Development of cetyl dimethicone based water-in-oil emulsion containing botanicals: Physical characteristics and stability

The aim of current research was to develop a water-in-oil emulsion containing grape seed extract for application in cosmeceuticals. Finally grinded dried grape seeds powder was extracted with hydro alcoholic mixture. Emulsions consisting of different concentrations of cetyl dimethicone [Abile EM90], the nonionic emulsifier, liquid paraffin as oily phase and water as aqueous phase were developed. Color, odor, pH, viscosity, liquefaction, phase separation, centrifugation and thermal stability of the formulated emulsions were observed at various storage temperatures i.e. 8 +/- 0.5[degree sign] C, 25 +/- 0.5[degree sign] C, 40 +/- 0.5[degree sign] C and 40[degree sign] C +/- 0.5[degree sign] C with 70% RH. The stable formulation consist of 16% mineral oil, 4% of ABIL EM 90[registered sign], 4% grape seeds extract, 1% rose oil and 75% distilled water. All the results derived from this study showed good stability over the three months study period which indicates w/o emulsion can be used as carrier of 4% grape seeds extract to enhance desired effects when applied topically

Effect of half adult dose of oral Rifampicin [300mg] in patients with idiopathic central serous chorioretinopathy

Objectives: To evaluate the effect of half adult dose of oral Rifampicin on mean change in best corrected visual acuity and central macular thickness in patients with central serous chorioretinopathy

Methods:Thirty-eight eyes of 31 patients with idiopathic central serous chorioretinopathy [CSCR] were registered. Unaided Visual acuity, best corrected visual acuity was documented and detailed slit lamp examination along with dilated ophthalmoscopy was performed. All subjects were treated with oral Rifampicin 300 mg [half adult dose] daily for 03 months. Patients underwent a complete ocular and systemic examination as well as central macular thickness [CMT] measurement by optical coherence tomography [OCT] every month after starting treatment until four months. Fundus fluorescein angiography [FFA] was performed in recurrent cases. Liver function tests were carried out prior to the treatment and during follow up period

Results:A total of 38 eyes of 31 patients [24 males, 07 females] were included in the study. Mean age of patients was 36.16+/-3.19 years [range 30-44]. Mean best corrected visual acuity [BCVA] before treatment was 0.56+/-0.11 and improved to 0.47+/-0.14 at 04 weeks [P<0.001] of treatment. The mean CMT at the time of presentation was 494.39+/-96.29 um and was decreased to 306.90+/-50.71 um after 04 weeks of treatment [P<0.001]. The mean induced reduction in CMT was 187.48+/-122 um [P<0.001] while that in BCVA 0.41+/-0.16 at 04 weeks of treatment [P<0.001]. Liver function tests were within normal range before and after the treatment

Conclusion:Half adult dose rifampicin [300mg] is effective and safe in treatment of central serous chorioretinopathy without causing any systemic imbalance

Aberrant Promoter Methylation at CpG Cytosines Induce the Upregulation of the E2F5 Gene in Breast Cancer / 한국유방암학회지

PURPOSE: The promoter methylation status of cell cycle regulatory genes plays a crucial role in the regulation of the eukaryotic cell cycle. CpG cytosines are actively subjected to methylation during tumorigenesis, resulting in gain/loss of function. E2F5 gene has growth repressive activities; various studies suggest its involvement in tumorigenesis. This study aims to investigate the epigenetic regulation of E2F5 in breast cancer to better understand tumor biology. METHODS: The promoter methylation status of 50 breast tumor tissues and adjacent normal control tissues was analyzed. mRNA expression was determined using SYBR® green quantitative polymerase chain reaction (PCR), and methylation-specific PCR was performed for bisulfite-modified genomic DNA using E2F5-specific primers to assess promoter methylation. Data was statistically analyzed. RESULTS: Significant (p<0.001) upregulation was observed in E2F5 expression among tumor tissues, relative to the control group. These samples were hypo-methylated at the E2F5 promoter region in the tumor tissues, compared to the control. Change in the methylation status (Δmeth) was significantly lower (p=0.022) in the tumor samples, indicating possible involvement in tumorigenesis. Patients at the postmenopausal stage showed higher methylation (75%) than those at the premenopausal stage (23.1%). Interestingly, methylation levels gradually increased from the early to the advanced stages of the disease (p<0.001), which suggests a putative role of E2F5 methylation in disease progression that can significantly modulate tumor biology at more advanced stage and at postmenopausal age (Pearson's r=0.99 and 0.86, respectively). Among tissues with different histological status, methylation frequency was higher in invasive lobular carcinoma (80.0%), followed by invasive ductal carcinoma (46.7%) and ductal carcinoma in situ (20.0%). CONCLUSION: Methylation is an important epigenetic factor that might be involved in the upregulation of E2F5 gene in tumor tissues, which can be used as a prognostic marker for breast cancer.

