Early laparoscopic cholecystectomy for acute cholecystitis is safe and feasible, offering the additional benefit of a shorter hospital stay. It should be offered to patients with acute cholecystitis, provided the surgery is performed within 72 to 96 h of the onset of symptoms.

No abstract

Bacterial resistance to multiple antibiotics is a serious and emerging threat. Several measures have been proposed to curb this growing trend. These include prescribing restrictions, education, and infection control that target transmission, among several others. Antibiotic cycling has been a subject of debate, and although many investigators have studied the utility of antibiotic cycling with the help of theoretical models or as part of clinical investigations, several areas remain undefined and unclear. This review summarizes the available information on antibiotic heterogeneity (antibiotic cycling, antibiotic mixing, and other types of antibiotic protocols) with a critical analysis of the published studies.

Patients with a right- or left-sided aortic arch and right-sided descending thoracic aorta, those with anomalies of systemic venous drainage masking the origin of great arterial branches, and those with disproportionately small subclavian arteries, constitute the ideal candidates for our suggested modification of the construction of a modified Blalock-Taussig shunt. The palliation provided by these shunts was satisfactory, with predictable growth of pulmonary arteries, insignificant distortion in the great majority, and easy take-down.

Background Point Of Care (POC) meters are a relatively less invasive and rapid method for monitoring of Prothrombin Time/Interational Normalized Ratio (PT/INR) in patients on anticoagulant therapy. The reliability of results obtained with meters, however, needs to be affirmed and their accuracy needs to be assessed by comparing with standard laboratory analysis. We assessed the Coaguchek XS (Roche) PT/INR meter for accuracy and reliability by comparing with the results obtained with standard laboratory analysis on Stago Coagulometer. Methods INR values of 42 patients were measured by standard laboratory method using thromboplastin, Neoplastin CI (Diagnostical Stago, France) with ISI of 1.7 on Coagulometer (Stago) in plasma. Simultaneously a drop of blood was taken on the strip for Coagulochek XS and the INR read by the meter. Correlation between INR values obtained by the two methods was assessed by computing the correlation coefficient and the intra class correlation coefficient. Agreement between the INR values was assessed by Bland Altman plots. Results An excellent correlation was observed between INR values obtained by coaguchek XS and the values obtained in the laboratory by standard method for a range of values. Bland Altman plots showed good agreement between values obtained by the two methods with only three values falling beyond 2SD limits. Conclusion In conclusion Coaguchek XS INR meters are reliable and accurate and can be used by patients for monitoring of anticoagulation therapy.