IMA Journal – July 2024

Message from Team IMA Chennai Kauvery Alwarpet Branch

Dear Colleagues,

Greetings from IMA Kauvery.

Doctor’s day wishes to you all.

This week also marks the importance of Plastic Surgeons.

Wishing our colleagues a Happy Plastic Surgeons Day.

We shall be effective and safe doctors only if we constantly organize, analyze, present and publish our clinical work.

This month’s edition carries various interesting articles which will reflect the above.

We extend our thanks to all the authors and co-authors.

Yours in IMA service,
Dr S Sivaram Kannan
President

Dear IMA members,

Kauvery IMA brings together doctors and aims at improving their partnership and knowledge sharing.

This month’s IMA journal is coming out with another issue filled with vignettes from various clinical specialties.

Yours in IMA service,
Dr. Bhuvaneshwari Rajendran
Secretary.

Dear friends

It is my pleasure to present to you the next edition of IMA Kauvery.

I am delighted that the contributions are from the post graduates in this edition.

I am thankful to them and to all the consultants for their support.

Thanks to branding and editorial teams.

With best regards
Dr. R. Balasubramaniyam
Editor

A Rare Form Of A Spectrum Of Guillain Barre Syndrome

A 58-year-old lady presented to ER on 24th April 2023 at around 7.30 pm with

  • History of low back pain x 2 days followed by sudden onset of giddiness, headache,
  • double vision involving both eyes with photosensitivity, and
  • bilateral numbness of hand and fingers, perioral numbness
  • decreased sensation over both feet

PAST MEDICAL HISTORY:

  • She is known Diabetic

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Clinical Profile, Renal Histology And Outcome Of Patients With Infection Related Glomerulonephritis

INTRODUCTION

Infection related glomerulonephritis (IRGN) is an immune mediated glomerulonephritis mediated by alternate complement pathway activation by bacterial, viral or parasitic infections.

AIM

To determine the clinical spectrum, nature of infection, renal histology, use of immunosuppressants and outcome of patients with biopsy proven IRGN.

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Management of a Patient with Addison’s Disease, Chronic Malnutrition, and Irritable Bowel Syndrome Presenting with Neurological and Heart Failure: A Case Report

Abstract

This case report describes the presentation, diagnosis, and successful management of a patient with Addison’s disease complicated by chronic malnutrition and irritable bowel syndrome (IBS). The patient presented with neurological symptoms and heart failure, which were addressed through antifailure measures, hormonal therapy, intravenous (IV) supplementation of vitamins, and re-initiation of feeding.

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Management of a young patient with fat embolism - A case report

Abstract

Fat embolism is a life threatening complication following a major orthopedic trauma. Diagnosis is only by strong clinical suspicion. Treatment is only supportive care. Here, we report a young male who presented with altered sensorium 48 hours after trauma, diagnosed as fat embolism and managed effectively with multi-disciplinary approach.

Introduction

Fat embolism is defined by the presence of fat globules in pulmonary circulation.

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Anaesthesia For Rigid Bronchoscopy And Stenting Of Acquired Tracheo Esophageal Fistula - A Case Report

61-year male known case of COPD, Diabetes mellitus, hypertension, Carcinoma oesophagus which was diagnosed in 2023 for which he received chemotherapy and radiotherapy.  OGD (2024) showed oesophageal stricture and dilatation was done. PET CT (2024) revealed residual disease, was started on chemotherapy. Feeding jejunostomy was done. Bronchoscopy revealed left vocal cord palsy.

Patient presented to ER with compliant of breathlessness and desaturation and diagnosed as aspiration pneumonia.

Patient received in ICU in view of desaturation and connected on NIV support.

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Robotic Pancreaticoduodenectomy – A Minimally Invasive Answer To An Extremely Technically Complex Surgical Procedure

Abstract:

Whipple operation – a pancreaticoduodenectomy is an advanced surgical procedure which requires a lot of technical expertise and is associated with a lot of morbidity and mortality. This is usually performed by open surgical approach, with a long wound which is painful . Currently minimally invasive surgery (MIS) is used worldwide with improved wound cosmesis and to minimize pain in most abdominal procedures, but minimally invasive pancreaticoduodenectomy is not very well established for complex pancreaticoduodenectomy due to its technical complexity. Robotic surgery which has been recently introduced can help overcome most of the limitations associated with the laparoscopic approach.

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