Relationship between the Preoperative Albumin Levels and Postoperative Complications in Carcinoma Stomach Patients

Background: Malnutrition in gastrointestinal cancer patients adversely affects the surgical outcomes. low serum albumin and postoperative complications were associated with one another. Objectives: To find out the relationship between preoperative albumin levels and postoperative complications among carcinoma stomach patients. Materials and Methods: The present study was a single institution retrospective study carried out in the department of general surgery, Saveetha medical college and hospital between February 2021 to July 2021. Fifty patients diagnosed with carcinoma stomach and electively posted for surgery during the study period were included into the study. The data was collected using structured proforma. Preoperative albumin and haemoglobin levels were estimated using blood samples. All the data collected were analysed using SPSS version 23. Results: The preoperative albumin levels among those who had reported complication was 3.04±0.19 g/dl while those who had no complication in the postoperative period had preoperative albumin level of 3.82±0.31g/dl. The preoperative mean haemoglobin level among those who developed complications in the post operative period was 9.68±0.95 mg/dl and the mean haemoglobin level among those with no complication was 11.46±1.89 mg/dl. Albumin and haemoglobin values were found to be negatively correlated with duration of stay in hospital. Conclusion: Malnutrition in the preoperative period would increase the probability of occurrence of postoperative complications and increased duration of stay in hospital. Attending to malnutrition of the admitted patients in the preoperative period would help in decreasing the postoperative complications and duration of stay.

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Simplified nutritional scoring system predicts complicated outcomes of upper gastrointestinal surgery

International Surgery ◽

10.9738/intsurg-d-16-00213.1 ◽

2017 ◽

Author(s):

Juyong Cheong ◽

Gregory Leighton Falk ◽

Jigar Darji

Keyword(s):

Postoperative Complications ◽

Gastrointestinal Surgery ◽

Subtotal Gastrectomy ◽

Postoperative Outcome ◽

Bowel Function ◽

Ivor Lewis ◽

Ivor Lewis Esophagectomy ◽

The Mean ◽

The Relationship ◽

Upper Gastrointestinal

Abstract Introduction: Postoperative complications after major upper gastrointestinal surgery can be devastating. Malnutrition has been found to be an important risk factor for postoperative complications. However, attempts at trying to detect malnourished patients preoperatively can be cumbersome and complex and are often not done. One simplified way of assessing nutritional status is the ANS system. The aim of this study was to show the relationship between ANS score and the postoperative outcome. Methodology: Medical record of all patients undergoing major EG and HB surgeries at Concord Hospital between 2010 and 2012 were retrospectively analysed. Results: 83 patients were operated and included (1) Whipples' procedure (20.5%), (2) total/subtotal gastrectomy (44.6%), (3) Ivor-Lewis esophagectomy (18%), and (4) distal pancreatectomy (14.5%). The mean ANS score was 1.58. Patients with higher ANS score (2 or more) were found to have significantly higher rates of wound infection (41% vs 12%, p<0.002), anastomotic leaks (13.7% vs 1.92%, p=0.034), unexpected return to operating theatre (31% vs 3.9%, p<0.001), slower return of bowel function as compared to patients with low ANS score (0 or 1). Conclusion: This study demonstrates the importance of screening for malnourished patients prior to their operation. Given its simplicity and effective predictive value, we recommend use of ANS system.

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Is suture ligation of cystic duct in laparoscopic cholecystectomy a safe alternative to clipping? Our experience in a rural centre

International Surgery Journal ◽

10.18203/2349-2902.isj20194430 ◽

2019 ◽

Vol 6 (10) ◽

pp. 3715

Author(s):

K. R. Manoj Prabu ◽

Dhinesh Balaji ◽

Vishwanath M. Pai

Keyword(s):

