The breakthrough of novel coronavirus (2019-nCoV) in Wuhan, a city of China, has damaged the status of health and quality of life. In the sequel of this epidemic or contagious disease, the patient experiences fever, chest paint, chills, a rapid heartbeat, breathing difficulties, pneumonia, and kidney failure. It has been suggested that this disease can spread through human-to-human transmission or by super spreading. By the help of the non-invasive fluid “saliva”, it is easy to detect the virus. This can help with the comfort of the patient as well as healthcare personnel. Under this perspective, we discuss the epidemic situation of 2019-nCOV and its relationship with human saliva.

Human whole mouth saliva (WMS) is secreted by salivary glands, namely parotid, submandibular/sublingual and other minor glands of the oral cavity. It is secreted in a systematic way, and contain informative proteins and peptides for the early detection of contagious diseases and organ-related diseases. The role of WMS as a liquid biopsy for the detection of cardiovascular diseases (CVD) through Myoglobin (MYO), Cardiac troponin I (cTnI), Creatine phosphokinase MB (CK-MB), Myeloperoxidase (MPO), brain natriuretic peptide (NT-proBNP), Exosomal miRNA, C-Reactive Protein (CRP), Matrix metalloproteinase-8 (MMP-8), MMP-9 and tissue inhibitor of MMP-8 (TIMP-1), leukotriene B4 has been well reported in last decade, that have been reviewed in the literature comprehensively below.

Background & Objective: Laparoscopic surgery is generally considered as better than open surgery in terms of less complications, minimal hospital stays and quick healing of the wounds. Our objective was to compare the immediate and early outcome of the different incarcerated hernias of anterior abdominal wall operated on as emergency cases by open and laparoscopic approach. Methods: This is a retrospective comparative study which was conducted at two hospitals of AlAhsa city of the Eastern region of the Kingdom of Saudi Arabia from July, 2017 to June, 2022. The data were retrieved from the medical records of the hospitals. All male and female patients having different types of incarcerated hernias of anterior abdominal wall presenting to the emergency room were included in the study. The patients were divided in two groups; those who were operated on by open approach (Group-I) and those who were operated on by laparoscopic approach (Group-II). Results: Out of total 70 male and female patients, 42 were in Group-I and 28 in Group-II. The variety of the incarcerated hernias in both groups overall was para-umbilical 26(37.14%), incisional 18(25.71%), inguinal (right & left) 17(24.28%) and epigastric 9(12.86%). The mean operative time taken by Group I and II was 126.07 (±9.728) and 98.57 (±10.079) minutes respectively with a difference of 27.50 minutes (p=0.807). The mean hospital stay of the patients in Group I and II was 1.36(±0.719) and 1.57(±0.997) days respectively (p=0.482). The post-operative complications rate in Group-I was 6(14.28%) and in Group-II, 6(21.43%) (p=0.658). Overall, 12(17.14%) patients developed the complications in both groups. When the number of the complications is compared, it shows that there was no significant difference between the two groups (p=0.583). Conclusion: Laparoscopic approach is not superior to the open approach in the terms of the immediate and early outcome/complications of the incarcerated hernias of the anterior abdominal wall operated as emergency cases in this study. doi: https://doi.org/10.12669/pjms.40.5.8899 How to cite this: AlWadaani HA, Memon AQ. Outcome of the incarcerated abdominal wall hernias managed by open and laparoscopic approaches. Pak J Med Sci. 2024;40(5):946-950. doi: https://doi.org/10.12669/pjms.40.5.8899 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

