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INTRODUCTIONIntestinal anastomosis is one of the most commonly performed surgical procedures, especially in the emergency setting and is also commonly performed in the elective setting. The major concern following bowel anastomoses is anastomotic failure leading to leakage peritonitis, sepsis, abscess, fistula, necrosis, stricture etc. adding to the morbidity and mortality. (e.g., 22% mortality in patients with a leak vs. 7.2% mortality in those without leak. 1Anastomotic leak after gastrointestinal anastomosis is one of the important postoperative complication that leads to significant morbidity and adversely affects length of hospital stay. Various factors that contribute to these complications includes nutritional status of the patient, anemia, intra operative hypotension, suturing technique, suture material, presence of concurrent sepsis, vascular compromise and so on. Serum albumin is a good and simple predictor of surgical risk and has a close correlation with the degree of malnutrition. Albumin is a single-chain, non-glycosylated polypeptide with a molecular weight of 66,500 Da containing 585 amino acids.2 It is a helical protein with turns and extended loops Low concentrations are common. The serum albumin level is one of several clinical parameters of the status of general health. There is a marked correlation between low albumin levels and the incidence of morbidity and mortality in hospitalized patients. Hypoalbuminemia is known to be associated with ABSTRACT Background: The serum albumin level is one of several clinical parameters of the status of general health. Hypoalbuminemia is known to be associated with delayed wound healing. The hypoalbuminemic state interferes with the normal functioning of the gastrointestinal tract. This study evaluates the relation of pre-operative albumin level and the risk for anastomotic leak in emergency gastrointestinal resection and anastomosis. Methods: A total of 112cases that meet the inclusion and exclusion criteria are included from Bangalore Medical College and Research Institute, Karnataka, India for a duration of 18 months November 2014 to October 2016.51 cases belonged to the stapled group and 61 cases belonged to the sutured group. Anastomosis using the two techniques, stapled and hand sewn anastomosis are evaluated separately. Results: The relation of pre-operative serum albumin and anastomotic leak is analysed in each study group separately and found that a pre-operative albumin of <3.5gm/dl is significantly associated with post-operative anastomotic leak, with a p-value of 0.0418 (p<0.05) in stapled anastomosis group and a p-value of 0.0357 (p<0.05) in hand sewn anastomosis group. Conclusions: Pre-operative albumin of <3.5gm/dl is significantly associated with post-operative anastomotic leak in both the groups, irrespective of the technique adopted.

This study shows that HIV infected individuals had increased titres of antibodies against S typhi from the baseline. This indicates a need for evaluation of current cut-off values of diagnostic titres for this group. We also suggest that it is best to perform baseline titres against S t yphi for each patient at the time of diagnosis of HIV status, and to use this for future reference.

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Background: Incidence of thyroid nodules varies according to the methods of diagnosis, 4-7% by palpation and 17-67% by high resolution ultrasound. The gold standard of diagnosis for thyroid nodules is fine needle aspiration (FNA); however, fine needle aspiration cytology (FNAC) alone is insufficient to detect cancer because of inadequate cytology (5-15%) and in cases of follicular neoplasm (15-25%) where only surgery is diagnostically conclusive. Therefore, other factors in addition to FNA should be considered to predict malignancy. This study was done to evaluate the association between elevated pre-operative thyroglobulin levels and histopathologically proven thyroid carcinoma.Methods: This retrospective study was conducted in Bowring and Lady Curzon Hospital, from December 2017 to November 2018. All patients above 18 years, undergoing total thyroidectomy, with normal antithyroglobulin levels and with indeterminate thyroid nodules or disease on FNAC were included. Patients proven to have malignancy by FNAC, who underwent hemithyroidectomy and patients with thyroglossal cyst or ectopic thyroid swellings were excluded.Results: A total of 50 patients were included. The Fischer’s exact test shows significant value of 0.037 and also the two-tailed test showed a p value <0.05, hence it is significant to conclude that the mean value of thyroglobulin levels among histopathologically proven malignant thyroid cancers is significantly higher compared to the benign thyroid disease.Conclusions: In addition to thyroid-stimulating hormone, thyroid nodules with elevated thyroglobulin levels were independently associated with the presence of thyroid cancer; therefore, the evaluation of pre-operative thyroglobulin level in patients with indeterminate FNAC might give additional information to predict malignancy.