COVID-19 pandemic: implications on the surgical treatment of gastrointestinal and hepatopancreatobiliary tumours in EuropeEditor a Ongoing treatment. b Patient referral. c Suspended gastrointestinal (GI) and hepatopancreatobiliary (HPB) surgical programmes, depending on performance size of the participating departments. d Attributed relevance of individual factors on restriction of capacities. e Need to triage surgical procedures. f Estimated degree of impact of individual factors on triage. OR, operating room. c, P = 0⋅008.

Summarystudy objective To assess the prevalence of risk factors for coronary heart disease (CHD) in a lower middle-class urban community of Turkey.design Cross-sectional study in an age-and sex-stratified random community sample with equal sample size per stratum. Direct age-standardization using the standard world population to allow international comparison of findings. Logistic regression modelling to identify risk factors for obesity.setting Gü lveren, a residential area in Ankara, total population 23 000 persons. participants A total of 1672 adults aged 25-64 years and resident in the study community were interviewed, 1272 (76.1%) of those came for physical examination. conclusions The prevalence of smoking, obesity and low HDL is high in this urban, lower middleclass population, even in comparison with industrialized countries. Unexpectedly, women have less favourable CHD risk profiles than men, except for smoking. Preventive action should be communitywide and address the common risk factors simultaneously to avoid replacement effects such as becoming obese after quitting smoking.

BACKGROUND: This study aims to discuss management strategies regarding phytobezoar induced ileus based upon clinical results. METHODS: In the present study, between December 2012 and December 2018, a total of 25 patients who were diagnosed with phytobezoar were evaluated retrospectively. Patients who had acute mechanical intestinal obstruction due to phytobezoars at different segments of gastrointestinal (GI) tract were included in this study. The clinical data (such as clinical findings, laboratory results, radiological evaluations, treatment methods) of the patients were examined. RESULTS: Twenty five patients were included in this study. Of the 25 patients, 13 were women (52%). The median age was 60 (31-84) years, and the overall median length of the stay was 7 (2-28) days. Previous abdominal surgery had been recorded for 13 patients (72%). Two patients (8%) were followed up conservatively, whereas 20 (80%) patients had needed surgical intervention. One (4%) patient underwent surgery for distal ileal obstruction due to the pieces of bezoar that crumbled with previous endoscopic intervention. Three of the patients had complications, such as surgical site infection, wound dehiscence and paralytic ileus in the postoperative period. There were no differences between milking and gastrotomy/enterotomy groups according to the length of stay and postoperative complications. One patient died on the 13 th postoperative day due to multi-organ failure. The mortality rate was 4%. CONCLUSION: Phytobezoars, which are common with many other different surgical entities, can be located at any segment of the gastrointestinal tract and may cause obstruction, strangulation and/or even perforation. Contrast-enhanced CT scan must be performed in case of suspicion and to rule out any other causes of acute mechanical intestinal obstruction. Conservative and endoscopic procedures may be useful for selected patients, but the surgical treatment may be needed for the vast majority of the patients with phytobezoar. The surgery is safe for phytobezoar if the enterotomy site is chosen wisely.

Complications of total thyroidectomy can be minimized with increasing experience and the refinement of surgical technique.

A 78-year-old male patient with history of righ hemicolectomy due to adenocarcinoma was admitted by the complaint of epigastric discomfort. Laboratory data showed increase in liver biochemistries (aspartate aminotransferase (AST): 159 IU/L, alanine aminotransferase (ALT): 235 IU/L, alkaline phosphatase (ALP): 350 IU/L, gamma glutamyl transferase (GGT): 911 IU/L, total bilirubin: 1.55 mg/dl and direct bilirubin: 0.82 mg/dl). Endoscopic retrograde cholangiopancreatiography (ERCP) done after the gastrointestinal (GI) upper endoscopy was compatible with tumoral lesion, and biopsy confirmed 'neuroendocrine carcinoma'. Pylorus-preserving pancreaticoduodenectomy (PPPD) had been performed with R0 resection. Pathologic evaluation revealed 1.5 cm tumor of large cell neuroendocrine carcinoma (LCNEC). Five months later, biyopsy of suspicious lesions in liver had been documented as 'high grade neuroendocrine carcinoma metastasis'. He was referred to oncology for chemotherapy but unfortunatelly he had expired three months later. Large cell neuroendocrine carcinoma (LCNECs) of ampulla of Vater may have aggressive clinical course despite radical resections involving lymph node dissections. Small tumor size and lymph node negativity are not reliable factors for this tumor type.

