INTRODUCTIONThe adverse effects of malnutrition on the morbidity and mortality of patients was first recognized by Hippocrates (460 BC-370 BC) many centuries ago. It is common and occurs in about 30% of surgical patients with gastrointestinal diseases and in up to 60%of those in whom hospital stay has been prolonged because of postoperative complications. There is a substantial evidence to show that patients who have signs of malnutrition have a higher risk of complications and an increased risk of death in comparison with patients who have adequate nutritional reserves. Nutritional assessment is essential for identifying patients who are at risk of developing complications related to significant malnutrition.
2A dietary history, physical examination (including anthropometric measurements) and relevant labs are the appropriate tools needed for an accurate evaluation of a patient's preoperative nutritional status. The serum albumin level is the most readily available and clinically ABSTRACT Background: The adverse effects of malnutrition on the morbidity and mortality of patients was first recognized by Hippocrates (460 BC-370 BC) many centuries ago. It is common and occurs in about 30% of surgical patients with gastrointestinal diseases and in up to 60% of those in whom hospital stay has been prolonged because of postoperative complications. There is a substantial evidence to show that patients who have signs of malnutrition have a higher risk of complications and an increased risk of death in comparison with patients who have adequate nutritional reserves. Nutritional assessment is essential for identifying patients who are at risk of developing complications related to significant malnutrition. Methods: All the collected data was entered in Microsoft Excel sheet. It was then transferred to SPSS ver. 17 software for statistical analysis. Quantitative data was compared by using student's t-test and qualitative data compared using frequency and usage. Efficacy of serum albumin and BMI as screening test to predict the occurance of complications in patients was compared using roc curve. P value of < 0.05 considered as significant. Results: Even though body mass index was associated with postoperative complications but serum albumin was better prognostic indicator than body mass index. Conclusions: Majority of patients had serum albumin < 2.5 gm/dl and more complications were seen with serum albumin < 3.5 gm/dl which was statistically significant (p value 0.01). Sr. albumin is a good prognostic indicator because of its ability to detect protein energy malnutrition.
Accessory lobes of the liver are very uncommon and rarely symptomatic. We report the occurrence of torsion and infarction of a pedunculated accessory lobe of the liver with acute cholecystitis. The speculated possibilities of the coexistent pathologies and its management are discussed.
Infections with Entamoeba histolytica are seen worldwide and are more prevalent in the tropics. About 90% of infections are asymptomatic, and the remaining 10% produce a spectrum of clinical syndromes, ranging from dysentery to abscesses of the liver or other organs. Extra-intestinal infection by Entamoeba histolytica most often involves liver. Pleuropulmonary involvement, seen as the second most common extra-intestinal pattern of infection, is frequently associated with amebic liver abscess. Pulmonary amebiasis occurs in about 2-3% of patients with invasive amebiasis. .
Superior mesenteric artery syndrome (SMAS) is a rare condition caused by compression of the transverse portion of the duodenum between the superior mesenteric artery (SMA) and the aorta, causing symptoms of duodenal outflow obstruction. We report a case of superior mesenteric artery syndrome in a 25-year-old female associated with rapid loss of weight and intermittent vomiting and resulting in severe duodenal compression that necessitated surgical treatment.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.