Efficacy of gatifloxacin in acute bacterial corneal ulcer

To assess the efficacy of Gatifloxacin 0.3% ophthalmic solution in infective corneal ulcer. This observational [non comparative] clinical analysis was done at the Department of ophthalmology unit-ll, Liaquat University Eye hospital Hyderabad of Liaquat University of Medical and Health Sciences Jamshoro / Sindh, Pakistan from April 2010 to March 2012. All the subjects who fulfilled the inclusion criteria were registered. Anterior segment examination was performed. Corneal staining and sensitivity test was done to exclude viral and paralytic element. Corneal samples were collected for gram's staining and culture sensitivity tests. After getting the preliminary laboratory results, Gatifloxacin 0.3% ophthalmic solution was used in bacterial corneal ulcer every 30 minutes for first twenty four hours, and every one hour till three days. On obtaining better response the drops were used every two hours up to 7 days. The treatment was continued with tapering of dosage for three weeks. After total recovery [re-epithelialization of corneal epithelium] the drops were used two times a day for one more week. The total of 170 patients [male=68.8%; female=31.2%] were recruited. Culture sensitivity examination revealed staphylococcus [36.5%], followed by fungi [24.1%]. Pseudomonas thus detected were 10%. Gatifloxacin showed highest sensitivity and lowest resistance i.e. 87.65% and 12.35% respectively against gram positive and gram negative isolates. Gatifloxacin 0.3% ophthalmic solution due to its strong activity against various gram-positive and gram-negative microbes is strongly effective in the treatment of acute bacterial keratitis

Pretreatment of Albino Rats with Methanolic Fruit Extract of Randia Dumetorum (L.) Protects against Alcohol Induced Liver Damage

Alcohol abuse and its medical and social consequences are a major health problem in many areas of the world. The present study was conducted to evaluate the protective effect of methanolic fruit extract of Randia dumetorum (L.) on alcohol-induced liver damage in rats. Rats were divided into five different groups (n=6), group I served as a control, group II received ethanol (3 ml/100 g/day p.o.), group III served as standard group and received silymarin (50 mg/kg p.o.), group IV and V served as extract treatment groups and received 50 & 100 mg/kg methanolic extract of R. dumetorum. All the treatment protocols followed 30 days and after rats were sacrificed blood and liver were used for biochemical and histological studies, respectively. The activities serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), triglyceride (TG), direct bilirubin (DB), total bilirubin (TB) and lipid peroxidation were statistically increased in rats exposed to alcohol while total protein and glutathione decreased compared to control rats. Treatment with R. dumetorum significantly decreased the elevated levels of ALT, AST, TG, DB, TB and lipid peroxidation compared to the group exposed to alcohol only. R. dumetorum significantly resulted in increased levels of total protein and reduced glutathione compared to the group that received alcohol only. Histology of the liver section of the animals treated with R. dumetorum improved the hepatotoxicity caused by alcohol. Hence the study concluded that R. dumetorum has potential hepatoprotective activity.