Laparoscopic Cholecystectomy ◽

Postoperative Complications ◽

Cystic Duct ◽

Operating Time ◽

Cost Effective ◽

Safe Alternative ◽

Suture Ligation ◽

Medical College ◽

The Mean ◽

Mean Time

Background: Laparoscopic cholecystectomy is one of the most common surgeries performed nowadays. It remains an enigma regarding efficacy, safety and postoperative complications for using suture ligation for ligating cystic duct in laparoscopic cholecystectomy. The aim of the present study was to study the efficacy of ligating the cystic duct with sutures in laparoscopic cholecystectomy.Methods: This prospective study was performed between June 2018 and April 2019 in Saveetha Medical College and Hospital, in a rural center, Kanchipuram, India. All the patients included consented for the study. Patients who underwent subtotal cholecystectomy were excluded from the study.Results: The study included 70 patients who underwent laparoscopic cholecystectomy in a single unit. All cases were operated by a single surgeon. Of the 70 patients, the Cystic duct (CD) was simply ligated in 55 patients with CD <5 mm in diameter. The CD in 15 of those patients had to be divided and sutured in continuity for wide CD (>5 mm). The mean time for ligation of cystic duct was 5 min. Similarly, the mean time for ligation of cystic artery was 1.50 min. The mean operative time was 50 mins. There were no postoperative complications, such as bile leakage.Conclusions: SL of the CD is a very safe and secure alternative to the application of metal clips. It can be used in dilated CD, readily available and very cost effective and the complications of clips are avoided. The only disadvantage is that it needs expertise to perform and subsequently increasing the operating time. This technique is recommended in all laparoscopic cholecystectomies, especially in difficult cases.

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Assessment of the relationship between self-esteem and academic score of undergraduate medical students of Azad Kashmir, Pakistan

Journal of the Pakistan Medical Association ◽

10.47391/jpma.01549 ◽

2021 ◽

Vol 71 (11) ◽

pp. 2641-2644

Author(s):

Arslaan Javaeed ◽

Farah Khan ◽

Nadia Sajjad ◽

Sadia Azam Khan ◽

Sanniya Khan Ghauri

Keyword(s):

Academic Performance ◽

Medical Students ◽

Self Esteem ◽

Undergraduate Medical Students ◽

Questionnaire Response ◽

Cross Sectional ◽

Medical College ◽

The Mean ◽

Azad Kashmir ◽

The Relationship

Objective: To assess the relationship between self-esteem and the academic score of undergraduate medical students of Azad Kashmir, Pakistan. Methods: This cross-sectional observational study was performed from June 2018 to June 2019. The study area was Poonch Medical College, Azad Kashmir. The data collection tool was well-verified and widely used Rosenberg self-esteem scale. The study questionnaire was electronically distributed to all Bachelor of Medicine and Surgery students on the Poonch Medical College. The total student was 500 and out of the 253 completed and submitted the questionnaire (response rate of 50.6%). Results: The mean academic score of all students was 66.61 ± 5.42 and the mean RSE score was 28.66 ± 3.98. A statistically significant correlation was not found between age, academic score, and RSE score. Female students had slightly higher academic performance scores and RSE scores compared to the male students, but this difference was not statistically significant. Conclusion: This study did not reveal any significant relationship between academic score and self-esteem of undergraduate medical students. However, both academic scores and self-esteem can be further improved. Future studies are invited to find out the other factors responsible for better academic performance. Keywords: RSE scale, academic performance, medical student, Pakistan Continuous...

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Residual Renal Function in a Large Cohort of Peritoneal Dialysis Patients: Change over Time, Impact on Mortality and Nutrition

Peritoneal Dialysis International ◽

10.1177/089686080002000411 ◽

2000 ◽

Vol 20 (4) ◽

pp. 439-444 ◽

Cited By ~ 51

Author(s):

Douglas Shemin ◽

Andrew G. Bostom ◽

Cynthia Lambert ◽

Connie Hill ◽

Jenny Kitsen ◽

...

Keyword(s):

