Background Currently, more than 30% of the population in the gulf demonstrate a body mass index (BMI) exceeding 30. This burden of obesity has proven to take a toll on the population; therefore, we created the first Kuwait National Bariatric Surgery Database to report on bariatric surgeries performed in Kuwait. Methods Data was collected from the six public hospitals in Kuwait. This data was then submitted to a merged National Registry. Data web portal were used to upload, merge, and analyze the data. Results The average age for participants was 32.6 years. The average preoperative BMI was 45.9 kg/m2 for males and 43.3 kg/m2 for females. 16.4% of males and 12.3% of females presented with type 2 diabetes, while the most prevalent obesity related disease was a poor functional status in both males and females (90.8% and 90.5%, respectively). Most procedures performed in Kuwait are sleeve gastrectomy. The most encountered in-hospital complication after primary bariatric surgery was bleeding (1.5%), with Roux-en-Y gastric bypass (RYGB) having the highest recorded rate of post-operative complications (3.6% bleeding). The overall rate of operative complications was 2.6%, which was most prevalent post-RYGB (10.3%) and lowest post-sleeve gastrectomy (2.5%). Conclusion The importance of tracking and documenting the journey and change in the rates of obesity and effectiveness of bariatric procedures in individual countries with significantly high obesity rates is imperative to be able to create a plan of action to tackle this worldwide epidemic. This report will be able to provide the population with an accurate accounting that demonstrates further the safety of bariatric/metabolic surgery.
Objective: The aim of this study was to evaluate the capability of magnetic resonance imaging (MRI) to depict and characterize the changes seen in diabetic foot infections. Subjects and Methods: MRI studies of 29 diabetic patients with suspected foot infection were evaluated. Sagittal and transverse T1-weighted images before and after intravenous gadolinium, and transverse fat-suppressed T2-weighted images were performed on the affected regions. The MRI findings were compared to subsequent clinical and/or histopathological findings. Results: The MRI findings were: osteomyelitis in 14 patients, abscess in 5, cellulitis in 26, tenosynovitis in 4 and neuropathic joint in 8. Three cases were normal. Pathological confirmations were obtained in 19 patients. MRI and histological diagnosis were in concordance in 79% of osteomyelitis cases, 100% of neuropathy cases and 100% of cellulitis cases. The sensitivity and specificity of MRI in diagnosing osteomyelitis were 100 and 63%, respectively. The positive predictive and negative predictive values, and the accuracy were 79, 100 and 84%, respectively. MRI helped surgical planning for limb salvage procedures in 6 of the osteomyelitis cases and in a cellulitis case. Conclusion: The results indicate that MRI is a sensitive and accurate imaging modality for the evaluation of foot infections in diabetic patients and for planning proper treatment.
Objective: To assess the value of ultrasonography (US) in reliably differentiating benign from malignant thyroid nodules, and in defining the malignant nature and the histotype of papillary thyroid carcinomas (PTC). Methods: A high-resolution real-time US system with a 7.5-MHz linear probe was used. The sonographic features of 39 histopathologically proven PTC cases were retrospectively reviewed and compared with the US features of 52 benign thyroid nodules (BTN). The US identification of PTC malignancy was based on the simultaneous presence of multiple US features seen exclusively in PTC and not in BTN. Results: Based on the simultaneous presence of exclusive malignant US features seen in PTC but not in BTN, identification of the malignant nature of PTC was certain in 74% of the cases and less certain in 8% of the cases. In a third group, 15% of the cases showed predominantly benign US features, while 1 patient (3%) was operated as a case of multinodular goiter and diagnosed histologically as having occult PTC. No malignant features were seen by US and it was not associated with metastasis. US identification of the histological type of PTC was based on the finding that a thyroid lesion presenting as a predominant cyst with a punctately calcified endoluminal projecting solid mural nodule was an exclusively specific feature of cystic primary PTC. Both, totally cystic and microcalcified predominantly cystic metastatic lymph nodes were also characteristically seen in metastatic PTC. Accordingly, the histotype of PTC was only identified in its cystic form, whether it was primary (13%) or metastatic (31%). Both constituted 44% of the 39 PTC cases. Conclusion: High-resolution real-time ultrasonography was found to be a useful first line diagnostic modality of PTC. It was reliable in differentiating benign from malignant thyroid nodules and in identifying the histotype of PTC in cases with cystic metastasis or where the primary or the metastatic nodule is cystic with microcalcified projecting solid mural nodule. Fine needle aspiration biopsy is to be resorted to, mainly in equivocal cases.
Background Currently, more than 30% of the population in the gulf demonstrate a body mass index(BMI) exceeding 30. This burden of obesity has proven to take a toll on the population; therefore, we created the first Kuwait National Bariatric Surgery Database to report on bariatric surgeries performed in Kuwait. Methods Data was collected from the six public hospitals in Kuwait. This data was then submitted to a merged National Registry. Data web portal were used to upload, merge, and analyze the data. Results The average age for participants was 32.6 years. The average preoperative BMI was 45.9kg/m2 for males and 43.3kg/m2 for females. 16.4% of males and 12.3% of females presented with type 2 diabetes, while the most prevalent obesity related disease was a poor functional status in both males and females(90.8% and 90.5%, respectively). Most procedures performed in Kuwait are sleeve gastrectomy. The most encountered in-hospital complication after primary bariatric surgery was bleeding(1.5%), with Roux-en-Y gastric bypass(RYGB) having the highest recorded rate of post-operative complications(3.6% bleeding). The overall rate of operative complications was 2.6%, which was most prevalent post-RYGB(10.3%) and lowest post-sleeve gastrectomy(2.5%). Conclusion The importance of tracking and documenting the journey and change in the rates of obesity and effectiveness of bariatric procedures in individual countries with significantly high obesity rates is imperative to be able to create a plan of action to tackle this worldwide epidemic. This report will be able to provide the population with an accurate accounting that demonstrates further the safety of bariatric/metabolic surgery.
Background: Currently, more than 30% of the population in the gulf demonstrate a body mass index(BMI) exceeding 30. This burden of obesity has proven to take a toll on the population; therefore, we created the first Kuwait National Bariatric Surgery Database to report on bariatric surgeries performed in Kuwait.Methods: Data was collected from the six public hospitals in Kuwait. This data was then submitted to a merged National Registry. Data web portal were used to upload, merge, and analyze the data.Results: The average age for participants was 32.6 years. The average preoperative BMI was 45.9kg/m2 for males and 43.3kg/m2 for females. 16.4% of males and 12.3% of females presented with type 2 diabetes, while the most prevalent obesity related disease was a poor functional status in both males and females(90.8% and 90.5%, respectively). Most procedures performed in Kuwait are sleeve gastrectomy. The most encountered in-hospital complication after primary bariatric surgery was bleeding(1.5%), with Roux-en-Y gastric bypass(RYGB) having the highest recorded rate of post-operative complications(3.6% bleeding). The overall rate of operative complications was 2.6%, which was most prevalent post-RYGB(10.3%) and lowest post-sleeve gastrectomy(2.5%).Conclusion: The importance of tracking and documenting the journey and change in the rates of obesity and effectiveness of bariatric procedures in individual countries with significantly high obesity rates is imperative to be able to create a plan of action to tackle this worldwide epidemic. This report will be able to provide the population with an accurate accounting that demonstrates further the safety of bariatric/metabolic surgery.
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