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  1. Article ; Online: Are Patients Suffering from Severe Obesity Getting a Raw Deal During COVID-19 Pandemic?

    Bhasker, Aparna Govil / Greve, Jan Willem

    Obesity surgery

    2020  Volume 30, Issue 10, Page(s) 4107–4108

    Keywords covid19
    Language English
    Publishing date 2020-05-12
    Publishing country United States
    Document type Letter
    ZDB-ID 1070827-3
    ISSN 1708-0428 ; 0960-8923
    ISSN (online) 1708-0428
    ISSN 0960-8923
    DOI 10.1007/s11695-020-04677-z
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  3. Article ; Online: Are Patients Suffering from Severe Obesity Getting a Raw Deal During COVID-19 Pandemic?

    Bhasker, Aparna Govil / Greve, Jan Willem

    Obesity Surgery

    2020  Volume 30, Issue 10, Page(s) 4107–4108

    Keywords Surgery ; Nutrition and Dietetics ; Endocrinology, Diabetes and Metabolism ; covid19
    Language English
    Publisher Springer Science and Business Media LLC
    Publishing country us
    Document type Article ; Online
    ZDB-ID 1070827-3
    ISSN 1708-0428 ; 0960-8923
    ISSN (online) 1708-0428
    ISSN 0960-8923
    DOI 10.1007/s11695-020-04677-z
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  4. Article: Non-Hodgkin's lymphoma of the appendix and distal ileum. A rare case report.

    Bhasker, Aparna Govil / Kotecha, Jay D / Pandey, Rahul / Wani, Sachin

    Journal of minimal access surgery

    2021  Volume 17, Issue 4, Page(s) 548–550

    Abstract: 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. Here, we report a rare case of non-Hodgkin's lymphoma tumours ... ...

    Abstract 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. Here, we report a rare case of non-Hodgkin's lymphoma tumours in the appendix and distal ileum in a non-immune compromised young male patient who presented with intermittent intussusception and pain in the right iliac fossa. A laparoscopic right hemicolectomy was performed and the patient recovered uneventfully. Adjuvant chemotherapy (CHOP) in the form of CHOP regimen has been further advised.
    Language English
    Publishing date 2021-08-19
    Publishing country India
    Document type Case Reports
    ZDB-ID 2186884-0
    ISSN 1998-3921 ; 0972-9941
    ISSN (online) 1998-3921
    ISSN 0972-9941
    DOI 10.4103/jmas.JMAS_3_21
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  5. Article ; Online: Selection of Bypass vs Sleeve for the Management of Type-2 Diabetes in Severely Obese: Could Ethnicity Play a Role?

    Bhasker, Aparna Govil / Dixon, John B / Lakdawala, Muffazal

    Obesity surgery

    2018  Volume 28, Issue 10, Page(s) 3073–3079

    Abstract: 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 ... ...

    Abstract 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. Age, BMI, C-peptide and duration of diabetes (ABCD - described by WJ Lee), insulin use, baseline HbA1c, and % weight loss were tested as modifiers. We present remission rates (HbA1c ≤ 6.0%) and between group remission odds ratio (OR) and adjusted OR after controlling for key modifiers.
    Results: Patients selecting RYGB (n = 113) vs SG (n = 73) were older (50.7 vs 44.2 years), had a lower BMI (44.1 vs 46.7), lower C-peptide (3.5 vs 4.7 ng/ml), greater duration of diabetes (8 vs 3 years), and higher HbA1c (8.90 and 7.9%) respectively p < 0.05 for all (combined R
    Conclusion: The analysis suggests SG may be superior to RYGB in this Indian population. Ethnicity may play a role in predicting the response to bariatric surgery and hence the choice of procedure. A randomized controlled trial is needed to clarify the relative benefit.
    MeSH term(s) Adult ; Bariatric Surgery/methods ; Bariatric Surgery/statistics & numerical data ; Diabetes Mellitus, Type 2/epidemiology ; Diabetes Mellitus, Type 2/surgery ; Female ; Humans ; India/epidemiology ; Male ; Middle Aged ; Obesity, Morbid/epidemiology ; Obesity, Morbid/surgery ; Prospective Studies
    Language English
    Publishing date 2018-04-09
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1070827-3
    ISSN 1708-0428 ; 0960-8923
    ISSN (online) 1708-0428
    ISSN 0960-8923
    DOI 10.1007/s11695-018-3294-9
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 3381: Show issues Location:
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    ab Jg. 2022: Lesesaal (EG)

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

    D'Silva, Mizelle / Bhasker, Aparna Govil / Kantharia, Nimisha S / Lakdawala, Muffazal

    Obesity surgery

    2018  Volume 28, Issue 9, Page(s) 2753–2759

    Abstract: 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 ... ...

