11th World Gastroenterologists Summit December 14-15, 2017 JW Marriott Dubai, UAE

Background Evaluate the effectiveness and response Gastric balloon ( Lexbal ) in the treatment of mild to moderate obesity Observational and retrospective Introduction Descriptive observational study in which the sample is made up of the 12 patients treated with balloon LEXBAL The variables studied were age , sex, weight , BMI, percentage of weight lost , fill volume , tolerance, satisfaction Objectives Evaluate the effectiveness and response balloon ( Lexbal ) in the treatment of mild to moderate obesity Methods We conducted in Hospital Paroissien an observational, retrospective study . We have compiled the results of 12 follow intragastric balloons (Balon Lexbal ) in obese patients with mild to moderate type I- II (BMI between 28 and 34.9 kg/m2 ) placed in 2012 and 2016 losses have been achieved over 70 % of excess weight The variables studied were age sex, weight BMI,% of weight lost ,fill volume,tolerance, satisfaction and dietary monitoring Results Over 80 % degree of patient satisfaction , 70 % decrease in weight above the average ( over 12 kilos ) better response in those presenting adherence to nutritional treatment and no differences were observed in the volume of filling the balloon Conclusion Treatment with intragastric balloon, along with a nutritional monitoring allows us to re-educate the patient, and change their eating habits. • Just for gradual diet, and to adapt each phase as tolerated by the patient, helps us to improve dietary behavior and facilitates greater weight loss The IG ballon is a safe, well tolerated, with few adverse effects

Gastroenterology Registrar for Dr. Martin Buckley, Mercy University Hospital

BACKGROUND: With the beginning of 21th century, the development of Wireless Video Capsule (WVC) caused a breakthrough in the intraluminal visualization of the entire small bowel in a well- tolerated and non- invasive way. It has enhanced the diagnostic gap between conventional gastroscopy and colonoscopy1. AIM: Compare MRE and WVC in detecting small bowel involvement in previously diagnosed CD and or suspected small bowel CD. Methodology: An observational cohort study conducted in Mercy University Hospital from January 2016 until August 2017. The recruited patients were patients referred for WVC with either established CD and/or suspected small bowel CD. All cases referred with suggestive clinical symptoms such as (diarrhoea, abdominal pain, weight loss and iron deficiency anemia) and biochemical signs of systemic inflammation (raised CRP/fecal calprotectine). A standardized work-up including blood and stool samples, gastroscopy, ileocolonoscopy and MRE were performed to all included patients. WVC performed in patients with no stenosis detected on ileocolonoscopy and MRE. Exclusion criteria were patient who had no MRE in 2016. RESULTS: Total of 20 patients were recruited, (13 female), aged 19-74 years (mean age 44). Of the 20 patients, 8 patients were established IBD and 12 patients with suspicion of small bowel CD. Out of 12 patients with suspected small bowel CD, only 8 patients had small bowel pathology detected radiologically. 4 patients (50 %) had positive WVC, one patient ( 12.5%) had positive MRE and 3 patients (37.5%) had positive WCV and MRE. In all IBD patients, small bowel pathology detected with WCV (100%). 2 out of 8 patients with IBD (25%), small bowel pathologies detected in both MRE and WVC In Conclusion Small bowel imaging is an essential component in diagnosing, monitoring and treating small bowel CD and suspected small bowel pathology. Both MRE and WVC are complementary methods for small bowel CD. VCE is more capable of detecting limited mucosal lesions that may be missed by MRE.

Introduction: Functional gastrointestinal disorder is illustrated by frequent abdominal pain or discomfort associated with a change in bowel habits. (Naem et al., 2012). Functional bowel disorders are common in the population, with the most prevalent being irritable bowel syndrome (IBS), which is defined by the presence of abdominal pain or discomfort in association with altered bowel habit (Longstreth et al.,2006). IBS may decrease the health-related quality of life (HRQOL), reduce work productivity, and increase the burden to the already spiraling health expenditure (Shah et al., 2014). Method: This is a cross-sectional study of physicians and interns working in king fahad hospital, maternity and children hospital, Saudi German hospital, King Abdul-Aziz hospital and oncology center in Jeddah, Saudi Arabia. Subjects were asked to reveal their identity and current position in the organization. Subjects were contacted face to face by researchers in their respective clinics, resting rooms, and nursing stations after patient rounds. On average it took 6-10 min to fill out the questionnaire In total, 500 physicians and interns participated. Interested subjects were requested to fill the questionnaire anonymously and no identifying data was collected. All questionnaires were voluntarily filled following an informed consent. The questionnaire is self-explanatory. The study protocol and survey were reviewed and authorized by the battrjee medical college (BMC). The study recruitment period was during January and February 2017.Subjects with pre-existing gastrointestinal disorders, medical students, and non-physicians (nurses and technicians) were excluded from the study. The remaining enrolled subjects were classified into two groups based on their attendance of overnight shifts. Discussion: Our research shows significant relationship between overnight calls and IBS symptoms pain, constipation and diarrhea. It was the first study to be done on physicians and interns. A similar study our study was limited due to convenient sampling and the questionnaire used was self-administered Result: here were 260 participants in the study. The mean age of participant in the study was 31.06 ± (9.390%) years. Number of female participated in the study was 156 ± (60%) and male was 104 ± (40%). About 217 ± (83.5%) of the participants were Saudi unlike 43 ± (16%) were non-Saudi. According to marital status we found that 124 ± (47.7%) participant were married and 136 ± (52.3%) were non-married. There was a significant relationship between number of overnight calls and pain (p=0.004), constipation (p=0.002), and diarrhea (p=0.001). The results concerning specialty indicated that there was no significant relationship between specialty and pain (p=0.093), while there was a significant relationship with constipation (p=0.031) and diarrhea (p=0.007(. Conclusion: Physicians among Jeddah who suffer from irritable bowel syndrome and taking Overnight calls seem to have increase in IBS symptoms; pain constipation and diarrhea. Attending courses of stress management, dietary and lifestyle modification, increase physical activity getting enough hours of sleep is recommended.

