Patients undergoing surgical treatment for calculous disease were considered to have had a partial cholecystectomy performed when a part of the gall bladder wall was retained for technical reasons. Forty patients underwent partial cholecystectomy: for chronic cholecystitis (20), acute cholecystitis (4), Mirizzi's syndrome (14), portal hypertension or partially accesible gall bladder (one patient each). Four patients (10%) developed infective complications and two patients had retained common bile duct stones. In a mean follow up period of 13 months (range 1–36 mths), only 3 patients have ongoing mild dyspeptic symptoms while the rest have remained asymptomatic. Partial cholecystectomy has been found to be a safe and effective procedure in difficult cholecystectomy situations, since it combines the merits of cholecystectomy and cholecystostomy.

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'Single-sitting' laparoscopic cholecystectomy followed by endoscopic common bile duct clearance is emerging as a viable option for management of cholelithiasis and concomitant choledocholithiasis. The only disadvantage of the procedure is logistical since it requires co-ordination between two teams-the surgeons and the endoscopists. This limitation can be overcome in centres where both the procedures are performed by one team. With a considerable experience in endoscopy, we conducted a prospective study in a select group of patients to assess the feasibility of this single-sitting approach. The study included 38 patients with a radiological diagnosis of choledocholithiasis or jaundice at presentation. After laparoscopic cholecystectomy, the patients were turned prone and subjected to endoscopic retrograde cholangiogram, sphincterotomy and extraction of the common bile duct stone. The procedure was successful in 33 (87 %) of patients. The mean procedure time and hospital stay were 2 h, 20 min and 2 days, respectively. None of the patients had any major complications. We conclude that in a select group of patients, single-sitting laparoscopic cholecystectomy followed by endoscopic clearance of the common bile duct stone is safe and effective.Keywords Choledocholithiasis . CBD Stone . Laparoscopic Cholecystectomy Common bile duct (CBD) stone occurs in about 3-15 % of patients undergoing laparoscopic cholecystectomy (LC) [1][2][3]. In the era of open cholecystectomy, preoperative endoscopic clearance of CBD followed by open cholecystectomy was comparable [4][5][6] or even considered inferior [7] to single-stage cholecystectomy and choledocholithotomy. With minimally invasive surgery becoming the 'gold standard,' the endoscopic approach has seen a revival and has been considered a viable alternative to laparoscopic CBD exploration for concomitant CBD stone. Traditionally, gallstones with CBD stones are managed in two sittings i.e., endoscopic clearance of CBD stone followed by laparoscopic cholecystectomy or vice versa [8]. This entails involvement of two teams led by the endoscopist and surgeon for CBD stones and gallstones, respectively. The endoscopic approach has been found to be similar to laparoscopic CBD exploration in terms of successful stone clearance, morbidity, and mortality except for longer hospital stay [9,10]. The latter disadvantage can be countered by carrying out the endoscopic CBD stone clearance as a single-sitting procedure in conjunction with LC [11]. The single-sitting approach, however, suffers from the logistic problem as it requires proper coordination between the surgeon and the endoscopist. We were encouraged to try this approach because of our considerable experience with both laparoscopy as well as endoscopy. We attempted to perform laparoscopic cholecystectomy as well as endoscopic clearance of the CBD stone ourselves without having the need to involve another team. In this report, we have presented our initial experience with this 'single-sitting' approach with respect to its...

In this paper, the higher nonlinear problems of fractional advection-diffusion equations and systems of nonlinear fractional Burger’s equations are solved by using two sophisticated procedures, namely, the q-homotopy analysis transform method and the residual power series method. The proposed methods are implemented with the Caputo operator. The present techniques are utilised in a very comprehensive and effective manner to obtain the solutions to the suggested fractional-order problems. The nonlinearity of the problem was controlled tactfully. The numerical results of a few examples are calculated and analyzed. The tables and graphs are constructed to understand the higher accuracy and applicability of the current method. The obtained results that are in good contact with the actual dynamics of the given problem, which is verified by the graphs and tables. The present techniques require fewer calculations and are associated with a higher degree of accuracy, and therefore can be extended to solve other high nonlinear fractional problems.

The crude methanol (MeOH), n-hexane (n-Hex), petroleum ether (PE), chloroform (CHCl 3 ) and Aqueous (Aq) extracts of Ganoderma lucidum (Fr.) P. Karst were screened to determine their bioactive constituents, antioxidant potential and antimicrobial activity. Among all the tested extracts, highest phenolics and tannins contents were observed in CHCl 3 (127.5 mg 100g -1 ) and PE fractions (78.52 mg 100g -1 ). The highest flavonoids moiety (84.9 mg 100g -1 ) and antioxidant activity (82.67%) was recorded in MeOH fractions. In vitro antibacterial and antifungal activities were evaluated by disc and well diffusion method. The maximum (72.14%) inhibitory zone was observed in CHCl 3 fraction with MIC value of 5.2mg ml -1 against the bacterial strain Staphylococcus sp. However E. coli was not susceptible to PE extract while Xanthomonas sp was resistible to n-Hex and PE extracts. Likewise CHCl 3 fraction showed significant activity against the fungal strain Penicillium sp having growth inhibitory zone of 68.42% with MIC value of 41.66 mg ml -1 . However no activity was observed for n-Hex against Penicillium sp and Aspergillus sp., CHCl 3 against Paecilomyces sp and Trichoderma sp while PE ether against Aspergillus sp. The present findings suggest that notable antimicrobial potential of extracts might be due the presence of bioactive compounds.