a) VBG produces less weight loss when compared to RYGB
b) Jejuno-ileal by-pass not done nowadays.
c) Dumping is due to non- compliance of dietary advice
d) LAGB requires once a 4-6wk follow up
Calorie restriction is responsible for long term weight loss and its beneficial effects such as control of diabetes, dyslipidemia, hypertension and other metabolic abnormalities.
Restrictive procedures are LSG and LAGB which decrease the appetite and induce early satiety.
The RYGB (ROUX en Y gastric bypass ) is a malabsorptive procedure with long term sustained weight loss.
Mechanism of weight loss after bariatric surgery
Ghrelin is orexigenic gut hormone, which increases appetite. After food intake ghrelin levels fall and appetite decreases.
After restrictive surgery such as LYGB and LSG, ghrelin levels fall and appetite decreases.
Vertical Banded Gastroplasty (VBG) This procedure has been abandoned in favor of other operations because of poor long-term weight loss, a high rate of late stenosis of the gastric outlet, and a tendency for patients to adopt a highcalorie liquid diet, thereby leading to regain of weight. Choice a is correct
Q. Least common complication of Meckel's diverticulum (NEET 2018)
Answer is free 7) c Neoplasm
The most common clinical presentation of Meckel’s diverticulum is gastrointestinal bleeding, which occurs in 25% to 50% of patients who present with complications
intestinal obstruction occur as a result of a volvulus of the small bowel around a diverticulum associated with a fibrotic band attached to the abdominal wall, intussusception, or, rarely, incarceration of the diverticulum in an inguinal hernia (Littre hernia)
Diverticulitis accounts for 10% to 20% of symptomatic presentations.
Neoplasms can also occur in a Meckel’s diverticulum, with NET as the most common malignant neoplasm (77%). Other histologic types include adenocarcinoma (11%), which generally originates from the gastric mucosa, and GIST (10%) and lymphoma (1%).
Hyperbaric oxygen therapy in radiation proctitis all are true except A. Indicated in acute radiation proctitis but not in subacute or chronic radiation proctitis B. Oxygen increases the growth of residual tumor and hence tumor should be completely resected C. Complications include Parkinsonism, barotrauma D. Usually 30-40 sessions are required for treatment
Answer free for all
Hyperbaric oxygen overcomes chronic tissue hypoxia in radiation damaged tissues and with repeated sessions induces growth of regenerative tissue, capillaries, and epithelium. Successful therapy may take multiple sessions. 18 to 60 treatments
Ref Shackelford page 2211
HBO treatments for hypoxic wounds are usually delivered at 1.9 to 2.5 atm
for sessions of 90 to 120 minutes each. Treatments are given once daily, five to six times per week and should be given as an adjunct to surgical or medical therapies. Clinical evidence of wound improvement should be noted after 15 to 20 treatments.Read More ...