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Cardiothoracic area ratio for evaluation of ejection fraction in patients

Aim: The advent of digital radiology and computerized workstations renders it very easy to measure cardiothoracic ratio (CTR) and cardiothoracic area ratio (CTAR) on chest radiographs. The aim of this study was to assess whether CTAR correlates with the left ventricular ejection fraction (EF) better than CTR in healthy individuals and patients with congestive heart failure. Material and Method: The study included 156 healthy individuals and 98 heart failure patients undergoing echocardiography and digital chest radiography. The CTR was calculated in the traditional manner, and the CTAR was taken as the ratio between the pixel counts of the cardiac area and whole thoracic area. Results: The traditional CTR showed an inverse correlation with ejection fraction in both healthy individuals (r = -0.13) and heart failure patients (r = -0.19). The CTAR showed an improved correlation (r = -0.32 for healthy individuals and r = -0.37 for heart failure patients). If it is assumed that an ejection fraction of 55% or more indicates normal cardiac function, a value of 50% or less for CTAR can be taken as normal. Discussion: Digital chest radiography is widely used as a popular technique for diagnosing various thoracic and cardiac diseases. Cardiomegaly is associated with an adverse outcome in patients with heart disease. Therefore, evaluation of heart size is an important clinical variable, and changes in heart size may be used to monitor and grade cardiac disease severity. Conclusion: Our findings suggest that the CTAR correlates better with cardiac function as assessed by the ejection fraction than the traditional CTR.

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The effect of using a larger port on reducing the complications of laparoscopic cholecystectomy: A randomized trial

Aim: Laparoscopic cholecystectomy (LC) is the gold standard treatment method for cholelithiasis. There are many complications related to LC and many different

microinvasive interventions have been performed to decrease the complication rate. In this study, we aimed to demonstrate the surgical results of the

LC that was performed with a 15-mm port tool. Material and Method: Two-hundred patients who underwent LC in our clinic were included in this study. These

cases were randomized as 10-mm port tool group (n=100) and 15-mm port tool group (n=100) according to the port-tool diameter that was used in LC. The

gallbladder extraction time, port site complications, length of hospital stay, postoperative pain and cosmesis scores were compared between two groups.Results:

The gallbladder extraction time was 135.3 sec in the 10-mm port tool group and 13.4 sec in the 15-mm port tool group (p<0.05). The complication rate

was 53% (53cases) in the 10-mm port tool group and 13% (13cases) in the 15-mm port tool group (p<0.05). The duration of hospitalization was the same in

both groups. The port site pain was 5.4 (2–9) in the 10-mm port tool group and 4.3 (1-7) in the 15-mm port tool group (p<0.05). None of the patients in either

group had port site hernias or infections, and there was no significant difference between the two groups with regard to the port site incision scarring. Discussion:

It was thought that it can reduce the operation time, the need for fascial expansion, gallbladder perforations during removal, and postoperative port site

pain. Moreover, it does not increase the risk of a port site infection or a hernia and is not different from wound scarring.

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Impact of aerobic training on plasma leptin and pulmonary functions in obese adolescents

Aim: The present study aimed to detect and relate alteration in reaction of plasma leptin and pulmonary functions (forced vital capacity “FVC” and forced

expiratory volume in the first second “FEV1”) in obese adolescent schoolboys and schoolgirls to aerobic training. Material and Method: Sixty obese secondary

school students with body mass index (BMI) of 30 kg/m2 or greater, with age range of 15 to 18 years participated in this study. Participants were allocated

into two equal groups based on their gender: 30 schoolgirls (Group A) and 30 schoolboys (Group B). All subjects in both groups practiced moderate-intensity

aerobic training program using a stationary cycle ergometer for a period of 4 months 5 days a week. Plasma leptin levels and pulmonary functions (FVC and

FEV1) were measured in all students’ before and after the program started. Participants were chosen from thirteen Secondary Schools, Jeddah, Saudi Arabia.

They received training program at Pediatric Out-Patient Clinic, King Abdul-Aziz Hospitals. The study was conducted between June 2015 and May 2016. Results:

After 4 months of aerobic exercise program, there was a significant decrease (p < 0.05) in leptin and significant improvement in pulmonary functions in both

groups. Moreover, there was a significant difference (p < 0.05) in both groups in leptin levels with favor to girls group. In contrast, there was a significant

difference (p<0.05) in both groups in pulmonary functions with favor to boys group. Discussion: Following aerobic exercise program, pulmonary functions

were improved in obese adolescent schoolboys more than in obese adolescent schoolgirls. In contrast, serum leptin hormone values were improved in obese

adolescent schoolgirls more than in schoolboys.

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