Mini gastric bypass with 4k technology as treatment of morbid obesity in patient with ventriculoperitoneal shunt

Ventriculoperitoneal (VP) shunt placement is used to treat idiopathic intracranial pressure. Obesity is a risk factor related to shunt migration, dislodgement, and subsequent failure due to increased intraabdominal pressure. Minigastric bypass consists in both restrictive and malabsorbative mechanisms, and indications to this procedure as an efficient primary and redo procedure are increasing lately. Technology can always improve the surgical act, and 4K vision is spreading in many operating rooms. Laparoscopic approach is subject to continuous change. Ultrahigh definition is the next development in video technology, it delivers fourfold more detail than full high definition resulting in improved fine detail, increased texture, and an almost photographic emulsion of smoothness of the image. New 4K ultrahigh-definition technology might remove the current need for the use of polarised glasses. We present the laparoscopic one anastomosis gastric bypass, done with the new 4K technology, as primary bariatric procedure for morbid obese patient with VP shunt

25th International Congress of the European Association for Endoscopic Surgery (EAES) Frankfurt, Germany, 14-17 June 2017 : Oral Presentations

Introduction: Ouyang has recently proposed hiatal surface area (HSA) calculation by multiplanar multislice computer tomography (MDCT) scan as a useful tool for planning treatment of hiatus defects with hiatal hernia (HH), with or without gastroesophageal reflux (MRGE). Preoperative upper endoscopy or barium swallow cannot predict the HSA and pillars conditions. Aim to asses the efficacy of MDCT’s calculation of HSA for planning the best approach for the hiatal defects treatment. Methods: We retrospectively analyzed 25 patients, candidates to laparoscopic antireflux surgery as primary surgery or hiatus repair concomitant with or after bariatric surgery. Patients were analyzed preoperatively and after one-year follow-up by MDCT scan measurement of esophageal hiatus surface. Five normal patients were enrolled as control group. The HSA’s intraoperative calculation was performed after complete dissection of the area considered a triangle. Postoperative CT-scan was done after 12 months or any time reflux symptoms appeared. Results: (1) Mean HSA in control patients with no HH, no MRGE was cm2 and similar in non-complicated patients with previous LSG and cruroplasty. (2) Mean HSA in patients candidates to cruroplasty was 7.40 cm2. (3) Mean HSA in patients candidates to redo cruroplasty for recurrence was 10.11 cm2. Discussion. MDCT scan offer the possibility to obtain an objective measurement of the HSA and the correlation with endoscopic findings and symptoms. The preoperative information allow to discuss with patients the proper technique when a HSA[5 cm2 is detected. During the follow-up a correlation between symptoms and failure of cruroplasty can be assessed. Conclusions: MDCT scan seems to be an effective non-invasive method to plan hiatal defect treatment and to check during the follow-up the potential recurrence. Future research should correlate in larger series imaging data with intraoperative findings

Phytochemical investigation and evaluation of antimicrobial activities of stem bark of Morella salicifolia

The Morella salicifolia bark is used as a traditional medicine for the treatment of toothache, headache and stomachache in the eastern Ethiopia. The stem bark of the plant was sequentially extracted with: petroleum ether, chloroform and chloroform/methanol (1:1) using Soxhlet apparatus. Phytochemical screenings tests were conducted on of stem bark this plant extracts were performed on petroleum ether, chloroform and chloroform/methanol (1:1) crude extracts. The results showed presence of alkaloid, tannins, saponins, flavonoid, protein, and triterpenoids in the petroleum ether extract; alkaloid, tannin, flavonoid, protein, triterpenoid and absence of saponins chloroform extract; tannin, flavonoid, triterpenoid and absence of alkaloid, tannin, saponins and protein in the chloroform/methanol (1:1) extract. Volatile oil of the stem bark of plant was analyzed by GC-MS and it constitute 14 compounds among which the major compounds were hexadecanoic acid methyl ester (29.40%), (Z)-9‑octadecenoic acids and methyl ester (28.64%). The volatile oil and crude extracts of the stem bark were tested in vitro for their antimicrobial activity by disk diffusion method. The highest activity was exhibited by volatile oil, CHCl3/MeOH (1:1) and petroleum ether extract against Shigela flexneri, Escherichia coli and Streptococcus agalactiae with an inhibition diameter of 21.66, 17.66 and 18.00 mm, respectively.               KEY WORDS: Antimicrobial activity, Disk diffusion, Morella salicifolia, GC-MS analysis Bull. Chem. Soc. Ethiop. 2019, 33(2), 293-306.DOI: https://dx.doi.org/10.4314/bcse.v33i2.1

