Dear Colleagues,
Greetings and Best wishes from IMA Chennai Kauvery Alwarpet branch.
This continuous medical education program in the digital platform is definitely a boon for our medical professionals to enrich their knowledge.
This month, we present a special platter of articles from our various specialties.
As we bid farewell to the year 2024 and look forward to the New Year, I thank all the IMA members for all their hard work and social services rendered in this year and we definitely assure that IMA will continue to aspire the young doctors and be a pillar of support to our members.
Yours in IMA service, Dr S Sivaram Kannan President
Dear IMA members,
2024 is almost over. Let us usher in 2025 with all hopes for peace and harmony in the world.
IMA Journal from Kauvery strives for continuation of medical education for all medical practitioners.
In this endeavour, we are bringing in another month’s edition with clinical cases from various specialities.
Yours in IMA service, Dr. Bhuvaneshwari Rajendran Secretary
Dear friends
Greeting to IMA Kauvery.
Happy to present this edition of our IMA Journal.
Like the downpour of rain giving the benefit to the soil, this variety of cases is like a downpour of knowledge for all of us.
Thankful to the postgraduates for their contributions and to the consultants for their contributions.
With best regards Dr. R. Balasubramaniyam Editor
Abstract
Chronic ITP with thrombocytopenia presenting with Hemoperitoneum can be a life-threatening event. In the current case report 27 yrs old unmarried woman with history of Chronic ITP but discontinued treatment for four years presented to ER with Acute abdominal pain and hemorrhagic shock. Her hemoglobin was low-6.3g/dl, Platelets very low-2000/cu.mm, urine beta Hcg negative. On CT imaging free fluid detected in the peritoneal cavity with Rt adnexal lesion. After immediate resuscitation in ER, pt was shifted to theater for Laparoscopy. Hemoperitoneum due to rupture of corpus luteum cyst was found intraoperatively. Adequate fluid ,platelets and component therapy was life saving for this patient.
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Bronchial blockers are inflatable devices that are passes through a single lumen tube to selectively occlude a bronchial orifice. First used by Sir Ivan Magill.
Characteristics :-
Case Report
Mr. X, a 47-year-old male, presented to the neurology outpatient department with a two-month history of left-sided chest pain radiating to the back. The pain was insidious in onset, intermittent, pricking in nature, and aggravated by movement or lying on the left side. Relief was noted with massage or adopting a flexed posture. The pain was associated with occasional dyspnea and a catching sensation during breathing. The pain did not respond to standard analgesics. He also had similar complaints 2 years ago, later resolved spontaneously.
Initial consultations included an orthopedic evaluation where an MRI of the chest and spine was performed.
Case Report:
Mr. X, a 70-year-old male with a history of diabetes mellitus and chronic liver disease, presented with a one-month history of chest pain radiating to the left shoulder. The pain had progressively increased in intensity. He did not report any trauma or pain in other joints. On clinical examination, restricted range of motion and pain were observed in the left shoulder. No symptoms or signs from other systems or joints were noted.
Consultation with an orthopedist was sought, and a recommendation for a CT scan of the shoulder was made, small geodes in glenoid- degenerative. The CT scan of the chest, in light of the patient’s clinical features, suggested a differential diagnosis of tuberculosis (TB).
Diabetic ketoacidosis (DKA) is defined as clinical syndrome with Ketonaemia > 3.0 mmol/L or significant ketonuria (more than 2+ on standard urine sticks) Blood glucose > 11.0 mmol/L or known diabetes mellitus Serum venous bicarbonate of < 15.0 mmol/L and/or venous pH < 7.3. Oral hypoglycaemic drugs, such as dapagliflozin and empagliflozin, belong to the class of Sodium-Glucose Cotransporter 2 inhibitors (SGLT2i). These drugs function blocking glucose reabsorption at the luminal membrane of the proximal renal tubules. Studies indicate that SGLT2i contribute to reduction in body weight, provide a slight decrease in both systolic and diastolic blood pressure, and may slow disease progression by enhancing β- cell insulin secretion and improving insulin sensitivity in peripheral tissues.
An 85-year-old male patient, who had been bedridden for two months, presented with a chief complaint of back pain and bilateral lower limb radiculopathy. Diagnostic imaging revealed an osteoporotic compression fracture of the L2 vertebral body, accompanied by severe spinal stenosis at the L4-L5 level (fig.1 & 2). The patient’s prolonged immobility, compounded by severe pain, had precipitated the development of a chest infection, further exacerbated by his persistent decubitus position over the preceding weeks.
Clinical Evaluation and Multidisciplinary Approach
The complex clinical presentation of the patient necessitated a multidisciplinary management strategy, involving discussions regarding the most appropriate therapeutic interventions.
