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IMA Journal – March 2025
Message from Team IMA Chennai Kauvery Alwarpet Branch
Dear Colleagues,
Warm greetings from IMA Kauvery.
As International Women’s Day is celebrated this month we extend our warm wishes to every woman and repeatedly emphasize on regular check-ups for women.
IMA Kauvery is organizing awareness talk on Health and Wellness, Work-life Balance, Mental Health Wellness, Diet Awareness, Financial Security and Fitness. We are also organising Health screening camps for women.
This month is yet another platter of interesting case studies to quench the knowledge hunger.
Yours in IMA service,
Dr S Sivaram Kannan
President
Dear IMA members,
IMA aims at providing platforms for doctors to pursue laurels in their fields.
IMA journal is another pillar in this integration.
Long live IMA.
Yours in IMA service,
Dr. Bhuvaneshwari Rajendran
Secretary
Dear friends
Happy to meet you all through this edition of our IMA Journal.
Post graduates and consultants contribute to the academic journey of our hospital.
Happy Women’s Day wishes to all our women warriors.
Thanks to branding and editorial teams for timely release of our journal.
Your feedback and suggestions are welcome.
With best regards
Dr. R. Balasubramaniyam
Editor
Atypical Pulmonary Infection With A Typical Presentation: A Case Report On Nocardia and NTM Co-Infection
Case History:
Mr. X, a 59-year-old male, presented to the OPD with complaints of cough for 2 years which was increased in intensity for past 6 months, aggravated while lying down, associated with sputum production which was scanty, muco-purulent, green colored, not foul smelling, not blood stained and he complained of breathlessness for 6 months (MMRC Grade III). He reported history of weight loss, decreased appetite and fatigue. He denied history of fever with chills and rigors, evening rise of temperature, chest pain, sweating, palpitations, nausea, vomiting, abdominal pain, headache, visual disturbances, dysuria, hematuria and increased frequency of micturition. He has a past history of Hodgkins Lymphoma treated with 6 cycles of chemotherapy, history of Old PTB treated with ATT.
Post-Infectious Cerebellitis: A Case Report and Management Approach
Introduction
Post-infectious cerebellitis is an inflammatory condition of the cerebellum, often occurring after a viral or bacterial infection. It presents with ataxia, dysarthria, nystagmus, and other cerebellar dysfunctions. While the condition is usually self-limiting, early diagnosis and appropriate management are crucial for better patient outcomes. This article presents a case of post-infectious cerebellitis in a 42-year-old male, detailing his presentation, diagnostic approach, and treatment course.
Case Presentation
A 42-year-old gentleman was transferred to our emergency department (ER) from an outside hospital with complaints of slurred speech.
Multiple Meningiomas – A Rare Brain Odyssey
Multiple Meningiomas (MM) in the brain is a rare condition in which two or more meningiomas are present intracranially separated from each other. The incidence ranges from 1 to 10%. The treatment of MM includes Surgery, Sterotactic Radiosurgery(SRS) and fractionated External Beam Radiotherapy (EBRT). We report a 33years old male who was evaluated for headache and was diagnosed with Supratentorial Meningiomas in 2008 for which he underwent Surgery at Coimbatore. Histopathological examination (HPE) was suggestive of Meningothelial Mengioma Grade I. He developed recurrence in 2017 and was managed conservatively. He underwent re surgery for the recurrence at Trivandrum in 2022. HPE was consistent with Atypical Meningioma WHO Grade II in left temporal/frontal region, left occipital and left parietal region.
Osler-Weber-Rendu disease (Hereditary Hemorrhagic Telangiectasia, HHT)
Abstract:
Osler-Weber-Rendu disease (Hereditary Hemorrhagic Telangiectasia, HHT) is a rare autosomal dominant disorder that results in vascular dysplasia, causing abnormal blood vessel development throughout the body and a predisposition to bleeding. We present a case of a 27-year-old female with hypoxemia, recurrent spontaneous epistaxis, and pulmonary arteriovenous malformations (AVMs), diagnosed through radiological workup. She was successfully treated with embolization of the AVM.
Introduction:
Osler-Weber-Rendu Syndrome, or Hereditary Hemorrhagic Telangiectasia (HHT), is a genetic disorder
Extraordinary Tavr in a Heavily Calcified Bicuspid AV with Horizontal Root and Severely Tortuous Aorta Using Novel Python BZ Introducer
Case:
83-year-old male
Admitted with Acute Heart Failure Syndrome
Past history of DM / HTN / TIA and COPD
No previous significant past surgical history
Echo: Severe Aortic stenosis with severe LV dysfunction (EF 20%) and moderate PAH
Serratus Anterior Plane Block
A 40-year-old male, known case of Ca lung with metastases to ribs and adrenal, was admitted with the complaints of breathing difficulty. Blood investigations were within normal limits, and chest X-ray showed moderate right-sided pleural effusion. Hence, this patient was posted for thoracoscopy and pleural biopsy.
Preop Evaluation
HR 98/min, BP – 110/60 mmHg, RR 22/min, Spo2 98% RA Blood investigations were within normal range
600ml of pleural fluid was drained previous day for better intraoperative status
Considering the respiratory concerns, thoracoscopy was planned under Serratus Anterior Plane Block to maintain respiratory stability.
Motion preserving endoscopic spine surgery in an obese elderly patient with recalcitrant sciatica
Case details:
A 79-year-old female presented with radiating pain and paresthesia in both lower limbs, pseudo-claudication pain reduced her walking distance and standing time significantly and had tried medications and epidural steroid injection with little success. Co-morbidities other than obesity include diabetes mellitus, systemic hypertension and hypothyroidism. On examination, she had forward stooping gait, straight leg raise test was negative and MRC grade 4 power in bilateral L5 myotome. Plain radiograph revealed grade I spondylolisthesis at L4-5 lumbar spine with no instability on dynamic stress radiographs. MR imaging(Fig. 1) showed significant facet hypertrophy on both sides encroaching the canal causing bilateral severe foraminal stenosis and moderate – severe central canal stenosis.