Renal Function ◽

Serum Albumin ◽

Serum Albumin Level ◽

Renal Dialysis ◽

Residual Renal Function ◽

Albumin Level ◽

The Mean ◽

The Relationship ◽

Over Time ◽

Solute Clearance

Objective Residual renal function contributes importantly to total solute clearance in peritoneal dialysis (PD) patients. This study was designed to examine the progression of residual renal function over time and its impact on nutrition and mortality in PD patients in the six New England states (ME, NH, VT, CT, MA, RI) comprising End Stage Renal Disease (ESRD) Network 1. Design As part of the ESRD Clinical Indicators Project, data on 990 PD patients in Network 1 were abstracted from data supplied by dialysis units in the fourth quarter of 1997. This included demographic information; dose of PD in L/day; weekly renal, dialysis, and total Kt/V urea; weekly renal, dialysis, and total creatinine clearance (CCr); serum albumin level; and mortality and transplantation information. Data collection was repeated in the second and fourth quarters of 1998 and in the second quarter of 1999. Patients 990 PD patients in Network 1. Outcome Measures The change in total and renal solute clearances over time, the relationship between renal clearance and mortality, and the relationship between renal clearance and nutritional status, as represented by serum albumin. Results Over the 2-year period, mean weekly renal Kt/V urea and weekly renal CCr dropped significantly. To examine the effect of residual renal function on mortality, patients were divided into high and low (above and below the median) weekly renal Kt/V urea and weekly renal CCr groups. Patients above the median levels of both weekly renal Kt/V urea and weekly renal CCr had a significantly decreased risk of dying during the observation period, after controlling for age, gender, serum albumin level, and diabetic status [OR for high vs low renal Kt/V urea 0.54 (CI 0.34 – 0.84), OR for high vs low renal CCr 0.61 (CI 0.40 – 0.94)]. The mean weekly renal Kt/V urea was significantly and directly correlated with the mean serum albumin level by Spearman rank correlation ( R = 0.133, p < 0.001), as was the mean weekly renal CCr ( R = 0.115, p < 0.001). Conclusions Residual renal function is an important contributor to total solute clearance in PD patients. Even at low levels it is linked to decreased mortality and better nutritional status.

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Development of Symphysio Fundal Height Curve

Bangladesh Journal of Obstetrics & Gynaecology ◽

10.3329/bjog.v32i1.56729 ◽

2017 ◽

Vol 32 (1) ◽

pp. 20-24

Author(s):

Chowdhury Taslima Nasrein ◽

Ferdousi Begum ◽

Jaglul Haider Khan ◽

Novera Islam ◽

Zahangir Alam

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Pregnant Women ◽

Gestational Age ◽

Cross Sectional ◽

Medical College ◽

Gestation Age ◽

The Mean ◽

Relationship Of ◽

The Relationship

Objective: To Develop a symphysio fundal height(SFH) curve of pregnant women from 20 weeks of pregnancy onwards; and to find out the relationship of fundal height with different variables. Methodology: A cross-sectional hospital based study was conducted from 1st january 2010 to 31st December 2010 on 159 patients with gestation age less than 20 weeks at entry in the OPD of Department of Obstetric and Gynaecology, Shaheed Suhrawardy Medical College & Hospital, Shere-e Bangla Nagar, Dhaka,Bangladesh. All the patients were followed up till delivery. Results: The measurements of SFH obtained on the basis of 10, 50th and 90th percentiles and the rate of growth of SFH was approximately 5 mm per week from 24 weeks to 36 weeks and thereafter it was 5-6 mm per week till 40 weeks.Patients with higher socioeconomic class had higher symphysio fundal height.SFH is less in younger subjects. SFH increases with increased height,weight,gestational age,gravidity of mothers and birth weight of the baby.Multiparous was predominant and more than one third (34.6%) of the study patients height belonged to 1.51 - 1.60 meters. The mean±SD gestational age was 39.2±1.4 weeks with range from 28 to 41 weeks. Low birth weight was found 17.0% and the mean±SD birth weight was 2.8±0.4 kg with range from 1.9 to 3.8 kg. Bangladesh J Obstet Gynaecol, 2017; Vol. 32(1): 20-24

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Albumin Difference as a New Predictor of Postoperative Complications following Pancreatectomy

Digestive Surgery ◽

10.1159/000513223 ◽

2021 ◽

pp. 1-9

Author(s):

Jian Shen ◽

Feng Guo ◽

Yan Sun ◽

Dianyun Ren ◽

Jingyuan Zhao ◽

...

Keyword(s):

