ABSTRACT
Persistent poststernotomy pain (PSP) is a well?known entity following cardiac surgery done with midline strenotomy. The severity of pain is usually mild to moderate in the majority of the patients. However, a small percentage of patients develop severe and persistent pain and need aggressive treatment. Our patient, a 63?year?old lady developed chronic severe parasternal pain following coronary artery bypass graft surgery. As multiple medications did not relieve her pain effectively, we did an ultrasound?guided pectoral?intercostal fascial plane block to which she responded with excellent and long?lasting pain relief. This is the first such case report of the use of this novel block technique for treating PSP.
ABSTRACT
Non-HIV AIDS or idiopathic CD4 lymphocytopenia (ICL) is an acquired immunodeficiency syndrome resulting in CD4 lymphopenia without any evidence of HIV infection or any other apparent cause of immunosuppression. A non-diabetic patient presented with adrenal histoplasmosis and UTI leading to adrenal failure. No immediate cause of immunosuppression was found, HIV, HTLV screening were negative. A CD4 count was done and the patient was found to be having non-HIV AIDS (idiopathic CD4 lymphocytopenia). He was treated and discharged. Few months later the patient presented again with adrenal failure & pulmonary tuberculosis. Adrenal FNAC showed persisting adrenal histoplasmosis. CD4 count found to be low again, but this time it was worse than the previous scenario