فهرست مطالب

Annals of Bariatric Surgery - Volume:6 Issue: 3, Summer 2017

Annals of Bariatric Surgery
Volume:6 Issue: 3, Summer 2017

  • تاریخ انتشار: 1396/06/10
  • تعداد عناوین: 6
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  • Mahsa Hatami, Gholamreza Mohammadi-Farsani * Page 2
    Background
    Migraine is a common and chronic neuro-inflammatory disease with progressive and episodic headache manifestation that leads to considerable disability. Many studies recognized that obesity is a risk factor for progression of migraine. Furthermore, both migraine and obesity is highly prevalent and important risk factors of chronic cardiovascular disease, stroke, and other inflammatory disease. Thus, it is very important if weight loss could alleviate the migraine headache and its related comorbidities.
    Aim: The present review article was conducted to assess the potential effect of Bariatric surgery on improvement of migraine headaches in morbid obese patients.
    Search Strategy: Scopus, PubMed and web of science electronic database were systematically searched with key words of “Bariatric surgery”, “gastric Bypass”; “Morbid Obesity” and “Migraine headache” for interventional studies investigated the impact of Bariatric surgery on migraine headache.
    Results
    The findings suggest significant improvement in headache frequency, duration, migraine-induced discomfort and migraine derived symptoms (nausea, phono and photophobia and) occurs as early as 3 months after bariatric surgery. Moreover, patients who had higher weight loss were more likely to experience a 50% or higher reduction in headache frequency, duration and severity.
    Conclusions
    The entire evidences suggest patients with indications of bariatric surgery will benefit from the improvements in the Migraine headache after surgery. However, it remains unclear whether Bariatric-induced endocrine, gut-brain axis alterations, or reduction in adipokine contribute to migraine improvement, so further studies are needed to confirm and clarify these findings.
    Keywords: Gastric Bypass, Bariatric Surgery, Morbid Obesity, Migraine Headache, Surgical Weight Reduction
  • Shahram Yazdani, Maryam Akbarilakeh * Page 3
    Background
    The need for internalization of values for professional development in medicine and surgery, and sense of duty linked to the practice of the medical professionalism were recognized in Iran. With regard to the shortcomings currently existed in the curriculum of the medical education, in 2013, the design of an operational model for the curriculum based on values was placed on the agenda through the PhD thesis.
    Objectives
    The aim of this study is to develop the operational model of the value-based curriculum for medicine and surgery education with respect to indigenous values in Shahid Beheshti University of Medical Sciences, Tehran, Iran.
    Methods
    Our value-based curriculum model was developed through qualitative ontology foundations of Hugh McKenna concept analysis. Finally we developed our operational model by comparing our domestic extracted attributes with what is existed and experienced in other countries through systematized searching, determined the process of value curriculum, the sequence of process steps, menu and taxonomy for operationalization of each step, and recommended practices for each step for integration of values in medicine and surgery education in Iran.
    Results
    Ten steps of curriculum model for integration of values in medicine and surgery education include: general need assessment of values, designing hierarchy system of values, need assessment of targeted learners’ values, developing value programme statement, determination of value outcomes and objectives, production of value rich content, value based teaching and learning methods, value based settings, value themes management, determination of values evaluation and assessment methods.
    Conclusions
    This Indigenous operational model of value based curriculum proposes the process with exact sequence for the concrete implementation of values education in medicine and surgery, accordance with our country offers. The operational value based curriculum model was prepared in order to develop a practical guideline for value based experiments in medicine and surgery, helps to move from the information level and expressing factual knowledge, to the conceptual and judgment level, understanding the connections and interactions between facts and analysis them.
    Keywords: Value Based Education, Value Curriculum, Professional Values
  • Ommolbanin Abed, Ali Kabir, Fatemeh Jesmi, Leila Janani, Peyman Alibeigi, Mohammadreza Abdolhosseini, Fahimeh Soheilipour, Abdolreza Pazouki * Page 4
    Background
    Laparoscopic one anastomosis gastric bypass (OAGB) and laparoscopic Roux-en-Y gastric bypass (LRYGB) are common treatments for morbid obese patients who suffer from type 2 diabetes mellitus (T2DM). It has been hypothesized that diabetes may be resolved or improved after bariatric procedures, although the exact effect has not been well established. The present study aimed to compare remission of T2DM after LRYGB versus OAGB in this study.
    Methods
    All diabetic obese patients, aged between 16 to 60, who referred to Hazrat Rasul Akram obesity clinic from April 2010 to March 2013 for LRYGB or OAGB were included in the present study. Pre-operative parameters, including glycosylated hemoglobin (HbA1c), fasting plasma glucose (FPG), body mass index (BMI), and type of diabetes medication were extracted from database and recorded. Pre-operative and three months postoperative values were then compared between the groups.
    Results
    Out of 95 eligible patients, 50 patients underwent OAGB and 45 patients had LRYGB. The two groups were homogenous in distribution of gender, mean age, weight, BMI, and FPG; however, mean HbA1C was relatively higher in LRYGB group (P = 0.05) than other group, which was non-significant after adjustment. Rate of remission was significantly higher in OAGB group than other group after three months follow-up (64.0 versus 31.1%, respectively) (P = 0.002).
    Conclusions
    In our short-term follow-up, OAGB had a higher rate of remission of T2DM compared to LRYGB, which could be due to different baseline value of HbA1c (before surgery) between two groups. Future research is thus suggested with linger follow-up and randomized study design.
    Keywords: Gastric Bypass, Roux, en, Y, Diabetes Mellitus, Type2, HbA1c, Obesity, One, Anastomosis Gastric Bypass (OAGB), Mini, Gastric Bypass (MGB)
  • Annu Babu *_Ankit Raikhy_Sanjeev Kumar Choudhary_Abhishek Bhartia_V. K Bhartia Page 5
    Introduction
    The radiation proctitis is a known complication following the pelvic radiation therapy. Radiation proctitis is categorized as acute and chronic. Most of the cases are managed conservatively except in grade four chronic radiation proctitis, which active surgical management is needed. Previously these surgeries were done by conventional open technique. With the evolution of minimal access surgery it has now possible to do these surgeries by laparoscopic methods.
    Case Presentation
    We here by present a case of 75 year old male patient presented with passage of dark colored blood mixed stools with tenesmus, pain and diarrhea. Patient had surgical history of transurethral resection of the prostrate (TURP) done for Benign Prostatic Hypertrophy. The tissue diagnosis of specimen was adenocarcinoma of prostate. Patient had received radiotherapy 9 months back for that prostatic carcinoma. The colonoscopy was suggestive of severe distal rectal proctitis, which was managed by laparoscopic proctectomy with partial sigmoidectomy and permanent end sigmoid colostomy.
    Conclusions
    Laparoscopy has definitive role in management of chronic radiation proctitis, blessing the patient with benefits of minimal access surgery.
    Keywords: End Colostomy, Laparoscopy, Radiation Proctitis
  • Beuy Joob *, Viroj Wiwanitkit Page 6