New Indian Journal of Surgery

Background: Hypoalbuminemia is prevalent in patients undergoing major abdominal surgeries and is associated with adverse postoperative outcomes, including prolonged hospital stays, higher infection rates, and increased mortality. The clinical impact of albumin supplementation in these patients remains under scrutiny. Objective: This study evaluates whether albumin supplementation in hypoalbuminemic patients (≤3.0 g/dL) improves postoperative outcomes. Methods: This retrospective study included patients who underwent major abdominal surgery between January 2021 and December 2024 at a tertiary care hospital. Patients with hypoalbuminemia were divided into two cohorts of 250 each: those who received postoperative albumin supplementation and those who did not. Outcomes measured included length of hospital stay (LOS), infection rates, ICU admission rates, and 30-day mortality. Results: The albumin supplementation group had a significantly shorter LOS (8.1 vs. 11.4 days, p < 0.001) and lower infection rates (10% vs. 17%, p = 0.02). There was no statistically significant difference in ICU admissions or 30-day mortality between the two groups (p = 0.58 and p = 0.19, respectively). Multivariate regression identified albumin supplementation as an independent predictor of reduced LOS and infection rates. Conclusion: Albumin supplementation in hypoalbuminemic patients post-major abdominal surgery improves recovery metrics by reducing LOS and infection rates without influencing short-term mortality. Future randomized controlled trials are necessary to validate these findings.

Introduction: Hemorrhoids are one of the most common benign anorectal problems worldwide. Surgical intervention is necessary for advanced cases. Stapler Hemorrhoidopexy (SH) and conventional emorrhoidectomy (CH) are widely used methods. This study aims to compare the efficacy of SH and CH in terms of operative time, pain, hospital stay, and complications. Aim: A Comparative study between minimal invasive procedure for haemorrhoids Stapler Haemorrhoidopexy and open haemorrhoidectomy

Introduction: Burns injury is one of the most common cause for hospitalization in the world. About 80% are first degree and second degree ones. Since paediatric skin has a faster rate of healing, superficial first and second degree burns have significant improvement. Recent advances show that collagen dressing in burns because of its biological properties have better outcomes reducing morbidity. A prospective, interventional observational study was conducted over 120 paediatric patients with less than 30% superficial burns dividing them in 2 groups (collagen and conventional dressing). The analgesic need, infection rate, rate of epithelialization, scarring, need for grafting and hospital stay were assessed. Chi square test was applied to obtain ‘p’ value to decide ignificance. 70 patients were offered collagen and 50 patients silver sulfadiazine(SSD) dressing. The mean rate of ithelialization with collagen and SSD dressing was 9.50 days and13.92 days respectively. The mean days for analgesic need was 4.02 days with collagen and 6.22 days with SSD dressing. Sterile culture at 1 week was seen in 88.57% patients with collagen and 52% patients with SSD. With collagen dressing healthy scarring was seen in 82.85% patients and with SSD dressing, 32%. Of 50 patients with SSD dressing 2 required skin grafting. Collagen rejection was seen in 4 of 70 patients. With collagen dressing the average hospital stay was 7.18 days and with SSD dressing, 12.10 days. Collagen dressing showed lesser analgesics, faster epithelialization, lesserantibiotic use, healthy scarring, lesser hospital stay.

Vagal nerve schwannomas are rare, benign neurogenic tumors originating from Schwann cells of the vagus nerve. Due to their rarity and nonspecific clinical presentation, these tumors are challenging to diagnose preoperatively. Here, we present a case of a 30-year-old female diagnosed with a vagal nerve schwannoma, highlighting the clinical, radiological, and histopathological findings, along with the successful surgical management and favorable outcome. This case emphasizes the significance of considering neurogenic tumors in patients with lateral neck masses and the role of imaging modalities in ensuring precise diagnosis and treatment planning.

Medicine is an ‘Art & a Science’ was the first thing that we were taught in Medical College UG curriculum. However, as we moved along, the thrust of the teaching was only on the science part of Medicine. The art part of Medicine was never taught in a structured manner. So, half of Medicine was actually not, part of the curriculum. It was learnt by observing our teachers & seniors. The sad part is that over the decades, the art of Medicine appears to have faded away or may be, it has acquired a different colour. Both the components of Medicine (Art & Science) are dynamic. They are expected to change with the passage of time & the everchanging world. We need to examine their journey across decades to see if there is a conscious need for some course correction. The authors have, out of their experiences & observations, divided the study into 3 phases – the past (i.e., the last 2-3 decades of the last millennium), the present (i.e., the first 2-3 decades of the present millennium) and the future (i.e., the subsequent decades yet to come). Of course, there are overlaps but they are being ignored for the sake of simplicity.

Introduction: Tubercular liver abscess is an extremely rare clinical entity, particularly when it presents in isolation without any pulmonary or gastrointestinal involvement and in the absence of immunocompromising conditions. Tuberculosis affecting the liver is observed in approximately 10 to 15 percent of all extrapulmonary tuberculosis cases, while extrapulmonary tuberculosis itself constitutes about 10 to 20 percent of the global tuberculosis burden. Among those with hepatic involvement, tubercular liver abscess represents only a small fraction approximately 0.34 percent making isolated cases in immunocompetent individuals especially uncommon. Case report: We report the case of a 42-year-old male farmer from Ganjam district who presented with right upper abdominal pain, vomiting, and intermittent fever lasting 20 days. Clinical and radiological investigations revealed an isolated abscess in the right lobe of the liver. There was no history of prior tuberculosis infection or known contact with tuberculosis patients, and the patient had no comorbid conditions. Microbiological analysis of aspirated pus confirmed the presence of Mycobacterium tuberculosis. The patient was treated successfully with percutaneous drainage and systemic antitubercular therapy.

Background: This is an unusual case of a young Indian girl who inserted multiple sewing needles, allegedly to clean her axillary sinus tract, which then went on to become life-threatening for her, and required a formal exploration under general anesthesia. Case: We report a case of self-insertion of 3 sewing needles in the right axilla for cleaning a sinus tract which migrated till the intercostal muscles threatening a pneumothorax, and discuss management of the case. Conclusion: A skillful history, appropriate imaging and early surgical intervention are a must to correctly diagnose and adequately treat retained foreign bodies in breast or axilla, thereby preventing life-threatening complications.