IMA Journal – April 2022

Message from Team IMA Chennai Kauvery Alwarpet Branch

Dear colleagues

Greetings and best wishes from IMA Chennai Kauvery branch.

It’s a great feel to be back to our routines after as the devastation caused by COVID is coming to an end.

This issue is coming out with a special focus on Oncology, I thank all the authors for their contribution.

Yours in IMA service,
Dr S Sivaram Kannan

Dear friends

Beginning of summer. End of school, start of holidays.

Time to spend time with families. Use it well.

We should be able to balance work and life well for a healthy mental and physical state.

Long live IMA.

Yours in IMA service,
Dr. Bhuvaneshwari Rajendran

Hello friends

I am happy to present this month IMA JOURNAL to you.

We focused on malignancies in various departments. The response from our consultants and post graduates are amazing and my thanks to all the contributors.

Kindly give your valuable feedback and suggestions.

Best wishes to you all for New Year, Easter and Ramzan.

Long live IMA.

With regards
Dr. R. Balasubramaniyam

Mimics of ENT Malignancies

In the discussion of malignancies, a clear word about its masquerading conditions is essential. In this write-up, I present three conditions that mimic malignancies in the ear, nose and throat.

Malignant otitis externa

Malignant otitis externa is a life-threatening condition that presents and spreads aggressively like a malignancy. It is an infection of the external auditory canal commonly caused by Pseudomonas aeruginosa. The name Malignant otitis externa is thus a misnomer even though due to the high incidence of mortality it was earlier termed so. The infection often spreads to the adjacent skull base. In recent times various terms are used for this condition including  “Necrotising otitis externa”, “skull base osteomyelitis” and “Osteitis of the base of skull”.

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Maxillofacial Prosthesis in Rehabilitation of Oral Cancer Patients


Cancer is one of the important emerging public health concerns in India. Statistics from the Hospital Based cancer registries (HBCR) report close to 1.39 million cancer cases in 2020. Cancers involving the head and neck region account for about one-third (31.2% )of these cases in males. Mouth cancer contributes to the highest number of cases related to the use of tobacco followed by lung and tongue as other primary sites.

High morbidity is associated with cancers of the head and neck; as several vital structures are involved in physiological functions such as mastication, deglutition, speech and facial expression.

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One Lung Ventilation and its Anaesthetic Challenges in Laparo-Thoracospic Esophagectomy for Oesophageal Malignancies


The anaesthesiologist has an important role in the multidisciplinary management approach to oesophageal malignancies. Anaesthetists provide good perioperative care by means of a reduction in pain and stress,  and ventilation and fluid management strategies in these high-risk oesophageal surgeries. These malignancies require complex minimally invasive surgical and anaesthetic techniques to reduce morbidity and mortality during the perioperative period. Minimally invasive oesophageal cancer resection needs one lung ventilation anaesthesia. One lung ventilation(OLV) is always a technically challenging procedure even in experienced hands, especially in laparo-thoracospic esophagectomy.

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Endometrial Cancer

Endometrial cancer arise from the inner lining layer of the uterus. It is often detected at an early stage because it frequently produces abnormal vaginal bleeding and have good prognosis. If diagnosed early, complete cure is feasible with regular follow up. The treatment comprises SURGICAL STAGING with adjuvant RADIOTHERAPY with or without CHEMOTHERAPY depending on final SURGICO- PATHOLOGICAL STAGE.


The age standardized incidence rate (ASIR) of endometrial cancer in India is 2.3/100,000 women. The rise in endometrial cancer in India is mainly attributed to changing trends in the lifestyle and reproductive profile of women, especially in urban areas.

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Targeted Therapy for Cancer

Globally, cancer is a leading cause of death. Conventional chemotherapy has been the mainstay of cancer therapy. Chemotherapy inhibits rapidly dividing cells like cancer cells, but in this process, normal cells of the body like epithelial cells of the gut, bone marrow, skin, and hair follicles are also affected which are responsible for the adverse reactions of chemotherapy. Targeted therapies are drugs that block the growth and spread of cancer by interfering with specific molecules like genes or proteins (molecular targets) that are involved in the growth, progression, and spread of cancer. By focusing on specific molecular changes which are unique to particular cancer, targeted therapies are advantageous in terms of being more selective, enhanced response, fewer effects on normal cells, and consequently fewer adverse reactions.

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Breast Cancer Recurrence In Elderly Woman After 27 Years-Attempt To Cure The Second Time!!!


Carcinoma breast is the most common malignancy in women and a five year relative survival rate is high when all stages are combined, owing to successful screening programs and early detection. [1] About 74% of the newly diagnosed breast cancers are in stage I-III and are estrogen receptor positive. They tend to recur even at a later period. About 50% of the recurrences occur after five years of the initial diagnosis. The current National Comprehensive Cancer Network guidelines recommend considering adjuvant endocrine therapy for all invasive, ER-positive breast cancers unless specific contraindications exist.[2]

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A Case of Late Onset Dyspepsia

Mr J, 67 years old gentleman, presented with symptoms of post cibal abdominal bloating and burning discomfort along with feeling of heaviness in retrosternal region for past 3 weeks.

His past history was significant for left orchidectomy for Seminoma testis (35 years), Systemic hypertension, CKD, Hypothyroidism, Sinus node dysfunction-S/P PPI (2019).

Clinical examination revealed normal vitals, mild pallor, no significant adenopathy/icterus, normal systemic examination including abdomen.

Specifically, no mass /organomegaly/ free fluid noted in abdomen.

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Highlights at Kauvery

Registration fee: For the Course & Exam Rs.2,500/-
Date : 09ᵗʰApril 2022  to 02rd July 2022 (*AIternate Saturdays)
Time : 04.00 PM to 06.30 PM
Venue : Auditorium, 7ᵗʰ Floor, Kauvery Hospital,
No. 81, TTK Road, Alwarpet, Chennai – 600 018.

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