بسم الله الرحمن الرحيم
هذا بحث طبي منشور في موقع طبي عالمي ( يوجد الرابط آخر الموضوع ) في جراحة السمنة بتكميم المعدة اشتركت ابنتي الدكتورة ( هناء - بارك الله فيها ) في عملياته وإعداده وتقديمه
The management of Internal Hernia (IH) following Laparoscopic Roux-en-Y Gastric Bypass (LRYGB): experience of one center in Kingdom of Saudi Arabia (KSA)
Ali Al-Aqoula MS,
Ahmed Al-Garzaieb MS, Shamma Al-Shammaric MBBS,
Aisha Alzuhaird MBBS, Hesham Eltomye MS,
Hana Alzahranif MBBS.
a,b,eDepartment of Surgery in KFMMC, Dhahran, Eastern
Province, KSA; c,d,fKFMMC, Dhahran, Eastern Province, KSA
Year : 2013 | Volume : 2
| Issue : 1 | Page : 157-162
Introduction: Internal Hernia (IH) following Laparoscopic Roux-en-Y Gastric Bypass (LRYGB) is a well known complication that has varying presentations and significant morbidity if not diagnosed and treated early. The diagnostic laparoscopy is the most sensitive tool for accurate diagnosis. The purpose of this study is to review our experience in King Fahad Military Medical Complex (KFMMC) in the Eastern Province of the Kingdom of Saudi Arabia (KSA) in managing IH following LRYGB and to compare our results with those in the literature.
Patients and Methods: Records of 18 patients with IH out of 600 patients underwent LRYGB treated at (KFMMC) between April 2005 and February 2011, were retrospectively reviewed. Demographic data, clinical presentation, preoperative evaluation and surgical treatment were retrieved from their records. Surgical complications and treatment outcome were noted. The published literature on IH following LRYGB was reviewed.
Results: We have a total of 18 patients (3%) with age range of (20–48 years) with IH, postoperatively. Two cases (11.1%) presented with symptoms of acute intestinal obstruction 2-3 days postoperatively, thirteen patients (72.2%) presented with abdominal pain 5 months to 4 years after surgery (mean time 23.3 months), and 3 cases ( 16.7%) were asymptomatic and were discovered incidentally at the time of performing elective laparoscopic cholecystectomy. Of all the diagnostic modalities for IH, laparoscopic evaluation is found to have highest sensitivity. All cases (100%) had the defect of IH in the jejunal mesentery below the jejunojejunostomy site. There was no operative mortality.
Conclusion: The diagnosis of IH needs high index of suspicion since the clinical presentation is highly variable. The diagnosis could be obtained by CT but the diagnostic laparoscopy is the most sensitive diagnostic tool. Closure of the mesenteric defect below the jejunojejunostomy site "propably" reduced the incidence of IH over a period of 9 months at least in our series, but to judge the efficiency of this technique we need a longer period of follow up. The laparoscpic management of IH is feasible if conducted by an expert laparoscopic surgeon.
Keywords: Hernia, laproscopy,
Roux-en-Y Gastric Bypass, abdominal, jejunojejunostomy
Ahead of publication
For
citing this article
1. Al-Aqoul A, Al-Garzaie A, Al-Shammari S, Alzuhair A, Eltomy H, Alzahrani H. The management of Internal Hernia (IH)
following Laparoscopic Roux-en-Y Gastric Bypass (LRYGB): experience of one
center in Kingdom of Saudi Arabia (KSA). PGJMR 2013; 2(1):157-162
REVIEW ARTICLE
Chronic
Obstructive Pulmonary Disease: A cocktail of many factors - A brief analysis
Shah Mohammed Abbas Waseema MD
aAssistant
Professor, Department of Physiology, Integral Institute of Medical Sciences
& Research, Lucknow, India
Year : 2013 | Volume : 2
| Issue : 1 | Page : 147-152
Broadly, risk factors for chronic
obstructive pulmonary disease (COPD) are divided into (i) external and (ii)
internal factors. The most common risk factor for COPD is tobacco smoking. Low
socio-economic status, recurrent childhood respiratory infections, occupational
factors, pollution and poor nutrition are the major contributors in the
development of COPD. Biochemical deficiencies like Alpha 1 antitrypsin
deficiency also contributes to COPD. Moreover, oxidative stress is
reported to play an important role in the patho-physiology of COPD. Free
Radicals by virtue of one or more unpaired electrons results in oxidative
stress in respiratory diseases especially COPD.
Keywords : COPD, oxidative stress, tobacco,
respiratory infections
Ahead of publication
For
citing this article
1. Shah Mohammed Abbas Waseem. Chronic Obstructive Pulmonary Disease, a
cocktail of many factors - A brief analysis. PGJMR 2013; 2(1):147-152
MINI
REVIEW
Tuberculosis
and HIV: An Emerging threat for India
Rajesh Kulkarnia MD
aAssistent Professor, Department of Community Medicine, JNMC, KLE
University, Belgaum, India
Year : 2013 | Volume : 2
| Issue : 1 | Page : 152-156
Tuberculosis (TB) and Human
Immunodeficiency Virus (HIV) have been closely linked since the emergence of
AIDS. The increasing rate of HIV infection in many countries has an impact on
TB epidemiology. There are around 3 million and 2.3 million cases of TB and HIV
in India, respectively. About 4.85% of TB patients estimated to be HIV
positive. HIV infection is associated not only with an increased incidence of
TB, but also with altered clinical manifestations especially in the advanced
stages of disease. Initiation of antiretroviral therapy (ART) result in decline
of the incidence of many AIDS-defining conditions and mortality.
