BACKGROUNDIn cases of a pathological state, there might be a low formation of the albumin in liver or high degradation of the albumin. In either of the ways, the serum albumin will be lowered. Stress and strain is also known to cause hypoalbuminemia i.e. low serum level of albumin. Since albumin is a protein, it has to be transcribed from the genes and studies have shown that TNF-alpha supresses this transcription process. The TNF-alpha is known to increase in any inflammation and thus forms a cascade. In case of hospitalised patients, the stress and strain in pre-surgical patients and chronically hospitalised patients, the serum albumin levels are known to be less than normal. In chronically hospitalised patients, the nutritional cause can also be taken into consideration for lower serum albumin levels. Early detection of these low levels of serum albumin levels helps the surgeons and the physicians to intervene and thus cut off the progression of the disease. A sincere effort has been made in this study to understand the relations of the serum albumin level and its effects on the prognosis of the disease and outcome of the surgery if the patient is undergoing any. This study is intended to help the physician, surgeon, and general practitioners to understand and intervene in the event and thus help the patient to recover earlier and in a better way.
Background: General surgery discipline has fragmented into several subspecialties over the past. This division has affected the surgical spectrum of general surgeons. Studies comparing the changes in the general surgeon's work spectrum were done in the ’90s but not in the recent past. Our study aims to compare the surgical spectrum of general surgeons between two time periods in our institute.Methods: We performed a retrospective study comparing the elective surgeries performed by general surgeons in the year 2009 and 2018 in an academic tertiary care centre.Results: There was a 28.9% rise in the total number of elective surgeries (1567 vs. 2020) in our study. There was a significant rise in the mean age of surgical patients (39.7 years vs. 41.9 years) but with no change in M: F ratio (1.7: 1). There was a significant rise in Hernia surgeries and Varicose veins surgeries (p<0.001) along with a rise in anal surgeries (p=0.018). There was a significant decrease in Breast surgeries (p=0.02) and Thyroid surgeries (p<0.001). There was a dramatic rise in the laparoscopic cholecystectomy rate (23.2% vs. 52%) and a fall in the laparoscopic appendectomy rate (26.3% vs. 8%). Open inguinal hernia surgeries were the most common surgeries performed in both the years.Conclusions: There was an increase in the surgical volume for general surgeons but the surgical spectrum has narrowed. We recommend conducting periodic surgical audits in institutions to monitor and maintain the standards of surgeries performed by general surgeons.
BACKGROUNDDiabetes Mellitus is not a disease, but can be considered as a metabolic syndrome in which not only the sugar metabolism is impaired, but also is said to have profound effects or influence on other metabolic disorders. Almost, all the metabolic pathways will be affected in this dreadful disease. It's a slow poison, which starts showing its effects as the time progresses. One of the commonest complaint seen in the diabetes patients is the loss of libido or derangement in the sexual physiology. The most common complaints include the erectile dysfunction and mood elevations. The patients also complain of stressfulness. These symptoms point out towards a common source i.e. decrease in the testosterone levels. A sincere effort has been put in this study to understand the relations of total serum testosterone seen in diabetes mellitus patients. This may help the physicians, operating surgeons, and also anaesthetists to understand the plethora of metabolic disturbances seen in the diabetes mellitus and take necessary steps to correct such conditions and also take necessary preventive members that may result in catastrophe.
BACKGROUND Raised serum uric acid has been associated with a lot of diseases like hypertension, cardiovascular diseases, chronic kidney disease, peripheral vascular diseases and metabolic disorders. But the association of serum uric acid levels to that of diabetes mellitus has not been successfully understood. A sincere effort has been put in this study to find out the serum uric acid levels in normal individuals, pre-diabetics and diabetics and come to a conclusion on the correlation of serum uric acid in diabetes mellitus. The pre-surgical evaluation of such conditions forms an important basis for conducting surgeries. As stress levels in surgeries are supposed to be high which may further worsen the diabetes, or serum glucose levels may increase which may ultimately result in postsurgical complications. So it should be mandatory to check the serum uric acid levels which may suggest the pre-diabetes which may ultimately lead us to prevent the post-surgical complications. METHOD One hundred eighty people who visited the Department of Surgery were selected. The study included ninety males and ninety females and in each group, there were thirty non-diabetics, thirty pre-diabetics and thirty diabetics. Pre-diabetics were considered as 110 to 125 mg/dL (6.1 mmol/L to 6.9 mmol/L) i.e. WHO criteria was followed. All the subjects were aged between 40-60 years. The correlations were made between the serum uric acid levels and serum fasting glucose, serum postprandial and HbA1c. RESULT The results show a rise in the serum uric acid levels in the pre-diabetic and not so much in the non-diabetics and the confirmed diabetics. CONCLUSION The serum uric acid level measurements can be used as a powerful tool in identifying the pre-diabetic condition and help an individual to make the necessary lifestyle adjustments so that the progression of the diseases can be stopped or may be infinitely delayed.
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