Laparoscopic sleeve gastrectomy for obesity treatment in adolescents and young adults: a systematic review and meta-analysis.

BACKGROUND: The incidence of obesity has been increasing in younger population, posing a significant impact on adolescents' life and health care system worldwide. METHODS: We critically analyzed the existing literature on the use of laparoscopic sleeve gastrectomy (LSG) for the treatment of obesity. We performed an in-depth evaluation of 37 studies and analyzed the effect of LSG in 2300 patients, aged ≤ 22 years. RESULTS: Mean body mass index (BMI) loss after LSG was 17.81 kg/m2. Gastroesophageal reflux was the most common complication. Most of the patients showed remission of comorbidities including hypertension, diabetes, and obstructive sleep apnea after LSG. CONCLUSIONS: These findings suggest that surgical intervention is highly beneficial for reducing BMI in appropriately selected adolescents and young adults suffering from obesity and comorbidities such as life-threatening obstructive sleep apnea.

Post-Keratoplasty Infectious Keratitis Caused by Elizabethkingia meningoseptica.

BACKGROUND Microbial keratitis is a major complication of keratoplasty that is associated with serious ocular sequalae if not adequately treated. The purpose of this case report is to present a case of infectious keratitis following keratoplasty caused by the rare microorganism Elizabethkingia meningoseptica. CASE REPORT A 73-year-old patient presented to the outpatient clinic complaining of a sudden decrease of vision in his left eye. The right eye was enucleated during childhood due to ocular trauma and an ocular prosthesis was placed in the orbital socket. He underwent penetrating keratoplasty 30 years ago for corneal scar and repeated optical penetrating keratoplasty for failed graft in 2016. He was diagnosed with microbial keratitis following optical penetrating keratoplasty in the left eye. Corneal scraping of the infiltrate showed growth of the gram-negative bacteria Elizabethkingia meningoseptica. Conjunctival swab of the orbital socket of the fellow eye was positive for the same microorganism. E. meningoseptica is a rare gram-negative bacterium, which is not part of the normal ocular flora. The patient was admitted for close monitoring and was started on antibiotics. He showed significant improvement after treatment with topical moxifloxacin and topical steroids. CONCLUSIONS Microbial keratitis is a serious complication following penetrating keratoplasty. An infected orbital socket could be a risk factor of microbial keratitis of the fellow eye. A high index of suspicion, along with timely diagnosis and management, may improve the outcome and clinical response and reduce the morbidity associated with these infections. Prevention of infectious keratitis is essential and may be achieved by optimizing the ocular surface and treating the risk factors for infection.

Linezolid vs Vancomycin in Induced Thrombocytopenia.

INTRODUCTION: Linezolid and vancomycin have an important place among therapeutic antimicrobial options for multidrug-resistant gram-positive infections. Thrombocytopenia is an adverse effect reported with both and can lead to treatment interruption. Our objective was to compare the incidence of thrombocytopenia in patients receiving linezolid or vancomycin and to identify risk factors associated with thrombocytopenia. METHODS: This was a retrospective observational cohort study that involved patients who received linezolid (intravenously or orally) or vancomycin (intravenously) at a tertiary care hospital, between January 2016 and October 2019, for a minimum of 5 days and in whom platelet values were measured during treatment. Data on platelet count were collected during therapy in each group to identify the incidence of thrombocytopenia. RESULTS: A total of 453 patients fulfilled the study criteria; 241 patients received linezolid and 212 patients vancomycin. The main logistic regression analysis revealed that patients in the linezolid group had approximately a four times higher incidence of thrombocytopenia (OR 4.39; 95% CI 2.38-8.08) compared to vancomycin. An increased incidence of thrombocytopenia was associated with advanced age, baseline platelet count and vasopressor use. CONCLUSION: Clinicians considering vancomycin or linezolid for a susceptible infection should weigh the higher risk of thrombocytopenia that may be observed with linezolid vs. vancomycin in their decision.

Knowledge, Attitudes, and Practices Toward Self-Medicating Eye Symptoms in Saudi Arabia.

Purpose: Self-medication is the selection and use of drugs by individuals to treat self-diagnosed diseases or symptoms. While some patients regard self-medicating as harmless, it is far from being a safe practice. The aim of this study was to evaluate the knowledge, attitudes, and practices toward self-medicating eye symptoms in Saudi Arabia. Patients and Methods: A cross-sectional study was conducted through an online questionnaire on a study population that consisted of Saudi nationals aged 18 and older who were using or had previously used ophthalmic medications. Results: Among the 524 responses obtained, 79.4% were female, and more than half were less than 40 years old. Participants admitting to practicing ophthalmic self-medication measured 62.4%. The most commonly self-prescribed ophthalmic medications were artificial tears (n=276), followed by antiallergic (n=57) and antibiotic medications (n=33). Many participants reported that the reason for self-treatment was for repeated and simple symptoms that did not require professional care. While approximately 51% showed high levels of knowledge about ophthalmic medications, no significant relationship was seen with their choice to self-medicate (P=0.153). Conclusion: Despite detecting a high level of knowledge and acceptable practices and attitudes among participants, a high incidence of self-medication was observed. This effect was mostly attributed to long hospital waiting times and patient self-diagnosis. Increasing the number of healthcare units and properly educating patients on ophthalmic medications may help decrease the incidence of self-medication.