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Background and Aim: Endoscopic sleeve gastroplasty (ESG) is gaining acceptance as a non-surgical option for the treatment of obesity. However, its role is still not consolidated for all populations and the ideal indications are yet to be determined. We aimed to study the efficacy and safety of ESG in Indian patients. Methods:We conducted a single-center retrospective study of obese patients who underwent consecutive ESG at our tertiary care center. Data on weight loss and adverse events at 1, 3, 6, and 12 months were collected and analyzed. Results: Fifty-three patients underwent ESG from March 2017 toOctober 2018. Eighty one percent of patients were female (43/53). Mean baseline age and body mass index were 40.54 AE 13.79 years and 34.78AE 5.20 kg/m 2 , respectively. Mean duration of procedure was 68.96 AE 11.19 min. Immediate postoperative complications included mainly epigastric pain (45.2%) and nausea (22.6%) but there was no serious adverse event. Average percentage of total weight loss (%TWL) was 8.26%, 11.96%, 14.25%, and 19.94% at 1, 3, 6, and 12 months, respectively. Eighty-eight percent of patients achieved >15% TWL at 12 months. Younger patients (<30 years old) and female patients had greater %TWL at 12 months (P = 0.01 and P = 0.021, respectively). Last 18 procedures were significantly faster than the first 35 cases (P = 0.01).Conclusions: Endoscopic sleeve gastroplasty is effective and safe at promoting weight loss in the Indian population. Young age and female gender are related to better outcomes.

Objective There is a need to determine which bariatric operations are the most effective for patients with super obesity and super‐super obesity. Methods A retrospective cohort study was performed on patients with super obesity and super‐super obesity at Mohak Bariatrics and Robotics Surgery Center in Indore, India. Results Five hundred fourteen patients with super obesity and super‐super obesity had surgery at our center from January 2010 through December 2013. The baseline characteristics were different in different operations. The initial average age, weight, and BMI were 44.4 (SD 11.9) years, 145.4 (SD 24.2) kg, and 55.48 (SD 5.32) kg/m2, respectively. Sleeve gastrectomy (SG) (227 [44.2%]) was the most common procedure, followed by one‐anastomosis gastric bypass (OAGB) (124 [24.1%]), Roux‐en‐Y gastric bypass (RYGB) (102 [19.8%]), banded sleeve gastrectomy (BSG) (33 [6.4%]), and banded Roux‐en‐Y gastric bypass (BRYGB) (28 [5.4%]). After 3 years, the percentages of excess body weight loss (%EBWL) for SG, OAGB, RYGB, BSG, and BRYGB were 62.38%, 78.59%, 69.55%, 85.11%, and 75.77% (P < 0.0001), respectively. Failure to achieve BMI < 35 kg/m2 was more frequent in the group who underwent SG (67.9%), followed by RYGB (29.16%), BRYGB (22.2%), OAGB (9.87%), and none in the BSG group. Conclusions BSG, OAGB, and BRYGB have very good to excellent midterm outcomes for patients with super obesity and super‐super obesity, whereas RYGB and SG have average outcomes at 3 years. There is a need for multicenter, long‐term, and prospective studies to be performed to confirm these findings.

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Background:The placenta is important for fetal growth and well-being. Defective placentation and impaired placental circulation may result in anomalies in fetal growth. Placental volume in the second trimester appears to be closely related to the neonatal weight. The association of body weight with urine output has been observed in human neonates. Our goal is to assess the association of the amniotic fluid index (AFI) with the estimated fetal weight (EFW).Materials and Methods:Thirteen hundred and ninety-three pregnant women were prospectively studied by means of an ultrasound over a 12–month period. The fetal weight (FW) was estimated using a combination of fetal parameters – bi-parietal diameter, fetal trunk cross-sectional area, and femur length. AFI was assessed using the four quadrant method. The level of statistical significance was set at P ≤ 0.05.Results:There was no statistically significant association between AFI and EFW (P > 0.05; r = 0.413). We also did not find a significant association between AFI and EFW for all subdivisions of gestation age, except in the 24 – 28 weeks and 29 – 32 weeks’ groups.Conclusion:The FW calculations and amniotic index show a variation in values in late pregnancy. There does not appear to be a linear association between the ultrasound estimate of FW and the amniotic index. The implication of this is that the fetal size need not be taken into cognizance when alterations in amniotic fluid values are noted.

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