An international Delphi consensus on patient preparation for metabolic and bariatric surgery.

Global obesity rates have risen dramatically, now exceeding deaths from starvation. Metabolic and bariatric surgery (MBS), initially for severe obesity (BMI ≥35 kg/m), is performed globally over 500 000 times annually, offering significant metabolic benefits beyond weight loss. However, varying eligibility criteria globally impact patient care and healthcare resources.

Increased regional activity of a pro-autophagy pathway in schizophrenia as a contributor to sex differences in the disease pathology.

Based on recent genome-wide association studies, it is theorized that altered regulation of autophagy contributes to the pathophysiology of schizophrenia and bipolar disorder. As activity of autophagy-regulatory pathways is controlled by discrete phosphorylation sites on the relevant proteins, phospho-protein profiling is one of the few approaches available for enabling a quantitative assessment of autophagic activity in the brain. Despite this, a comprehensive phospho-protein assessment in the brains of schizophrenia and bipolar disorder subjects is currently lacking.

EPAC Regulates Melanoma Growth by Stimulating mTORC1 Signaling and Loss of EPAC Signaling Dependence Correlates with Melanoma Progression.

Unlabelled: Exchange proteins directly activated by cAMP (EPAC) belong to a family of RAP guanine nucleotide exchange factors (RAPGEF). EPAC1/2 (RAPGEF3/4) activates RAP1 and the alternative cAMP signaling pathway. We previously showed that the differential growth response of primary and metastatic melanoma cells to cAMP is mediated by EPAC.

Impact of COVID-19 pandemic on bariatric surgery in India: An obesity and metabolic surgery society of India survey of 1307 patients.

Background: Although safe practice guidelines were issued by the Obesity and Metabolic Surgery Society of India (OSSI) in the end of May 2020, surgeons have been in a dilemma about risk of subjecting patients to hospitalisation and bariatric surgery. This survey was conducted with the objective to evaluate the risk of coronavirus disease-19 (COVID-19) infection in peri- and post-operative period after bariatric and metabolic surgery (BMS).

Methods: A survey with OSSI members was conducted from 20 July 2020 to 31 August 2020 in accordance with EQUATOR guidelines.

Non-Hodgkin's lymphoma of the appendix and distal ileum. A rare case report.

Primary gastrointestinal (GI) tract lymphomas constitute 1%-4% of all GI malignancies. Primary lymphomas of appendix are even more rare and are seen in 0.015% of all appendicectomy specimens.

Emotional Resilience and Bariatric Surgical Teams: a Priority in the Pandemic.

The infection control measures implemented as a result of COVID-19 led to a postponement of bariatric surgical procedures across many countries worldwide. Many bariatric surgical teams were in essence left without a profession, with many redeployed to other areas of clinical care and were not able to provide the levels of patient support given before COVID-19. As the pandemic continues, some restrictions have been lifted, with staff adjusting to new ways of working, incorporating challenging working conditions and dealing with continuing levels of stress.

Complications after bariatric surgery: A multicentric study of 11,568 patients from Indian bariatric surgery outcomes reporting group.

Background: Complications after bariatric surgery are not uncommon occurrences that influence the choice of operations both by patients and by surgeons. Complications may be classified as intra-operative, early (<30 days post-operatively) or late (beyond 30 days). The prevalence of complications is influenced by the sample size, surgeon's experience and length and percentage of follow-up.

Obesity and Metabolic Surgery Society of India (OSSI) Recommendations for Bariatric and Metabolic Surgery Practice During the COVID-19 Pandemic.

Bariatric and metabolic surgery (BMS), the only effective option for patients with obesity with or without comorbidities, has been stopped temporarily due to the ongoing novel corona virus disease (COVID-19) pandemic. However, there has been a recent change in the governmental strategy of dealing with this virus from 'Stay at Home' to 'Stay Alert' in many countries including India. A host of health services including elective surgeries are being resumed.

Trends and progress of bariatric and metabolic surgery in India.

Bariatric and metabolic surgery are being performed in India for 2 decades. Aim of this paper is to evaluate the changing clinical trends over the last 5 years and to present the other aspects helmed by Obesity and Metabolic Surgery Society of India (OSSI) to aid the growth of research, education, data management and registry, quality control, insurance-related issues and policy change. OSSI conducts an annual survey to collect data pertaining to numbers of surgical procedures.

OSSI (Obesity and Metabolic Surgery Society of India) Guidelines for Patient and Procedure Selection for Bariatric and Metabolic Surgery.

Background: India is the largest hub for bariatric and metabolic surgery in Asia. OSSI is committed to improve the quality of care and set the standards for its practice in India.

Methods: The first draft of OSSI guidelines was prepared by the secretary, Dr.

Perioperative Practices Concerning Sleeve Gastrectomy - a Survey of 863 Surgeons with a Cumulative Experience of 520,230 Procedures.

