Background: One of the top worldwide health problems is overweight and obesity, Body weight gain over a number of years could be achieved through cumulative positive energy balances, which may be the result of habitual behaviors adopted through personal choice. Despite the increased in physical activity, the percentage of people who are overweight has increased, after decades-old efforts and awareness on the issue to nudge consumers towards healthier lifestyles through dietary guidelines, diet-related diseases are still on the rise. Is there potential variables need to be evaluated for any relation with gaining weight and obesity in the patient's life styles? Objectives: Exploration of the possible factors in the life style of overweight and obese patients, resulting in weight gain. Patients and Methods: A prospective randomized study including 440 overweight or obese patients from a total of 689 patients, who consulted for advice, diet and or drugs and various bariatric operations. This was conducted in the period of 5 years from January 2, 2012 to October 1, 2017. For the information collection, each patient was interviewed face-to-face, by three Surgical Board Trainees were interviewing patients face-to-face to fill an originally-designed questionnaire in English translated to the Kurdish language. The questionnaire was composed of demographic data, medical data, biological data, and potential factors of their overweight or obesity. A comparison was made between these patients in the conception of case matching to 446 patients who were of normal body weight, and a normal BMI. Results: Most of the patients (females; n = 200, 86.95% and males; n = 167, 79.52%) in group A, while (females; n = 14, 5.90% and males; n = 21, 10.05%) were drinking water within 30 min after every meals, meanwhile (females; n = 202, 85.23%, and males; n = 173, 82.77%) from group B patients were drinking water 60 min after every meals. Nearly half of the patients have a Television in their kitchen/dining room (n = 239/440, 54.39%), however only (51.59%), (13.90%) of the patients from group A, and B respectively were watching TV while eating, A great number of the patients (Group A: n = 358, 81.36%) were operating their computers while eating, versus minority (n = 53, 11.88%), in Group B, and majority of the patients in group A were using their smart phones or making phone calls while eating (n = 390/440, 88.63%) versus small number (n = 49/460, 10.65%) in group B. Conclusion: Excessive habitual usage of a cell phone, early drinking (within 30 min) of water or other liquids after meals may be the potential factors in the initiation of becoming overweight and obese. University students living in the areas where entertainments are not affordable for all, the only remaining entertainment is using cellphones for social media and communication may be more vulnerable to gain weight, overweight and obesity. Highlights:
Background Anastomotic stricture is the main complication after surgical repair of esophageal atresia and balloon dilatations remain the treatment of choice for symptomatic esophageal strictures. Objectives The aim of this study was to evaluate the frequency of anastomotic stricture and the efficacy and complications of esophageal balloon dilatations for symptomatic anastomotic stricture in children with esophageal atresia treated in our center. Patients and Methods The medical records of 28 children operated on for esophageal atresia type C (Gross) over a 6-year period were retrospectively reviewed. Results Anastomotic stricture developed in 6 (21.4%) of the patients. They were submitted to 17 dilatation sessions. Stricture resolution occurred after a mean dilatation of 2.83 per patient (range, 1-7). Dilation was successful in 100% of patients. No complications were happened during or after the dilatation sessions. Conclusions Anastomotic stricture, secondary to the surgical treatment of esophageal atresia, is a common complication in patients with esophageal atresia. Esophageal dilation with balloon dilators is an effective and very safe procedure in the management of strictures.
Background Hypospadias is a challenging field of urogenital reconstructive surgery with different techniques being currently used. Numerous reconstruction techniques have been described previously; none can be used to correct all forms of hypospadias. The ideal result of surgery is the construction of a good caliber urethra with a slit-like urethral meatus at the tip of the glans and a straight penis. Objectives Assessing the early outcome of the meatal mobilization technique for repairing distal hypospadias regarding parent’s satisfaction for the cosmetic appearance of glans, position of the meatus, and urine stream. Patients and Methods The work approved by the ethics committee of the College of Medicine – University of Sulaimani (no.5, on 19/2/2019). Sixty male children enrolled in the pediatric surgery center in Shar hospital/ Sulaimani city /Kurdistan region-Iraq in the period of 5 years from July first, 2013 to June 30th 2018. Informed consent was taken from the parents in the form of face to face interview in the Kurdish language; for discussion of the options of treatment and possible complications. All the patients were followed up, weekly in the first month and monthly in the first 6 months, and yearly there after postoperatively. Results Patients enrolled in the study their age ranged from 6 months to 7 years, most of them were from the age group 7-12 months. The second and third age group were (13-18 months), (19-24 months) respectively. The most common complication following hypospadias repair by meatal mobilization technique (MEMO) technique was meatal stenosis (n=3, 5%) followed by urethrocutaneous fistula, breakdown requiring re-do surgery, and urethral stricture (n=2, 3.33%) (n=2, 3.33%) (n=1, 1.66%) respectively. The majority of the patient’s parents were satisfied with the result of the repair, regarding the position of the opening, cosmetic appearance, and urine stream. While satisfaction among the parents concerning the stream of the urine was (n=54 90%). Conclusion Meatal Mobilization Technique is a relatively safe and effective procedure for correction of all types of distal hypospadias including glandular, coronal, and subcoronal variants.it is associated with a minimal complication rate and a good parental satisfaction rate regarding the cosmetic appearance and urine stream.
Background Neonatal and pediatric gynaecological problems are those gynecologic disorders among younger females. Although they are common problems in Sulaimani province, but pediatric surgical unit receive most of the congenital disorders, while the acquired one usually referred to other department, with lack of a guideline for management. Objectives To ascertain the magnitude of neonatal and pediatric gynaecological disorders encountered in pediatric surgery unit in Sulaimani and to discover the pattern of presentation and principles of management with clarifying some of the anatomical variation in the rare anomalies with measuring its prevalent rate. Patients and Methods A prospective hospital based study carried out on 173 patients, all were females with gynecologic problems and have been managed at Pediatric Surgical Unit at the Sulaimani Pediatric Teaching Hospital and Shar Hospital, between Dec 2006 and Dec 2016. Excluding cases of trauma either sexual or accidental, cases of persistent cloaca, and vestibular anus. The data collected, including age, presenting complaints, type of the abnormality. The findings on physical examinations, investigations and operative procedures were collected and discussed, statistical analysis done by SPSS-21 , p value<0.05 regarded significant . Result During the study period, 173 patients had been managed from a gynecological pathology. Their ages ranged from few hours to 12 years, preschool age group was the most frequent (32.6%) and (30.64%) of them had acquired anomalies. Labial adhesion and ovarian cysts were the most frequently encountered neonatal/ pediatric gynecological disorders. The main presenting complains was abnormal looking genitalia. Conclusion Gynecological problem not restricted to adolescent or women, it may present in females at any age. Neonates may complain from acquired anomalies, although it is more common in preschool group. Pediatric atmosphere can calm fears about what can be a traumatic experience. Pediatric surgeon manage the congenital anomalies in majority, while acquired cases mostly managed by gynecologists, pediatricians, urologists, and family medicine doctors’ without same guide line for management.
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