IMA Journal – October 2023

Message from Team IMA Chennai Kauvery Alwarpet Branch

Dear colleagues

Greetings from IMA Chennai Kauvery Alwarpet.

Wishing all our anesthetists a Happy World Anesthesiology Day celebrated today the 16th of October.

Any health care stands strong on the foundation of its Anesthetists who maintain the air way in life threatening situations, who totally make us pain free in either electively or in emergency surgeries and give critical care support in the ICU round the clock with their clinical expertise.

We thank to all the Anestgesiologists for your contributions to patient care and sharing your valuable experiences through IMA.

Long Live IMA.

Yours in IMA service,
Dr S Sivaram Kannan
President

There is so much unrest, intolerance and violence in our World.

Let us love and accept one another with all our differences so there is peace and no fight.

This month’s IMA comes to you with articles from the departments of Anaesthesia and Critical Care. These specialties are key to good patient care and for the success of a hospital.

Long live IMA.

Yours in IMA service,
Dr. Bhuvaneshwari Rajendran
Secretary.

Dear friends

Happy to meet you all once again with this edition of our journal.

World Anesthesiology Day falls on the 16th of October. It marks the first day when Ether was first administered as an anaesthetic agent.

Anaesthesiologists are the real heroes not only in the operation theatres but in intensive care units, emergency services and so on their contribution to patient care is invaluable.

Thanks to all the Anestgesiologists for your contributions to patient care.

This edition is contributed by the our Anesthesiologist and Critical Care specialists.

Thanks to all the contributors and to the branding and editorials teams.

Your feedback and suggestions are welcome.

With best regards
Dr. R. Balasubramaniyam
Editor

A Case of Severe Mitral Stenosis posted for Uncemented Hemiarthroplasty

Mitral stenosis(MS) is one of the commonest valvular lesions seen  in patients with Rheumatic heart disease. Patients with severe MS are at increased risk of developing complications such as perioperative pulmonary edema, cardiac failure, arrythmias, embolic events, hemoptysis, infective endocarditis, pulmonary infection, etc, during the perioperative period.  Hence adequate preop optimization and planning is necessary before the surgery. We are going to discuss about one such a case posted for hemiarthroplasty

History

69/F came to ER with a history of giddiness and fall, sustained left intertrochanteric fracture of femur.

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Artificial Intelligence in Anaesthesiology

Introduction

In the field of anaesthesia, Artificial Intelligence has become a game changing technology. It has the potential to impact the practice of anaesthesiology in various aspects include preoperative risk stratification, perioperative support, post operative monitoring, pain management, critical care observation and wireless intelligence tracking in ward. This article explores the current uses and prospective application of AI in anaesthesia.

What is Artificial Intelligence?

It is the development of computer systems that are capable of performing tasks that normally require human intelligence, such as decision making, object detection, solving complex problems.

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An Arcane presentation of Renal Tubular Acidosis

Introduction:

Metabolic acidosis results from either the gain of an acid or the loss of a base. The former is due to exogenous or endogenous acid loads, resulting in normal anion gap metabolic acidosis. The latter is due to the loss of a base from either the gastrointestinal or genitourinary tract, producing a non-anionic gap or hyperchloremic metabolic acidosis. Renal tubular acidosis (RTA) arises from the kidney’s inability to excrete enough acid or retain enough bicarbonate (HCO3), resulting in a clinical syndrome characterized by non-gap metabolic acidosis, hyperchloremia, and impaired urinary acidification.

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Ultrasound Guided Interventional Pain Management in Cervicogenic Head Ache

Introduction

Headaches are experienced by most people from time to time, which affects relatively large minority of the people. Among  them Migraine and tension headaches are the two most commonly encountered headaches. But cervicogenic headaches are contributes only 0.4-4% of people, which often misdiagnosed due to its complex presentation. It affects younger age group between 30 to 50 years. This disease needs early diagnosis and management to stop the chronicity and complex presentation. Hence the early management reduces the burden of medication overuse in this age group to more severe pain.

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Difficult Intubation Case Scenario: Awake Fob Intubation for Morbidly Obese Patient with Cervical Spine Injury

History:

Mr Abdul Samath, 61 years gentleman, came to emergency  department. He sustained  injury over his right shoulder and complained of shoulder & neck pain. X Ray of right shoulder revealed communited fracture of right shaft of humorous and accompanied C4 osteophyte fracture.

Preoperative evaluation:

Diabetes  mellitus * 10 years on oha

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Breathing Easy Again: Navigating Post-Intubation Tracheal Stenosis

Index case

A 69-year-old female hypertensive patient presented to the emergency department with complaints of noisy breathing and exertional shortness of breath for the last 1 month which worsened over the last 2 days to NYHA class IV. On examination she was conscious, and her vital signs revealed pedal edema, elevated jugular venous pressure, tachypnea (RR 35-40/min) with usage of accessory muscles of respiration, sinus tachycardia (HR 120/min), elevated blood pressure (BP 160/90 mmHg) and hypoxia (SpO2 85% in room air). She got intubated with 7mm Endotracheal tube in view of worsening respiratory distress and was managed further in intensive care unit.

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Highlights @ Kauvery

World Heart Day wishes to our Cardiology team

In order to raise awareness on heart health, we had a community connect event today at Elliots Beach. Over 300 people participated in the Walkathon which was flagged off by our senior consultants.This was followed by Zumba, Mime show on heart health and a wonderful demonstration of BLS and usage of AED by Dr Vidya and ER team. Thanks to everyone who participated in the event and made it a grand success.

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