Author: Ridha Jawad Kadhim
Effect of laparoscopic sleeve gastrectomy on blood sugar and blood pressure
Abstract Background: Surgery is one and may be the most effective method to treat obesity. In the last decade, Laparoscopic Sleeve Gastrectomy is perceived to be less invasive, technically simple, less morbid and more popular form of bariatric surgery. Objectives: This study aims to assess the effect of Laparoscopic Sleeve Gastrectomy on Fasting Blood Glucose Levels and Blood Pressure. Methods: A prospective controlled study in which 50 obese patients were involved, 36 of patients have hypertension and type 2 diabetes mellitus , 7 patients have type 2 diabetes mellitus only, and 7 patients don’t have hypertension or type 2 diabetes. All patients were submitted to Laparoscopic Sleeve Gastrectomy at Al-Kindy Teaching Hospital between October 2014 and October 2016. Results: Forty five of patients were females, while five were males . Mean age was 34 years, mean height 159 cm mean pre Laparoscopic Sleeve Gastrectomy weight was 121kg. Mean post- Laparoscopic Sleeve Gastrectomy weight was 82kg. Mean weight loss outcome at 1 year follow-up is 32.23% of total body weight. . Preoperative initial mean value of fasting blood glucose was 157.4 mg/dL and the declining occurred at 12 months after Laparoscopic Sleeve Gastrectomy was 97 mg/dL . The hypertension remission rates 1 year after Laparoscopic Sleeve Gastrectomy ranges up to 54% of total number of patients and 75% of those with Hypertension. Conclusions: Laparoscopic Sleeve Gastrectomy has an effect in improving Fasting Blood Glucose Levels and Blood Pressure. Keywords: Obesity, Laparoscopic Sleeve Gastrectomy Type 2 Diabetes Mellitus, Hypertension . DOI: https://doi.org/10.47723/kcmj.v15i1.88
INTENSIVE CONSERVATIVE IN CERTAIN COMPLICATED CASES OF DIABETICFOOT CAN SALVAGE LIMB AND PREVENT AMPUTATION
ABSTRACT Background: Foot infection associated with diabetes, the so- called “Diabetic Foot =DF“, is a common problemamong diabetics, especially in neglected or uncontrolled cases. Diabetic foot infections require attention to local (foot) and systemic (metabolic) issues and coordinated management, preferably by a multidisciplinary foot care team. In most cases, amputation of a part of a limb is usually applied. In the lower limb, this usually bellow – knee (BKA) or above –knee (AKA) amputation. In our study try to approach such cases with aggressive conservative management to save the limb. Aim: To show the benefits of intensive conservative management of some patients with diabetic foot (DF) in certain situations and if this management can salvage limb and avoid amputation. Patients and Methods: This study includes (100) patients seen as a specialized center for endocrinology and diabetes (SCED) and Al-Kindy Teaching Hospital (ATH) during the period from February 2008 to December 2011. Average age was 47 years (range 25-89). Males were 63 (63%) and females were 37 (37%). All patients in the study were having type 2 diabetes (T2D) with a server and complicated foot infection (diabetic foot, DF). Results: The end result of treatment was complete wound healing in 30 patients (35.294%), scar or ulcer in 30 patients (35.294%) while in 25 patients (29.412%) needs more than 60 days for complete healing. Conclusion: Intensive conservative management of diabetic foot (DF) can slaving extremity and avoid amputation. KEYWORDS: Types 2 Diabetes, Diabetic Foot, Conservative Management, Insulin Therapy, Amputation
Endometriosis Of Cesarean Section Why On Left Side?
Abstract Background: Endometriosis is defined as the presence or growth of ectopic endometrial tissue outside their usual site ( the uterus). It is a common condition in women. It may occur in the ovaries, fallopian tubes, vagina and rarely, endometriosis may occur in the abdomen and lungs. Endometriosis is common among women of reproductive age. It is either primary or secondary. The triad of diagnosis is a pain with menstruation, cesarean scar and a mass in the scar. Methods: A report a series of 65 patients in the period from 1st Jan 2013 to 31st Dec 2017. The study was performed in Al-Kindi Teaching Hospital and a private hospital. The mean age was 35 years (range 20-45).All patients were treated surgically i.e. excision of the tumor and old surgical scar in the lower abdomen. Result: mean age was 35 years (range 20-45). Thirty patients (46.15%) were housewives while 35(53.84%) were officers. The interesting finding is that 52 patients had the mass in the left side, 10 in the middle and only 3 in the right side of the scar respectively. Conclusion: Our study demonstrated a lateral asymmetry in the location of scar endometriosis i.e. mostly on the left side. The prevalence on left side of scar can be added to the triad of diagnosis mentioned above I.e. cyclical pain, cesarean scar and mass mostly in left side of the scar. Keywords: endometriosis, Cyclical pain, cesarean scar, mass in cesarean scar DOI: https://doi.org/10.47723/kcmj.v15i2.160