Professor of Physiology, Faculty of Medicine, Dammam University

Abstract Bee propolis which is a natural resinous product collected by honey bees from plants, is used as folk medicine since ancient time. Propolis has been shown to produce various beneficial biological and pharmacological effects due its immunomodulatory , anti-inflammatory, antioxidant and antimicrobial properties which have been investigated extensively in the last decade. Objectives :The aim of the present study was to investigate the possible therapeutic effects of propolis against destructive and oxidative changes of acute pancreatitis induced by 2 intraperitoneal injections of L-Arginine (250 mg/100gm).Also , to find out the mechanism of action of propolis as anti-inflammatory agent. A total number of 45 male albino Wistar rats 150-250 gm were conducted in the present study . They divided into 3 equal groups 15 rats each: Group I: The negative controls ( did not receive any treatment). Group II: The positive controls (15 rats injected IP with a dose of L-Arginine 250 mg/100 gm and repeated after 1 hour to induce acute pancreatitis. Group III: Propolis treated group. 300 mg/kgm was injected I.P Blood Sampling After fasting for 12 hours from the induction of pancreatitis, all rats were weighed, and lightly anaesthetized with ketamine 50mg/kg i.p. Sera were separated to perform the following investigations : 1-Amylase and Lipase : 2- interleukins (IL-1B , IL-6, IL-22) and TNF-alpha 3-lipid peroxidation product level :Thiobarbituric acid-reactive substances (TBARS). Also, histopathological studies on the pancreatic cells were done using hematoxyline &eosin to detect the edema, w,b,c infiltration and destructive changes of acute pancreatitis and to access the effect of propolis treatment. Our results showed a significant improvement in pancreatitis by ethanolic extract of propolis(EPE) which significantly reduced the proinflammatory cytokines and lipid peroxidation due to its strong anti-inflammatory and anti-oxidant effect . The present study also showed a novel and a new mechanism by which propoils might exert its therapeutic effect in acute pancreatitis via IL-22 signalling pathway with a significant increase in anti-inflammatory IL-22 in the propolis treated group in relation to the positive control and negative control groups. Keywords : Propolis , Acute pancreatitis, L-arginine, Interleukine -1B, Interleukin-6 , Interleukine-22, TNF-alpha and TBARS.

Background: Endoscopic sphincterotomy (ES) is the standard technique for common bile duct stone removal. Recently, endoscopic papillary large balloon dilation (EPLBD) has been shown to be a safe and effective technique for the removal of large common bile duct stone. The aim of this study was to determine the therapeutic outcomes and safety of EPLBD compared with ES for large common bile duct stone extraction. Patients and Methods: 124 patients with large bile duct stones were randomized into two groups, the first group included 61 patients subjected to EPLBD and the second group included 63 patients underwent ES. We compared the success rate of stone removal, frequency of mechanical lithotripsy requirement, morbidity and mortality. Results: Baseline characteristics were not significantly different. The overall ductal clearance rate was ultimately similar between the EPLBD group (96.7%) and the ES group (93.7%) (P=0.53), the one session ductal clearance rate was significantly different (86.9% vs. 71.4%; p=0.01). Requirement of mechanical lithotripsy was significantly different between the EPLBD and ES group (9.8% vs. 17.5%, p=0.04). There were no differences in complication rates between the EPLBD and ES group; pancreatitis, 4.9% vs. 6.3%; minor hemorrhage, 1.6% vs. 6.3%; acute cholangitis, 3.3% vs. 1.9%, recurrent stones, 3.3% vs. 3.2%. Conclusions: The therapeutic outcomes of EPLBD for removal of large bile duct stones are better than those of ES with comparable complication rate. EPLBD is also recommended for removal of large common bile duct stone in patients with an underlying coagulopathy or need for anticoagulation following ERCP.