Postoperative Complications ◽

Delayed Gastric Emptying ◽

Training Group ◽

Comprehensive Complication Index ◽

Specific Complication ◽

High Incidence ◽

Intra Abdominal Infection ◽

The Relationship ◽

Preoperative Albumin ◽

Good Calibration

Background: Postoperative complications after pancreatectomy are a challenging problem due to their high incidence and serious consequences. The majority of studies have focused on a specific complication, but data on predictors of overall postoperative complications (OPCs) are limited. Methods: The data of patients who underwent pancreatectomy at a single institute between 2017 and 2019 were analyzed retrospectively. Univariate and multivariate logistic regression were used to investigate predictors of the outcomes of interest. The Clavien-Dindo classification and comprehensive complication index (CCI) were used to assess postoperative complications and the severity of postoperative complications. The relationship between predictors and the CCI was evaluated by linear regression. Results: A total of 490 patients were divided into a training group (n = 339) and a validation group (n = 151). The rate of OPCs was 44.25%. Fluid transfusion and albumin difference (AD) were predictors of OPCs. AD showed a good discrimination (AUC = 0.70) and good calibration in the validation cohort. AD was associated with complications, including pancreatic fistula, intra-abdominal hemorrhage, intra-abdominal infection, delayed gastric emptying, and re-intervention, and was positively correlated with complication severity. Intraoperative blood loss and preoperative albumin were independent predictors of AD. Conclusions: AD, a variable that reflects dynamic physiological changes is a new and accessible predictor of OPCs following pancreatectomy.

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Platelet Count In Preeclampsia

Journal of Dhaka National Medical College & Hospital ◽

10.3329/jdnmch.v18i2.16018 ◽

2013 ◽

Vol 18 (2) ◽

pp. 24-26 ◽

Cited By ~ 3

Author(s):

Razia Sultana ◽

SM Fazlul Karim ◽

Farhana Atia ◽

Shahnila Ferdousi ◽

Selina Ahmed

Keyword(s):

Platelet Count ◽

Pregnant Women ◽

Case Control Study ◽

Case Control ◽

Third Trimester ◽

Medical College ◽

Significant Difference ◽

The Mean ◽

The Relationship ◽

Control Study

Preeclampsia is one of the most leading causes of maternal mortality in developing countries like Bangladesh. Several studies have demonstrated the relationship between platelets count and preeclampsia. The aim of the study was to assess the association of platelets count with preeclampsia. A case control study was conducted in the Department of Biochemistry, Dhaka Medical College, Dhaka from July 2010 to June 2011. A total number of 100 pregnant women in third trimester of pregnancy attending in Obstetrics & Gynaecology Department of Dhaka Medical Hospital were selected as study subjects. Among them 50 diagnosed cases of preeclampsia were selected as cases and 50 normal healthy pregnant women as controls. Platelet count was measured in all study subjects. The mean platelet count in cases and controls were 1,44,260±96,472 and 1,98,100±51,219 respectively. The present study showed significant difference of mean platelet count between cases and controls. The study revealed that low platelets count is associated with preeclampsias. DOI: http://dx.doi.org/10.3329/jdnmch.v18i2.16018 J. Dhaka National Med. Coll. Hos. 2012; 18 (02): 24-26

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VESICOURETERAL REFLUX

The Professional Medical Journal ◽

10.29309/tpmj/2018.25.02.445 ◽

2018 ◽

Vol 25 (02) ◽

pp. 211-217

Author(s):

Muhammad Rameez Irshad ◽

Arslan Ali ◽

Shujat Ahmed Riaz ◽

Aamir Furqan

Keyword(s):

Postoperative Complications ◽

Hospital Stay ◽

Vesicoureteral Reflux ◽

Duration Of Stay ◽

Ureteric Reimplantation ◽

Duration Of Surgery ◽

The Mean ◽

Primary Vesicoureteral Reflux

Objectives: The objective of our study is to compare the extravesical andintravesical ureteric reimplantation for the treatment of bilateral vesicoureteral reflux in children.Period: April 2013 and July 2016. Setting: Urology Department of Mayo Hospital, Lahore.Methodology: 66 children diagnosed with primary vesicoureteral reflux and undergoingureteric reimplantation. The Cohen cross-trigonal reimplantation (intravesical) and modifiedLich-Gregoir procedure (extravesical) were performed on two separate groups Group IRand group ER. The following parameters were compared: postoperative duration of stay inthe hospital, hematuria and bladder spasm. Frequency of hematuria, bladder spasm andaverage duration of stay in the hospital were compared in both group. Mean and standarddeviation was calculated for age, gender and duration of surgery in both groups.). Chi squaretest was applied to check the association of outcome variables with demographical variablesand duration of surgery. Results: These 100% (n=66) patients were divided into 2 groupsequally, 33 in each, i.e. group ER and group IR. The mean age and duration of surgery ofthe patients of group ER were 13.78±2.83 years, 102.45±4.13 minutes respectively. Whilethe mean age and duration of surgery of the patients of group IR was 30.33±4.58 years and119.7±10.70 minutes respectively (Table-II).The main outcome variables of this study werethe hospital stay, postoperative bladder spasm and hematuria. The mean hospital stay of thepatients of group ER and group IR was 4.30±1.35 days and 5.84±1.0 respectively (Table-II).It was observed that bladder spasm in group ER and group IR was 39.4% (n=13) and 54.5%(n=18) respectively (Figure-1). It was also observed that hematuria in group ER and group IRwas 36.4% (n=12) and 48.5% (n=16) respectively (Figure-2). Conclusion: The observation ofthis study concludes that extravesical ureteric reimplantation has an edge over conventionalprocedure of intravesical ureteric approach. Intravesical procedure has disadvantages of morefrequency of postoperative complications like, hospital stay, bladder spasms and hematuria.

