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BACKGROUND:The importance of gallstone disease derives from their frequency and pathological potential. Spectrum of gallstone diseases is very wide and complications are not infrequent. MATERIAL AND METHODS: The present cohort study was conducted on 240 consecutive cholecystectomies performed for various indications in Post Graduate Department of Surgery, RMCH, Bareilly. This tertiary care institute caters the healthcare needs of Rohilkhand region. RESULTS:The commonest age group having the gallbladder disease was Vth decade (29.6%). Females outnumbered males by the ratio of 5.32:1. The commonest presenting symptom was pain in right upper/mid upper quadrant of abdomen (96.6% of symptomatic cases) followed by nausea/vomiting (45.0%). Out of 240 cholecystectomies performed, the gross and histopathological evaluation revealed that 180 cases (75%) were having chronic cholecystitis with cholelithiasis only; 46 cases (19.2%) were of acute on chronic cholecystitis with cholelithiasis, and 7 cases of acute acalculus cholecystitis. 60 cases (25%) were also having other associated histopathological changes in gallbladder mucosa like metaplasia (31), dysplasia (22) and carcinoma (7). CONCLUSION: In today's era of safe laparoscopic cholecystectomy, available even in small hospitals of North India, prophylactic cholecystectomy can be offered to asymptomatic cases of gallstones, especially if diagnosed in younger age because of the expected prolonged exposure to chronic irritation by gallstones and development of their complications including metaplasia, dysplasia and carcinoma gallbladder.

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Background: Medical Expulsive Therapy (MET) has become an established part of the protocol for treatment of ureteric stones of less than 5 mm size in the lower 1/3rd of the ureter. Drugs like calcium channel blockers and α-1 adrenergic blockers with or without corticosteroid along with hydration have been used to facilitate expulsion of stones. Aims & Objective: In this study effectiveness of α-1 adrenergic blocker Tamsulosin alone and in combination with corticosteroid deflazacort have been compared. Materials and Methods: Total of 70 symptomatic patients of lower ureteric stones, who presented in the OPD of Rohilkhand Medical College Hospital between Jan 2011-May 2013, were selected for the study. Patients were randomly divided in two groups: Group 1 (Tamsulosin Group) & Group 2 (Tamsulosin + deflazacort Group). Results: It was found that with Tamsulosin + deflazacort better stone clearance rate with in shorter period was achieved. There was minimum discomfort to the patients during stone expulsion. Success rate was comparable in both groups up to 10 mm stone size. There was marked difference in stones bigger than 10 mm (25% and 62.66% in 11-12 mm size, 16.66% and 57.14% in 13-15 mm size and 0.0% and 50% in 16-17 mm size). Conclusion: MET using Tamsulosin has definite role in passage of smaller size ureteric stone of less than 10mm size. It has acceptable success rate in bigger size stone in our study up to 17 mm size, when Tamsulosin was combined with Deflazacort.