WEBSITE SEBAGAI MEDIA INFORMASI DAN KOMUNIKASI PELAYANAN GEREJA

ABSTRAK - Digitalisasi adalah sasaran pergerakan dan perubahan zaman. Kondisi ini makin terasa pada era generasi milenial saat ini. Salah satu dampaknya adalah tren penggunaan teknologi informasi dan komunikasi seperti internet dan media sosial makin menjadi kebutuhan utama. Fenomena ini melanda hampir semua institusi masyarakat termasuk gereja. Hal serupa terjadi juga di jemaat Gereja Masehi Injili di Timor (GMIT) Koinonia Kupang yang persentase jemaatnya didominasi generasi milenial. Dampaknya adalah diperlukan model-model pelayanan yang menjangkau dan menjembatani kebutuhan jemaat yang berbasis teknologi informasi dan komunikasi (TIK). Solusi yang ditawarkan untuk masalah di atas adalah membuat website Gereja Koinonia sebagai sarana informasi dan komunikasi pelayanan gereja ke jemaat. Jemaat dapat mengakses informasi pelayanan kapan saja dan dimana saja menggunakan perangkat laptop atau smartphone. Selain itu dengan mengetahui informasi pelayanan memungkinkan anggota jemaat melibatkan diri dalam pelayanan gereja. Website koinonia juga memuat tabloid pelayanan online yang memuat secara rinci informasi kegiatan badan/unit dan lingkungan pelayanan dalam lingkup Jemaat Koinonia Kupang. Jemaat pun dapat memantau data statistik jemaat melalui database jemaat online pada website koinonia.   &nbsp

Laparoscopic splenectomy in the management of benign and malignant hematologic diseases

Objectives: The use of laparoscopy to treat malignant hematological diseases is not completely accepted. Our aim was to analyze operative and postoperative results of laparoscopic splenectomy performed for benign versus malignant hematological disorders. Methods: Between 1994 and 2003, 76 consecutive patients underwent laparoscopic splenectomy. The first 38 cases were performed by using an anterior approach, whereas in the remaining 38 cases a semilateral position was used. Results: Baseline characteristics showed that patients with malignant diseases were significantly older (56.9 vs 32.6 years, P 0.001). Seventy-two (94.7%) procedures were completed laparoscopically. Conversion was required in 4 cases (5.2%). Mean operative time was 138.5 minutes for benign and 151.0 minutes for malignant diseases, (P 0.05, ns). The hand-assisted technique was used in 3 patients with massive splenomegaly. Pathologic features showed that spleen volume was higher in patients with malignant diseases (mean interpole diameter 18.1 cm vs 13.7 cm, P 0.001). Massive splenomegaly (interpole diameter over 20 cm, weight over 1000 g) was present in 13 patients (17.1%); 9 had malignant diseases. Overall perioperative mortality was 1.3% and major postoperative complications occurred in 6 patients (7.8%). Postoperative splenoportal partial thrombosis was identified in 9.7% of patients. Conclusions: Laparoscopic splenectomy is a well-accepted, less-invasive procedure for hematological disorders. Neoplastic diseases or splenomegaly, or both, do not seem to limit the indications for a minimally invasive approach after the learning curve

Investigation of a typhoid fever epidemic in Moyale Sub-County, Kenya, 2014\u20132015

Aim: Typhoid fever is a vaccine-preventable bacterial disease that causes significant morbidity and mortality throughout Africa. This paper describes an upsurge of typhoid fever cases in Moyale Sub-County (MSC), Kenya, 2014\u20132015. Methods: We conducted active hospital and health facility surveillance and laboratory and antimicrobial sensitivity testing for all patients presenting with headache, fever, stomach pains, diarrhea, or constipation at five MSC health facilities between December 2014 and January 2015. We also conducted direct observation of the residential areas of the suspected cases to assess potential environmental exposures and transmission mechanisms. Demographic, clinical, and laboratory data were entered into, and descriptive statistics were calculated with, MS Excel. Results: A total of 317 patients were included in the study, with mean age 24 \ub1 8.1 years, and 51% female. Of the 317 suspect cases, 155 (49%) were positive by Widal antigen reaction test. A total of 188 (59%) specimens were subjected to culture and sensitivity testing, with 71 (38%) culture positive and 54 (76%), 43 (60%), and 33 (46%) sensitive to ceftriaxone, cefuroxime, and ciprofloxacin, respectively. Environmental assessments through direct observations showed that commercial and residential areas had limited (1) clean water sources, (2) latrines, and (3) hygiene stations for street food hawkers and their customers. Conclusions: Typhoid fever is endemic in MSC and causes significant disease across age and sex groups. The local health department should develop policies to (1) assure community access to potable water and hygiene stations and (2) vaccinate specific occupations, such as food and drink handlers, against typhoid

