Sleeve gastrectomy versus endoscopic intragastric balloon in decreasing weight and associated comorbidities in Erbil city: A comparative study

Background: Surgical obesity treatment is difficult for both surgeons and patients. The three main categories of bariatric surgery procedures are malabsorptive, restrictive, or both in combination. Intragastric balloon (IB) is an easily applicable restrictive interventional and nonsurgical strategy for obese patients, and the surgical procedure known as laparoscopic sleeve gastrectomy (LSG) is frequently used to help obese patients decrease weight. Objective: To assess and compare these two restrictive approaches. Patients and Methods: A prospective study of 138 LSG patients was conducted, (n=82) and IB (n=56) between 1st January 2016 to 31st December 2021 in private hospitals in Erbil, Iraq. The study retrospectively evaluates patients' demographic information, changes in total body weight (TBW), changes in body mass index (BMI), and percentage of excess weight loss (%EWL), morbidities and change of comorbidities during a year of follow-up, at months 1, 3, 6, and 12 after surgery. Comparative analysis was undertaken for the follow-up results after 6 and 12 months. Results: In the IB group, 12 patients did not tolerate insertion, leaving 56; in the LSG group, 82 patients completed treatment. In terms of age (p=0.121), gender (p=0.242), and BMI (p=0.078), there were no statistical differences between the IB and LSG groups. The LSG group achieved statistically significant superior treatment outcomes in terms of changes in TBW, BMI, and %EWL. Conclusion: Both LSG and IB are beneficial in the short term for helping obese patients lose weight. IB has the benefit of being performed as an outpatient procedure with less complications, but it is less successful in helping people lose weight than LSG. The best options for various patient groups in terms of clinical outcomes and health system effectiveness must be determined through prospective, randomized control studies.

Associated Complications and survival rate after thyroid cancer operation

Background: Thyroid cancer is a common endocrine neoplasm in all parts of the world and the commonest histologic type is PTC. The Treatment of choice for this pathology is surgery and it has associated complications commonly hypocalcaemia and RLNP with specific survival rates. Objective: To find out the incidence of associated complications of thyroid surgery with their survival rates. Patients and Methods: We analysed data from 574 patients diagnosed with TC from 2018 to 2021, using the Kaplan-Meier method and log-rank test to determine complications of thyroid surgery and overall survival. Results: The mean age of the patients was 41.3 (±14.1) years, there were 92(16%) patients aged >55 years and 482(84%) patients ≤ 55 years old at the time of diagnosis. Females were more affected by the female: male ratio (3.9: 1); 456 cases occurred in females (79.4%) and 118 in males (20.6%). The most common modes of presentation were neck lump in 492 (85.7%) patients and tumor size ≤4 cm in 495(86.3) patients. The commonest stage at diagnosis is stage I 494(86.1%), of the cases confined to the thyroid gland. The main surgical procedure was total thyroidectomy for 470(81.9%) patients. The common complications are hypocalcemia 70(12.6%) and 46(8.3%) developed RLN damage. The mean survival time was (55.87) months (CI = 54.86-56.88 months), but varies according to age < 55 years (58.02 months) and ≥ 55 years (44.426 months). Sex female has a better prognosis (56.540 months) while males (52.40 months). stage I mean survival was (58.79months) while a decrease in stage IV mean survival was (23.36 months). Conclusion: The incidence of complications associated with TC surgery in our study is close to what was published elsewhere in the world with slight differences in percentages of each complication. The survival rate drops within the available ranges

На путях к федеративным Георгиевским договорам 1783 и 1802 гг.: мусульманские общества и владения Дагестана в арабоязычной дипломатической переписке и соглашениях с Картли-Кахети и Российской империейXVIII в.

This selection of 15 diplomatic letters and agreements between Muslim khanates and village leagues of the East Caucasus, Georgia and imperial Russia sheds light on how a federative union under the Russian imperial protectorate formed in the region between the 1740s and the beginning of the nineteenth century. Documents were gathered in private and state archives, translated from Arabic into Russian, commented and introduced by Vladimir O. Bobrovnikov and Ilyas A. Kayaev with assistance of Karimulla G. Khalikov and Fasih Baderkhan.Эта подборка из 15 образцов дипломатической корреспонденции и соглашений между мусульманскими владетелями и сельскими объединениями Восточного Кавказа, Грузией и имперской Россией позволяют внести ясность в процесс формирования федеративного союза под протекторатом России в период между 1740-ми гг. и началом девятнадцатого столетия. Документы происходят из частных и государственных архивов; перевод с арабского языка на русский, комментарий и предисловие принадлежат В.О. Бобровникову и И.А. Каяеву, при участии К.Г. Халикова и Ф. Бадерхана

