Effect of preoperative oral carbohydrate loading on postoperative insulin resistance, patient-perceived well-being, and surgical outcomes in elective colorectal surgery: a randomized controlled trial.

Background: Insulin resistance (IR) is one of the independent determinants influencing the length of hospital stay (LOHS) and postoperative complications in colorectal procedures. Preoperative oral carbohydrate loading (OCL) has emerged as a prospective countermeasure for IR. This study aimed to investigate the effects of preoperative carbohydrate loading on postoperative IR, inflammatory parameters, and clinical outcomes in patients undergoing elective colorectal surgery.

Clinical Outcomes and Their Determinants in Patients With Gastric Variceal Bleed Undergoing Endoscopic Cyanoacrylate Injection: An Observational Study.

Background And Aims: Gastric variceal bleeding (GVB), compared to esophageal varices, is rare but often massive and associated with high mortality. Endoscopic cyanoacrylate glue injection (ECGI) is the first-line treatment for GVB. Hence, we conducted this study to assess the clinical outcomes and the determinants of ECGI for gastric variceal bleeding.

Role of specific nutritional biomarkers in predicting post-operative complications among patients undergoing elective abdominal surgery.

Purpose: Nutritional biomarkers like serum prealbumin, transferrin, retinol-binding protein (RBP), C-reactive protein (CRP), leptin, and insulin-like growth factor 1 (IGF1) have the inherent ability to diagnose undernutrition objectively before it is clinically manifested. The primary objective of the study was to evaluate the diagnostic efficacy of the specific nutritional biomarkers in predicting post-operative complications.

Methods: A prospective cohort study was conducted in the department of surgery and included all patients aged 18 years and above who underwent elective abdominal surgery.

Clinicopathological features and survival outcomes for gastric adenocarcinoma: Real-world single-center data.

Introduction: Gastric cancer is the fifth most-common cancer and fourth common cause for cancer-related deaths globally. Surgery preceded or followed by chemotherapy or chemoradiotherapy is considered an optimal treatment for locally advanced gastric cancer. This study is a real-world data from a tertiary referral institute in southern India, in its experience with treating gastric adenocarcinoma over a period of four years with a minimum of two-year follow-up.

Prophylactic Negative Pressure Wound Therapy in Reducing Surgical Site Infections in Closed Abdominal Incision: A Randomized Controlled Trial.

This study aimed to evaluate the efficacy of prophylactic negative pressure wound therapy (PNPWT) in reducing the incidence of surgical site infection (SSI) and other wound complications in closed abdominal incisions. This was a prospective, single-center, open-label parallel arm superiority randomized controlled trial conducted over 2 years. Participants were randomly assigned to PNPWT and standard surgical dressing (SSD) group.

Comparison of Enhanced Recovery After Surgery (ERAS) Pathway Versus Standard Care in Patients Undergoing Elective Stoma Reversal Surgery- A Randomized Controlled Trial.

Background: Practices such as prolonged preoperative fasting, bowel preparation, delayed ambulation and resumption of orals result in morbidity in 15-20% of stoma reversal cases which can be improved by Enhanced Recovery After Surgery (ERAS) pathways.

Aim: To evaluate the safety, feasibility and efficacy of ERAS pathway in patients undergoing elective loop ileostomy or colostomy reversal surgery METHODS: This was an open-labeled, superiority randomized controlled trial in which patients undergoing loop ileostomy or colostomy reversal were randomized to standard or ERAS care. Patients with ASA class ≥3, needing laparotomy for stoma reversal, cardiac, renal and neurological illnesses were excluded.

Comparison of Short-Course and Conventional Antimicrobial Duration in Mild and Moderate Complicated Intra-Abdominal Infections: A randomised controlled trial.

Objectives: Studies have shown the feasibility of short-course antimicrobials in complicated intra-abdominal infection (CIAI) following source control procedure (SCP). This study aimed to compare postoperative complication rates in short-course (5 days) and conventional (7-10 days) duration groups after antimicrobial therapy.

Methods: This was a single-centre, open-labelled, randomised controlled trial conducted in Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India, from July 2017 to December 2019 on patients with CIAI.

Diagnostic Utility of NLR, PLR and MLR in Early Diagnosis of Gastric Cancer: an Analytical Cross-Sectional Study.

Purpose: Inflammatory markers such as neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and monocyte-to-lymphocyte ratio (MLR) are linked with the pathogenesis of gastric cancer (GC). However, the clinical significance of the combination of these markers is unclear. Hence, this study was carried out to determine the individual and combined diagnostic accuracy of NLR, PLR and MLR among patients with GC.

Is There an Association between Variceal Bleed and Helicobacter pylori Infection in Cirrhotic Patients with Portal Hypertension?: A prospective cohort study.

Objectives: This study aimed to determine the association between infection and variceal bleeding as well as rebleeding in cases of cirrhosis with portal hypertension.

Methods: This prospective cohort study included patients with bleeding oesophageal varices and was conducted at the Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India, from August 2016 to July 2018.

Results: A total of 190 patients were assessed for eligibility, of which 159 patients were included in this study.

The Diagnostic Dilemma of Ruptured Liver Metastasis in a Patient with Lung Cancer: A case report.

Spontaneous rupture of a metastatic liver tumour is rarely documented in the literature when compared to hepatocellular carcinoma and other liver lesions, especially from a lung primary. We report a case of ruptured liver metastasis from an adenocarcinoma of the lung mimicking ruptured liver abscess, challenging the clinical diagnosis. A 42-year-female patient presented to a tertiary care institute in 2020 with complaints of abdominal pain, breathlessness and fever.

Effect of Synbiotics in Reducing the Systemic Inflammatory Response and Septic Complications in Moderately Severe and Severe Acute Pancreatitis: A Prospective Parallel-Arm Double-Blind Randomized Trial.