No abstract

Background: Thyroidectomy; which involves the removal of total or part of the thyroid glandis a routinely performed surgery that may have perioperative risks and complications which can be life-threatening. Objective: Main objective of this study is to determine the incidence of postthyroidectomy complications at Banadir Hospital, and to put forward the clinical benefits of those which had been performed under local anesthesia.Materials and Methods: Present study; which is prospective in nature, was conducted on 25 patients between 18 and 70 years of age who were scheduled to undergo elective thyroidectomy beginning from May to July, 2017. Blood samples for calcium, albumin, thyroid hormone levels were collected pre-operatively; within 48 hours and 5 days post-operatively. Relevant data had been achieved from the medical achieve of the department.Results: Patients between 20 and 40 years of age occupied the highest percentage of population in the study. Two (8%) patients had records of previous thyroid surgery. Ultrasonographic (USG) evaluations revealed benign thyroid nodule for 23 (92%) patients, as 2 (8%) other patients were confirmed as malignancy on their fine needle aspiration cytology (FNAC) which had suspicious findings on ultrasonographic (USG) evaluations. 21 (84%) patients had pain as the chief complaint. 19(76%) patient operations had been performed under local anesthesia, while 6(24%) patients had undergone operations undergeneral anesthesia. Total thyroidectomy was performed for 10 (40%) patients, whereas the rest (n=15 (60%) were performed with subtotal, near total and partial (lobectomy, nodulectomy) resections. No permanent hypocalcemia was recorded during the postoperative period, though 2 (8%) patients had transient hoarseness due to laryngeal nerve injury and another 2 (8%) patients had findings of surgical site infections.Conclusion: Thyroidectomy procedure could end up with undesired outcomes like nerve paralysis or hypocalcemia even at most experienced hands. Considering that, definite and precise operation should be performed at once to prevent re-operations that could increase the rate of morbidity.International Journal of Human and Health Sciences Vol. 04 No. 03 July’20 Page : 222-225

Background: Cancer is the second leading cause of death globally and is estimated to account for 9.6 million death in 2018. Lung, prostate, colorectal, stomach and liver cancers are those most common among men; while breast, colorectal, lung, cervix and thyroid cancers are most frequent types among women. Objectives: The present study aims to assume a leading role for forthcoming researches to establish a national cancer registry database in Mogadishu, Somalia. Methodology: This is a retrospective 6-months analysis of cancer patients whose data were achieved from pathology department registries of Liban and Veritas Hospitals in Mogadishu, Somalia. Results: 126 (M/F: 51 (41.5%) / 75 (59.5%)) patients were included in the study. Esophagus had been recorded as the most frequent site of organ which was diagnosed with cancer (n=74 (58.7%)). Squamous cell carcinoma was recorded to be the most frequent histopathologically confirmed subtype (n=91 (72%), M/F:34/57), which was followed by adenocarcinoma (n=16 (12.7%), M/F:11/5) and sarcoma (n=6 (4.8%), M/F:5/1) consequtively. Majority of both squamous cell carcinoma (n=37 (40.7%)) and sarcoma patients (n=3 (50%)) were >60 years of age, whereas patients diagnosed with adenocarcinoma (n=7 (43.75%)) were between 41-50 years of age. Conclusion: Emphasis should be placed on finding ways to ensure early detection and diagnosis of cancer in Mogadishu, Somalia promptly. That should begin by giving educations to community to raise public awareness, and establishing national cancer registry to reveal up-to date data in order to make risk assessment and coordinate management strategies accordingly. Bangladesh Journal of Medical Science Vol.20(4) 2021 p.756-761