Background High rates of revision surgery have been reported for laparoscopic sleeve gastrectomy (LSG), with weight regain (WR) as the most frequently reported cause. Roux-en-Y gastric bypass (RYGB) is the most commonly performed revision procedure, whereas one-anastomosis gastric bypass (OAGB) is a less popular approach. Methods A single-blinded randomized controlled trial was conducted. One hundred seventy-six patients were enrolled and randomized. After loss to follow-up, 80 patients for RYGB and 80 patients for OAGB were analyzed, with a 2-year follow-up. Patients with grade B or higher gastroesophageal reflux disease (GERD) were excluded. Early and late postoperative complications were recorded. Body mass index (BMI), percentage of excess BMI loss (%EBMIL), nutritional laboratory test results, and the resolution of associated medical problems were assessed after revision surgery. Results After 2 years, both groups achieved significantly lower BMI than their post-LSG nadir BMI (p < 0.001). The %EBMIL changes showed significantly faster weight loss in the OAGB group than in the RYGB at the 6-month follow-up (mean difference: 8.5%, 95% confidence interval [CI]: 0.2 to 16.9%). However, at 1-year and 2-year follow-ups, the differences were statistically insignificant (p > 0.05). Early and late complications were similar between two groups. Both groups showed improvement or resolution of associated medical problems, with no statistically significant differences after 2 years (p = 1.00). Conclusion Both revisional RYGB and OAGB have comparable significant weight loss effects when performed for WR after LSG. After a 2-year follow-up, both procedures were safe, with no significant differences in the occurrence of complications and nutritional deficits. Graphical abstract

Background: Egypt joined several countries in immunizing her citizens with COVID19 vaccines; a priority was given to health care workers (HCWs), then to patients with chronic diseases. However, HCWs are exposed to a higher viral load; in addition, asymptomatic infection is commoner among them, thus potentially exposing them to a more severe illness. Objective(s):To identify the determinants of the severity of COVID-19 infection among HCWs. Methods: A case control study was conducted, where we recruited HCWs diagnosed as moderate or severe COVID-19 from isolation and critical care units; and compared their vaccination exposure with that among matched controls. A data collection sheet was filled by residents and included information about mask wearing, comorbidities, smoking, and COVID-19 manifestations. Results:The predictors that significantly affected severity of infection were cardiovascular or cerebrovascular diseases, being a nurse, and mask compliance (OR 17.38 p=0.012 *, OR 5.86, p=0.002*, and OR=0.06, p=0.001 *respectively). Most females, as well as nurses were not vaccinated (90% p= 0.009 *, and 83.3% p=0.016 *respectively). There was no significant difference in mean oxygen saturation between vaccinated and non-vaccinated cases. Conclusion: Among HCWs, the most significantly protective factor against COVID-19 moderate and severe illness was mask compliance. Furthermore, being a nurse as well as having cardiovascular or cerebrovascular disease were significant positive predictors of getting a more severe disease. There was no significant effect of vaccination on severity of COVID19 illness.

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