Abstract: Abstract Sleeve gastrectomy (SG) has become the primary surgical modality of treatment for obesity. This operation could be associated with motor gastric dysfunction and abnormal gastric emptying. The purpose of this prospective study is to present a comparison study of gastric emptying to solids after performing sleeve gastrectomy with two different techniques using scintigraphy. Prospectively; 26 morbidly obese patients were submitted for laparoscopic SG. Group A: 15 patients had sleeve gastrectomy started 7 cm from the pylorus and then vertical gastrectomy along a 40 French size tube. Group B: 11 patients have the sleeve started at 4 cm from the pylorus and then vertical gastrectomy along a 40 french size gastric tube. Gastric emptying of solids was measured by scintigraphic technique. Results of gastric emptying after SG is variable according to point of starting sleeve gastrectomy from the pylorus. At 4 cm it is associated with delayed emptying in 73% of patients and at 7 cm it is associated with accelerated emptying for solids in 87% of patients. These results should be considered to select the appropriate technique according to gender and preoperative foregut condition.

Abstract: Obturator hernia is a rare type of hernia which accounts for only 0.07–1.4% of all intra-abdominal hernias and 0.2–5.8% of small-intestinal obstructions. It develops predominantly in elderly underweight women. It has nonspecific early symptoms, so these hernias are usually discovered only after they have become incarcerated. Incarcerated obturator hernias are usually discovered on abdominal computed tomography scan or emergency surgery due to bowel obstruction. Here we present a case of a 65-year-old female who presented with intermittent abdominal pain, distension and nausea for last 3 days. She was a known case of hypothyroidism, taking Levothyroxine in inadequate dose. Her intial abdominal Xray was showing few air-fluid level with air present in rectum. She was initially managed conservatively but later developed features of peritonitis for which she was operated. In laparotomy, Richter type of right-sided incarcerated obturator hernia was discovered with a small necrotic area and perforation of small bowel. Bowel resection was performed and obturator hernia was closed with interrupted sutures. The patient recovered without complications. Obturator hernia, due to its rarity and nonspecific early symptoms, can still be misleading even to the most experienced clinicians. Delay in diagnosis of obturator hernia can lead to bowel necrosis and perforation with significant postoperative morbidity and mortality.

Abstract: Introduction: This study tries to determine the impact of stereotaxy on cognitive domains of patients with glioma. Methods and Materials: It was a cross-sectional study performed on 42 glioma patients aged from 15 to 65 years old. All of the patients were examined by neurosurgeons, neurologists and psychiatrists and then 42 patients were referred to stereotaxy. Cognitive evaluations were done through Stroop, CPT, and TOL tests. Results: Based on the performance assessment of the patients before and after stereotaxy, a significant difference was observed between Stroop, CPT and TOL tests measures (P<0.05). Conclusion: The present study indicated that cognitive impairments could be found in patients with glioma after stereotaxy so that for survival, longevity and better life quality they need cognitive rehabilitation simultaneous with stereotaxy.

Abstract: Treatment of maxillofacial fractures may require maxillomandibular fixation (MMF) as an important step in the treatment modality. Interdental eyelet wiring (Ivy loop method) is one of the commonly used methods. This method has the disadvantage that associated dentoalveolar fractures and subluxated teeth were not addressed. Also, this method lack horizontal bracing across the fracture site, as possessed by Risdon’s method of horizontal wiring. The purpose of this article is to present extended eyelet method of wiring which avoid these disadvantages.