A Periodic Case of Maxillo-Nasal Dysplasia or Binder Syndrome Successfully Operated With Bilateral Le Fort II Osteotomy With Distraction Osteogenesis

Binder syndrome (BS) is an uncommon congenital disorder affecting the face. The condition, which also goes by the names naso-maxillary hypoplasia (NMH) and maxilla-facial dysplasia (MFD), causes the central face to develop inward and may also affect the upper jaw and the nose. A 19-year-old male with a known case of BS presented with a complaint of poor esthetics since birth. Previously, the patient was admitted to a private hospital where he was operated on for cleft lip and palate in the years 2003 and 2005. In 2017, he visited the dental clinic where the orthodontic treatment started for poor esthetics, and then he was referred to the oral surgery ward for surgical intervention. For about five years, he has been undergoing orthodontic treatment. A physical examination of the oral cavity was done and the physician suggested a CT scan of the brain. Recently, the patient underwent bilateral Le Fort II osteotomy with distraction osteogenesis under general anesthesia which repaired the patient's esthetics.

A Case Report on Ischemic Dilated Cardiomyopathy with Compensated Alcoholic Liver Disease with Acute Pancreatitis and Right Sided Pleural Effusion

Introduction: Ischemic heart disease is the most common cause of dilated cardiomyopathy. In ischemic heart disease, the capability of the coronary heart to pump blood is reduced due to the fact that the principle pumping chamber of the heart, the left ventricle, is enlarged and dilated. This is due to a loss of blood supply to the heart muscles due to coronary artery disorder. This condition is sometimes referred to as dilated cardiomyopathy. Clinical Finding: shortness of breath since 3 months, dry cough, loss of appetite, loss of weight (Weight 50 Kg), lower limb swelling, increased frequency of stools since 3 months. Diagnostic Evaluation: chest x-ray right hydropneumothorax, ECG QS complexes in V1, V2, V3, 2 D Echo ejection fraction 15%, all chambers dilated, poor biventricular systolic function, mild mitral regurgitation, tricuspid regurgitation. USG for liver mild hepatomegaly, USG for thorax gross pleural effusion on right side, CECT Abdomen bulky tail of pancreas, right side pleural effusion with collapse of underlying lung. Therapeutic Intervention: Patient was treated with diuretics, alpha and beta-blocker, angiotensin receptor, Antibiotic, protein powder and supportive treatment and intercostals chest drainage was done. Outcome: pleural tapping was done. Patient general condition was poor with breathlessness. Conclusion: This situation indicates the subsequent mental impact at the affected person, as well as on career and family. After getting appropriate treatment patients symptoms relived and the progression of heart failure slowed down.