Early sac shrinkage predicts a low risk of late complications after endovascular aortic aneurysm repair

Background Aneurysm shrinkage has been proposed as a marker of successful endovascular aneurysm repair (EVAR). Patients with early postoperative shrinkage may experience fewer subsequent complications, and consequently require less intensive surveillance. Methods Patients undergoing EVAR from 2000 to 2011 at three vascular centres (in 2 countries), who had two imaging examinations (postoperative and after 6-18 months), were included. Maximum diameter, complications and secondary interventions during follow-up were registered. Patients were categorized according to early sac dynamics. The primary endpoint was freedom from late complications. Secondary endpoints were freedom from secondary intervention, postimplant rupture and direct (type I/III) endoleaks. Results Some 597 EVARs (71·1 per cent of all EVARs) were included. No shrinkage was observed in 284 patients (47·6 per cent), moderate shrinkage (5-9 mm) in 142 (23·8 per cent) and major shrinkage (at least 10 mm) in 171 patients (28·6 per cent). Four years after the index imaging, the rate of freedom from complications was 84·3 (95 per cent confidence interval 78·7 to 89·8), 88·1 (80·6 to 95·5) and 94·4 (90·1 to 98·7) per cent respectively. No shrinkage was an independent risk factor for late complications compared with major shrinkage (hazard ratio (HR) 3·11; P < 0·001). Moderate compared with major shrinkage (HR 2·10; P = 0·022), early postoperative complications (HR 3·34; P < 0·001) and increasing abdominal aortic aneurysm baseline diameter (HR 1·02; P = 0·001) were also risk factors for late complications. Freedom from secondary interventions and direct endoleaks was greater for patients with major sac shrinkage. Conclusion Early change in aneurysm sac diameter is a strong predictor of late complications after EVAR. Patients with major sac shrinkage have a very low risk of complications for up to 5 years. This parameter may be used to tailor postoperative surveillance. Towards personalized surveillanc

Endovascular aortic aneurysm repair: Aspects of follow-up and complications

Endovascular aortic aneurysm repair (EVAR) is the procedure of choice in most patients with abdominal aortic aneurysm. The drawbacks of EVAR are a higher rate of complications and frequent need for reinterventions, requiring regular postoperative follow-up. Non-stratified follow-up may have a deleterious effect on patients and the health care system. The aim of this thesis is to develop strategies that can stratify the EVAR follow-up programme according to an individual patient´s risk profile. Study I, an international multicentre study of all abdominal aortic aneurysm (AAA) patients with EVAR in three centres (2000 to 2011) demonstrated a lower rate of late complications and reinterventions in patients with sac shrinkage during the first postoperative year, compared to the non-shrinkage group. Study II, an international multicentre study of patients treated for a ruptured aortic aneurysm with EVAR in three centres (2000 to 2012) demonstrated that ruptured EVAR (rEVAR) in patients with hostile anatomy is associated with a high rate of graft-related complications, reinterventions and increased overall mortality. Study III, a two-centre cohort study of 326 patients with EVAR (2001 to 2012), with first postoperative computerised tomographic angiography (CTA) within one year of the operation. Patients with adequate proximal and distal sealing zones and no endoleak in the first postoperative CTA had significantly lower risk for AAA-related complications and reinterventions up to five years postoperatively. Study IV, studied all complications and reinterventions in a two-centre cohort study of all EVAR patients (1998 to 2012), One-fourth of the patients in the study developed complications during a mean follow-up of five years. Most complications were asymptomatic imaging-detected. Ultrasound could detect most of the clinically significant complications

Factors affecting quality of life in the daily living of persons with Multiple sclerosis

Multipel skleros är en sjukdom som påverkar kroppen på många olika sätt både fysiskt och psykiskt. Många unga drabbas och det påverkar hela livssituationen. Syftet med studien var att beskriva faktorer som påverkar livskvalité i det dagliga livet hos personer med Multipel skleros. Metoden utgjordes av en litteraturstudie där Polit och Becks (2008) åtta steg har använts. Studien är baserad på 10 kvalitativa och vetenskapliga artiklar. Artiklarna identifierades genom elektronisk sökning i databaserna CINAHL och PubMed. Betydande delar i artiklarnas resultat, som svarade på studiens syfte, markerades för att finna likheter och skillnader, dessa organiserades sedan i huvudkategorier och underkategorier. Resultatet visar att stöd kan upplevas både positivt och negativt och detta påverkar på det sättet livskvaliten. Att ha ett arbete, sociala relationer och känna en känsla av oberoende genom självständighet och kontroll är viktiga faktorer som påverkar livskvaliten