BACKGROUNDLaparoscopic Cholecystectomy (LC) is most commonly performed hepatobiliary minimally access surgery worldwide. Laparoscopic cholecystectomy has become the standard treatment for symptomatic gallstone diseases. However, there still is a substantial proportion of patients in whom laparoscopic cholecystectomy cannot be successfully performed and for whom conversion to open surgery is required. The NIH postulated that the outcome of LCs would be greatly influenced by surgeon-specific factors such as training, experience, skill and judgment. (1) In addition numerous patient and disease-related factors, such as male gender, obesity, old age (>65), prior abdominal surgery, acute cholecystitis, choledocholithiasis and anomalous anatomy have been reported as significant risk factors for conversion to the open procedure. (2)(3)(4)(5) Although the rate of conversion to open surgery and the complication rate are low in experienced hands, the surgeon should not enter the Operating Room with idea of opening the abdomen in difficult case as failure or insult to the surgeon. Various preoperative factors can help in deciding the difficult gallbladder and conversion to open cholecystectomy. The aim of this study is to predict the difficulty of laparoscopic cholecystectomy and the possibility of conversion to open cholecystectomy before and during surgery using the clinical and ultrasonographic criteria in our setup.

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 Abstract: Spillway is an important component of the storage structure, meant to discharge excess amount of water in the reservoir. It also acts as a measure to control floods and protect the structure from overtopping and failure. For the safety of the structure, an appropriate energy dissipator is provided at the toe of the spillway. Of many alternatives, a flip buclet is often provided as a energy dissipater and its design plays a significant role. The design involves an accurate estimation of various parameters viz., trajectory jet velocity, angle of throw, length and height of the trajectory jet. The present study was carried out to analytically estimate the design parameters and compare them with the ANSYS-CFD simulation results. A new equation is proposed by means of user-defined function, based on the macro generated VOF -multiphase analysis. The analytical results estimated by the proposed equations were observed to have a good consonance with the simulation results having a variation less than 5%.

BACKGROUNDGastric Outlet Obstruction implies complete or incomplete obstruction of the distal stomach pylorus or proximal duodenum.(1) Gastric outlet obstruction poses diagnostic and therapeutic challenges to general surgeons practicing in resource-limited countries. There is no sufficient data on this subject in our setting. Studies throughout the world shows drastic reduction in peptic ulcer disease (PUD) after Proton Pump Inhibitor (PPI) era. (1) This study was undertaken to highlight the etiology and treatment of Duodenal Ulcer (DU) and its most important complication, gastric outlet obstruction in Tertiary Hospital in South India. This study was done in SRM Medical College Hospital and Research Centre, Chennai, where in for all Gastric Ulcer (GU) and Duodenal Ulcer (DU) patients, eradication of H. Pylori has become a standard treatment. Surgical treatment is required for complications of peptic ulcer disease. (1) The aim of the study are two: first to analyze sex and age distribution of GU and DU and second to study the various types of management.