RESUMO
BACKGROUND: Obesity is a long-standing health issue in Saudi Arabia, known to be associated with various complications. The management of obesity encompasses both non-surgical and surgical interventions, such as sleeve gastrectomy. Although sleeve gastrectomy is one of the effective options for individuals with morbid obesity, it is not without potential complications. This study aims to examine the outcomes of patients who underwent laparoscopic sleeve gastrectomy. METHODS: A descriptive, retrospective study was conducted on adult patients who underwent laparoscopic sleeve gastrectomy at King Fahad General Hospital in Jeddah, Saudi Arabia, between January 2017 and July 2022. RESULTS: Among the 561 adult patients in the study, 53.5% were classified as having class III obesity, and 74.2% had comorbidities. Complications observed following the procedure included leaking (3.2%), symptomatic gallstone disease (2.9%), internal hernia (1.8%), and readmission (2.1%). There were no cases of bleeding, aspiration pneumonia, or mortality reported. Leakage and gallstone disease were more prevalent among patients classified as class I and II obesity, respectively, while internal hernia and readmission were more frequently observed in patients with class III obesity. CONCLUSION: Laparoscopic sleeve gastrectomy is a viable procedure for managing obesity, as it is associated with minimal complications and no recorded mortality.
RESUMO
Background: Nonalcoholic Fatty Liver Disease (NAFLD) has become a significant public health concern, affecting approximately one-fourth of the population. Despite its prevalence, no FDA-approved drug treatments specifically target NAFLD. Aim: To provide a review of clinical trials investigating the use of herbal remedies and dietary supplements in NAFLD management, utilizing the ClinicalTrials.gov database. Methods: This review evaluates the current evidence by examining completed phase III and IV clinical trials registered on ClinicalTrials.gov. An exhaustive search was performed on April 17, 2023, using the terms "Nonalcoholic Fatty Liver Disease" and "NAFLD." Two independent reviewers appraised eligible trials based on pre-defined inclusion and exclusion criteria. Results: An initial search yielded 1,226 clinical trials, with 12 meeting the inclusion criteria after filtration. The majority of trials focused on Omega-3 fatty acids (20.0%) and vitamin D (26.7%), followed by caffeine, chlorogenic acid, ginger, phosphatidylcholine, Trigonella Foenum-graecum seed extract, vitamin C, and vitamin E (each 6.7%). Most studies were Phase 3 (75.0%) and used a parallel assignment model (91.7%). Quadruple masking was the most prevalent technique (58.3%), and Iran was the leading country in terms of trial locations (25.0%). These interventions constitute two herbal interventions and nine supplement interventions. Conclusion: This reveals a diverse range of nutraceuticals, with Omega-3 fatty acids and vitamin D being predominant in the management of NAFLD. The global distribution of trials highlights the widespread interest in these therapeutics. However, more rigorous, large-scale trials are needed to establish safety, efficacy, and optimal dosages.
RESUMO
Schistosomal cholecystitis is remarkably uncommon disease which is associated with concomitant gallstone disease. The disease prevails with low socio-economic conditions of population. It is still not clear that the widespread fibrocalcific reaction in the wall of gallbladder and the cystic duct, observed for all the reports, predisposes to cholelithiasis or gallstones coexist. In the present study, we report a case of the Saudi male patient affected with schistosomal granulomatous lithiasic cholecystitis. The patient's gallbladder was badly inflamed therefore performing a safe cholecystectomy in the patient was extremely difficult. Also, infection with schistosoma is related with chronic granulomatous inflammation making the cholecystectomy procedure difficult and risky, therefore, we mainly focused on preventing the injury of bile duct by being prepared that the patient will present a complicated case. This was achieved by using the technique of laparoscopy to safely excise the gall bladder.