Aim: This study aimed at evaluating the efficacy of synbiotics in reducing septic complications in moderately severe and severe acute pancreatitis.

Methods: This was a prospective, parallel-arm, double-blinded superiority randomized control study. All patients with moderately severe and severe acute pancreatitis were included in the study.

Comparison of Efficacy of Aspirin Plus EOX vs. EOX Alone in Patients with Locally Advanced and Metastatic Gastric Cancer: a Randomized Clinical Trial.

Purpose: The role of aspirin in cancer prevention has been well defined; the last decade revealed its therapeutic role with improved efficacy when aspirin was added to capecitabine in heavily pre-treated metastatic colorectal cancer. Aspirin affects tumour growth through the PI3K pathway, which regulates apoptosis and autophagy. The objective was to compare the efficacy of aspirin plus epirubicin, oxaliplatin, capecitabine (EOX) chemotherapy versus EOX alone in locally advanced and metastatic gastric cancer.

Assessment of the quality of randomized controlled trials in surgery using Jadad score: Where do we stand?

Introduction: Quality assessment of randomized controlled trials (RCTs) is important to prevent clinical application of erroneous results.

Materials And Methods: This was an assessment of published RCTs in surgical subspecialties during 2011-2018 based on MEDLINE and EMBASE search. The primary objective of the present study was to quantitatively and qualitatively analyze the RCTs published from India based on year of publication, geographical distribution, and subspecialty using the modified Jadad score (high quality if score is ≥3; or ≥2 if blinded design was not feasible).

Acute Upper Non-variceal and Lower Gastrointestinal Bleeding.

Acute gastrointestinal (GI) bleeding is a common surgical emergency requiring hospital admission and associated with high morbidity and mortality. Appropriate decision-making is essential to make a prompt diagnosis, accurate risk assessment, and proper resuscitation of patients with gastrointestinal bleeding. Despite multiple randomized trials and meta-analyses, there is still controversy on various management issues like appropriate risk stratification, the timing of endoscopy, choosing an appropriate endoscopic, and radiological intervention in these groups of patients.

Adapted ERAS Pathway Versus Standard Care in Patients Undergoing Emergency Surgery for Perforation Peritonitis-a Randomized Controlled Trial.

Background: Enhanced Recovery After Surgery (ERAS) pathways have an uncertain role in emergencies. To the best of our knowledge, there are no trials studying ERAS in perforation peritonitis across the GI tract, despite it being a common surgical emergency.

Aims: To evaluate the safety, feasibility and efficacy of adapted ERAS protocols in emergency laparotomy for perforation peritonitis.

Serial estimation of serum C-reactive protein and procalcitonin for early detection of anastomotic leak after elective intestinal surgeries: a prospective cohort study.

Objectives: Anastomotic leak can adversely affect the outcome of surgery especially if detected late. The present study was carried out to detect the anastomotic leak early in the postoperative period using serial estimation of procalcitonin (PCT) and C-reactive protein (CRP).

Material And Methods: A single centre prospective cohort study was done on patients undergoing elective gastrointestinal surgery with anastomosis.

Role of Sarcopenia in Predicting the Postoperative Morbidity and Perioperative Mortality in Patients Undergoing Elective Surgery for Gastric Cancer.

Purpose Of Study: This study was done to assess the effect of sarcopenia and other risk factors on the postoperative morbidity and perioperative mortality of patients undergoing elective surgery for gastric cancer.

Methods: This was a prospective cohort study comprising a single group of patients undergoing elective surgery for gastric cancer carried out in a tertiary care center in India. Patients diagnosed with gastric cancer underwent contrast-enhanced computed tomography preoperatively.

Management of Helicobacter pylori infection: The Bhubaneswar Consensus Report of the Indian Society of Gastroenterology.

The Indian Society of Gastroenterology (ISG) felt the need to organize a consensus on Helicobacter pylori (H. pylori) infection and to update the current management of H. pylori infection; hence, ISG constituted the ISG's Task Force on Helicobacter pylori.

Pulmonary cryptosporidiosis in a case of adenocarcinoma of stomach: A rare case report.

species are commonly known to cause chronic intractable diarrhea in patients suffering from human immunodeficiency virus (HIV)-acquired immunodeficiency syndrome, however extra-intestinal presentations have been rarely reported. Hereby, we report a rare case of isolated pulmonary cryptosporidiosis in a 75-year-old HIV-negative patient with metastatic carcinoma of the stomach who was managed conservatively with hemostatic radiotherapy for palliative care. The patient had presented with cough with expectoration for 2 months.

Erratum: Serial estimation of serum C-reactive protein and procalcitonin for early detection of anastomotic leak after elective intestinal surgeries-prospective cohort study.

[This corrects the article on p. 022 in vol. 37.

Factors predicting prolonged hospitalization after abdominal wall hernia repair - a prospective observational study.

Objectives: The aim of this study was to identify the factors predicting prolonged hospitalization following abdominal wall hernia repair.

Material And Methods: This was a prospective observational study which included patients operated for elective and emergency abdominal wall hernias. Details of the patients including demographic profile, hernia characteristics, and perioperative factors were collected.

Clinicopathological profile and its association with peritoneal disease among gastric cancer patients.

Background: There are no clinicopathological criteria or test to predict peritoneal metastasis either in primary or recurrent gastric cancer. The early prediction will help in altering or adding other adjuvant potential therapy modalities like HIPEC and maintenance chemotherapy.

Methods: Paraffin based blocks of 110 gastric tumor specimens were subjected to IHC staining to assess VEGF, Her 2 neu, E cadherin, bcl 2 and p 53 expression and its association with peritoneal disease evaluated.