Alireza Rezapanah

We present a case study of a 34‐year‐old man with morbid obesity and a suspected Bartter–Gitelman spectrum tubulopathy (without genetic confirmation), weighing 135 kg, and with a BMI of 42.5 kg/m ² , who was referred to the metabolic and bariatric surgery department due to morbid obesity to address abnormal electrolyte levels. The clinical presentation suggested renal tubular salt wasting. Post‐sleeve gastrectomy, the patient had sustained and prolonged normalization in his electrolytes without the use of any medications. This provides evidence of a possible relationship between metabolic surgery and renal tubular function. This case supports recognizing a suspected tubulopathy in candidates for metabolic surgery.

Summary: The optimal size of Gastrojejunostomy (GJ) in Laparoscopic Roux‐EnY Gastric Bypass (LRYGB) for a‐ preferential weight loss is still unknown. This study aimed to investigate the influence of linear‐stapled GJ size in long‐term LRYGB weight reduction results. We performed a retrospective analysis of 100 patients who underwent LRYGB surgery between January and July 2021. The patients were divided into two 50‐patient groups based on the size of their linear‐stapled GJ, either 30 or 45 mm. Their weight loss was observed and compared on day 15, and the following appointments were 1, 3, 6, 9, 12, 18, and 24 months after surgery. After 24 months, the 30‐mm group reduced their BMI by an average of 19.23, compared with the 16.43 kg/m² of the 45‐mm group (p < .001). Overall, repeated measures ANOVA showed a beneficial weight loss pattern for the 30‐mm group in all four categories (weight, BMI, EWL, and TWL). Upon adjusting for age, biliopancreatic length, alimentary length, sex, history of diabetes, and a history of hypertension in repeated measures ANOVA, this difference remained significantly in favour of the 30‐mm GJ. Based on the results of this study, performing a gastrojejunostomy with a 30‐mm stapler compared to a 45‐mm stapler increases weight loss in LRYGB patients.

Key Clinical Message: Although gastro‐pleural fistulas after bariatric surgeries are rare, they are life‐threatening complications that should be suspected in patients who present with gastrointestinal or respiratory symptoms after bariatric surgery. Previous studies showed an incidence rate of 0.2%–0.37% for gastro‐pleural fistulas after bariatric surgery. We report a 56‐year‐old female with a rare presentation of gastro‐pleural fistula after Roux‐en‐Y gastric bypass, simultaneous fistula of the gastric pouch, and remnant to the pleural space.

In this study, we successfully utilized nitrate precursors for the synthesis of silver (Ag)-doped borate-based mesoporous bioactive glass (MBGs) based on the 1393B3 glass formulation in the presence of a polymeric substrate (polyvinyl alcohol (PVA)) as a stabilizer of boric acid. The X-ray diffraction (XRD) analysis confirmed the glassy state of all the MBGs. The incorporation of 7.5 mol% Ag into the glass composition led to a decrease in the glass transition temperature (T_g). Improvements in the particle size, zeta potential, surface roughness, and surface area values were observed in the Ag-doped MBGs. The MBGs (1 mg/mL) had no adverse effect on the viability of fibroblasts. In addition, Ag-doped MBGs exhibited potent antibacterial activity against gram-positive and gram-negative species. In summary, a modified sol–gel method was confirmed for producing the Ag-doped 1393B3 glasses, and the primary in vitro outcomes hold promise for conducting in vivo studies for managing burns.

Background: Hydatid disease is a parasitic infection that is endemic in Iran. It infests humans and herbivorous animals and reflects infection by Echinococcus granulosus. Although it can develop anywhere in the body, the liver and lungs are the most common sites of involvement. Primary muscular hydatidosis with no involvement of thoracoabdominal organs is a rare event. Methods: Case report and review of relevant literature. Results: We treated a 27-year old male patient with a swelling on his right shoulder that turned out to be a hydatid cyst by magnetic resonance imaging scan. The treatment included surgical excision combined with post-operative anthelminthic administration. Of the total reported cases of hydatidosis, 0.7–3% were described as musculoskeletal cysts. Conclusions: Especially in endemic areas, to avoid fine-needle biopsy and the risk of spillage of cyst contents irrespective of their location, hydatid disease should be considered in the differential diagnosis of muscular masses, and the diagnosis should be made by imaging and serology insofar as possible.