No abstract

INTRODUCTIONSymptomatic cholelithiasis is a common gastrointestinal surgical entity having the complication of accumulation of gall stones. Although, therapeutic options are laparoscopic, endoscopic, percutaneous surgery and open traditional technique either through a combination of any of cited treatments or by conducting those in a step wise sequence to manage gallstones and common bile duct (CBD) stones, there is no clear consensus on the correct strategy.Obviously, endoscopic retrograde cholangiopancreatography (ERCP) remains the preferred approach for assessing CBD stones in patients. Often, a CBD clearance is carried out by ERCP with the endoscopic sphincterotomy (ES), before laparoscopic cholecystectomy (LC) as the preferred strategy. ABSTRACTBackground: Nowadays in patients with cholelithiasis with choledocholithiasis, the ideal treatment is endoscopic retrograde cholangiopancreatographic (ERCP) removal of duct stone and laparoscopic cholecystectomy. But when to do and whether we can do it simultaneously or one after another and what interval should be there, that is always controversial. The purpose was an optimal gap for cholecystectomy after ERCP. Methods: We have done a comparison study in 60 patients within a duration of 2 year who had already done ERCP. Group 1, those patients who had laparoscopic cholecystectomy within 72 hours compared with group 2 who had laparoscopic cholecystectomy after an interval of 6 week. Primary outcome was the conversion rate from lap to open cholecystectomy. Secondary outcome was duration of operation, intra-operative difficulties, postoperative morbidity and hospital stay. Results: Of 60 consecutive patients 30 were in group I and 30 were in group II. There is no difference in demographics, laboratory or ultrasonographic findings. The hospital stays in group I is significantly shorter than group II and conversion rate; operative time is higher in group II. No statistically significant difference in postoperative morbidity between both groups. Conclusions: Early laparoscopic cholecystectomy within 72 hr is better than interval (6 week) cholecystectomy after ERCP with shorter hospital stay and less intraoperative difficulties.

No abstract

Background: Major complications of laparoscopic cholecystectomy are bleeding and bile duct injury, and it is necessary to clearly identify structures endoscopically to keep bleeding and injury from occurring. The aim of this study was to depict the anatomic landmark in the Calots triangle, a vein (cystic vein), a constant feature which can help Laparoscopic surgeons to conduct a safe LC along with other precautions to be adopted. Methods: A total of 100 patients (58 male, 42 female) who underwent cholecystectomy were examined preoperatively by clinically. The origin and number of cystic veins and their relationship with the Calot triangle was evaluated. Results: The cystic veins were delineated intraoperatively in 80 of the 93 patients. The relationship between the cystic vein and the Calot triangle was identified in 80 (86.02%) of the 93 patients. One cystic vein was found in 53 (66.25%) patients, while multiple cystic veins were found in 27 (33.75%) patients. All these veins are above the cystic common bile duct junction. Conclusion: The configuration of the cystic veins and their relationship in the Calot triangle with cystic artery and cystic duct can be identified intraoperatively and used as a guideline for safe laparoscopic cholecystectomy.

No abstract

Background: Patients with surgical jaundice need quick and precise diagnosis for the presence of an obstruction in the biliary tract, to establish the level and nature of the lesion. The importance of history and clinical examination in arriving at a correct pre-operative diagnosis needs to be emphasized. Present study attempts to determine the various causes, age and sex pattern in extra hepatic obstructive jaundice.Methods: 100 patients with surgical jaundice were studied at IMS and SUM Hospital, Bhubaneswar, India during the period from September 2015 to September 2017 who were diagnosed by investigation like ultrasonography and liver function test.Results: 76% of patients were between the age group of 50-80 years, there was a slight male predominance in 53.33%, malignant cause for surgical jaundice constituted in 66.67% with carcinoma head of pancreas the commonest cause in 33.33%, benign cause for surgical jaundice constituted in 33.33%, with choledocholithiasis the commonest cause in 23.33%.Conclusions: Most common age group seen in surgical jaundice was between 50-80 years. The sex ratio is near equalizing. Most common cause of surgical jaundice was carcinoma head of pancreas and choledocholithiasis.

No abstract

Phosphorus (P), the second most essential nutrient, plays a remarkable role in energy transfer, storage, plant growth, and development. It is the least mobile and accessible to plants in most soil conditions as compared to the other key nutrients. Phosphate‐solubilizing fungus (PSF) plays a vital role in supplying phosphorous to plants from the soil. Hence this research intends to assess the phosphorous and nutritional status of collected soil samples as well as isolation of potential fungal strains. Twelve soil samples were taken from three costal districts of Odisha (Bhadrak, Jajpur, and Balasore). All six key soil parameters like pH, electrical conductivity, organic carbon, nitrogen, phosphorous, and potassium were examined for correlation and found to be significantly associated with each other. Fungal colonies were enumerated, grown and pure colonies were found. A total of four potential fungal strains were isolated, screened from rhizospheric soil and evaluated for their phosphate solubilization efficiency on Pikovskaya's agar selective media. They produce the halo zones around their colony approximately 3.3 cm (PRF2), 2.96(PRF3), and 3.06(PRF4) cm within 10 days of incubation. Aspergillus niger was a highly efficient strain in solubilizing phosphate with the solubilization index (SI) of 3.56 cm and also showed the greatest drop in pH in the PVK broth containing rock phosphate.