Hyperinsulinemic Hypoglycemia after Bariatric Surgery

Early Surgical Outcomes of Metabolic and Bariatric Surgery for Super Obesity in Korean Morbidly Obese Patients

Purpose

To know about the feasibility and effectiveness of metabolic/bariatric surgery (MBS) in Korean super obese patients.

Materials and Methods

We reviewed the medical records of 18 super obese (body mass index [BMI] ≥50 kg/m2) patients among 131 morbidly obese patients who underwent MBS at Incheon St. Mary's Hospital, the Catholic University of Korea from May 2011 to July 2024 and investigated the early surgical outcomes of these patients.

Results

Male/female ratio was 10 to 8, the mean age was 35.4±10.6 year, the mean body weight was 161.6±35.2 (range 112.9-241) kg, and the mean BMI was 58.3±8.2 (range 50.0-78.7) kg/m2. Sleeve gastrectomy (SG) was performed in 10 patients, SG plus procedure (SG+) in 5 patients, single anastomosis duodenoileal bypass with SG (SADI-S) in 2 patients and long biliopancreatic limb Roux-en-Y gastric bypass (LBPL RYGB) in 1 patient. The mean operation time was 170.3±64.5 minute and the mean postoperative hospital stay was 9±4.6 day. There was no postoperative morbidity and no mortality. The percentage of total weight loss at 1 year after surgery was 34.3±0.6% in SG, 23.1±3.2% in SG+, 45.8±4.5% in SADI-S and 47% in LBPL RYGB.

Conclusion

MBS was feasible and effective in Korean super obese patients. However, SG+ was less effective than expected in these patients.

Uptake of HIV Self-Testing and Associated Factors Among Female Sex Workers at Non-Governmental HIV Testing Facilities in Debre Markos and Bahir Dar Towns, Northwest Ethiopia, 2022

Background

Human immunodeficiency virus self-testing (HIVST) is universally accepted as an HIV testing option to achieve the United Nations Agency for International Development first 95 goal by 2030. HIV testing coverage through voluntary counseling and testing and provider initiated testing and counseling is low among female sex workers (FSWs). However, there is no evidence on the level of HIVST among FSWs in the study area.

Objective

To assess the uptake of HIVST and associated factors among FSWs at non-governmental facilities in Debre Markos and Bahir Dar towns, Northwest Ethiopia, 2022.

Methods

An institution-based cross-sectional study design was employed. A total of 423 study participants were selected by systematic random sampling technique. The data were collected using a structured and pre-tested questionnaire; entered into EpiData version 3.1 and exported to SPSS version 25 for analysis. An adjusted odds ratio (AOR) with a 95% confidence interval (CI) was estimated to assess the strength of association between independent variables and dependent variable. Bivariable logistic regression was done for each variable and those with a P-value of < 0.25% were selected for multivariable analysis. Finally, P-value < 0.05% was declared statistically significant.

Results

The magnitude of HIVST uptake among FSWs was 59.3%. Time since engagement of sex work > 5 years [AOR 2.16 (95% CI: 1.158-4.013)], age of first sexual debut >19 years [AOR 3.23 (95% CI: 2.045-5.093)], previous urban residence [AOR 3.99 (95% CI: 2.58-6.18)], good knowledge towards HIVST [AOR 1.78 (95% CI: 1.066-2.964)], education status being college and above [AOR 5.6 (95% CI: 3.12-9.30)] were significantly associated factors.

Conclusion

HIVST uptake among FSWs was 59.3% which is lower than expected at national level. Educational status, age at first sexual debut, knowledge towards HIVST, and time since engagement in sex work were significantly associated with HIVST uptake.