Dear Colleagues,
Warm greetings from IMA Chennai Kauvery Alwarpet.
The month of July began on a memorable note with the grand celebration of National Doctors’ Day on 1st July. The enthusiastic participation of our members made the event a true reflection of unity, dedication, and professional camaraderie.
I extend my heartfelt appreciation to all doctors for their tireless service and commitment to the health and well-being of our society.
On behalf of our branch, I also convey my warm wishes on Plastic Surgery Day and acknowledge the remarkable contributions of plastic surgeons in restoring function, confidence, and quality of life.
Let us continue to uphold the values of ethical practice, continuous learning, and compassionate patient care while strengthening the spirit of fellowship within our IMA family.
Yours in IMA service, Dr S Sivaram Kannan President
Greetings to all IMA Members,
Happy World Plastic Surgeons Day!
This July issue reflects the clinical excellence and academic rigor that define our hospital. From complex case studies to evolving treatment protocols, every article reaffirms our shared commitment to advancing medicine through knowledge and innovation.
My sincere gratitude to all the authors for their time, expertise, and research. A special thanks to our editorial and branding team for their dedication in bringing this journal to life.
Yours in IMA service, Dr. Bhuvaneshwari Rajendran Secretary
This July issue showcases the great clinical work and learning from our hospital.
It features interesting cases and new treatment methods — all aimed at better patient care.
A big thank you to all the authors and to our editorial & branding team for making this possible.
Special congratulations to Dr. K.P. Suresh Kumar for receiving the IMA Achievement Award.
With regards Dr. R. Balasubramaniyam Editor
Introduction
Ageing is a universal physiological process that affects every organ of the body. The face, being the most visible part of the human body, reflects these changes more prominently than any other region. While ageing cannot be prevented, scientific advances allow us to delay its manifestations and restore facial harmony through a combination of lifestyle measures, medical therapies, minimally invasive procedures, and surgery. Anti-ageing treatment is therefore based on sound anatomical and physiological principles rather than cosmetic enhancement alone.
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Abstract:
Profound anemia severe enough to precipitate cardiac arrest is an exceptionally uncommon presentation in current clinical practice. We describe a middle-aged man with long-standing alcohol dependence who developed circulatory collapse following a short history of diarrheal illness and poor oral intake. On arrival, he was in cardiac arrest and achieved return of spontaneous circulation (ROSC) after advanced resuscitative measures. Laboratory evaluation demonstrated profound macrocytic anemia with a hemoglobin concentration of 2.3 g/dL. Peripheral blood smear showed macro-ovalocytes, hypersegmented neutrophils, and Howell-Jolly bodies, while biochemical investigations confirmed folate deficiency with normal vitamin B12 levels. Following intensive care management, blood transfusion, folate supplementation, vitamin replacement, and supportive therapy, the patient demonstrated progressive clinical and hematological recovery.
Abstract
Combined femoral anteversion and tibial torsion deformity represents a complex rotational malalignment of the lower extremity and is a common cause of persistent intoeing gait in children. Although isolated femoral anteversion and internal tibial torsion frequently resolve spontaneously during growth, severe deformities may persist and result in gait abnormalities, functional limitations, cosmetic concerns, and psychosocial distress. Accurate clinical assessment of the rotational profile remains essential for diagnosis and treatment planning. Surgical intervention is reserved for symptomatic patients with significant rotational deformities that persist beyond the age of expected spontaneous correction. We report a case of a 9-year-old child with symptomatic combined femoral anteversion and bilateral internal tibial torsion who underwent bilateral distal tibial and fibular derotation osteotomy with approximately 40° correction. Postoperatively, the patient demonstrated marked improvement in gait pattern, functional mobility, and confidence during ambulation. This case highlights the effectiveness of distal tibial derotation osteotomy in appropriately selected patients.
Simultaneous acute ischemic stroke (AIS) and acute pulmonary embolism (PE) is an uncommon but life-threatening clinical scenario that presents a significant therapeutic challenge. While AIS requires urgent cerebral reperfusion therapy, PE is primarily managed with anticoagulation or systemic thrombolysis. The coexistence of these conditions creates a difficult balance between preventing neurological deterioration and minimizing the risk of hemorrhagic transformation of cerebral infarction. We report the case of a 68-year-old woman presenting with acute neurological deficits in the setting of suspected pulmonary embolism and discuss the pathophysiology, diagnostic approach, current evidence, and decision-making process regarding thrombolytic therapy. We emphasize that management should be individualized according to stroke severity, PE severity, hemodynamic status, imaging findings, and bleeding risk.
Persistent hypereosinophilia requires a systematic evaluation to distinguish reactive causes from clonal hematological disorders. Although allergic diseases, parasitic infections, and drug reactions account for the majority of cases, failure to identify the underlying etiology may delay appropriate treatment and predispose to irreversible organ damage.