Indoor air pollution and respiratory illnesses in exposed children

To find out the common indoor air pollutant present in study population and their relation with respiratory ailments in children exposed to these pollutants. It was a descriptive, cross-sectional study. The study was conducted at outpatient clinic and ward of Pediatric department. Abbasi Shaheed Hospital Karachi, Abbasi Shaheed Hospital is a tertiary care teaching hospital, associated with Karachi Medical and Dental College. The study was conducted during January 2010 to June 2010. It was convenient sampling [Non-probability]. The sample size of children aged between 2 months to 12 years was calculated according to an expected prevalence, a precision of 3% and an error risk of 500. The sample and target population size allowed a correction factor leading to a sample size of 100 children. The children with respiratory illness of specified age group were included, a verbal consent was taken from parents and a questionnaire was filled by the trainee doctors and final year medical students. Data was entered in SPSS-14 and analyzed by means of graphs, charts and frequency tables. The average age of the children was 34.8 months and 66% were less than 5 years of age. No of episodes of respiratory illnesses in children was 2.16 per year, while the average no. of admissions was 0.73 per year. The average family size was 9 and parity was 4. The average no of persons sharing a bed room was 4. Male to female ratio was 1:1.04. ln study group 16% had open kitchen while 10% did their cooking inside bed rooms. 39% used wood or coal and 14% used biomass. 36% houses were poorly ventilated and 8% had dampness in the house. Smoking in family was present in 55% use of talcum powder was positive in 71% cases and mosquito repellent was used in 85% of cases. The practice of cooking, cleaning and smoking were found to be important factors contributing to indoor air pollution and thus causing increased risk of respiratory illness in exposed population. As the children between 2 months to 5 years and mothers spent most of their time inside home, they were exposed more to indoor pollutant and thus had increased prevalence of respiratory illnesses. By awareness campaign and corrective measures we can reduce the risk of indoor air pollutants associated respiratory diseases

Correlation between admission criteria and academic performance of students in Dental Colleges of Khyber Pukhtunkhawa

Educational Testing and Evaluation Agency Khyber Pukhtunkhwa, Pakistan, since its inception [1998] has conducted 12 sets of Entrance Test, for the Medical and Dental Colleges of the province. The aim of this study was to assess the relationship of entry test conducted by ETEA and subsequent performance of the students. A cohort of 386 dental students, who were admitted for the four-year program in the two public sector dental colleges of Khyber Pukhtunkhwa during the academic sessions 2000-2005, comprised the sample of the study. The association between the predictors [F.Sc, Entry test scores and overall merit] and the criterion [academic achievements/scores of dental students from first to final year] were analyzed using Pearson correlation techniques on SPSS-16. The data show significant correlation between predictor and criterion variables. Gender wise analysis revealed that the performance of female students was better than male students. Overall, our findings show a significant relationship between the predictor. variable and the academic achievement of dental students. However, the inclusion of additional predictors, such as interview or test of non-cognitive domains of the students in the admission criteria may improve the accuracy of admission decisions

Surgical outcome of 7-millimeter bilateral medial rectus recession in large angle child esotropia

To evaluate the surgical success in the patients undergoing bilateral 7 mm medial rectus recession for large angle esodeviation. The subjects less than 15 years of age presenting with concomitant esotropia with deviations of 60 prism diopter [PD] and more were registered for bilateral medial rectus recession surgery. Anterior segment slit lamp examination and posterior segment examination was performed with 90 D and 78D fundoscopes in selected cases. Angle of deviation was measured. All necessary investigations were completed. Surgical procedures were performed under general anesthesia. Postoperative follow-up was done. Almost 71% children underwent successful surgery with residual deviation of less than 15 PD, while 29.0% subjects developed residual strabismus. Four patients presented with foreign body granuloma. Two children developed limitation in adduction. The preoperative deviations of 60 PD showed good results with residual deviation of fewer than 15 PD. There is a need for guarded muscle correction during bilateral medial rectus recession for improvement in visual alignment and binocular function

