Percutaneous nephrolithotomy (PCNL) has been an excellent option for the management of kidney stones. There have been many complications in regards to solid organ injury during PCNL. Here we discuss an interesting case of 45-year-old woman, who underwent PCNL for right renal staghorn calculus, and had an accidental puncture of the gall bladder. Post operatively, the patient was conservatively managed and recovered well. A small number of cases has been reported until now in literature.

Objective: To evaluate effects of Continuous low dose antibiotic prophylaxis versus no antibiotics in the patients with DJ stents with respect to urinary tract infection (UTI and biofilm formation. Material and Methods: A prospective randomized study in 36 patients being stented for stone disease, pelvi-ureteric junction obstruction (PUJO), were divided into 2 groups. Group 1 containing 18 patients received T. Nitrofurantoin 100mg once a day after stenting and Group 2 containing 18 patients received no antibiotic after stenting. Both the groups received pre-op single dose intravenous (IV) Levoflox and Amikacin according to their body weight. After stent removal, stents were sent in normal saline for evaluation of Culture and Biofilm formation. Positive stent cultures were processed for the formation of biofilm using Christensen's Tube method. Results: 2 out of 18 pre-stent removal cultures in group 1, 7 out of 18 pre-stent removal cultures in group 2 were positive. Biofilm was not detected in any of the groups. Febrile urinary tract infection was not seen in any of the groups. Dysuria and pain abdomen were most common presenting symptoms in stented patients. Conclusion:The incidence of infection in both the groups is same. There was no added advantage of prophylactic antibiotics for patients on DJ-stent. Unnecessary and irrational use of antibiotics should be avoided to prevent bacterial resistance in future. Studies on antibiotic prophylaxis in patients on DJstents are sparse. Larger studies are required to confirm the findings.

Adenocarcinoma of prostate typically involves axial skeleton and has been infrequently reported in unusual sites like orbit. It is noteworthy that upto 1989, only 28 cases of occulo-orbital metastases of prostate cancer (PC) had been reported in the literature. PC is mostly known to metastasize to the bony skeleton. The lack of skeletal metastasis does not exclude the possibility of visceral/ distant metastasis, and serum PSA levels usually do not correlate with the extent of metastatic disease. Here in, we report a rare case of unilateral orbital metastasis from PC.

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