HIV-seropositive patients with tuberculosis respond well to anti tuberculosis
therapy, as long as the regimen contains isoniazid and rifamycin. Multidrug
therpay has offered better cure rates of TB in AIDS patients.
Key words-Tuberculosis, Human Immunodeficiency Virus, Emerging Threat
Ahead of Publication
For
citing this article
1. Kulkarni R. Tuberculosis and HIV: An Emerging threat for India. PGJMR
2013; 2(1):152-156
Accumulation
of Advance Glycated End (AGE) products in Systemic Lupus Erthymatosus (SLE) - A
5 year update
Sana Alama MD, Akif Ahsanb MD
aSenior
Demonstrator, Department of Biochemistry, HIMSR, New Delhi, India; bSenior
Resident, Department of Biochemistry, AMU, Aligarh, India
Year : 2013 | Volume : 2
| Issue : 1 | Page : 142-146
Systemic Lupus Erythematosus (SLE), a
multisystem autoimmune disorder, is characterized primarily by inflammation,
vascular abnormalities and formation of pathogenic auto-antibodies and immune
complexes. SLE patients are more prone to develop cardiovascular diseases and
diabetes mellitus which can’t be explained by the traditional risk factors.
Recent studies have highlighted the importance of advanced glycation end
products (AGEs) in the understanding of pathogenesis of SLE. Oxidative
stress and inflammation in SLE generates AGEs, which further increases the
inflammation. This short review attempts to cover the recent pathological
advancements in the role of AGEs in SLE.
Keywords : systemic lupus
erythematosus, advanced glycation end products, auto-antibodies, oxidative
stress
Ahead of publication
For
citing this article
1. Alam S and Ahsan A. Accumulation of Advance Glycated End (AGE) products
in Systemic Lupus Erthymatosus (SLE) - A 5 year update PGJMR 2013; 2(1):142-146
Vitamin
D and Polycystic Ovary Syndrome - An association less explored
Amina Mobashira MBBS, Kamran Alib DNB
a Department
of Pulmonology and Intensive Care Unit, Fortis Hospital, New Delhi,
India; b Department of General Surgery,
SGRH, New Delhi, India
Year : 2013 | Volume : 2
| Issue : 1 | Page : 132-136
Polycystic ovarian syndrome (PCOS) is
a state of ‘excess’ in the body - excess of circulating androgens, estrogen,
serum insulin and body fat. Relatively underplayed is the role of possible
nutritional deficiencies that contribute to the pathogenesis of PCOS, one of
them being hypovitaminosis D. Recent studies point out the importance of
vitamin D in both prevention of the disease and managing its diverse clinical
manifestations. A large body of literature suggests that vitamin D deficiency
may lead to insulin resistance and PCOS, and is detrimental for females of
reproductive age group. However, the exact mechanism whereby vitamin D
influences the reproductive physiology remains unclear. This review article
highlights a need for appropriate intervention trials to bridge the existing
knowledge gaps regarding the specific role of vitamin D in PCOS.
Keywords : Vitamin D, Polycystic
Ovarian Syndrome, Infertility
Ahead of Publication.
For
citing this article
1. Mobashir A, Ali K. Vitamin D and Polycystic Ovarian Syndrome - An
association less explored. PGJMR 2013; 2(1):136-142
Diagnosing
disease the molecular way - A brief overview
Kavita Gaura MD, Ravindra Kumar Saranb MD
aSenior
Resident, Department of Pathology, GB Pant Hospital, New Delhi, India; bProfessor,
Department of Pathology, GB Pant Hospital, New Delhi, India
Year : 2013 | Volume : 2
| Issue : 1 | Page : 136-142
Molecular biology is in a
revolutionary phase. The enormous efforts of dedicated researchers over
the last few decades are finally being translated into significant changes in
disease management. Clinicians require both diagnostic input & theranostic
markers for customized patient care. Morphology complemented by
immunohistochemistry and molecular techniques will yield maximum information to
enable the success of targeted therapies.Knowledge of the basics behind
the complex techniques involved, is essential not just for laboratory personnel
but also for the treating physician as well as the budding scientist
intending to take this research to the next level. This review intends to
elucidate the elementary concepts of various molecular diagnostic modalities
including the amplification techniques, hybridizations and array chips.
Keywords : Molecular, Amplification, Probes, DNA
Ahead of Publication
For
citing this article
1. Gaur K, Saran RK. Diagnosing disease the molecular way - A brief
overview. PGJMR 2013; 2(1):132-136
……………………………………………………..
