Mid- and long-term renal outcomes after metabolic surgery in a multi-center, multi-ethnic Asian cohort with T2DM.

Background: Metabolic surgery is recognized for its effectiveness in weight loss and improving outcomes for individuals with type 2 diabetes mellitus (T2DM). However, its impact on renal function, especially in multi-ethnic Asian populations, remains underexplored. This study investigates mid- and long-term renal outcomes following metabolic surgery in Asian patients with T2DM.

Revision/Conversion Surgeries After One Anastomosis Gastric Bypass-An Experts' Modified Delphi Consensus.

Purpose: There is a lack of evidence for treatment of some conditions including complication management, suboptimal initial weight loss, recurrent weight gain, or worsening of a significant obesity complication after one anastomosis gastric bypass (OAGB). This study was designed to respond to the existing lack of agreement and to provide a valuable resource for clinicians by employing an expert-modified Delphi consensus method.

Methods: Forty-eight recognized bariatric surgeons from 28 countries participated in the modified Delphi consensus to vote on 64 statements in two rounds.

Technical Variations and Considerations around OAGB in IFSO-APC and IFSO-MENAC Chapters, an Expert Survey.

Objective: This study aimed to evaluate the technical variations of one-anastomosis gastric bypass (OAGB) among IFSO-APC and MENAC experts.

Background: The multitude of technical variations and patient selection challenges among metabolic and bariatric surgeons worldwide necessitates a heightened awareness of these issues. Understanding different perspectives and viewpoints can empower surgeons performing OAGB to adapt their techniques, leading to improved outcomes and reduced complications.

First Global Report of Catastrophic Results Due to Internal Herniation of Roux Limb in the Space Between the Gastric Pouch and Band: a Series of 3 Cases of Banded Roux-en-Y Gastric Bypass (BRYGB).

Background: Banded Roux-en-Y gastric bypass (BRYGB) is associated with complications known with the bypass along with specific complications related to the band. Roux-limb gangrene, due to herniation between the gastric pouch and band, however, has no mention in literature.

Methods: We report this potentially fatal complication of BRYGB and its management in a series of 3 patients.

Co-administration of AYUSH 64 as an adjunct to standard of care in mild and moderate COVID-19: A randomized, controlled, multicentric clinical trial.

Objective: Evaluate the efficacy of AYUSH 64, a standard polyherbal Ayurvedic drug in COVID-19.

Methods: During the first pandemic wave, 140 consenting and eligible hospitalized adult participants with mild-moderate symptomatic disease (specific standard RT-PCR assay positive) were selected as per a convenience sample, and randomized (1:1 ratio) to an open-label (assessor blind) two-arm multicentric drug trial; standard of care (SOC as per Indian guidelines) versus AYUSH 64 combined with SOC (AYUSH plus). Participants were assessed daily and discharged once clinical recovery (CR, primary efficacy) was achieved which was based on a predetermined set of criteria (resolution of symptoms, normal peripheral oximetry, and negative specific RT-PCR assay).

Patient Selection in One Anastomosis/Mini Gastric Bypass-an Expert Modified Delphi Consensus.

Purpose: One anastomosis/mini gastric bypass (OAGB/MGB) is up to date the third most performed obesity and metabolic procedure worldwide, which recently has been endorsed by ASMBS. The main criticisms are the risk of bile reflux, esophageal cancer, and malnutrition. Although IFSO has recognized this procedure, guidance is needed regarding selection criteria.

Cross-Sectional and Longitudinal Mental Health Status Prevailing among COVID-19 Patients in Mumbai, India.

Introduction: The aim was to determine the prevalence and predictors of depression among less symptomatic COVID-19 patients.

Methods: A questionnaire-based assessment was conducted among asymptomatic or mildly symptomatic COVID-19 patients when admitted in a COVID-19 facility (T1) and after 6 months (T2). Interviews were conducted using the Patient Health Questionnaire-9 instrument.

A Global Survey by the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) on Perceptions of Bariatric Medical Tourism (BMT) by Health Professionals: Guidelines from IFSO for BMT.

Background: Bariatric medical tourism (BMT) is a rapidly expanding industry, with over 650 million people with obesity worldwide and total number rising by over 300% between 2003 and 2014. The overall health tourism industry is worth over $400 billion/year.

Methods: International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) conducted a global survey to analyze the details of BMT and the perceptions of bariatric health care professionals (HCP) regarding BMT.

Long-term outcomes of metabolic surgery in overweight and obese patients with type 2 diabetes in Asia.

Aim: To assess the outcomes of metabolic surgery in overweight and obese patients in Asia with type 2 diabetes (T2D).

Materials And Methods: The treatment outcomes of 1999 patients from the Asian Diabetes Surgery Summit database were analysed. The changes in treatment effects across time were assessed with respect to the surgical procedures performed by using generalized estimating equations.

IFSO Endoscopy Committee Position Statement on the Practice of Bariatric Endoscopy During the COVID-19 Pandemic.

COVID-19 (Coronavirus disease 2019) caused by SARS-CoV-2 has become a global pandemic. Obesity is a risk factor for severe disease, and the practice of endoscopy poses special challenges and risks of SARS-CoV-2 transmission to patients and providers given the evolving role of the gastrointestinal tract in viral transmission and aerosol generation during endoscopic procedures. It is therefore necessary to distinguish between urgent interventions that cannot be postponed despite the risks during the pandemic and, in contrast, purely elective interventions that could be deferred in order to minimize transmission risks during a time of infection surge and limited access.

Gastro-Colic Fistula After Sleeve Gastrectomy Leak: Our Experience with this Rare Complication.

Background: Sleeve gastrectomy (SG) is one of the commonest bariatric procedure performed worldwide (Asian Journal of Endoscopic Surgery 7:314-6, 2014). Leaks reported in 1 to 7% of cases are difficult to manage after SG. Leaks can be graded into acute (within 7 days), early (within 1-6 weeks), late (after 6 weeks) and chronic (after 12 weeks) (Asian Journal of Endoscopic Surgery 7:314-6, 2014).

Metabolic Syndrome Rather than Obesity Alone Is More Significant for Kidney Disease.

Introduction: Obesity is associated with metabolic syndrome, nonalcoholic steatohepatitis, and kidney disease. BMI may not be the ideal measure of obesity when used to assess its effect on kidney disease as it does not discriminate for age, sex, ethnicity, muscle, bone, or fat mass.

Objectives: To assess the prevalence microalbuminuria and identify independent risk factors for development of kidney disease in the obese Indian population.

The HAALT Non-invasive Scoring System for NAFLD in Obesity.

Background: The prevalence of NAFLD increases in obese diabetics. Accurate diagnosis of NAFLD requires invasive liver biopsies, which is costly, and time consuming and labor intensive. Currently, there is a lack of non-invasive diagnostic methods to identify those with NASH, in obese Indians.

Influence of Asian Ethnicities on Short- and Mid-term Outcomes Following Laparoscopic Sleeve Gastrectomy.

Purpose: Prevalence of obesity in Asia has been on the increasing trend, with corresponding increase in utilisation of bariatric surgery. The objective of this study was to examine differences in weight loss outcomes following bariatric surgery between Asian ethnicities.

Materials And Methods: A retrospective database review was conducted of patients undergoing primary laparoscopic sleeve gastrectomy between 2009 and 2013 in 14 centres from Singapore, Malaysia, Taiwan, Hong Kong, Japan, Korea, India, Australia, Switzerland, and the USA.

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.

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.