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.
Bodas de sangre es una tragedia en verso del escritor Federico García Lorca escrita en 1932, y estrenada el 8 de marzo de 1933 en el teatro Beatriz de Madrid con gran éxito tanto en España como en Hispanoamérica. Fue llevada al cine por Carlos Saura en 1981. Es una producción poética y teatral que se centra en el análisis de un sentimiento trágico. Desde la vida y la muerte, a lo antiguo y lo moderno, en la manera de ver la tragedia. Todo ello enmarcado en un paisaje andaluz trágico y universal.
El tema principal que se trata en este drama es la vida y la muerte. Pero de un modo arcano y ancestral, en la que figuran mitos, leyendas y paisajes que introducen al lector en un mundo de
... Show MoreResumen:
En este artículo se indaga sobre fenómenos como la metáfora, la metonimia, la polisemia, y la homonimia en las lenguas árabe y española, según la teoría cognitiva, basada en el pensamiento y la práctica lingüística. Esta teoría intenta investigar la relación entre el lenguaje humano, la mente y la experiencia. En realidad, los fenómenos que estudiaremos crean ambigüedad léxica y sintáctica tanto en árabe como en español. Además, dichos conceptos tienen sus propias características, especificaciones y formas en cada lengua.
Abstract:
This article studies phenomena such as metaphor, metonymy, polysemy, homonymy in Arabic and Spanish, according to cognitive theory, based on linguistic thought a
... Show MoreAlthough the number of stomach tumor patients reduced obviously during last decades in western countries, but this illness is still one of the main causes of death in developing countries. The aim of this research is to detect the area of a tumor in a stomach images based on fuzzy clustering. The proposed methodology consists of three stages. The stomach images are divided into four quarters and then features elicited from each quarter in the first stage by utilizing seven moments invariant. Fuzzy C-Mean clustering (FCM) was employed in the second stage for each quarter to collect the features of each quarter into clusters. Manhattan distance was calculated in the third stage among all clusters' centers in all quarters to disclosure of t
... Show MoreBackground: The demographic characteristics of Iraqi patients with the metabolic syndrome (MS) and presenting with acute coronary syndrome (ACS) has been scarcely studied before.
Aim of the study To study the socio-demographic characteristics of a group of Iraqi patients with MS presenting with ACS.
Patients and Methods: A convenience sample of 150 cases presenting with ACS and admitted to the coronary care unit (CCU) of Al-Yarmouk Teaching Hospital in Baghdad from mid-January through July 2011 were included in the current cross-sectional study. The data needed for the study was collected through a direct interview to fill a questionnaire by all cases carried out by a consu
... Show MoreBackground: The diagnosis of interstitial lung disease (ILD) is frequently delayed, because clinical clues are neglected and respiratory symptoms are ascribed to more common pulmonary diagnosis such as asthma and chronic obstructive pulmonary disease in the primary care setting.
Objective: To evaluate the diagnostic yield of open lung biopsy in patients with suspected ILD in relation to clinical and radiological features.
Patients and methods: Thirty-five patients were admitted with suspected interstitial lung disease (ILD), and scheduled for open lung biopsy (OLB) in Ghazi AL-Hariri hospital for surgical specialty, were included in this study. Data collected from the patient's files (who were subjected to open lung biopsies which
La vorágine es una novela insigne de la literatura colombiana e hispanoamericana que trata de manera singular el tema de la violencia. Este artículo propone una reflexión filosófica novedosa para abordar la violencia como objeto de conocimiento. Se plantea, en primer lugar, un nuevo enfoque a partir de la teoría literaria,enseguida se consideran aspectos del relato, tales como: la doble naturaleza del mundo, el absurdo y la dinámica autoproductiva de la violencia y con ayuda de varios autores, constatamos cómo estos mismos aspectos admiten nuevas aproximaciones. Este artículo nos lleva a pensar nuevas formas de ser y de actuar en el mundo a partir del modo como nos relacionamos con lo otro.
Resumen
Este trabajo de investigación ofrece uno de los temas relevantes en la lengua, el cual es estudiar las dimensiones sintácticas, semánticas y pragmáticas de las preposiciones, en general, y de las dos preposiciones "Para" y "Por" en concreto, en una unidad linguística más amplia que la llamada "Oración". En la parte referida al estudio de las dos preposiciones mencionadas, estudiamos sus distntos usos funcionales, usos que se acercan, unas veces, entre sí y se alejan en otras.
Abstract
... Show MoreRESUMEN:
Pretendemos hacer con este trabajo un breve recorrido sobre lo que han dicho algunos gramáticos de las construcciones condicionales, a la par señalaremos los criterios que los mismos establecen y siguen para diferenciar entre distintos tipos de estructuras condicionales o entre las construcciones que ellos entienden o consideran como tales y las que no, atendiendo fundamentalmente a dos criterios; formal y semántico-pragmático. El presente trabajo tiene como objetivo la clasificación y la descripción de las construcciones condicionales, demostrando que no todas las condicionales son hipotéticas ni todas las hipotéticas son condicionales.
Abstract
We intend to make this work
... Show MoreBackground: The association of celiac disease and type 1 diabetes mellitus is known worldwide due to shared auto immunological background, since celiac disease could present in diabetic patients with non specific symptoms or asymptomatically, periodic serological screening is necessary for early diagnosis.
Objectives: To estimate the prevalence of celiac disease in children with type 1 diabetes.
Patients and methods: A total of 152 children with type 1 diabetes attending the Children Welfare Teaching Hospital; 67 boys, 85 girls with mean age of 10.3 year± 3.7 and mean duration of diabetes 3.5years ±2.5, from May 2010 -May 2011 were screened for celiac disease using immunoglobulin A and G tissue trans
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