Prevalence of tuberculosis in pediatric patients undergoing chest intubation

This is a prospective cross sectional descriptive observational study. This is designed to see indications and complications of chest intubation and to see prevalence of tuberculosis in chest intubation patients. This study was carried out in the Department of Pediatrics, DHQ Teaching Hospital, Gomal Medical College, Dera Ismail Khan. In a period of two years [Jan 2007 to Dec 2008]. All those patients who underwent chest intubation during the study period were included in the study analysis. After admission, a detailed history was taken and a thorough examination was performed. Investigations included X-ray chest, full blood count, ESR, analysis and culture of pleural fluid, Mantoux test and ultrasonography of chest and abdomen. Later a chest tube was placed in the relevant pleural space under local anaesthesia. Chest tube was removed when pus/fluid drainage was stopped for at least 24-48 hrs. Diagnosis of tuberculosis was based on prolonged illness, history of contact, history of measles, raised ESR, positive Mantoux test [>10mm] and poor response to appropriate antibiotics and chest intubation beyond 10-14 days, all or some in various combinations. Data was analysed for age, sex, duration of illness, investigations, diagnosis, duration/complications of chest intubation, mortality during the study period and prevalence of tuberculosis in these patients. A total of 40 patients [n=40] underwent chest intubation during the study period. Twenty six [65%] patients were male and 14 [35%] were female. Four patients [10%] were less than 1 yr of age, 25 [60%] were 1-5 yr of age and 12 [30%] were above 5 yrs of age. Indications for chest intubation included pyothorax in 27 [67.5%], pneumothorax in 11 [27.5%] and pyopneumothorax in 2 [5%] patients. Seventeen patients [42.5%] were suffering from tuberculosis. The criteria for the diagnosis were positive Mantoux test [more than 10mm] in 12 patients, suggestive pleural fluid analysis in 9 patients, history of contact in 8 patients, slow response to standard antibiotic therapy and closed tube thoracostomy in 5 patients, history of measles in preceding weeks in 2 patients and suggested CT scan in 2 patients. Complications included local wound infection in 5 [12.5%], tube blockage in 2 [5%], surgical emphysema in 2 [5%] and no response to conservative measures due to pleural thickening and fibrosis in 1 [2.5%] patients. Mean duration of chest drainage was 8.1 +/- 2.4 days. Tuberculosis is a common cause of pleural diseases and it must be considered in the differential diagnosis of pleural infections, particularly pyopneumothorax

Primary chiasmal sarcoid granuloma masquerading as glioma of the optic chiasm

A 37-year-old woman presented with a 6 months history of headaches and memory impairment. Examination showed no neurological deficit with normal vision. MRI scans showed an enlarged optic chiasm. There was no dural or leptomeningeal enhancement or hydrocephalus. Open biopsy of the suprasellar mass showed non-caseating chronic granulomatous inflammation compatible with sarcoidosis. Systemic features of sarcoid were absent. Patient showed marked improvement on steroid therapy

Prevalence of hepatitis band c infection in patients admitted at tertiary eye care centre: a hospital based study

To determine the prevalence of hepatitis B virus [HBV] and hepatitis C virus [HCV] infections and the risk factors in patients admitted for ocular treatment at a tertiary eye care centre in Sindh Pakistan. Nine hundred thirty one patients admitted at Liaquat University Eye hospital Hyderabad for ocular treatment, were screened for HBV and HCV. Patients of either sex, with more than thirty years of age were included. Screening for HBV surface antigen [HBsAg] and antibodies against HCV [anti-HCV] was performed through chromatography method. Samples repeatedly reactive for HBsAg or anti-HCV were considered positive. Out of 931 registered patients, 497 [53.3%] were male and 434 [46.7%] female. Hepatitis B and C was detected in 167 [17.9%] subjects. The overall seroprevalence of HBV infection within the study period was 4.6%, HCV 13.3%, and for HBV and HCV both was 3.9%. Regarding the predisposing factors, past history of blood transfusion was present in 08.3% subjects, needle injection 89.2%, barber shaving 52.6%, and 46 [27.5%] patients presented with past history of surgery. For the prevention of transmission of HBV and HCV infection, the community awareness regarding vaccination against Hepatitis - B and risk factors for spread of HBV and HCV, implementation of population based screening and vaccination for HBV on large scale should be ensured

Comminuted fractures of shaft of femur; bridge plate versus interlocking nail in low velocity gun shot injuries

Comminuted fracture shaft of the femur is a common entity faced by orthopaedic surgeon. Road traffic accidents are the major cause of these comminuted fractures. But with increase in violence, gun shots are also causing these fractures frequently. To see and compare the result of intrameduliary interlocking nailing and biological plating in terms of infection rate, union rate and to assess the other complications. Prospective study. Department of Orthopedic Surgery Allied Hospital Faisalabad. From Sept 2001 to Sept 2003. Forty comminuted fractures of femur were managed .twenty by bridge plating and twenty by interlocking nailing. Results were compared with reference to healing time, infection rate, operating time and hospital stay and was comparable to other studies. Closed interlocked intra-medullary nailing is an excellent method for treating comminuted femoral shaft fracture. But requires expensive equipment and more expertise. Bridge plating require no special instrumentations and can be done at periphery with less facilities available

