From this study, it is shown that RYGBP operation gives very good results as regards reduction of body weight in morbidly obese patients. Postoperative supplementation with calcium and vitamin D partially corrects osteoporosis. Thus, these patients need periodic follow-up for BMD, PTH, calcium, serum vitamin D, and markers of bone resorption and formation specially postmenopausal female.

Background: Vascular injury resulting from trauma is a leading cause of morbidity and mortality worldwide. Exsanguination is perhaps the most important cause of potentially preventable death after injury. The resulting ischemic tissue damage leads to high rates of amputation in a characteristically young and active population. Objective: To determine the incidence of vascular injuries, modes and mechanisms of trauma and their relations with regional vascular injury distribution and the outcome of vascular injuries in polytrauma patients. Patients and methods: This is a prospective observational analytical (cohort) study that included 520 patients who were presented by multiple causes of trauma to Mansoura University Emergency Hospital, Mansoura, Egypt. A level 1-trauma center with about 250,000 visits and 25000 trauma cases admission per year. This study was conducted over the period of 1 year from January 2019 to December 2019. Results: According to abbreviated injury scale (AIS) ≥3, patients with vascular injuries had considerable more severe injuries than other patients. The most common regions with vascular injuries were peripheral vascular injuries in 95.8% [52.6% in lower limb and 43.2% in upper limb], followed by central vascular injuries in 4.2% [1.6% in neck, 1.6% in thorax and 1 % in abdomen]. Blunt trauma was considerably more common than penetrating trauma in both groups. Moreover, blunt trauma was more common in all regional vascular injuries (66.7% of neck, 75% of lower limb, and 100% of thoracic and abdominal vascular injuries) except upper limb (in 47.8%). Conclusion:The vascular trauma is associated with more injury severity AIS, injury severity score (ISS) and higher mortality rate than other polytrauma patients.

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