Objective: Investigate the potential use of the neutrophil-to-lymphocyte ratio (NLR) in the identification and differentiation of acute appendicitis patients, specifically between simple and complicated presentations. Methods: An observational retrospective cohort study was conducted in Aseer Central Hospital, Saudi Arabia. Results: In total, 103 patients were included in this study, in which males (50.5%) were more common than females (49.5%), and the most common age group was found to be 36-45 years (56.3%), followed by 18-25 years (23.3%). All patients (100%) had a diagnosis of acute appendicitis. The means of neutrophils, lymphocytes, and NLR were found to be 68.970%, 22.067%, and 5.020, respectively. The majority (69%) had non-complicated appendicitis, while (31%) had complications. A significant association was seen between NLR and the occurrence of complications (p-value = 0.00001). Conclusion: This study can comprehensively support the evidence presented in the literature review. The use of the NLR demonstrates a notable level of accuracy in diagnosing acute appendicitis and differentiating between complex and uncomplicated cases.

Background/Objectives: Rapid weight loss after bariatric surgery is linked to a higher risk of symptomatic gallstone disease, which could require a cholecystectomy. This meta-analysis aimed to assess the efficacy and safety of conducting laparoscopic cholecystectomy concurrently with sleeve gastrectomy in morbid obese patients. Methods: Scopus, PubMed, ProQuest, Web of Science, and Google Scholar were searched for this review. Quality assessment was conducted using the Newcastle-Ottawa Scale for observational studies and ROB2 for randomized clinical trials. Eight of thirteen studies were high-quality. Pooling for BMI difference and LOS was used to measure efficacy, and the pooled proportion was utilized to assess safety through bleeding, wound infection, and leakage. Heterogeneity was explained via leave-one-out analysis and meta-regression. Results: The pooled standardized mean difference in BMI peri-operation was 3.26 (95% CI: 2.51–4.01, p < 0.01), where the age and initial BMI explained 98% of the heterogeneity through meta-regression. The pooled mean of LOS was 3.18 days (95% CI: 2.23–4.14, I² = 99%, p < 0.001), where age explained 33.22% of the heterogeneity through meta-regression. The pooled proportion of bleeding was 0.03 (95% CI: 0.02–0.04, I² = 2%, p = 0.42). The pooled wound infection was 0.04 (95% CI: 0.02–0.08, I² = 80%, p < 0.001), where age accounted for 99% of the heterogeneity. The pooled biliary/gastric leakage was 0.02 (95% CI: 0.01–0.05, I² = 0, p = 0.52). Conclusions: These findings indicate that the combined procedures can be executed with an acceptable safety profile. The heterogeneity in outcomes underscores the necessity of personalized patient care, standardized perioperative practices, and continuous research to enhance results and mitigate dangers.

Background and Aim: Hemorrhoids affect 75% of people worldwide. surgical hemorrhoidectomy remains the definitive intervention for severe cases. Postoperative wound care is critical, and alternative treatments, like Myrrh, are of growing interest due to their potential wound‐healing properties. This study aimed to compare the safety, efficacy, and treatment outcomes of Myrrh sitz baths with standard clinical care in promoting wound healing after hemorrhoidectomy.Methods: A retrospective cohort study was carried out using medical records from Abha Private Hospital for the period of January–December 2022. The data of patients who underwent hemorrhoidectomy were collected and categorized based on postoperative wound care into two groups: Group A for Myrrh‐based wound care as a self‐medication and Group B for standard wound care.Results: The study included 67 patients who underwent hemorrhoidectomy. Out of these patients, 52 had standard wound care, while 15 used Myrrh‐based wound care as self‐treatment without medical advice. The Myrrh group patients were significantly older with more comorbidities. The Myrrh group had significant Grade III wound healing outcomes 9/15 (60%) compared to the standard care group 2/52 (3.8%) (p < 0.001). However, despite the better healing outcomes, the Myrrh group had a significantly higher complication rate 7/15(46.7%) than the standard care group 1/52 (1.9%) (p < 0.001). These results indicate that despite the good healing capacity of Myrrh, cautious usage must be considered.Conclusion: Myrrh sitz baths appear more effective than standard wound care in enhancing healing after hemorrhoidectomy. However, increased complications suggest the necessity for comprehensive evaluation and research on its safety profile. These findings can guide future research and clinical practices related to postoperative wound care.