Determinants of incomplete and no immunization

Expanded program for immunization [EPI] is working in our country for many decades but despite of the widespread campaign in print and audio-visual media, active efforts by health care providers, EPI coverage is not very satisfactory. In this study we tried to find out the reasons, why the parents attending a tertiary care hospital for treatment of their sick children, were not utilizing free services of vaccination. It was a comparative cross sectional study, conducted in paediatric department of Abbasi Shaheed Hospital. A questionnaire was designed and filled by the doctors and final year MBBS students. Informal consent was taken from parents of patients attending both the Pediatric OPD and Indoor department. The percentage of various vaccines received by those who were partially immunized were; BCG 42%, DPT 23.7%, Hepatitis B 6.2% and measles 1%. Hib vaccine was not included in national EPI schedule at the time of study. There was a marked difference in the causes of no immunization and partial immunization. The important cause in no immunization was lack of awareness in 46% of cases. In partially immunized group the important cause was adverse reaction to previous vaccination 7.2%, sickness of child in 18.5% and missing of vaccination card in 15% of cases while 66% have more than one cause. The poor compliance for EPI programme was mainly due to lack of awareness of the parents about importance of vaccination for their children

Open globe injuries in the child population in hyderabad / 国际眼科杂志(Guoji Yanke Zazhi)

·AIM: To evaluate the causes, frequency, severity of eye injury, management, visual outcome and prevention in children with penetrating ocular injury.·METHODS: The study was conducted on patients under 15 years presenting with penetrating ocular injuries. Anterior segment slit lamp examination was performed for cornea and corneo-scleral penetration, hyphema, iris prolapse, etc. Posterior segment slit lamp examination wih 90D funduscopes was done in selected cases. After performing necessary investigations, urgent surgical intervention was carried out. ·RESULTS: Out of 43 (55%) registered patients; boys were 67%, and girls 33%. The agents of trauma were glass, pencil, stick, etc. The site of entrance through cornea was 62.7%, sclera 25.6%, and limbus 11.7%. The presenting visual acuity was 6/60 and above in 32.5% children, 6/24 in 9.3%, and 6/12 and above in 2.3% cases. 37.2% cases had perception of light. Out of 36 operated eyes, twenty-nine completed post operative follow up. 10 4% subjects had final visual acuity (FVA) of 3/60. 24 2% had FVA of 6/60. 17.2% children had FVA of 6/24 partial. In 34.4% subjects, the FVA was restricted to perception of light. 10.4% developed phthisis bulbi.·CONCLUSION: Ocular trauma is a significant cause of visual loss in child population. Preventive efforts are extremely important in domestic and outdoor activities.

Surgical outcome of 21 patients with congenital upper eyelid coloboma / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To evaluate the surgical outcome of congenital upper eyelid coloboma repair.METHODS:All patients underwent complete ophthalmic and general examination before going to surgery,and then examination under anesthesia was performed to assess the site and size of eyelid defect,conjunctival involvement.The status of cornea and ocular motility with forced duction test was also being noted.The surgical procedure was performed according to the size of defect.RESULTS:Out of 21 cases of congenital upper eyelid coloboma,18 occurred in isolation with upper eyelid medial defect,13 were bilateral and 5 were unilateral.Others were associated with Goldenhar syndrome and CHARGE syndrome with bilateral upper lid medial defects.All patients were presented for surgical corrections during age of 2.5-4.0 years except one that presented at 25 years of age.Cosmetically surgical results were acceptable,except one that was already presented with opaque corneal.CONCLUSION:In this study overall surgical results were satisfactory except one that was presented late with compromised cornea.

A study on surgical management of 17 patients with consecutive strabismus in hyderabad / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To determine the clinical course and management of patients undergoing surgery for consecutive strabismus.METHODS: Patients less than 45 years of age presenting with consecutive strabismus were divided into two groups (1-Esodeviation and 2-Exodeviation). Angle of deviation was measured in prism diopter (PD). Conservative therapy was experienced during the course of follow-up after first surgery. All the subjects with deviation of more than 15PD after six months of follow-up were selected for repeat surgery. Compulsory investigations were performed. Secondary surgical procedures were performed under general anesthesia. Postoperative follow-up was done at 3 days, 15 days, 3 months and 6 months.RESULTS: Subjects(28.8%)developed consecutive stra-bismus within the study period. Second surgery on a dominant (fixating) eye in all patients was performed within 6 to 9 months after first surgery. After second surgical interven-tion, good surgical outcome was obtained and the tendency towards over correction was not observed in both groups during follow-up period.CONCLUSION: There is a need for guarded muscle correction during second surgery to avoid over corrections in future.

