duct ligation and severance on day 0. Following 7 days, laparotomy was again performed using ketamine, propofol, pentobarbital, or fentanyl anesthesia. After 2 hours, the animals were sacrificed and tissue specimens were acquired for histopathological scoring and determination of malondialdehyde (MDA), superoxide dismutase (SOD) and catalase (CAT) activities. RESULTS: All rats demonstrated enlargement in the bile duct, obstructive jaundice, and histopathologic ductal proliferation. MDA and SOD levels were significantly lower in the ketamine group compared with the thiopental and fentanyl groups. CAT was significantly increased in the ketamine group compared with the other groups. The best portal polymorphonuclear leukocyte and necrosis scores were in the ketamine group, but this difference was not statistically significant ( p=0.07). CONCLUSION: Ketamine and propofol were observed to cause the least amount of oxidative stress in this rat model of induced oxidative stress generated by ligation of the common bile duct. This experiment is the first study on this subject in the literature (Tab. 3, Ref. 65).

The comparison of the effects of hepatic regeneration after partial hepatectomy, silybum marinaum, propofol, N-acetylcysteine and vitamin E on liver.

AIM: We investigated the comparison of the effects of N-acetylcysteine, silybum marinaum, propofol, and vitamin E on liver hepatic regeneration after partial hepatectomy. METHOD: Forty-eight rats were randomized into 6 different groups of the same age and weight. After partial hepatectomy, all animals were resuscitated with 5 ml of isotonic sodium chloride solution administered subcutaneously while group 1 (sham) did not receive any injection, group 2 (control) received serum physiologic intraperitoneally, group 3 received 25 mg /kg of propofol intraperitoneally, group 4 received 20 mg/kg of N-acetylcysteine intraperitoneally, group 5 received 400 mg/kg of vitamin E intraperitoneally, and group 6 received 10 mg/kg of silybum intraperitoneally. None of these groups were given antibitotics. On the third day, a half of the rats, and on the seventh day, the other half of rats were reoperated and sacrificed. RESULTS: Blood samples were used for biochemical parameters (AST, ALT). Ki-67 proliferation index was used for histopathologic parameters. A statistically meaningful difference was detected in silybum, vitamin E, N-acetylcysteine, and propofol groups for AST, ALT levels when compared to control and sham groups (p<0.05). Ki-67 regeneration proliferation index of all groups, which were given agents on the third and seventh days were statistically higher than the control and sham groups (p<0.05). During the evaluation, AST, ALT, Ki-67, Ro (regeneration value) levels of silybum group displayed a statistically significant difference according to other groups (p<0.05). CONCLUSION: Our experimental study indicates that hepatic regeneration after partial hepatectomy was meaningful and significant in groups with intraperitoneal administration of silybum marinaum,vitamin E, N-acetylcysteine and propofol. Hepatic regeneration rate was particularly higher in silybum group compared to other groups (Fig. 16, Ref. 26).

The anterior extraperitoneal approach to the rare presacral/ retroperitoneal schwannoma.

Presacral/retroperitoneal schwannomas are extremely unusual and their surgical approach is challenging. Various surgical approaches have been proposed. Here we describe our experience with the anterior extraperitoneal approach for the Type 3 presacral/retroperitoneal schwannoma. A 33-year-old woman presented with a history of infertility and a presacral/retroperitoneal mass. The patient underwent abdominal/pelvic CT and MRI that demonstrated presence of a solid, well circumscribed Type 3 presacral/retroperitoneal schwannoma. The anterior extraperitoneal approach was successfully used to remove the presacral/retroperitoneal schwannoma. The histopathological evaluation confirmed the preoperative diagnosis. The anterior extraperitoneal approach is helpful as an alternative approach in the surgical management of benign Type 3 presacral/retroperitoneal schwannomas (Fig. 4, Ref. 15).

Protective effects of N-acetylcysteine and beta-glucan pretreatment on oxidative stress in cecal ligation and puncture model of sepsis.

This study was designed to compare the effect of pretreatment with N-acetylcysteine (NAC) and beta -glucan (beta GLU) on inflammatory response in a rat model of sepsis. The study was performed in the animal laboratory of the Kahramanmaras Sutcu Imam University, School of Medicine. Forty rats were randomized into four groups (control, sham, NAC, and beta GLU). Control and Sham groups received saline or NAC (200 mg/kg, po) in the NAC group and beta GLU (50 mg/kg, po) in the betaGLU group via intragastric gavage once a day for 10 days and 30 min prior to surgery. Sepsis was induced by cecal ligation and puncture (CLP) in rats. In the NAC, beta GLU, and control groups, a laparotomy was performed with the CLP procedure. In the sham group, laparotomy was performed and cecum was manipulated but not ligated or perforated. TNF-alpha and IL-6 levels were significantly elevated in the control group and decreased in the NAC and beta GLU groups. IL-10 levels were significantly increased in the beta GLU group (p < .05). Superoxide dismutase and catalase levels in the liver tissue were significantly increased in the NAC and beta GLU groups, whereas superoxide dismutase levels were higher in the beta GLU pretreatment group than the NAC pretreatment group (p < 0.05). Malondialdehyde levels in the liver tissue were significantly elevated in the control group and decreased in the NAC and beta GLU groups (p < .05). Prophylactic administration of NAC or beta GLU similarly ameliorated sepsis syndrome by reduction of the proinflammatory cytokines and increase of the anti-inflammatory cytokine levels and accession of cellular antioxidants, which protect cells from oxidative stress, thereby recruiting inflammatory cells into tissue.

