![]() The average weight loss was between 40 and 60 kgs, 46 subjects had weight loss of more than 60 kgs and only 10 had less than 20 kgs. Bulk of the study subjects had their surgery preformed more than 12 months ago with 142 subjects in this category. Forty-one subjects had a BMI above 50 kg/m 2 and 14 subjects had BMI of less than 35 kg/m2. Furthermore, BMI ranged between 40 and 50 kg/m 2, 98 subjects. Majority of subjects were medically free 147, 13 subjects had DM, 9 had HTN, 15 had pulmonary diseases and 13 subjects had a combination of both HTN and DM. There were 107 females (93 males), majority aged between 18 and 50, 28 subjects were between ages 50–60, with 5 subjects only being above 60 years old. The points for individual questions are then summed yield a total score ranging from – 14 to + 6, a total score of + 2 or above is considered diagnostic for VVS. The CSS consists of seven diagnostic questions depending on the answer points are added or subtracted. The interviewers used a questionnaire that included demographic data, BMI prior to the surgery, time of surgery, amount of weight loss since the operation, the onset of symptoms, and CSS. Subjects' hospital records were reviewed in addition to telephone-based interviews. Each arm was further subdivided into 2 subcategories subjects who are medically free versus subjects with comorbidities such as diabetes mellitus (DM), hypertension (HTN), and or pulmonary diseases diagnosed by pulmonologist with low risk for surgery. The study subjects were divided into two major arms based on the type of surgery they underwent either laparoscopic RYGBP or LSG. Institutional review board approval was obtained, date, no 18/0726/IRB. Subjects were randomly selected using the random number generator. We have evaluated the records of 200 patients who underwent bariatric surgery in King Khalid University Hospital between the years 20 from an existing surgical database. Due to limited studies on the prevalence of syncope following bariatric surgery the aim of the current study is to assess the incidence of syncope following weight loss surgery in morbid obese patients. That warrants an urge to further investigate the pathophysiology behind the development of VVS following bariatric surgery. Nonetheless, the true and exact incidence and prevalence remain to be undetermined. Several case studies reported incidences of VVS and near syncopal events. The symptoms of VVS usually manifested upon standing upright and may include syncope, near syncope, and lightheadedness. VVS reflects the failure of the autonomic nervous system to react to the orthostatic stress of gravity resulting in inadequate cerebral perfusion with subsequent syncopal attack. Several studies reported side effects in the form of VVS and pre-syncopal attacks. However, as surgical intervention grows in popularity subsequently the incidence of complications increased. ![]() Furthermore, several reports showed changes in the autonomic nervous system function following weight loss surgery. The benefits of such interventions have been well-documented in the literature as well as the reduction in its related co-morbidities. Commonly performed procedures include RYGBP and sleeve gastrectomy. There are multiple procedures that can adapt the gastrointestinal tract in reducing its absorbing capacity as well as volume. It is a common problem following bariatric surgery which needs more attention by a physician. Syncope is a transient brief loss of consciousness accompanied by loss of postural tone. The same applied to the decline of adjustable gastric band procedure. On the other hand, RYGBP gastric bypass is considered the gold standard procedure (mal-absorptive type) but the number of cases declined and dominated by LSG procedure. However, LSG which is considered as a restrictive type of surgery is the most popular performed procedure nowadays. Currently, there are three primary weight-loss surgical procedures being performed, namely laparoscopic Roux-en-Y gastric bypass (RYGBP), LSG, and adjustable gastric banding. Bariatric surgery is the most efficient and enduring treatment for obesity, particularly morbid obesity. Therefore, nowadays bariatric medicine is very popular. Obesity is a major public health challenge. The prevalence of obesity has increased globally in the last fifty years reaching pandemic levels.
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