Twenty cases of scapho-lunate instability have been reviewed, to determine the effect of dorsal capsulodesis on disability and wrist pain. The average follow-up was 41 (range 13-63) months. There was a significant improvement in the pre-operative Patient Rated Wrist Evaluation score from 108 (range 18-150) to a postoperative score of 60 (range 0-132). All wrist movements and grip strength were reduced postoperatively but only the reductions in flexion and radial deviation were statistically significant. Seventeen (85%) patients were satisfied with the operation. One patient remained unemployed after surgery. Five patients returned to their normal jobs. This study shows that dorsal capsulodesis should remain an important option in the treatment of scapholunate instability.

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Background: Urinary stone disease or Urolithiasis is on a surge of increase with an incidence of 6.3% among men and 4.1% among women. The site of development of the calculi is variable and dependable on various factors. The aim of study was to identify the various predisposing and causative factors, with clinical presentations and complications and to identify identifying various modalities of treatment.Methods: A prospective observational study was conducted for a period of one year after ethical committee approval. All the cases of Urolithiasis confirmed by ultra-sonogram was included and socio demographic data, clinical and laboratory investigations were performed on all the cases and the data was entered in Microsoft excel and analyzed. Surgical approach to all the cases were recorded.Results: 150 cases with 64% males and 36% females were included in the study and mean age was 38.21 years. Pain abdomen was the most common symptom. Calculus was most common on right side with upper pole of the kidney being most common site of calculus in the study. Mean size of calculus in the study was 12.5mm. Statistically significant association was found with Diabetes mellitus, Obesity and low water intake (P value <0.05) in the study. Ureteroscopy (URS) was performed in 36 cases (24%), PCNL in 22 cases (14.67%), ECSWL in 46 (30.67%), cystolithotomy in 34 (22.67%) and urethral extraction in 12 cases (8%).Conclusions: For renal calculi, PCNL is the best treatment modality as of now, but it is associated with greater post-operative morbidity. For stone less than 1cm size, ECSWL is a good alternative to PCNL, but has poor clearance rate and thus greater need for auxiliary procedure. For ureteral calculi, both ECSWL and ureteroscopy have given good results but ECSWL is better tolerated by the patients.

to reduce negative appendectomy and to reduce the risk of complications like perforation which increases morbidity by 15 fold and mortality by 50 fold.