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Cholecystectomy is the most common elective procedure performed on the biliary tract and the second most common abdominal operation performed today. With more and more endeavors being made in the field of laparoscopy, more and more complicated cases which were relatively contraindicated a few years ago are now being tackled laparoscopically.Inspite of increasing expertise and advances in technology,conversion rate is still 1.5 to 35% in different centers. This conversion is neither a failure nor a complication,but an attempt to avoid complications. So the identification of parameters predicting conversion would be useful to improve preoperative patient counseling, provide for better perioperative planning, optimize operating room efficiency, and to avoid laparoscopic- associated cost & complications by performing an open operation when appropriate. AIM AND OBJECTIVE: Pre-operative risk factors for prediction of difficult laparoscopic cholecystectomy using clinical, biochemical & ultrasonographic parameters. 1. To evaluate clinical parameters as one of the predictors of conversion. 2. To evaluate ultrasonography parameters as one of the predictors. 3. To evaluate biochemical parameters as one of the predictors. 4. To calculate the conversion rate. PATIENTS AND METHODS: All indoor patients admitted for Laparoscopic cholecystectomy during the study period (from November 2018 to October 2020) in Department of General Surgery M K C G Medical college and Hospital Berhampur, Ganjam, Odisha, India. Total 60 patients were included in this Descriptive prospective cross-sectional study. RESULTS: The operative parameters taken to assess the difficulty of the laparoscopic cholecystectomy were total time taken to operate from the insertion of the trocar to the extraction of the gallbladder (more than 90mins), tear of gallbladder with spillage of bile and stones, and conversion to open cholecystectomy. The rate of conversion was found to be 8.3%. Overall, 12 out of 60 patients were predicted to be difficult cases based on clinical parameters out of which 8 were difficult on surgery and 5 out of the 12 cases got converted. Out of 60 patients 5 patients were predicted to be difficult based on biochemical parameters of which 4 were difficult on surgery. Out of 4 difficult cases 2 got converted to open procedure. Out of 60 patients 7 were predicted to be difficult of which 5 were found to be difficult on ultrasonographic parameters. Out of these 5 difficult cases 2got converted to open procedure. CONCLUSION: From this study, we can conclude that preoperative clinical, biochemical and ultrasonographic parameters are good predictors of difficulty in laparoscopic cholecystectomy in the majority of cases and should be used as a screening procedure. It can help surgeons to get an idea of the potential difficulty to be faced in a particular patient. [ABSTRACT FROM AUTHOR]

Background: Worldwide, around 1.28 billion adults, aged 30–79 years have hypertension (HTN) and most (two‑thirds) of them living in low‑ and middle‑income countries like India. While only less than half of adults (42%) with HTN are diagnosed and treated. This study is an effort to estimate the prevalence and determine the determinants of HTN among the rural elderly population in Tigira block, Cuttack district of Odisha. Methodology: This cross‑sectional study was carried out among 725 rural elderly (>60 years) people using probability proportionate to sample (PPS) sampling in the year 2019–2020. Previous medical history of HTN diagnosed by medical professional was taken as positive for HTN. Bivariate analysis was performed using the Chi‑square test. The binary logistic regression model was used to find out the predictors of HTN. Results: This cross‑sectional study found an HTN prevalence of 34.75% (n = 252) among rural older adults. Factors found to be significantly associated with HTN were female gender (adjusted odds ratio [AOR] = 1.73, confidence interval [CI] = 1.129–2.666), elderly aged ≥80 years (AOR = 1.98, CI = 1.170–3.379), not working elderly (AOR = 2.14, CI = 1.178–3.89), lower‑middle socioeconomic status (SES) (AOR = 1.61, CI = 1.093–2.372), overweight elderly (AOR = 2.01, CI = 1.309–3.098) and diabetics (AOR = 4.56, CI = 2.704–7.718), respectively. Conclusion: HTN prevalence was found to be high in the rural area, and the factors such as female gender, elderly aged ≥80 years, not working elderly, lower‑middle SES, overweight elderly, and diabetes were found to be the determinants of HTN in the rural elderly population of Odisha. [ABSTRACT FROM AUTHOR]