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Clinicopathological Progress of Colorectal Resection in Gynecological Malignancy Patients : Does the risk of anastomotic leakage increase after surgery?

10.21203/rs.3.rs-737626/v1 ◽

2021 ◽

Author(s):

Ayoung Kang ◽

Byung-Soo Park ◽

Sung Hwan Cho ◽

Gyung Mo Son ◽

Yong Jung Song ◽

...

Keyword(s):

Postoperative Complications ◽

Anastomotic Leakage ◽

Medical Records ◽

Colorectal Resection ◽

Gynecological Cancer ◽

Benign Diseases ◽

Gynecological Malignancy ◽

The Mean ◽

Preoperative Albumin ◽

Female Genital

Abstract Objective: This study was conducted to investigate the clinicopathological outcomes of colorectal resection in patients with advanced gynecological malignancies.Methods: We reviewed the medical records of 104 patients of gynecological cancer with co-operation for colorectal resection from December 2008 to August 2020 by retrospective cohort study in a single center (PNUYH). Variables for risk factors and postoperative complications were compared by descriptive statistics. We excluded the cases with malignancies from other than female genital organs, gynecological benign diseases, primary creation of stoma, and any other bowel surgeries except colorectal resection.Results: Of 104 patients in total, the mean age was 62.0 years. The most common gynecological malignancy was ovarian cancer(85 patients, 81.7%) and the most commonly performed operation was low anterior resection(80 patients, 76.9%). 61 patients(58.7%) had postoperative complications, while only 3 patients(2.9%) with anastomotic leakage. Only preoperative albumin was statistically significant(p=0.019) among the risk factors.Conclusion: Our experience suggests that colorectal resection can be safely and efficaciously performed in patients with advanced gynecological malignancy.

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Clinical assessment and follow up of post-operative outcomes in endonasal dacryocystorhinostomy: our experience

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20182965 ◽

2018 ◽

Vol 4 (5) ◽

pp. 1225

Author(s):

Mayur H. Ingale ◽

Vinod V. Shinde ◽

Ashutosh S. Kumar ◽

Harsh R. Singh

Keyword(s):

Postoperative Complications ◽

Invasive Procedure ◽

Nasolacrimal Duct ◽

Female Dominance ◽

Age Group ◽

Medical College ◽

Operative Outcomes ◽

Endoscopic Dcr ◽

The Mean

Background: Endonasal dacryocystorhinostomy (DCR) was the gold standard for the treatment of nasolacrimal duct obstruction. The objective of the study was to assess the postoperative outcomes of endoscopic DCR.Methods: This prospective study was conducted in Department of Otorhinolaryngology, Dr. D. Y. Patil Medical College and Hospital Pimpri, Pune from July 2011 to September 2013. A total of 50 patients with complaints of continuous lacrimation were included in the study. All the patients underwent endoscopic DCR and they were observed for postoperative complications and outcome. Results: Most of the patients were in 31-40 years age group with the mean age of 33.18 years. Female dominance was observed in the study (M:F- 1:4). Postoperative complications such as epistaxis were observed in 2 cases (4.0%), nasal synechiae in 3 cases (6.0%) and postoperative crusting in 15 cases (30.0%). In 45 (90%) patients the outcome was successful at the end of 6 months and in case of 5 (10.0%) patients it was unsuccessful.Conclusions: The findings of the study concluded that endoscopic DCR was a simple, safe and invasive procedure as it has direct approach to the sac, produces excellent results without any external scar.

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