Tuberculosis (TB) is not only a major public health problem of developing countries like India, since its incidence is increasing due to increasing immune-depressive states including HIV, malignancies and cytotoxic chemotherapy. Laryngeal TB occurs usually a secondary to associate with pulmonary disease, and primary form is very rare in immune-competent people. We report a 49-years-old non-smoker, non-diabetic, immunocompetent man presenting with chronic dry cough and hoarseness without any constitutional symptoms, family or contact history of TB. The chest X-ray was normal. Laryngoscopy showed congested larynx without any ulcer or mass and normal vocal cords. Biopsy from aryepiglottic fold was suggestive of TB, but caseation was absent. Diagnosed to be primary laryngeal TB, he responded well to antitubercular therapy. Primary laryngeal TB without pulmonary TB can mimick chronic laryngitis. Before anti-tubercular drug use, in the 1950's, it was a common and frequently fatal disease but it's clinical features, age group involved and prognosis has changed over the last few decades. It is more infectious than pulmonary form primarily due to delayed diagnosis. It can mimick a common condition like chronic laryngitis, although different macroscopic lesions are described. Diagnosis needs a high index of suspicion, confirmed by histological examination, as it still can occur occasionally in immunocompetent persons. Response to specific treatment is good after diagnosis.
Introduction: Osteoarthritis of knee is more common among all types of arthritic conditions. High tibial osteotomy is an accepted surgical technique for treatment of medial compartment arthrosis of knee in younger patients. Selection of the appropriate patients, extensive pre-operative planning and accurate surgical technique are essential for successful outcome. The methods of high tibial osteotomy include open wedge osteotomy and closed wedge osteotomy, the later procedure being more popular. Aims and Objectives: To assess the functional outcome among patients undergoing high tibial osteotomy. Methodology: A hospital based prospective interventional study was done on 30 patients of osteoarthritis with varus deformity. For all the 30 patients after a proper preoperative assessment the surgical intervention in the form of high tibial osteotomy was done and the outcome was evaluated using knee society scoring system. Results: Among the study population 73.3% of the patients had grade III type of osteoarthritis and only 26.6% had grade IV type of osteoarthritis based on Kellgren and Lawrence type of classification. The mean knee score and the mean functional score of the patients before surgery were 54.6 and 53.9 respectively and post operatively at the end of 12 months the knee score and functional score was 83.1 and 82 respectively. A statistically significant improvement was seen in both the knee society score and the functional score. Conclusion:The main improvements seen in this study was the increase in the knee score and functional score after high tibial osteotomy for the patients of osteoarthritis with varus deformity. Appropriate patient selection, proper osteotomy types and precise surgical techniques are essential for the success of high tibial osteotomy.
Craniometaphyseal dysplasia is a rare genetic craniotubular bone remodeling disorder characterized by progressive hyperostosis, undertubulation of the long bones, causing metaphyseal deformities of the long bones, and sclerosis of craniofacial bone. We are reporting a case of craniometaphyseal dysplasia in a 12-year-old indian child, highlighting the importance of radiological diagnosis of this rare genetic disorder.
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