Aetiology and factors associated with bacterial diarrhoeal diseases amongst urban refugee children in Eastleigh, Kenya: A case control study

Introduction: Kenya is home to over 400 000 refugees from neighbouring countries. There is scanty information about diarrhoea amongst urban refugees in Kenya. Objectives: We investigated the enteric bacteria causing diarrhoea amongst urban refugee children and described the associated factors. Method: During the period of August–December 2010, urban refugee children between the ages of two and five who attended Eastleigh County Council Health Centre were enrolled into the study. Diarrhoeal cases were compared with age-matched children with no diarrhoea (controls). Stool specimens were collected and enteric bacteria isolated. A questionnaire was administered to identify risk factors. Results: A total of 41 cases and 41 controls were enrolled in the study. The age and country of origin were similar for cases and controls. The bacterial isolation rates amongst the cases were: non-pathogenic Escherichia coli 71%, Shigella dysenteriae 2.4%, Shigella flexneri 2.4%, Salmonella paratyphi 5%. For the controls, non-pathogenic E. coli 90% and enterotoxigenic E. coli (ETEC)2.4% were amongst the organisms isolated. All isolates were resistant to amoxicillin; resistance to other antibiotics varied by isolate type. Factors associated independently with diarrhoea included children not washing their hands with soap (aOR 5.9, p < 0.05), neighbour(s) having diarrhoea (aOR 39.8, p < 0.05), children not exclusively breastfed for their first 6 months (aOR 7.6, p < 0.05) and children eating food cooked the previous day (aOR 23.8, p = 0.002). Conclusions: Shigella species, Salmonella species and ETEC were found to be responsible for diarrhoea amongst the urban refugee children. Measures to control and guide the use of antibiotics are critical for the prevention of antibiotic resistance. Efforts to improve personal and domestic hygiene, including educational campaigns to promote appropriate handwashing, should be encouraged

TIPS MEMILIH DAN MENYIMPAN TELUR YANG AMAN UNTUK DIKONSUSMI

Eggs are perfect foodstuffs because they contain nutrients such as protein, fat, vitamins, and minerals in sufficient quantities. Under certain conditions, the complete nutritional content in eggs can be a good growth medium for microorganisms. It is important to educate the community about how to differentiate egg quality and how to store eggs properly so that people can choose and get eggs of good quality in the long term. The benefit is that they can be more careful in choosing the eggs to buy, and know-how to store eggs properly so that the egg's shelf life can last longer. This education was carried out online during the Covid-19 pandemic Work From Home (WFH) period using the Zoom meet application. The participants in this counseling consisted of housewives and students

Colorectal cancer after bariatric surgery (Cric-Abs 2020): Sicob (Italian society of obesity surgery) endorsed national survey

Background: The published colorectal cancer (CRC) outcomes after bariatric surgery (BS) are conflicting, with some anecdotal studies reporting increased risks. The present nationwide survey CRIC-ABS 2020 (Colo-Rectal Cancer Incidence-After Bariatric Surgery-2020), endorsed by the Italian Society of Obesity Surgery (SICOB), aims to report its incidence in Italy after BS, comparing the two commonest laparoscopic procedures—Sleeve Gastrectomy (SG) and Roux-en-Y gastric bypass (GBP). Methods: Two online questionnaires—first having 11 questions on SG/GBP frequency with a follow-up of 5–10 years, and the second containing 15 questions on CRC incidence and management, were administered to 53 referral bariatric, high volume centers. A standardized incidence ratio (SIR—a ratio of the observed number of cases to the expected number) with 95% confidence intervals (CI) was calculated along with CRC incidence risk computation for baseline characteristics. Results: Data for 20,571 patients from 34 (63%) centers between 2010 and 2015 were collected, of which 14,431 had SG (70%) and 6140 GBP (30%). 22 patients (0.10%, mean age = 53 ± 12 years, 13 males), SG: 12 and GBP: 10, developed CRC after 4.3 ± 2.3 years. Overall incidence was higher among males for both groups (SG: 0.15% vs 0.05%; GBP: 0.35% vs 0.09%) and the GBP cohort having slightly older patients. The right colon was most affected (n = 13) and SIR categorized/sex had fewer values < 1, except for GBP males (SIR = 1.07). Conclusion: Low CRC incidence after BS at 10 years (0.10%), and no difference between procedures was seen, suggesting that BS does not trigger the neoplasm development