Dear Colleagues,
Wishing you all a very happy and prosperous 2025.
IMA Kauvery extends its Pongal wishes to all.
I would like to congratulate Dr Senguttuvan for assuming the office of state president and assure him our fullest cooperation and wish him and his team a successful tenure.
Happy to share that our branch was awarded with 7 awards in the state conference held at Erode including one for this journal.
Thanking all the departments for their contribution to this edition.
Yours in IMA service, Dr S Sivaram Kannan President
Dear IMA members,
This month’s IMA journal is coming out with yet another collection of exciting clinical cases from various specialities.
IMA Kauvery wishes all the members a very Happy Pongal.
Let’s continue our years of connectivity through these monthly journals which enriches our knowledge.
Yours in IMA service, Dr. Bhuvaneshwari Rajendran Secretary
Dear friends
Our next edition of Kauvery IMA Journal is in your hands.
Kauvery hospital Alwarpet with post graduate programs in specialty and super-specialty departments have academically oriented postgraduates with committed consultants who contribute regularly to our journal.
Kindly go through these articles and give us your feedback and suggestions.
Thanks to our editorial and branding teams.
Belated New Year and Pongal wishes to you all.
With best regards Dr. R. Balasubramaniyam Editor
Introduction
Renal transplantation has become the cornerstone treatment for patients with end-stage renal disease (ESRD), conferring significant survival benefits and improvements in quality of life. However, the long-term survival of the transplanted organ necessitates rigorous immunosuppressive therapy, typically incorporating agents such as mycophenolate mofetil (MMF), tacrolimus, and corticosteroids. While these medications are effective in preventing allograft rejection, they are not without adverse effects, including gastrointestinal disturbances, hematologic abnormalities, and various mucosal manifestations, such as aphthous stomatitis. Aphthous ulcers are commonly observed in the general population, but their occurrence in transplant patients.
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Paraneoplastic Rhombencephalitis is a rare and serious neurological condition often associated with underlying malignancy. It is a type of paraneoplastic syndrome, where the immune system generates an autoimmune response against tumor antigens that cross-react with normal neuronal tissues. Paraneoplastic Rhombencephalitis affects the brainstem and cerebellum, regions involved in motor coordination and autonomic functions.
Case:
A 66 years old male presented with progressive imbalance while walking, letharginess hiccups and constipation. CSF analysis was normal.
Case Report:
50 years old male, known case of type 2 Diabetes mellitus presented to ER with complaint of swelling of left side of face along with left periorbital edema, gradually progressing over 1 week. History of fever for 2 days.
CT neck and facial bone– Ill-defined soft tissue edema and Inflammatory fat stranding in left parotid, para-pharyngeal, submandibular, masticator space (altogether measuring 7.5 ×7cm), extending upto the level of pharyngeal mucosa space on the left side at the level of oropharynx with associated airway luminal narrowing. Multi-compartmental cellulitis.
Plan– Exploration, Incision and drainage of left large suppurative parotitis.
A 4 years 6 months old boy with no known comorbidities came to the emergency department with C/O neck pain for the past 3 days unable to extend the neck associated with headache since that morning. Had an episode of vomiting, watery, non bilious and non blood stained . Parents also observed him to be irritable with decreased oral intake after the onset of headache. The child was admitted 4 days back for AGE with dehydration and discharged after a day. After that he had twice presented to ER , once with neck pain with painful neck movements, treated as musculoskeletal pain and again with neck and throat pain with no other associated symptoms was treated supportively for URI.
Introduction:
Leptospirosis is a zoonotic disease that occurs worldwide, with an increased prevalence mostly in tropical and subtropical regions. The source of infection is generally direct or indirect contact with the urine of infected animals, such as rodents. Leptospirosis has become more common in urban areas owing to climatic change and poor sanitation. Leptospirosis is a common infection in rice-field workers due to prevalence of wild rats. Leptospirosis is known to cause various systemic manifestations, but in some rare cases, pancreatitis can occur. Thus, here is a case of acute pancreatitis associated with leptospirosis.
Neck of femur fracture is one of the commonest fractures in elderly people. Commonly performed surgery for Femoral neck fracture in elderly are total hip replacement and hemiarthroplasty. The aim of our study is to evaluate the functional outcome and complications of head retaining osteosynthesis in stable neck of femur fracture in elderly with minimally invasive yet rotationally stable femoral neck system.
Methodology
Prospective study conducted in kauvery hospital Chennai. 15 elderly patients who were admitted with stable neck
Clavicle fractures are common injuries, but delayed union with secondary brachial plexopathy is a rare and debilitating condition that poses unique diagnostic and therapeutic challenges.
This case report highlights the comprehensive management of a 59-year-old male who presented with an 8-week-old delayed union of right clavicle midshaft fracture and an ipsilateral scapula body fracture, also known as floating shoulder (Fig.1,2). The patient was conservatively managed elsewhere when the patient developed right upper limb plexopathy three weeks post-injury. The patient presented at Kauvery hospital in the eighth week post-injury, with monoparesis and paraesthesia primarily affecting C8 and T1 motor functions, along with sensory deficits in the C6-C8 dermatomes.