    Abstract 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.
    Aim: To study the percentage of symptomatic and asymptomatic pathological EGD findings in obese patients undergoing bariatric surgery and to analyze whether these findings influence the eventual choice of bariatric surgery.
    Materials and methods: All patients posted for bariatric surgery at our institute from January 2015 to March 2017 had a pre-operative EGD done by the same team of endoscopists.
    Results: In this study, totally, 675 patients were assessed prior to routine bariatric surgery. 78.52% of all pre-operative patients had an abnormal EGD. The most common endoscopic abnormalities found were hiatus hernia (52.44%), gastritis (46.22%), presence of Helicobacter (H.) pylori (46.67%), reflux esophagitis (16.89%), Barrett's esophagus (1.78%), gastric erosions (13.19%), and polyps (7.41%). Fifty patients had upper gastrointestinal polyps: 41 in the stomach, 3 in the esophagus, and 6 in the duodenum, mostly benign hyperplastic or inflammatory polyps. Two patients had gastrointestinal stromal tumor (GIST), 6 leiomyoma, and 6 neuroendocrine tumors (NET). Of those with endoscopic evidence of gastroesophageal reflux disease (GERD), 70 (60.03%) of patients were asymptomatic. The pre-operative EGD findings resulted in a change of the planned surgical procedure in 67 (9.93%) patients.
    Conclusion: Our study suggests that a large percentage of patients undergoing bariatric surgery have pathologically significant endoscopic findings of which a significant number are asymptomatic; this can lead to a change in the planned bariatric procedure in a section of patients; hence, we believe that EGD should be made mandatory as a pre-operative investigation in all bariatric surgery patients.
    MeSH term(s) Bariatric Surgery/methods ; Bariatric Surgery/statistics & numerical data ; Endoscopy, Gastrointestinal/statistics & numerical data ; Gastrointestinal Diseases/complications ; Gastrointestinal Diseases/diagnosis ; Gastrointestinal Diseases/epidemiology ; Humans ; Obesity, Morbid/complications ; Obesity, Morbid/epidemiology ; Obesity, Morbid/surgery ; Preoperative Care/statistics & numerical data
    Language English
    Publishing date 2018-04-14
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1070827-3
    ISSN 1708-0428 ; 0960-8923
    ISSN (online) 1708-0428
    ISSN 0960-8923
    DOI 10.1007/s11695-018-3230-z
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    Zs.A 3381: Show issues Location:
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    ab Jg. 2022: Lesesaal (EG)

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  7. Article ; Online: Perioperative Practices Concerning Sleeve Gastrectomy - a Survey of 863 Surgeons with a Cumulative Experience of 520,230 Procedures.

    Adil, Md Tanveer / Aminian, Ali / Bhasker, Aparna Govil / Rajan, Reynu / Corcelles, Ricard / Zerrweck, Carlos / Graham, Yitka / Mahawar, Kamal

    Obesity surgery

    2019  Volume 30, Issue 2, Page(s) 483–492

    Abstract: 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 ... ...

    Abstract 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.
    Methods: A 37-item questionnaire-based survey was conducted to capture the perioperative practices of the global community of bariatric surgeons. Data were analyzed using descriptive statistics.
    Results: Response of 863 bariatric surgeons from 67 countries with a cumulative experience of 520,230 SGs were recorded. A total of 689 (80%) and 764 (89%) surgeons listed 13 absolute and relative contraindications, respectively. 65% (n = 559) surgeons perform routine preoperative endoscopy and 97% (n = 835) routinely use intraoperative orogastric tube for sizing the resection. A wide variation is observed in the diameter of the tube used. 73% (n = 627) surgeons start dividing the stomach at a distance of 3-5 cm from the pylorus, and 54% (n = 467) routinely use staple line reinforcement. Majority (65%, n = 565) of surgeons perform routine intraoperative leak test at the end of the procedure, while 25% (n = 218) surgeons perform a routine contrast study in the early postoperative period. Lifelong multivitamin/mineral, iron, vitamin D, calcium, and vitamin B12 supplementation is advocated by 66%, 29%, 40%, 38% and 44% surgeons, respectively.
    Conclusion: There is a considerable variation in the perioperative practices concerning SG. Data can help in identifying areas for future consensus building and more focussed studies.
    MeSH term(s) Adult ; Contraindications, Procedure ; Female ; Gastrectomy/methods ; Gastrectomy/statistics & numerical data ; Geography ; Humans ; Laparoscopy/methods ; Male ; Middle Aged ; Obesity, Morbid/epidemiology ; Obesity, Morbid/surgery ; Postoperative Period ; Practice Patterns, Physicians'/statistics & numerical data ; Stomach/pathology ; Stomach/surgery ; Surgeons/statistics & numerical data ; Surveys and Questionnaires ; Suture Techniques/standards ; Suture Techniques/statistics & numerical data ; Sutures/statistics & numerical data
    Language English
    Publishing date 2019-10-29
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1070827-3
    ISSN 1708-0428 ; 0960-8923
    ISSN (online) 1708-0428
    ISSN 0960-8923
    DOI 10.1007/s11695-019-04195-7
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  8. Article ; Online: Management of gastro-colic fistula after laparoscopic sleeve gastrectomy.

