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.
Background: Duplex ultrasound is inexpensive, non-invasive and can provide functional and anatomical information about vessel stenosis and plaque morphology. Color duplex flow ultrasonography has thus become the most widely used noninvasive method of assessing extra cranial cerebrovascular occlusive disease.
Objectives:To find the relation of the severity of carotid artery stenosis, intima media thickness, and atheromatous plaque morphology with the size of cerebral infarction.
Patients and Methods: A prospective study, conducted from September 2010 to May 2011, in Department of Radiology in Baghdad Teaching Hospital. A total of 62 Patients with clinical & radiological (brain CT) diagnosis of acute stroke, (42 males & 20 fe
Background: Acute pancreatitis is an acute inflammatory condition. It's not an uncommon disease, in both the developed and developing countries, causes high morbidity and mortality, and inflicts a heavy economic burden. Severe acute pancreatitis is present in up to 25% of patients with acute pancreatitis, with considerable mortality. Changes in the management of acute pancreatitis in the last 2 decades contributed to reduce the mortality.
Objective: was to review the diagnosis and management and outcomes of patients with acute pancreatitis of patients with acute pancreatitis in Al- Karama teaching hospital.
Patients and Methods: This prospective study included 63 patients
... Show MoreBackground: Coronary artery bypass graft is routinely performed on an arrested heart using cardiopulmonary bypass with aortic cross clamping and Cardioplegia. Off-pump coronary artery bypass graft (OPCABG) is being increasingly used in selected cases as an attempt to decrease morbidity and mortality.
Objective: The main objective of this study is to clarify those patients who are indicated for OPCABG despite it is surgically demanding technique and to evaluate the mortality and morbidity associated with such procedures.
Patients and methods: It is a retrospective study of 28 patients with coronary artery disease, in need for coronary artery bypass graft admitted and surgically treated at the Iraqi Centre fo
Background: Although pain after laparoscopic cholecystectomy is less intense than after open Cholecystectomy, some patients still experience considerable discomfort, and use of local anaesthetics irrigation is controversial.
Objectives :to evaluate the effect of intraperitoneal and port site instillation of local anaesthetics on pain relief in the first 6 hours postoperatively.
Patient and Method: Forty patients underwent elective laparoscopic cholecystectomy were included in this study and sample was divided into two equal groups. Group A received 20 ml of 0.9% normal saline instilled in the gallbladder bed, while group B received 20 ml of 0.25% bupivacaine instilled in
... Show MoreBackground: Patients with chronic kidney disease have multiple alterations of thyroid hormone metabolism in the absence of concurrent thyroid disease. These may include elevated basal TSH values, which may transiently increase to greater than 10 mU/liter, blunted TSH response to TRH, diminished or absent TSH diurnal rhythm, altered TSH glycosylation, and impaired TSH and TRH clearance rates. In addition, serum total and free T3 and T4 values may be reduced, free rT3 levels are elevated while total values are normal, serum binding protein concentrations may be altered, and disease-specific inhibitors reduce serum T4 binding .
Objective:. To assess the prevalence of hypothyroidism and u/s abnormalities of t
Background: Cytokines are the messengers of the immune system.They are mostly secreted by macrophages and lymphocytes and their production is induced in response to injury or infections.
Objective: Biopsy speciemens from the middle body of the stomach were obtained from 18 patients with gastric carcinoma, 32 patients with atrophic gastritis, 50 patients with chronic gastritis and 20 healthy subjects and IL-8 and IL-1B levels were detrmined.
Methods: Sandwich-type enzyme-linked immunosorbent assay kit was used to determine the IL-8 and IL-1B levels.
Results: IL-8 and IL-1B levels were significantly higher in gastric carcinoma patients than patients with atrophic gastritis and both significantly higher than healthy subjects.
C
As a consequence of a terrorist attack, people may experience posttraumatic stress disorder (PTSD) and lack of feeling secure in relationships. This longitudinal study aimed to examine the prevalence of PTSD symptoms over time, the relationship between adult attachment styles and PTSD, as well as their association with degree of exposure, and finally to consider the distribution and the trajectory of attachment styles. The sample consisted of 235 students (M=125, F=110) who were exposed to different levels of trauma intensity in response to a bombing attack. Participants were recruited and assessed approximately 1 month and 5 months after the attack using a battery of questionnaires. Findings revealed, as expected, that 79.5% of the part
... Show MoreThe present study aims at assessing the effects of chronic kidney disease (CKD) on thyroid hormone and leptin by evaluating the level of: leptin hormone along with thyroid hormone in CKD patients. The study has been conducted on 70 subjects, 50 patients with an age range between 20-50 years (25 males and 25 females) who were diagnosed to have CKD stage-5, and 20 normal controls whose ages ranged between 20-48 years (10 males and 10 females), who attended the Nephrology and Transplant Center in Medical City of Baghdad- Iraq from April 2018 to July 2018. The study showed a highly significant (P<0.01) increase in TSH level in CKD patients in comparison with controls. While T3 and T4 levels observed highly significant decrea
... Show MoreLas formas verbales: el infinitivo, el gerundio y el participio, son derivados verbales que se comportan como sustantivos, adverbios o adjetivos, respectivamente; aunque, dado su carácter verbal pueden también funcionar como verbos y, por tanto, como núcleos del predicado.
El presente trabajo presenta una visión general sobre las formas no personales del verbo en español. Se debe recordar que las formas no personales del verbo tiene funciones y valores dentro de la oración.
Este trabajo lo dividimos en dos partes: la primera presenta un breve marco teórico en que se explica las formas no personales del verbo y como se forman además de sus funciones.
Abstract
... Show MoreDuring the educational practices in the Spanish department at the Faculty of Languages , University of Baghdad , we noticed that the personal pronouns in effect replaced by the direct and indirect characterized hardly be expressed , and the difficulty of her education.
Rationale: I chose this topic because the personal pronouns differ between the Spanish language and the Arabic language. We believe that this study may be useful not only for language teachers, but also for students, because it can contribute to a greater awareness of and correct weaknesses.
Objectives: To apply the model from which to address the problems in the use of personal pronouns Spanish , and the difference between effect of direct and indire
... Show More