Multiply comminuted fragmented fracturesof the maxillofacial area are difficult to fix with titanium plates because of the small size of fragments, complex 3D anatomy, thin bone which is unable to hold screws and multidirectional pull of muscles.This study intend to present a case series of extremely comminuted maxilla fractures involving orbital floor both of which rereconstructed with Titanium mesh, cut to shape and used to mold the small fragmented segments in to the shape of the facial bones. Severe fragmentation of maxillary wall leads to facial hollowing, tissue prolapse and asymmetry even after major facial buttresses are reconstructed. Simple Titanium mesh can be used to reconstruct these severe fragmentations of thin bones of the maxillary wall as shown in the series and avoid late and unsightly complications.
Retrosternal extension of goiter is one of the most common types of masses in the superior mediastinum. These types of goiters classically present with compressive symptoms such as dyspnoea, dysphonia, dysphagia, or sleep apnea. Surgical treatment with a total thyroidectomy and complete removal of the intrathoracic portion of thyroid is the gold standard treatment. These cervico-mediastinal lesions at times may not be continuous, and a sternotomy may be required for complete and safe excision of the mediastinal mass to achieve decompression of the surrounding structures and preventing the hemorrhagic complications if attempted from cervical incision.
Background: Bone marrow abnormalities are common in HIV infected individuals and patients with AIDS. Most of the bone marrow abnormalities associated with HIV infection appear to be related directly to the infection or its complications and not to therapeutic intervention. Bone marrow study is an important investigation in HIV infected patients with peripheral hematological abnormalities. The primary objective was to study bone marrow aspiration findings in HIV positive patients and their correlation with CD4 count. Methods: The interventional, crossectional and prospective study was conducted in Department of Pathology, Government Medical College and Rajindra Hospital Patiala on 100 HIV positive patients, during a period of 2 years. Hematological investigations including complete hemogram, peripheral blood film and bone marrow aspiration was done. Absolute CD4 counts were done. Correlation of various bone marrow abnormalities was done with CD4 count. Results: Bone marrow revealed normocellular marrow in majority of cases, followed by hypocellular. Overall prevalence of myelodysplasia was 78%. Dyserythropoiesis was most common dysplastic change (62%) followed by dysmegakaryopoies (36%), dysgranulopoiesis (25%). Reactive plasmacytosis was seen in 44% cases in the range from 6-20%. Increased lymphocytes seen in 9% cases. There was seen significant correlation between myelodysplasia and CD4 count. Conclusion: Bone marrow abnormalities are common in HIV infected individuals and patients with AIDS.So HIV infection should be considered in the differential diagnosis of patients with secondary myelodysplasia or unexplained bone marrow changes.
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