Diagnosis of fasciola hepatica cases in an operating room.

Fascioliasis is a zoonotic disease that is acquired by ingestion of the metacercaria form on uncooked aquatic plants, and humans act as an accidental host. Diagnosis is confirmed by the demonstration of the parasites or evidence of them in faeces and serology. In the absence of these data, delays or misdiagnosis may occur since it may mimic many diseases. In this study, we present three cases, among them two were similar to the above-mentioned statement. The first case, to the best of our knowledge, is the first case with adult-type living fluke in the gall bladder, diagnosed by laparoscopic cholecystectomy.

An unusual presentation of polyarteritis nodosa: A case report.

Polyarteritis nodosa with gallbladder involvement is a rare condition. Autosomal dominant polycystic kidney disease is also a rare condition and rarely complicated. We describe an extremely rare case of Polyarteritis nodosa, involving gallblader and ureter without obstruction, in a patient with autosomal dominant polycystic kidney disease. To the best of the authors' knowledge, such a case has not been reported previously.

An unusual presentation of polyarteritis nodosa: A case report / Una manifestación poco usual de la poliarteritis nodosa: Reporte de un caso

Polyarteritis nodosa with gallbladder involvement is a rare condition. Autosomal dominant polycystic kidney disease is also a rare condition and rarely complicated. We describe an extremely rare case of Polyarteritis nodosa, involving gallblader and ureter without obstruction, in a patient with autosomal dominant polycystic kidney disease. To the best of the authors' knowledge, such a case has not been reported previously.

La periarteritis nodosa con compromiso de la vesícula es una condición rara. La enfermedad poliquística renal autosómica dominante es también una condición rara y raramente complicada. Describimos un caso extremadamente raro de poliarteritis nodosa, con compromiso de la vesícula y el uréter sin obstrucción, en un caso de enfermedad poliquística renal autosómica dominante. Al leal saber y entender de los autores, no ha sido reportado antes un caso como éste.

Nonalcoholic Wernicke's encephalopathy with prominent astasia and optic neuropathy.

OBJECTIVE: To present a case with nonalcoholic Wernicke's encephalopathy (WE) developing astasia and optic neuropathy as major sequelae. CLINICAL PRESENTATION AND INTERVENTION: A 47-year-old woman developed WE following operation for pyloric stenosis. She received total parenteral nutrition before and after operation, but on the second postoperative day she developed visual hallucination and confusion, followed by nystagmus, ophthalmoplegia, apathy, dysarthria and coma. Although the patient has recovered with thiamine treatment, astasia and optic neuropathy persisted s major morbidities. CONCLUSION: The report shows that astasia and optic neuropathy may be prominent sequelae in some patients with WE.

Association of adenosine deaminase, superoxide dismutase, and catalase activities with Helicobacter pylori.

Our purpose was to investigate associations between adenosine deaminase (ADA), superoxide dismutase (SOD), and catalase (CAT) activities and H. pylori.Ninety-nine patients were studied. Eight antral mucosal biopsies were taken for biochemical assessment of ADA, CAT, AND SOD activity and histological assessment. H. pylori density wAS evaluated according to the updated Sydney system. Patients were divided into three groups according to Sydney classification. ADA activity was found to be higher in patients having H. pylori in the present study. Also, ADA activity was higher in patients with a severe density of H. pylori. SOD level was found to be significantly higher with increased H. pylori density in our study (P < 0.05). In addition, SOD activity was higher in it H. Pylori-positive than H. pylori-negative patients. We did not find CAT activity in some antral tissue specimens. The significantly high levels of ADA activity in patients with H. pylori infection may reflect the regulator role of ADA in acid secretion. The higher ADA level with increased H. pylori density and H. pylori positivity indicate the probable malign lymphoid process of the stomach. But these findings must be confirmed with larger studies that include different gastric lesions.

Experimental hydatid disease of the liver.

Hydatid disease caused by Echinococcus granulosis is an endemic problem in many parts of the world and the liver is the most frequently involved organ. A suitable experimental model for hydatid disease of the liver, resembling naturally infected livers, is established in this study by injection of protoscolices via the mesenteric vein of the mice. This model can be used in assessment of the efficacy of various agents in treatment of hydatid disease of the liver.

Comparison of prosthetic materials used for abdominal wall defects or hernias (an experimental study).

The prosthetic materials polypropylene and polytetrafluoroethylene were comparatively studied for postinterventional infection, development of adhesions, and recurrence of hernias and tissue reactions in rats in which abdominal defects 1 by 2 cm in size had been repaired with one of these materials. As regards infection and hernias there was no significant difference vs. a control group of rats. There was no collagen deposition in polytetrafluoroethylene, and the mononuclear inflammatory cell reaction and fibroblastic activity outside the graft layer were steadily less intense with polytetrafluoroethylene than with polypropylene. Adhesions were significantly (p < 0.05) more marked with polypropylene.