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.
Many tools and techniques have been recently adopted to develop construction materials that are less harmful and friendlier to the environment. New products can be achieved through the recycling of waste material. Thus, this study aims to use recycled glass bottles as sustainable materials.
Our challenge is to use nano glass powder by the addition or replacement of the weight of the cement for producing concrete with enhanced strength.
A nano recycled glass p
Many of the key stream generators which are used in practice are LFSR-based in the sense that they produce the key stream according to a rule y = C(L(x)), where L(x) denotes an internal linear bit stream, produced by small number of parallel linear feedback shift registers (LFSRs), and C denotes some nonlinear compression function. In this paper we combine between the output sequences from the linear feedback shift registers with the sequences out from non linear key generator to get the final very strong key sequence
A novel robust finite time disturbance observer (RFTDO) based on an independent output-finite time composite control (FTCC) scheme is proposed for an air conditioning-system temperature and humidity regulation. The variable air volume (VAV) of the system is represented by two first-order mathematical models for the temperature and humidity dynamics. In the temperature loop dynamics, a RFTDO temperature (RFTDO-T) and an FTCC temperature (FTCC-T) are designed to estimate and reject the lumped disturbances of the temperature subsystem. In the humidity loop, a robust output of the FTCC humidity (FTCC-H) and RFTDO humidity (RFTDO-H) are also designed to estimate and reject the lumped disturbances of the humidity subsystem. Based on Lyapunov theo
... Show MoreA study to find the optimum separators pressures of separation stations has been performed. Stage separation of oil and gas is accomplished with a series of separators operating at sequentially reduced pressures. Liquid is discharged from a higher-pressure separator into the lower-pressure separator. The set of working separator pressures that yields maximum recovery of liquid hydrocarbon from the well fluid is the optimum set of pressures, which is the target of this work.
A computer model is used to find the optimum separator pressures. The model employs the Peng-Robinson equation of state (Peng and Robinson 1976) for volatile oil. The application of t
Glaucoma is one of the most dangerous eye diseases. It occurs as a result of an imbalance in the drainage and flow of the retinal fluid. Consequently, intraocular pressure is generated, which is a significant risk factor for glaucoma. Intraocular pressure causes progressive damage to the optic nerve head, thus leading to vision loss in the advanced stages. Glaucoma does not give any signs of disease in the early stages, so it is called "the Silent Thief of Sight". Therefore, early diagnosis and treatment of retinal eye disease is extremely important to prevent vision loss. Many articles aim to analyze fundus retinal images and diagnose glaucoma. This review can be used as a guideline to help diagnose glaucoma. It presents 63 artic
... Show MoreThis paper is concerned with introducing and studying the first new approximation operators using mixed degree system and second new approximation operators using mixed degree system which are the core concept in this paper. In addition, the approximations of graphs using the operators first lower and first upper are accurate then the approximations obtained by using the operators second lower and second upper sincefirst accuracy less then second accuracy. For this reason, we study in detail the properties of second lower and second upper in this paper. Furthermore, we summarize the results for the properties of approximation operators second lower and second upper when the graph G is arbitrary, serial 1, serial 2, reflexive, symmetric, tra
... Show MoreWe introduce and discus recent type of fibrewise topological spaces, namely fibrewise bitopological spaces, Also, we introduce the concepts of fibrewise closed bitopological spaces, fibrewise open bitopological spaces, fibrewise locally sliceable bitopological spaces and fibrewise locally sectionable bitopological spaces. Furthermore, we state and prove several propositions concerning with these concepts.
In this paper, we used four classification methods to classify objects and compareamong these methods, these are K Nearest Neighbor's (KNN), Stochastic Gradient Descentlearning (SGD), Logistic Regression Algorithm(LR), and Multi-Layer Perceptron (MLP). Weused MCOCO dataset for classification and detection the objects, these dataset image wererandomly divided into training and testing datasets at a ratio of 7:3, respectively. In randomlyselect training and testing dataset images, converted the color images to the gray level, thenenhancement these gray images using the histogram equalization method, resize (20 x 20) fordataset image. Principal component analysis (PCA) was used for feature extraction, andfinally apply four classification metho
... Show MoreWe introduce and discuss the modern type of fibrewise topological spaces, namely fibrewise fuzzy topological spaces. Also, we introduce the concepts of fibrewise closed fuzzy topological spaces, fibrewise open fuzzy topological spaces, fibrewise locally sliceable fuzzy topological spaces and fibrewise locally sectionable fuzzy topological spaces. Furthermore, we state and prove several theorems concerning these concepts.
The essential objective of this paper is to introduce new notions of fibrewise topological spaces on D that are named to be upper perfect topological spaces, lower perfect topological spaces, multi-perfect topological spaces, fibrewise upper perfect topological spaces, and fibrewise lower perfect topological spaces. fibrewise multi-perfect topological spaces, filter base, contact point, rigid, multi-rigid, multi-rigid, fibrewise upper weakly closed, fibrewise lower weakly closed, fibrewise multi-weakly closed, set, almost upper perfect, almost lower perfect, almost multi-perfect, fibrewise almost upper perfect, fibrewise almost lower perfect, fibrewise almost multi-perfect, upper* continuous fibrewise upper∗ topol
... Show More