A comparative study between open and Laparoscopic cholecystectomy in gallstone disease

INTRODUCTION: Gastro-intestinal surgery has undergone a revolution in the recent years by the introduction of laparoscopic techniques. The concept of “keyhole surgery” created an immediate disparity between the potential of the new technique and training of surgeons to perform it. Now modern surgical methods are aimed at giving cure along with minimal invasive techniques with patient in mind, safety never being compromised. Cholelithiasis, which continues to be one of the most common digestive disorders encountered, was traditionally being dealt by conventional or open cholecystectomy. With the introduction of laparoscopic cholecystectomy, the surgical community witnessed a revolution in basic ideology and the importance of minimal access surgery. Laparoscopic cholecystectomy (LC) has become so safe and easy that it can be performed with much ease and safety because of better magnification. Although LC has shown clear benefits in terms of shortened hospital stay, less morbidity, mortality, a quicker return to work and with cosmetic advantage, many questions regarding this procedure remain unanswered, particularly relative to the gold standard procedure of open cholecystectomy. Some surgeons have suggested that the rates of serious complications, particularly bile duct injury might be significantly higher in laparoscopic procedures resulting in major morbidity and even mortality. Apart from the high costs of the equipment and the specialized training that is mandatory for mastery of the technique, the procedure inherently carries hazards and risks. In a developing country like ours, where the medical costs and loss of working days constitute major issues, could laparoscopic cholecystectomy establish itself as a safe and cost effective alternative to the open method? In our study, we have made an attempt to compare the advantages and drawbacks of both the procedures in an Indian set up. AIMS AND OBJECTIVES: The aim of this study is to compare conventional cholecystectomy and laparoscopic cholecystectomy with respect to: 1. Duration of the procedure, 2. Post operative discomfort or pain, 3. Analgesic requirement, 4. Complications encountered, 5. Diet, 6. Period of hospitalization, 7. Return to normal activity. MATERIAL AND METHODS: The study subjects consisted of 81 patients with a diagnosis of calculous cholecystitis that underwent cholecystectomy at Tirunelveli Medical College Hospital, Tirunelveli-11 from July 2007 to December 2009. The patients were interviewed for detailed clinical history according to a definite proforma. All the patients were examined and underwent routine blood investigations with LFT wherever necessary. Abdominal USG was performed in all the cases. Inclusion Criteria: Patients with cholelithiasis proven by USG with at least one attack of upper abdominal pain and considered fit for elective cholecystectomy were included in the study. Exclusion Criteria: The patients with following conditions were excluded from the study: • History or investigations suggesting CBD stones. • Patient’s underwent surgery for acute cholecystitis • Patient’s who underwent surgery for complications like empyema gall bladder, perforation gall bladder. RESULTS: This study was conducted during a two and half year period from July 2007 to December 2009, a total of 81 cases of Cholecystectomy were studied. Of these, 49 patients underwent laparoscopic Cholecystectomy and 15 patients underwent open type and 5 patients had to be converted to open type. CONCLUSIONS: Laparoscopic cholecystectomy is a considerable advancement in the treatment of gall bladder disease. The advantages of laparoscopic cholecystectomy are several: • Technically, the dissection of the cystic artery and cystic duct is very precise and bleeding is easily controlled with less peri operative blood loss. • LC is associated with less chances of wound infection and there is no risk of wound dehiscence. • The antibiotic usage in LC is comparatively lesser than that of OC. • The degree of post operative pain and its duration is less. • The amount of analgesic requirement is less in LC. • LC patients tolerate oral feeds earlier and are mobilized faster. • The duration of hospital stay is less and patients can be discharged quickly from the hospital. • Patients of LC group can resume their work earlier. • The cosmetic advantage in LC is obvious. Cholecystectomy remains a common operation. Laparoscopic management of symptomatic gallstones has rapidly become the new standard for therapy throughout the world. Many patients can now undergo this operation in an ambulatory setting. There are numerous advantages of LC over OC. However, occasionally anatomical or physiological considerations will preclude the minimal access approach, and conversion to an open operation in such cases reflects sound judgment and should not be considered a complicatio

Method Dvelopment and Validation for the Simultaneous Estimation of Atazanavir Sulphate and Ritonavir in Bulk and Tablet Dosage form by RP-HPLC.

Analytical chemistry may be defined as the science and art of determining the composition of material in terms of elements or compounds contained in it1. Analytical chemistry is divided into two branches quantitative and qualitative. A qualitative method is the information about the identity of atomic or molecular species or functional groups in the sample. A quantitative method provides numerical information as to the relative amount of one or more of these components. For analysis of these drugs different analytical methods are routinely being used. These analytical methods are classified as chemical and instrumental. The chemical methods include Gravimetric and Titrimetric. These methods are simple but less precise and more time consuming so now days these methods are not suggested for the routine analysis. The instrumental methods include electrochemical methods - Electro gravimetric method, Potentiometry, Colorimetry, Conductometry, Polarography and Optical methods - Absorption and Emission methods. The Absorption methods include Visible Spectrophotometry, Ultraviolet Spectrophotometry, Atomic Absorption Spectrophotometry, Infrared Spectrophotometry, and Emission methods include Emission Spectroscopy, Flame Photometry, Fluorimetry, etc. The other outstanding methods include isotopes, radioactivity, X-ray fluorescence and separation methods as various chromatographic principles viz. HPLC, GC, HPTLC, LC-MS. The present study indicated that the developed method is simple, precise and cost effective for the simultaneous estimation of Atazanavir sulphate and Ritonavir for routine quality control analysis of these either in bulk and pharmaceutical formulation. The developed and validated RP-HPLC method outlined is very obvious, affordable, dynamic, low cost, rapid easy to perform with small sample volume and good repeatability. It can be adopted for the routine quality control analysis of simultaneous determination of Atazanavir sulphate and Ritonavir because of good resolution of the chromatographic peaks

