Dear friends
Greetings from IMA.
The various articles in our journal always teaches us the teamwork in patient care and need of an interdepartmental relationship for patient care.
This month’s edition carries various interesting articles which will reflect the above.
We extend our thanks to all the authors and coauthors.
Yours in IMA service, Dr S Sivaram Kannan President
Dear IMA members,
IMA Kauvery has been showcasing high standards of clinical practice and bringing in articles of immense clinical merit.
This month is another issue with many interesting cases.
Happy Reading.
Yours in IMA service, Dr. Bhuvaneshwari Rajendran Secretary.
Kauvery IMA Journal is regularly publishing scientific work done in our hospital on monthly basis.
I am delighted to present our next journal with a mix of articles from the consultants and postgraduates.
Thanks to the editorial and branding teams
Your suggestions are welcome.
With best regards Dr. R. Balasubramaniyam Editor
CASE STUDY:
A 40 years old gentleman with the known case of systemic hypertension for 5 years on treatment with Telmisartan and Metoprolol, presented with semisolid consistency of stools 5 to 6 episodes per day for past 1 year. Initially he was treated with the Anti diarrheal, Luminal antibiotics in the first two OPD reviews. He was suggested to do stool tests including Stool routine microscopy, Fecal calprotectin and baseline bloods includes CBC, LFT, Thyroid profile and Serum electrolytes which were normal. CT abdomen revealed no abnormalities. Hence he was suggested to undergo endoscopy and colonoscopy as there was no symptomatic relief. OGD revealed mildly edematous mucosa in the D2. D2 biopsy was taken and sent for HPE reports.
Read Full Article
Introduction
Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by chronic inflammation affecting multiple organ systems. Lupus nephritis (LN) is one of the most severe complications of SLE, involving inflammation of the kidneys that can lead to end-stage renal disease (ESRD). While SLE predominantly affects women, accounting for approximately 90% of cases, it is crucial to understand its presentation and impact on male patients, particularly concerning lupus nephritis.
Epidemiology
SLE is significantly less common in males, with a female-to-male ratio of about 9:1.
A 77 year-old male came with complaints of fever with chills and rigor, seizure and generalized fatigue.
Patient underwent MRI. MRI image shows T2/FLAIR hyperintensities with diffusion restriction and low ADC values seen in ventral pons extending to both middle cerebellar peduncles, sulcal space of bilateral medial frontal lobes in the pericallosal gyrus .Post contrast images showed small conglomerate ring-enhancing lesions largest measuring 5.6 x 5.5 mm in both medial frontal lobes with meningeal enhancement. Meningeal enhancement was also noted along the ventral pons and middle cerebellar peduncles. Diffusion restriction with T2/FLAIR hyperintensity seen in right medial thalamus.
A 71-year-old male presented to the ER with a history of confusion and amnesia around 05:30 pm. At the time of the episode, he had just finished his shower and was found standing in his room with excessive sweating and confusion while repeating the same question: “What happened?”. He was not able to recognize his family members. Prior to the shower, he was normal.
There was no past medical history of stroke, seizures, dementia, traumatic brain injury, psychiatric illnesses or similar episodes. Currently on beta-blockers, anti-platelets and statins for hypertension and coronary artery disease.
Scoliosis is a deformity of the spine resulting in lateral curvature and rotation of the vertebrae as well as deformity of the rib cage. Prior to surgical correction, a thorough pre operative assessment is essential as it involves preoperative multiorgan dysfunction, intraoperative blood loss and post operative pain management
Case Report
A 29-year female with history of neglected congenital scoliosis came for surgical correction. Clinical history showed no other congenital abnormality with poor cardiorespiratory effort. Cobb’s angle was found to be 150 degrees.
We present the case of a 61-year-old female who was brought to our hospital with multiple episodes of flash pulmonary edema. On admission she was in heart failure with uncontrolled hypertension and required NIV. She had undergone angiogram of the Aorta and renal vessels which revealed significant stenosis of proximal segment of the right renal artery with increased PSV. Her left kidney was found to be contracted and measured around 5.8x 6.0cm. Her right kidney was normal in size with maintained corticomedullary differentiation. Renal parameters were deranged – Serum creatinine was 1.8mg/dl. She continued to have hypertension and recurrent episodes of flash pulmonary edema despite continuous lasix infusion and four classes of antihypertensives. Hence, she was dialysed through the right IJV.