    Bhasker, Aparna Govil / Khalifa, Hind / Sood, Amit / Lakdawala, Muffazal

    Asian journal of endoscopic surgery

    2014  Volume 7, Issue 4, Page(s) 314–316

    Abstract: 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. While reperforming ... ...

    Abstract 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. While reperforming laparoscopy and/or stenting remain the mainstay of early leak management, chronic complications such as a gastro-colic fistula are rare and require a tailor-made approach. Stenting alone has a limited role in managing chronic fistulas after LSG.
    MeSH term(s) Adult ; Anastomotic Leak/surgery ; Colonic Diseases/etiology ; Colonic Diseases/surgery ; Female ; Gastrectomy/methods ; Gastric Fistula/etiology ; Gastric Fistula/surgery ; Humans ; Intestinal Fistula/etiology ; Intestinal Fistula/surgery ; Laparoscopy/methods ; Obesity/surgery ; Postoperative Complications/surgery
    Language English
    Publishing date 2014-11
    Publishing country Japan
    Document type Case Reports ; Journal Article
    ZDB-ID 2492135-X
    ISSN 1758-5910 ; 1758-5902
    ISSN (online) 1758-5910
    ISSN 1758-5902
    DOI 10.1111/ases.12122
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  9. Article ; Online: Bariatric Nutrition Guidelines for the Indian Population.

    Remedios, Carlyne / Bhasker, Aparna Govil / Dhulla, Neha / Dhar, Shilpa / Lakdawala, Muffazal

    Obesity surgery

    2016  Volume 26, Issue 5, Page(s) 1057–1068

    Abstract: 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 ... ...

    Abstract 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. Nutritionists in India often rely on recommendations and guidelines meant for the Caucasian population. Religious and cultural practices influence the dietary habits and patterns of the Indian population to a great extent; because of which the nutritional requirements are very different. This document was put together with an aim to provide nutritionists with recommendations on how to manage the Indian bariatric patient.
    Methods: A bariatric nutrition round table meeting was initiated by the Centre for Obesity and Digestive Surgery (CODS) to bring together experts in the field of bariatric nutrition to review current data on nutritional deficiencies in the morbid obese and existing post-operative deficiencies and to formulate nutritional recommendations for bariatric/metabolic surgery specific to patients from India.
    Results: Percentage of nutritional deficiencies and reasons for the same were identified among the Indian population and recommendations were made to suit this particular population.
    Conclusion: It is recommended that all patients undergo compulsory pre-operative nutritional counseling and nutritional investigations and that nutritional follow-up be continued lifelong. In addition, long-term implications like hypoglycemia, dumping syndrome, sugar cravings, and weight regain, need to be picked up and managed efficiently. Most importantly, post-operative supplementation is a must irrespective of type of surgery.
    MeSH term(s) Bariatric Surgery/adverse effects ; Bariatric Surgery/rehabilitation ; Deficiency Diseases/epidemiology ; Deficiency Diseases/prevention & control ; Diabetes Mellitus, Type 2/diet therapy ; Diabetes Mellitus, Type 2/epidemiology ; Diabetes Mellitus, Type 2/surgery ; Dietary Supplements ; Feeding Behavior ; Humans ; India/epidemiology ; Middle Aged ; Nutrition Assessment ; Nutrition Policy ; Nutritional Requirements ; Obesity, Morbid/diet therapy ; Obesity, Morbid/epidemiology ; Obesity, Morbid/surgery ; Postoperative Period
    Language English
    Publishing date 2016-05
    Publishing country United States
    Document type Consensus Development Conference ; Journal Article
    ZDB-ID 1070827-3
    ISSN 1708-0428 ; 0960-8923
    ISSN (online) 1708-0428
    ISSN 0960-8923
    DOI 10.1007/s11695-015-1836-y
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Zinc Deficiency after Gastric Bypass for Morbid Obesity: a Systematic Review.

    Mahawar, Kamal K / Bhasker, Aparna Govil / Bindal, Vivek / Graham, Yitka / Dudeja, Usha / Lakdawala, Muffazal / Small, Peter K

    Obesity surgery

    2017  Volume 27, Issue 2, Page(s) 522–529

    Abstract: 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. The British Obesity ... ...

    Abstract 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. The British Obesity and Metabolic Surgery Society, therefore, recommends that zinc level should be monitored routinely following gastric bypass. However, the American guidance does not recommend such monitoring for all RYGB patients and reserves it for patients with 'specific findings'. This review concludes that clinically relevant Zn deficiency is rare after RYGB. Routine monitoring of zinc levels is hence unnecessary for asymptomatic patients after RYGB and should be reserved for patients with skin lesions, hair loss, pica, dysgeusia, hypogonadism or erectile dysfunction in male patients, and unexplained iron deficiency anaemia.
    Language English
    Publishing date 2017-02
    Publishing country United States
    Document type Review ; Journal Article
    ZDB-ID 1070827-3
    ISSN 1708-0428 ; 0960-8923
    ISSN (online) 1708-0428
    ISSN 0960-8923
    DOI 10.1007/s11695-016-2474-8
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