Modified Pipelining Hybridization of Job Shop Scheduling

Hybridization involves generally genetic algorithm in a stage .Here instead of genetic algorithm,metaheuristics method Local search method, is applied as primary search routine, for tacklingcombinatorial search and optimization problems.The dispatching rule LPT is applied first, servingas a preprocessor. The local search methods are works on the iterative exploration of a solutionspace: at each iteration a local search algorithm start search from one solution to one of itsneighbor. The method is analysis the job shop bench mark problems. The comparison of theperformance measure is evaluated

Evaluation of Antiproliferative Activity of Red Sorghum Bran Anthocyanin on a Human Breast Cancer Cell Line (MCF-7)

Breast cancer is a leading cause of death in women worldwide both in the developed and developing countries. Thus effective treatment of breast cancer with potential antitumour drugs is important. In this paper, human breast cancer cell line MCF-7 has been employed to evaluate the antiproliferative activity of red sorghum bran anthocyanin. The present investigation showed that red sorghum bran anthocyanin induced growth inhibition of MCF-7 cells at significant level. The growth inhibition is dose dependent and irreversible in nature. When MCF-7 cells were treated with red sorghum bran anthocyanins due to activity of anthocyanin morphological changes were observed. The morphological changes were identified through the formation of apoptopic bodies. The fragmentation by these anthocyanins on DNA to oligonuleosomal-sized fragments, is a characteristic of apoptosis, and it was observed as concentration-dependent. Thus, this paper clearly demonstrates that human breast cancer cell MCF-7 is highly responsive by red sorghum bran anthocyanins result from the induction of apoptosis in MCF-7 cells

Robust detection and classification of biomedical cell specimens from light microscope images

Ph.DDOCTOR OF PHILOSOPH

IOT Enabled Smart Charging Stations for Electric Vehicles

As we are aware about the mass adoption of EVs on the horizon, the smart electric vehicle charging will become essential for both the charging point network operators, and the National electricity grid. EVs are becoming popular across the globe. As the number of EVs increases, EV charging infrastructure will also be a basic need. This work is to make a smart application to know the different tariff rates of the grid by connecting to the grid. The tariff rates will include both, the power intake rate and also the outgoing power rate. When the user comes to the grid, the application will also display the battery SOC. The main agenda is to optimize low carbon technologies through one connected platform using rule based algorithms, helping to decarbonize both the production and consumption of energy

A Rare Case of Accessory Breast Mimicking Lipoma in a Male

Accessory breast tissue is a rare condition in which there is a presence of breast tissue in an ectopic site in addition to normal site. It occurs in about 0.4-6% of women and 1.68% occurrence is seen in men. The obstacle to management comes in the diagnosis of the accessory breast tissue. The commonest site is the axilla, and the other sites of occurrence are groin, buttock and thigh. The disease may present as a unilateral swelling with changes occurring during the time of pregnancy, lactation and menses due to the influence of hormones. This breast tissue also undergoes the changes that occur in a normal breast tissue such as fibrocystic changes or carcinomatous changes. A case of accessory breast tissue was reported in a 28-year-old-male which was initially suspected to be a pedunculated lipoma in the right axillary region and later on histopathological evaluation diagnosed to be an accessory breast tissue

Agricultural bio-waste recycling through efficient microbial consortia

In India and other countries, rice straw, a byproduct of rice production, is burned in enormous amounts, which contributes to environmental pollution and climate change by releasing greenhouse gases viz., CO2, N2O, CH4, into the atmosphere. This study aimed to accelerate the degradation of this enormous amount of agricultural biomass via microbial inoculants. Four treatments—rice straw (RS), rice straw plus water (RSW), rice straw plus water plus Pusa decomposer (RSWF), and rice straw plus water plus Tamil Nadu Agricultural University (TNAU) biomineralizer (RSWB) were used in the current investigation. The study's findings demonstrated that rice straw treated with microorganisms decomposed more quickly than RS and RSW treatments. According to EDAX spectra of elemental composition, the carbon content of rice straw in the RS, RSW, RSWF, and RSWB treatments was 33.66%, 29.75%, 13.33%, and 20.65% w/w, respectively. The RSWF treatment of rice straw was found to have the highest nitrogen concentration (0.64% w/w), followed by RSWB (0.61% w/w), RSW (0.45%) w/w, and RS (0.43% w/w). Treatments RSWF and RSWB had lower C/N ratios 20.83, and 33.85, respectively, than that RSW (66.11) and RS (78.28). The RSWF and RSWB treatments' porous, distorted, and rough surface structures provided further evidence that both microbial consortia could decompose rice straw more quickly than the RSW and RS treatments. Therefore, the results of this study imply that rice straw could be added to the soil to improve soil fertility for sustainable crop production rather than being burned