Three-dimensional computer-aided surgery adds a 'third-dimension' to endoscopic sinus surgery. The images it provides have the potential to provide the surgeon with further information that might result in safer and more effective surgery with less surgical morbidity. The gold test, as yet untested, will be whether the technique leads to fewer revision procedures and complications as a result of more complete and safe initial surgery. Its greatest asset lies in reinforcing the surgeons' estimate of an instrument's position in a difficult anatomical area. It can augment the learning curve and enhance teaching and training in endoscopic sinus surgery but it is not a substitute for a thorough knowledge of paranasal sinus anatomy.
In the present study, a conservative approach for removal of a fractured instrument located at the apical root area of maxillary left central incisor of a 35 years old male was performed and the clinical outcome was evaluated. On clinical examination, localized swelling associated with discharge of pus was seen near to the affected tooth. Furthermore, the tooth was restored with temporary filling and it was severely discolored. On radiographic examination, a radiolucent area around the apex was seen and there was a fractured instrument at the apex of the tooth. Tooth was then treated as nonsurgical endodontic technique and an attempt to remove the fractured instrument was undertaken. The results confirms that fractured instrument was successfully removed by using the File Braiding technique and after 3 months follow up, the tooth was asymptomatic and radiograph shows complete healing of the periapical lesion.DOI: http://dx.doi.org/10.3329/updcj.v2i1.13957 Update Dent. Coll. j: 2012; 2 (1): 25-30
Background: Anaemia is very common in hypothyroid patient. The results of the type of anaemia in hypothyroid patient studied outside may not be similar on Bangladeshi population. So far, there is no such study regarding the types of anaemia in hypothyroid patients in Bangladeshi population.
Methods: This was a cross sectional study in patients with hypothyroidism who was attending in the thyroid and endocrine clinic of Bangabandhu Sheikh Mujib Medical University, Dhaka over a period of one year. All newly diagnosed cases were selected considering inclusion and exclusion criteria. A structured questionnaire was used for data collection.
Results: Fifty newly detected hypothy sroid patients were studied among the study population, 52.0% was between 05 to 35 years and another 48.0% were in 36 to 65 years. 76.0% were female. Bradycardia was found in 20.0% cases. Puffiness of face, peripheral oedema and cold intoleran ce were found in 78.0%, 68.0% and 82.0% cases respectively. Hoarseness of voice, delayed relaxation of tendon reflexes and paraesthesia were found in about 80.0% cases. Myxoedema and vitiligo were found in 54.0% and 6% cases. FT4 level was reduced in 100.0% cases (Normal range of FT4-9.14-23.81 pmol/L). The mean of FT4 was 5.10 pmol/L. On the other hand TSH level increased in all cases (Normal range of TSH-0.47-5.0l mIU/L). The mean of TSH was 109.88 mIU/L. 50 cases were positive anti TG-Ab and also anti PO-Ab was positive in Fifty cases. Hemoglobin concentration was reduced in 70.0% cases. The mean of haemoglobin concentration was 10.67 gm/dl. In this present study, association of serum anti TG Ab and anti PO Ab of the patients with hypothyroidism and their corresponding hemoglobin concentration were found significant (p<0.05) but on the other hand there was no association between serum FT4 of the patients with hypothyroidism and their corresponding haemoglobin concentration (p> 0.05). Normocytic normochromic anaemia were found in 64.0% cases, and Microcytic hypochromic anaemia in 32% and Macrocytic anaemia in 4.0% of the cases. Iron deficiency was found in 90.0% and chronic blood loss in 44.0% of the cases.
Conclusion: Anaemia is frequently found in hypothyroid patients. So, hypothyroidism should be excluded in anaemia of nonspecific origin.
Bangladesh Med Res Counc Bull 2020; 46(1): 55-60
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