Diabetic ketoacidosis - a study of 67 episodes in known type 1 and type 2 diabetic patients

Review and describe the clinical characteristics and outcomes of Diabetic Ketoacidosis [DKA] in type land type 2 Diabetic patients. We reviewed the medical records of all patients with a diagnosis of DKA in known diabetics and followed their clinical course and outcome. We classified patients as "type 1" and "type 2" diabetes mellitus based on their treatment history. DKA with recent onset of diabetes excluded because of uncertainty of type of diabetes. We compared the groups for precipitating factors, clinical characteristics and outcomes. Sixty-seven patients fulfilled criteria for inclusion in the study. Of 67 patients 44 [65.7%] were male. Twenty [30%] patients had type 2 diabetes. Mean age of type 1 diabetics was 21.6 +/- 6.lyears while type 2 Diabetics were older and had 48.7 +/- 9 years mean age. Body Mass Index [BMI] and duration of diabetes were greater in type 2 Diabetes. A history of prior DKA was noted in 28 patients and all of them were type 1 Diabetics. Infections were the most common precipitating factor in total [41.8%] but in type 2 Diabetes noncompliance was the main precipitating factor. There were 8 deaths in total and mortality rate was apparently higher in type 2 Diabetes. DKA could frequently complicate type 2 Diabetes contrary to belief and carries relatively high mortality

Diurnal fluctuation of the heat fluxes over the Northern Arabian Sea

The sea surface hourly meteorological parameters that were recorded at five time series stations under the North Arabian Sea Environment and Ecosystem Research [NASEER] programme [1992-1994] were used to study the heat fluxes including; momentum, latent, sensible and moisture heat fluxes as well as the net heat gain and total heat loss over the northern Arabian Sea. The study is the part of research on the formation and distribution of northern Arabian Sea water mass. The momentum or wind stress fluxes during the January 1992 and December 1994 were quite large in both the components of eastward [0.188 N m -2] and northward [0.148 N m -2]. During the August 1992, the east and north components were negative indicated direction of momentum from southwest with values under 0.1 N m-2. The data recorded during the March of 1993, have the visible diurnal variational pattern. The average of sensible heat fluxes during January 1992 was 76 Wm -2, while in the August of 1994 was 71 Wm -2. The results of evaporation indicated the similar pattern of diurnal variation as observed for the data of latent heat fluxes. During the January 1992 cruise, minimum evaporation is computed in the early morning and maximum after 1100 hours. However, during the December 1994, minimum evaporation was observed after sunrise and maximum near to sun set. The mean of the Net Heat Gain during the January 1992 was 138 Wm -2 while, in the August 1992, mean of the area was computed as 96 Wm -2. The Net Heat Gain values depicted that in the entire area of observation, heat was lost from sea surface to the atmosphere

Minilaparotomy cholecystectomy - A review of 152 cases

This study was carried out in DHQ Teaching Hospital, DI Khan from January, 1999 to December, 2001. One hundred and fifty two patients with cholelithiasis were enrolled for the study. All the patients underwent minilap cholecystectomy and the results were analysed for mean operative time, hospital stay, post operative pain, complications and patient's acceptance on 1st and 2nd outdoors visits. Comparison was made with the reported results of laparoscopic cholecystectomy. The objective of this study was to analyse the results of cholecystectomy through a small muscle-splitting incision regarding complications rate, operative convenience and patient's acceptance of results. A reference has also been made to the literature about laparoscopic cholecystectomy to determine the place of minilap cholecystectomy in the present era. Mean operative time was 45 minutes [35 - 95 min], mean hospital stay was 4.5 days [2-11 days] with overall complication rate of 15%. Most of the patients were satisfied with the results of operation in terms of pain, participation in physical and social activities and postoperative scar. The procedure is affordable in our setup. As a conclusion mini lap cholecystectomy is the best alternate option to laparoscopic cholecystectomy in our set up because of technical and economic reasons. Compared to standard cholecystectomy it has great edge due to overall lower complications rate