Background: Obesity (body mass index >30) is increasing worldwide with an estimated 1.7 billion people currently affected by the disease, Gallstone represent the third most common disease observed among obese patients. Moreover about 30% of the patients who are candidates for bariatric surgery either have undergone a prior cholecystectomy or are found to present gallstones at time of surgery, On the other hand, newly formed gallstones may be diagnosed in 27% to 43% of patients who have undergone bariatric surgery within a very short period of time.
Objective: To determine the prevalence of gallstone disease requiring cholecystectomy after laparoscopic sleeve gastrectomy and roux en Y gastric bypass during a one year follow up and to determine the need for prophylactic cholecystectomy in these patients.
Patients and methods: prospective study among patients with morbid obesity treated with laparoscopic sleeve gastrectomy and Roux- en- Y Gastric Bypass between 1st of February 2013 till 31st of July 2015 at Saint Raphael hospital and Al-Hayat private hospital, patients with negative abdominal ultrasound preoperatively, patient with at least one year follow up after surgery were included in this study, The patients were divided into two groups for comparison. Group A patients who had laparoscopic sleeve gastrectomy, and group B included the patients who underwent laparoscopic Roux en Y gastric bypass. The primary outcome measure was the formation of symptomatic gallstones or sludge with or without complications.
Results: 284 patients in group A(sleeve) and 45 patients in group B(Bypass) were included in the analysis, the mean age of was 34.5 years for group A, and 191(67.3%) of the patients were women, whereas it was 41.5 years for group B and 33 (73.3%) of the patients were women, Symptomatic cholelithiasis subsequently requiring cholecystectomy occurred in 29 (10.2%) of 284 laparoscopic sleeve gastrectomy patients, and 5(11.1%) of 45 Roux en Y gastric bypass patients , symptomatic gallstone developed in a median of 7 months in group A, while the median time to developed symptomatic gallstone in group B was 8 months. No significant difference in symptomatic gallstone disease was found between the patients who underwent laparoscopic gastric bypass and those who had sleeve gastrectomy
Conclusions: Cholelithiasis was common in our patients before weight reduction surgery. The rate for symptomatic gallstones after surgery was not so high.. Routine prophylactic cholecystectomy should not be recommended for these patients.
Alfonso Sastre escribió La Sangre y la ceniza, su primera obra dentro de la llamada “Tragedia Compleja” en los primeros años de la década de los sesenta, pero la primera edición no apareció hasta el año 1967 y fue en lengua italiana. Por causa de la censura la obra estuvo prohibida a lo largo de muchos años, finalmente su primera edición en castellano apareció en el número 1 de la revista Pipirijaina, en octubre del año 1976. El estreno tuvo lugar en el Teatro Villarroel de Barcelona en enero de 1977, a cargo del Colectivo de Teatro ‹‹El Búho›› el cual realizó con este espectáculo una gira por toda España y más tarde lo ha representado en los Festivales Internacionales de T
... Show MoreBackground &objectives: Angiogenesis plays an important role in the growth, progress and the metastasis of solid tumors. This study was done to determine the significance of angiogenesis as another prognostic factor in gastric carcinoma in an attempt to identify the patients at high risk of recurrences after surgical therapy who may benefit from postoperative adjuvant therapy.
In this study the correlation between the microvessel count(MVC) and the various clinicopathological factors was investigated. A highly significant statistical correlation was found between the mean microvessel count in different histological grades and the stage of gastric adenocarcinoma .
No correlation was found between the MVC and the age and sex of t
In a previous work, Ali and Ghawi studied closed Rickart modules. The main purpose of this paper is to define and study the properties of y-closed Rickart modules .We prove that, Let and be two -modules such that is singular. Then is -y-closed Rickart module if and only if Also, we study the direct sum of y-closed Rickart modules.
Thoudy sustainable development attention of researchers and scholars at various orientations intellectual economies were or Ssayasn, or others as gaining the process of paramount importance in the light of major developments and unprecedented in the modern world at the levels of all and which turned the world sprawling into something like a global village is small, being aimed at elimination of backwardness and development branches of the national economy and raise the level of economic performance, and what was the province of Kurdistan-Iraq from areas with privacy clear and meets the elements of economic development has seen the movement of economic development and social with special features de facto geographical, political a
... Show MoreBackground: Diabetic foot problems are one of the most important complications of diabetes mellitus
which causing a worldwide high cost morbidity which could be due to poor self-practices.
Objectives: To assess the preventive food care practices among diabetic patients and to find out any
significant association of these practices with selected socio-demographical and diabetic related
characteristics.
Patients and Methods: A descriptive cross-sectional study was conducted in Baquba city from the
period of 20th Septembers, 2016 up to 20th March, 2017, by selecting a sample of (120) patients by
using a structured questionnaire, the questionnaire composed of three parts, the first part contains
information related to
This study designed to examine association between-174G/C polymorphism of interleukin-6 gene and phosphate, calcium, vitamin D3, and parathyroid hormone levels in Iraqi patient with chronic kidney disease on maintenance hemodialysis. Seventy chronic renal failure patients (patients group) and 20 healthy subjects (control group) were genotyped for interleukin-6 polymorphism and genotyping was performed by conventional polymerase chain reaction-restriction fragment length polymorphism. No significant differences in phosphate levels were observed in patients and control with different interleukin-6 genotypes. Control had non-significant differences in calcium levels, while patients with GG and CG genotypes displayed significant e
... Show MoreGames engagement has become one of the main concerns in game industry. Early study revealed that Malaysian digital traditional games are suffering with the same issue due to several factors. One of it is the lack of the game itself. Although many Malaysian traditional games have been digitized, none of them has incorporated rewards despite its importance in games engagement. Realizing the importance of rewards in games engagement, one of Malaysian traditional Congkak has been chosen to be enhanced by incorporating rewards. Experiments have been conducted among 50 gamers among the Millennials. Prior interview, game demo and human test are conducted. Experiments focused on the influence of rewards on games flow, games challenge, and its ef
... Show MoreBackground: Endothelial dysfunction is thought to be a key event in the development of atherosclerosis. It is a systemic process that simultaneously affects different vascular territories including coronary arteries. It is recommended that noninvasive approaches assessing endothelial function in peripheral vessels like flow mediated dilatation are indirectly representative of coronary vascular function.
Objectives: This study is aimed to assess endothelial dysfunction by using flow mediated dilatation in patients with coronary artery disease
Patients and methods: 82 patients of either sex with an age range of 40-65years are involved in this study. Each patient was subjected to two tests; first test was the flow mediated dilatation
The research aims to study the importance of applying lean accounting techniques and the tools and methods they contain, the most important of which is the “value path costs” technique and its impact on rationalizing and controlling costs, as well as reducing production costs in general and reducing quality costs in a way Special by reducing or eliminating waste and waste in both time and resources and meeting customer requirements. In order to achieve this goal, the researcher relied on the application of lean accounting tools by obtaining data related to the mill, in addition to that, the information obtained as a result of field coexistence in the mill and being able to view the records of the mill in the research sample. From the
... Show MoreAbstract
Financing is one of the important pillars for activating and activating the agricultural sector, through which we can see an agricultural project on the ground. However, supplying the agricultural sector with financial resources requires a credit policy that is capable of making the right financing decision, because the financial resources are limited. The credit policy, and the financing decision, must be the best use not only to provide the necessary money, but to work to provide everything that would develop and activate the agricultural sector.
The transformation of the Agricultural Cooperative Bank of Iraq from specialized banking to the overall would lead to a decrease in the volume
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