A total of 244 patients with hereditary haemolytic anaemias (HHA) were screened for acute symptomatic human parvovirus B19 infection (HPV-B19) in a prospective study. To assess the risks associated with HPV-B19 infection, patients were classified into Group I and Group II according to presence or absence (symptoms, signs and specific serology) of acute HPV-B19 infection respectively. In all, 131 (53·7%) patients had β-thalassaemia, 75 (30·7%) hereditary spherocytosis (HS), 27 (11·1%) sickle cell anaemia (SCA) and 11 (4·5%) glucose-6-phosphate dehydrogenase (G6PD) deficiency. Of 33 (13·5%) patients who presented with symptomatic HPV-B19 infection, 19 (57·5%) had HS, nine (27·3%) had β-thalassaemia and five (15·2%) had SCA. In Group I, there were significant differences in the mean white blood cell, red blood cell and platelet counts, haemoglobin concentration, total bilirubin (TB), alanine aminotransferase, aspartate aminotransferase and serum creatinine (all P < 0·001) compared to Group II. In all, 27 (81·8%) patients had arthropathy and bone marrow failure (BMF); 13 (39·4%) had acute kidney injury (AKI), more in SCA (80%); and 12 (36·4%) patients had hepatitis, more in HS (66·8%). Five (15·2%) patients with HS had BMF, AKI, nervous system involvement and extreme hyperbilirubinaemia (TB range 26·3–84·7 mg/dl). Five (15·2%) patients had haemophagocytic syndrome. Two patients with HS combined with Type-I autoimmune hepatitis presented with transient BMF. Complete recovery or stabilisation was noted at 12 months in every patient except for one patient with SCA who died during the infection. HPV-B19 must be suspected and screened in patients with HHA with typical and atypical presentations with careful follow-up.

Abstract

Background:   The incidence of morbid obesity is sharply increasing throughout the world. Obesity, and the accompanying elements of metabolic syndrome (dyslipidemia, hypertension, and diabetes mellitus), Increases the incidence and severity of cardiovascular disorders among patients. Bariatric surgery has the best efficacy regarding the management of obesity.

Objective: To assess the efficacy of sleeve gastrectomy in weight loss and improvement of co-morbidities related to obesity, especially diabetes, dyslipidaemias, hypertension, and osteoarthritis symptoms.  

Patients and methods:  A prospective data collection of 100 patients underwent laparoscopic sleeve gastrectomy between April 2015 and June 2018 have been collected throughout a year. 

Results: Mean EWL was 63.5%. Mean HBA1c has decreased from 8.5 to 6.4. Remission has occurred in 52% of hypertensive, 56% of osteoarthritis   and 67% of obstructive sleep apnea syndrome patients. 

Conclusion: LSG is a secure technique, it has a low incidence of major complications. It has a high success rate regarding the loss of weight and improvement/resolution of co-morbidities related to obesity. 

Keywords: LSG laparoscopic sleeve gastrectomy, co_morbidities