BACKGROUND/ PURPOSE: Perforated peptic ulcer (PPU) is still an existing disease that occurs frequently in the 21st century despite of the wide availability of antiulcer medication and Helicobacter eradication. The current study aimed to evaluate the hypothesis that its outcome might be improved by using the laparoscopy. The outcome of treatment in terms of complications, mortality and hospital stay with relevant to laparoscopy was analyzed. This prospective descriptive study was carried on the period of 3 years from July 2009 till July 2012. All patients with acute abdominal pain that was clinically diagnosed as having perforated peptic ulcer were included. Excluded from this study were those patients with concomitant bleeding from the ulcer and evidence of gastric outlet obstructions. Also excluded were those with evidence of large perforation more than 10 mm and patients with symptoms of more than 36 h durations for fear of septic shock. Forty seven patients were studied out of a total 53 PPU patients; they were 41 males and 6 females with the male to female ratio of 6.8:1. Their age ranged from 19 to 55 years with the mean age of 39.5 ± 8.6 years. Forty five patients were successfully treated by laparoscopy while only 2 cases that were early presented with signs of hypovolumic shock were converted into laparotomy due to severe bleeding. The mean hospital stay was 75 ± 12.6 h. Post operative complications included death of one patient in the postoperative period at the Intensive care unit (ICU) plus post operative fever in the 2 patients who underwent laparotomy and it was amenable to treatment. Laparoscopic repair of a perforated peptic ulcer is an amenable and feasible technique within the hands of experienced laparoscopic surgeon when the cases are early and properly diagnosed.

Saudi Arabia’s obesity prevalence is 19.2% among men and 21.4% among women. Treatment includes lifestyle modifications, medication, and bariatric surgery. Procedures reach up to 1200 annually in our center. Porto-mesenteric venous thrombosis associated with venous mesenteric ischemia and bowel necrosis is a rare complication that necessitates an early workup and management. A 29-year-old Saudi male underwent laparoscopic sleeve gastrectomy. Post-surgery, he experienced abdominal pain, nausea, and vomiting, exacerbated by eating and smoking. Abdomen computed tomography scans revealed engorged portal veins, congested mesenteric veins, and small bowel thickening. He underwent exploratory laparoscopy shifted to laparotomy with resection of an infarcted omentum and 1 m of jejunal small bowel loop, and was discharged postoperatively after 7 days. Porto-mesenteric venous thrombosis is a rare complication after laparoscopic sleeve gastrectomy, requiring early diagnosis and appropriate treatment. Patients present with non-specific symptoms, necessitating high suspicion for computed tomography recommendations.

Objective: To find out effectiveness of revisional laparoscopic sleeve gastrectomy (RLSG) in the patients who had laparoscopic adjustable gastric banding (LAGB) and failed to reduce or regained the weight and effectiveness of sweet abstaining and exercise on postoperative weight loss.Methods: This retrospective observational study was conducted at AlMoosa Hospital, Al-Ahsa, Kingdom of Saudi Arabia from December 2011 to November 2016. The patients who failed to reduce, regained the weight or had complications after LAGB, were performed RLSG. They were followed-up at three, six, twelve and twenty-four months intervals. Their weight, percent excess weight loss (%EWL) and body mass index (BMI) at pre-RLSG were compared with post-RLSG. The data was recorded in SPSS 22 and analyzed.Results: Thirty-six patients with male/female ratio of 1:5 underwent RLSG. Twelve (33.3%) were frequent sweet-eaters and twenty-four (66.7%) were not. Fourteen (38.88%) did not have exercise, while twenty-two (61.11%) had daily regular exercise. Their mean pre-RLSG weight, percent excess weight loss (%EWL)and BMI were compared with post-RLSG at the period of three, six, twelve and twenty-four months. Their mean weight reduced from 111.69 kilograms to 96.94, 87.25, 79.56 and 76.11 kilograms respectively. Their mean of the percent excess weight loss (%EWL) reduced to 22.08, 45.75, 59.64 and 66.42 kilograms respectively. Their mean pre-RLSG BMI was 43.50 kg.m-2, which reduced to the mean of 37.79, 34.02, 30.97 and 29.70 respectively. There were no post-operative complications in thirty (83.3%), mild like wound infection and seroma in four (11.1%) and bleeding in two (5.6%) patients. None of the patients had leakage. The patients who kept themselves abstained from sweet consumption and performed regular postoperative exercise had better results. They also had considerable reduction in appetite after RLSG.Conclusion: RLSG is an effective procedure after failed LAGB in terms of weight loss having minimal rate of complications. Moreover, abstaining from sweet consumption and continuing exercise postoperatively has better results.doi: https://doi.org/10.12669/pjms.333.12874How to cite this:AlWadaani HA, Qadeer A. Revisional laparoscopic sleeve gastrectomy in failed gastric banding and effects of exercise and frequent sweet-eating on its outcome. Pak J Med Sci. 2017;33(3):524-528.