Short-term outcomes of laparoscopic gastric plication in morbidly obese patients: Importance of postoperative follow-up

Demand for feasible, safe, and preferably low-cost methods of weight reduction is rising every day. The present study reports findings from laparoscopic gastric plication (LGP), which is a new restrictive bariatric technique, combined with a postoperative follow-up program. A 2-year prospective study was performed following LGP in 53 female morbidly obese patients from Gorgan, Iran, with a mean age of 36.3 years and mean body mass index (BMI) of 42.6 kg/m2 (35.3-62.4). Through a four-port approach, the greater omentum and short gastric vessels were transected and the greater curvature was imbricated into the body of the stomach with two rows of nonabsorbable sutures. After surgery, all patients were scheduled to attend a weekly group meeting for behavioral modification and psychotherapy. The mean operative time and hospital stay was 95 min and 72 h, respectively. No intraoperative complications occurred. Mean percentages of excess weight loss (%EWL) were 25.6 %, 54.2 %, 70.2 %, and 74.4 % after 1, 6, 12, and 24 months, respectively. Six patients lost >84 % of their excess weight after 24 months. Patients who did not participate in the group meetings had a lower %EWL after 12 (79.5 % vs. 55.6 %) and 24 months (90 % vs. 43.4 %) compared with the patients who regularly participated in the group meetings (P < 0.005). LGP is a feasible, safe, and effective surgical method for weight loss for at least 24 months when performed on morbidly obese patients. Postoperative group meetings (POGM) for psychotherapy and behavioral modification helped patients to achieve better results. © 2012 Springer Science + Business Media, LLC

The effect of gag reflex on cardiac sympatovagal tone

Objectives: Heart velocity may be influenced by gagging. The medulla oblongata receives the afferents of gag reflex. Neuronal pools of vomiting, salivation and cardiac parasympathetic fibers are very close in this area. So, their activities may be changed by spillover from each other. Using the heart rate variability (HRV) analysis, the effect of gagging on cardiac sympatovagal balance was studied. Methods: ECG was recorded from 9 healthy nonsmoker volunteer students for 10 minutes in the sitting position between 10 and 11 AM. Gagging was elicited by tactile stimulation of the posterior pharyngeal wall. At 1 kHz sampling rate, HRV was calculated. The mean of heart rate at low and high frequencies (LF: 0.04-0.15; HF: 0.15-0.4 Hz) were compared before and after the stimulus. Results: The mean of average heart rate, LF and HF in normalized units (nu) and the ratio of them (LF/HF) before and after the gagging were 89.9 ± 3 and 95.2 ± 3 bpm; 44.2 ± 5.8 and 21.2 ± 4; 31.1 ± 5.3 and 39.4 ± 3.8; and 1.7 ± 0.3 and 0.6 ± 0.2 respectively. Conclusion: Gagging increased heart velocity and had differential effect on two branches of cardiac autonomic nerves. The paradoxical relation between average heart rate and HRV indexes of sympatovagal tone may be due to unequal rate of change in autonomic fiber activities which is masked by 5 minutes interval averaging. © OMSB, 2012

Janssen effect and the stability of quasi 2-D sandpiles

We present the results of three dimensional molecular dynamics study of global normal stresses in quasi two dimensional sandpiles formed by pouring mono dispersed cohesionless spherical grains into a vertical granular Hele-Shaw cell. We observe Janssen effect which is the phenomenon of pressure saturation at the bottom of the container. Simulation of cells with different thicknesses shows that the Janssen coefficient $\kappa$ is a function of the cell thickness. Dependence of global normal stresses as well as $\kappa$ on the friction coefficients between the grains ($\mu_p$) and with walls ($\mu_w$) are also studied. The results show that in the range of our simulations $\kappa$ usually increases with wall-grain friction coefficient. Meanwhile by increasing $\mu_p$ while the other system parameters are fixed, we witness a gradual increase in $\kappa$ to a parameter dependent maximal value

Study of embryotoxicity of mentha piperita l. during organogenesis in balb/c mice

Mentha piperita (Labiatae), commonly known as peppermint is a native Iranian herb which is used in folk medicine for various purposes. This study was carried out to reveal the teratogenic effect of Mentha piperita on mice fetuses. In this experimental study, pregnant Balb/c mice divided to four groups. Case group received 600 (treatment I) and 1200 (treatment II) mg/kg/day the hydroalcoholic extract of Mentha piperita during 6-15 of gestational days and one control group received normal saline during GD6-GD15 by gavages and other control group did not receive any matter during 6-15 of gestational days. Mice sacrificed at GD18 and embryos were collected. Macroscopic observation was done by stereomicroscope. 20 fetuses of each group were stained by Alizarin red-S and Alcian blue staining method. The Mean weight of fetuses decreased in treatment groups rather than control (P<0.05) but CRL there was no significant difference between treatments and controls groups. In the treatment I (600 mg/kg/day) and treatment II (1200 mg/kg/day), normal saline and control group, no gross congenital malformations were observed in fetuses. Treated fetuses also had no delayed bone ossification as determined by Alizarin red-S and Alcian blue staining method. This study showed that the hydroalcoholic extract of Mentha piperita (600 and 1200 mg/ kg/day) has no teratogenic effect in mice fetuses if used continuously during embryonic period

The clinical study of wound healing after laparotomy in Cyprinus carpio

However the different stages of wound healing in animals have been comprehensively investigated, but this issue has received little attention in regard with the fishes. Since only limited information on the subject was available, this study was carried out. To study wound healing in fish, 171 one year old Cyprinus carpio were divided into three groups. Each group consisted of 32 carps and the rest were used as the controls. The fishes were nesthetized by MS 222 (100 ppm in 30 l) and kept in this condition using a circulator, then incised about 3-4 cm along the midline from posterior thorax to near the anal area. The abdominal organs were observed and manipulated allowed by the closure of abdominal wall. The abdominal incision was closed one layer in simple interrupted pattern. The incision in the first group was sutured by chromic cut gut # 1, the second group by plain cut gut # 2 and the third group by polyglycolic acid suture # 3/0. After the operation the fishes sere kept in three different aquaria and were checked clinically every 5th day for 50 days. Local wound inflammation was classified as moderate in 40.6% and mild in 1.25% in the first group (chromic cut gut #1). In the second group (plain cut gut #2) severe inflammation was noticed in 53.12%, moderate inflammation in 0.25% and mild in 15.62% of the fishes, but in the third group (polyglycolic acid suture # 3/0) the inflammation was mild in 18.75% of the fishes. The results proved that the plain cut gut suture had the highest inflammation rate and the polyglycolic suture had the lowest rate. The wounds surfaces in third group healed smoother than the other two groups. Therefore using polyglycolic acid suture in fish surgery can be recommended