Background: Sleeve Gastrectomy (SG) is the most commonly performed bariatric procedure worldwide. There is currently no scientific study aimed at understanding variations in practices concerning this procedure. The aim of this study was to study the global variations in perioperative practices concerning SG.

Role of miR-214 in regulation of β-catenin and the malignant phenotype of melanoma.

Wnt/β-catenin signaling plays an important role in melanocyte biology, especially in the early stages of melanocyte transformation and melanomagenesis. β-catenin, encoded by the gene CTNNB1, is an intracellular signal transducer of Wnt signaling and activates transcription of genes important for cell proliferation and survival. Wnt/β-catenin signaling is frequently activated in melanoma through oncogenic mutations of β-catenin and elevated β-catenin levels are positively correlated with melanoma aggressiveness.

Selection of Bypass vs Sleeve for the Management of Type-2 Diabetes in Severely Obese: Could Ethnicity Play a Role?

Purpose: Prospective data was evaluated to see whether bariatric procedure type made any difference to diabetes remission.

Methods: One hundred eighty-six consecutive patients of Indian ethnicity (M:F 89:97) with type 2 diabetes mellitus (T2DM) and HbA1c > 6.5 were assessed before and at 1 year following surgery.

High-Percentage Pathological Findings in Obese Patients Suggest that Esophago-gastro-duodenoscopy Should Be Made Mandatory Prior to Bariatric Surgery.

Unlabelled: ᅟ: Obesity is a global epidemic and will soon become the number one priority in healthcare management. Bariatric surgery causes a significant improvement in obesity and its related complications. Pre-operative esophago-gastro-duodenoscopy (EGD) is done by several bariatric surgical teams across the world but is still not mandatory.

Evaluation of abrin induced nephrotoxicity by using novel renal injury markers.

Abrin is a potent plant toxin analogous to ricin that is derived from the seeds of Abrus precatorius plant. It belongs to the family of type II ribosome-inactivating proteins and causes cell death by irreversibly inactivating ribosomes through site-specific depurination. In this study we examined the in vivo nephrotoxicity potential of abrin toxin in terms of oxidative stress, inflammation, histopathological changes and biomarkers of kidney injury.

Zinc Deficiency after Gastric Bypass for Morbid Obesity: a Systematic Review.

Up to 50% of patients have zinc deficiency before bariatric surgery. Roux-en-Y gastric bypass (RYGB) is the commonest bariatric procedure worldwide. It can further exacerbate zinc deficiency by reducing intake as well as absorption.

Leg to leg bioelectrical impedance analysis of percentage fat mass in obese patients-Can it tell us more than we already know?

Background: Bioelectrical impedance analysis (BIA) is well tolerated, inexpensive, and readily available, but can it be used to detect with clinical precision aberrant changes in the proportion of fat mass to fat-free mass during weight loss?

Objectives: To assess the variance in percentage body fat mass explained by the readily available inputs and assess residual variance provided by leg-to-leg BIA scales.

Methods: Using cross-sectional data from a cohort of 665 patients of Indian ethnicity presenting for bariatric surgery, we examine the determinants of percentage body fat as provided by leg-to-leg output from Tanita SC-330 BIA scales.

Results: Four input factors-sex, weight, height, and age-contributed to provide 92% and 95% explanation in output variance for percentage fat mass (%FM) and actual fat mass, respectively, in 665 patients.

Laparoscopic revision of Roux-en-Y gastric bypass to sleeve gastrectomy: A ray of hope for failed Roux-en-Y gastric bypass.

Introduction: Roux-en-Y gastric bypass (RYGB) is the most commonly performed bariatric operation across the world, but sometimes revision is necessary. Inadequate weight loss, weight regain, and complications such as dumping syndrome are common reasons for revision. We report the 1-year outcomes of five patients who underwent laparoscopic conversion of RYGB to sleeve gastrectomy during surgical revision.

Bariatric Nutrition Guidelines for the Indian Population.

Background: Bariatric surgery numbers have seen a sharp rise in India in the last decade. A country known for its undernourished population has seen economic growth and with it, greater influence of western culture and foods. The obesity epidemic is on the rise here and India is one of the 10 most obese nations of the world being second only to China in the number of type 2 diabetes.

Predictors of Remission of T2DM and Metabolic Effects after Laparoscopic Roux-en-y Gastric Bypass in Obese Indian Diabetics-a 5-Year Study.

Background: Bariatric surgery has proven results for diabetes remission in obese diabetics. Despite this, a lot of ambiguity exists around patient selection. The objectives of this study are the following: (1) evaluation of results of laparoscopic Roux-en-y gastric bypass (LRYGB) in obese type 2 diabetic (T2DM) Indian patients at 5 years and (2) to define predictors of success after surgery.

Management of gastro-colic fistula after laparoscopic sleeve gastrectomy.

Laparoscopic sleeve gastrectomy (LSG) is the most common bariatric procedure performed in Asia. Staple-line leaks post LSG are notoriously difficult to treat. Here we report a case of a gastro-colic fistula after a post-LSG leak.