Background: Gall stone disease is a common disease affecting human beings. Over the past two decades, laparoscopic cholecystectomy has become gold standard for the surgical treatment of gallbladder disease. The advantages of laparoscopic cholecystectomy over open surgery are a shorter hospital stay, less postoperative pain, faster recovery, better cosmoses. This study was planned to identify the circumstances and the risk factors influencing the conversion of laparoscopic cholecystectomy to open procedure.Methods: This is a Prospective study conducted over a period of 24 months. A total of 50/500 patients who were electively posted for laparoscopic cholecystectomy and got converted into open cholecyctectomy were included in the study. The Factors recorded and analysed were Age and Sex of the patient, presence of diabetes mellitus, previous episode of Acute Cholecystitis, Body Mass Index, presence of abdominal scar, total count, Ultrasonagram Abdomen findings of Gallbladder wall thickness and presence of pericholecystic fluid.Results: In our study, it has been observed that Patient Related Factors - Age >50yrs, Male gender, Presence of Diabetes Mellitus, Obesity, previous Abdominal surgeries and Disease Related Factors - previous episode of Acute Cholecystitis, presence of Acute Cholecystitis, Gallbladder wall thickness >4mm, presence of Pericholecystic fluid were found to be significant risk factors in conversion of laparoscopic to open cholecystectomy.Conclusions: These risk factors help to predict the difficulty of the procedure and this would permit the surgeon to better inform patients about the risk of conversion from laparoscopic to open cholecystectomy.

Objectives. Pathogenesis of gallstone includes bile stasis due to defect in the gallbladder muscle contraction. Our aim of the study is to find out the role of 99mTc-HIDA scan in assessment of gallbladder dyskinesia in cholelithiasis patients before laparoscopic cholecystectomy and compare the gallbladder dyskinesia with various parameters like symptoms of patients, diabetic status of patients, gallstones size and number, and cholecystitis features in histopathology report after surgery. Material and Method. This is a prospective observational study conducted at our hospital for three years. Totally 40 patients with gallstone were subjected to 99mTc-HIDA scan, to assess the ejection fraction of gallbladder. For all these patients detailed clinical history, presence of comorbid illness like diabetics, and symptomatology were elicited. For all patients, ultrasonogram of abdomen was done to assess number and size of stones. All parameters were tabulated and correlated. Result. While comparing 99mTc-HIDA scan findings with symptoms of patients, 21.2% were asymptomatic and 78.8% symptomatic patients who had ejection fraction less than 80%. All patients in EF >80% group were symptomatic only. It is not statistically significant. On comparing 99mTc-HIDA scan findings with diabetic status of the patients, 42.4% of diabetic and 57.6 % of nondiabetic patients had ejection fraction less than 80%. It is not statistically significant (0.681). While comparing 99mTc-HIDA scan findings with size of the gallstone in ultrasound, 63.6% patients with size less than 1cm and 36.4% with size more than 1cm had ejection fraction < 80%. It is statistically significant (0.048). On comparing 99mTc-HIDA scan findings with number of stones in ultrasound, 18.2% single gallstone patients and 81.8% multiple gallstone patients had EF less than 80% which is statistically significant (0.001). While comparing the 99mTc-HIDA scan findings with histopathology report after laparoscopic cholecystectomy, 21.2% non-cholecystitis patients and 78.8% cholecystitis patients had EF less than 80%, which is statistically (0.017) significant. Conclusion. 99mTc-HIDA scan can be an accurate method to diagnose the gallbladder dyskinesia. Gallbladder dyskinesia in 99mTc-HIDA scan can be used to predict large size stones and multiple stones before surgery. The sensitivity can be improved by 99mTc-HIDA scan in diagnosing cholecystitis patients.

Chronic pancreatitis (CP) is a fibro-inflammatory condition defined by permanent anatomical changes in the pancreas. The causes of CP are described by the TIGAR-O classification system: toxin-related, idiopathic, genetic mutations, autoimmune disorders, episodes of recurrent acute pancreatitis, and obstructions. Pain is multifactorial in nature, and common psychopathological consequences of CP, including depression and anxiety, complicate the clinical picture of chronic pancreatitis. As a result, the quality of life of patients with CP is decreased. This review describes the pathophysiology of pain and its relationship to underlying psychological consequences, with a focus on a long-term, holistic management approach. Strategies that combine physical and psychological management align with SDG 3 (Good Health and Well-being). CP predominantly affects patients from low socioeconomic backgrounds due to disparities in medical care, underscoring the relevance of achieving SDG 10 (Reduced Inequalities). This review emphasizes the importance of targeted research in developing a holistic care model for CP that aligns with the SDGs.

Background: Parotid gland is the largest of the salivary glands present in the body. Neoplastic lesions in parotid gland always causes difficulty in tissue diagnosis due to their diversified histology. Lesion in the superficial lobe of parotid is more amenable for clinical diagnosis but deep lobe lesion requires imaging to confirm the diagnosis. Managing parotid swelling seems like a mystery due to these issues. Methods: There were 30 patients who presented with complaints of swelling in the parotid region. For all these patients detailed history was taken and clinical examination was done and findings noted. Contract enhanced computed tomography (CECT) of the parotid region was done followed by fine needle aspiration cytology (FNAC) and the management was planned accordingly. Results: All the 30 patients were within the age group of 25 years to 65 years. All the patients presented with swelling in the parotid region. Among the 30 patients, 10 patients had complaints of associated pain in the parotid region. On clinical examination, all the patients had lesion in the superficial lobe of parotid and 2 patients had deep lobe involvement. 1 patient had features of facial nerve palsy. Contrast enhanced computed tomography (CECT) and Fine needle aspiration cytology (FNAC) was done. For all the patients’ surgical management was planned accordingly. Conclusions: Routinely submitting all parotid swelling patients to Fine needle aspiration cytology and computed tomography helps to solve the mystery of diversified histology and presentation.