Craniofacial fibrous dysplasia is a slow-growing bony disorder causing asymmetry of the face; leading to aesthetic, functional, and psychological ramifications. Surgical recontouring is the most accepted form of treatment. Reconstruction of the orbit poses a serious challenge to the surgeon; hence the present study is intended to describe and evaluate a most anatomically accurate virtual treatment planning and defect-specific implant technique, enumerating postoperative functional and esthetic outcome. The study highlights a valid application of three-dimensional models and computer-guided surgical splints. The current study included 5 patients with craniofacial fibrous dysplasia involving orbits with a mean age of 19.6 years. Detailed pre-and post-operative ophthalmologic workup were documented for one year. All the participants showed improvement in eyeball position and movement. Visual acuity and intraocular pressure have returned to near normal values, and astigmatism was reduced significantly. No recurrence was noted in any of the subjects. The current technique was found helpful in reconstructing the complex orbital anatomy; however, long-term follow-up studies with a greater number of patients are recommended.
This case report describes a rare presentation of presumed brain stem tuberculoma in a 28-year-old male who presented with acute onset of third cranial nerve palsy with contralateral hemiparesis (Weber syndrome) and upgaze palsy. Isolated midbrain tuberculoma is rare, presenting with varied clinical manifestations and radiological findings posing as a diagnostic dilemma. Weber syndrome is commonly caused by midbrain infarct secondary to occlusion of branches of the posterior cerebral artery and rarely from a tuberculoma. The patient is a case of disseminated tuberculosis with granuloma in midbrain causing pressure effect, thereby presenting with features consistent with Weber syndrome and upgaze palsy. The patient had good recovery with antitubercular treatment and systemic steroids.
Healthy nails appear smooth and have consistent coloring. Nail dyschromias have a wide variety of presentation. There are numerous causes of discoloration of the nail affecting the nail plate, nail attachments, or the substance of the nail. Different pattern of nail dyschromias can point out certain dermatological or systemic diseases. To evaluate the causes of nail dyschromias in our clinical setting. Cross sectional observational study. 200 patients presenting with nail dyschromias were included in the study from April 2015 to July 2015. Detailed history was taken and cause for nail dyschromias was evaluated. 115 (57.5%) were males and 85 (42.05%) were females. The most seen nail dyschromia in this study was melanonychia (86.5%) followed by leukonychia (5%), blue chromonychia (5%), brown chromonychia (2%) yellow chromonychia (1.5%). The cause of nail dyschromias were:60 cases(%) were due to antiretroviral drugs, 25(12.5%) due to HIV, 30(15%) physiological melanonychia, 7(3.5% of onychomycosis, 8(4%) of lichen planus, 7(3.5%) of eczema, 15(7.5%) vitamin B12 deficiency, 10(5%) chemotherapy induced blue chromonychia, 3(1.5%) haematoma, 10(5%) leukonychia, 3(1.5%) jaundice 2(1%) Addison’s disease induced, 3(1.5%) cosmetic induced and 17(7.5%) due to other dermatological and systemic conditions. Examination of nail should always be a part of routine cutaneous examination and presentation with nail dyschromias should be worked up with the help of a good history and examination. Careful examination of the nail may help in identifying the root cause and many a times unravels some underlying systemic disorder
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