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IMA Journal – April 2025
Message from Team IMA Chennai Kauvery Alwarpet Branch
Dear Colleagues,
IMA Kauvery extends warm wishes to everyone for an Iniya Tamil Puthandu!
Chithirai thirunaal is here to celebrate the onset of the new Tamil year.
May this new year enrich us with good clinical skills and patient care.
Summer is in its peak.
Keep your body hydrated with fluids with quench your thirst.
Similarly, our interesting cases will quench your knowledge thirst.
We thank all the departments for their contribution.
Yours in IMA service,
Dr S Sivaram Kannan
President
Dear IMA members,
Iniya Tamil Puthandu Vazthukkal!!!
IMA journals are focused on clinical cases committed to improve the physical, mental, psychological, and social health of patients.
We thank all the departments for their contribution.
Long live IMA.
Yours in IMA service,
Dr. Bhuvaneshwari Rajendran
Secretary
Dear friends
Happy to meet you all with the next edition of Kauvery IMA journal.
The journal has articles across specialities and thanks to the postgraduates and consultants for active participation.
Your suggestions and feedback are welcome.
With best regards
Dr. R. Balasubramaniyam
Editor
Rare yet interesting case of Pyrexia of unknown origin: A case report on Subacute thyroiditis
Case History:
Mr.X, a 51-year-old gentleman, who is a known case of Diabetes mellitus, systemic hypertension and dyslipidemia on regular treatment and follow up, presented with history of High-grade fever with chills for 7 days, along with minimal flu-like symptoms. He had no history of significant weight loss, night sweats, respiratory, urinary or gastrointestinal symptoms. No history of any recent travel. He denied any livestock exposure or sick contacts. He received a course of oral antibiotic cefuroxime in an OPD basis. Despite which the fever failed to resolve; hence the patient was admitted for further evaluation.
Bloody Sweat : A Rare Frightening Condition
Introduction:
Hematidrosis or hematohidrosis or bloody sweat is a rare and self-limiting condition characterized by blood oozing from the intact skin and mucous membranes in the absence of any bleeding problem.1It commonly affects young females of Asian ethnicity. Bleeding most commonly occurs from the ear, nose, oral cavity and other facial areas.2 Unusual anxiety, fear or stress factor play a major role in the starting of symptoms.3 Here we present a 15-year-old girl who presented with similar complaints and was diagnosed as a case of hematidrosis after ruling out other bleeding diathesis.
Infective Endocarditis by A Uncommon Bacteria
Introduction:
Pasteurella sp have general characteristics being non-motile, facultative anaerobic and Gram-negative coccobacilli. These are mostly found in the oral cavity and the gastrointestinal tract of certain animals which transmit the infections. Cats and dogs being the highest carriage rates, at 70% to 90% and 20% to 50%, respectively. Usually, infections by Pasteurella spp. in humans is more common in the context of an animal bite leading to a skin and soft tissue infection (SSTI). Pasteurella spp rarely causes Infective endocarditis, and because of its rarity there is both diagnostic with therapeutic dilemmas. Here we present a case of Infective Endocarditis caused by Pasteurella.
Side strain: Tear of internal oblique musculature
Introduction:
Side strain is a condition diagnosed clinically, characterized by a sudden onset of pain and localized tenderness along the rib cage. This injury is commonly associated with sports such as cricket, javelin throwing, rowing, and ice hockey. While it is relatively rare, it is particularly impactful for elite athletes as it can lead to their exclusion from competitions and require an extended period of recovery.
Through MRI examinations of patients with side strain, we have identified that it typically results from a tear in the internal oblique muscle where it attaches to the rib or costal cartilage.
Nutrition Intervention for Hospitalised Population
Objectives
- Significance of nutrition assessment and monitoring
- The importance of nutrition in improving patient outcomes and recovery
- Role of muscle loss and impact on clinical outcomes
Critically ill patients undergo various physio- metabolic changes. These changes may increase the risk of malnutrition.
Reduction in total calories and protein intake complicates the deteriorating clinical condition.
Renal Artery Stenosis
Case History:
An elderly gentleman on maintenance hemodialysis since 3-4 years, was admitted last week with complaints of breathing difficulty. He was admitted in ICU and treated with NIV support and dialysis, after which he settled. His cardiac function was evaluated and found to have LV dysfunction. The shortness of breath was attributed with the failing LV. However, on further analysis, it was found that he multiple episodes of pulmonary edema in the recent past, warranting admission and management. Cardiologist opinion was taken and CAG with drive by angiogram was done and found to have SVD with 90 % bilateral renal artery stenosis.
