Warm greetings to all.
On the auspicious occasion of Tamil New Year, I extend my heartfelt wishes to you and your families. May this new year bring renewed hope, good health, and continued success in our professional journey.
The excitement of the Indian Premier League reminds us of teamwork and excellence. We take pride in Kauvery Hospital’s association with the Chennai Super Kings, reflecting shared values of performance and commitment.
As our branch continues its academic initiatives, I encourage all members to actively participate and stay updated.
Wishing you all a prosperous year ahead.
Yours in IMA service, Dr S Sivaram Kannan President
Dear Colleagues
April is when summer starts.
It’s holiday time and when students and adults move to the next level in academics in school, college, or work.
Kauvery IMA shares a set of real patient case studies to help doctors and medical students keep learning in continuity and get better at their clinical skills.
Learning and being updated with evidence-based medicine is always the aim of IMA.
Yours in IMA service, Dr. Bhuvaneshwari Rajendran Secretary
Respected IMA Members
IMA wishes everyone a very happy Chithirai Thirunaal and Tamil New Year’s Day.
The new year begins with a wonderful hope of good health and prosperity. IMA wishes everybody good health, and we thank the departments for giving such insightful case studies which enhance the knowledge and skills of our students.
Health is our wealth and having a vision of how to stay healthy is very important these days. Through continuous education, it’s like an eye-opener. As they say, what the eyes see, the mind should also know. Otherwise, it doesn’t really help in the medical field.
So, if the mind knows what the eyes see, then the diagnosis is easier.
Wishing everybody a good, healthy, and prosperous life.
Happy Chithirai, Happy Tamil New Year’s Day.
With regards Dr. R. Balasubramaniyam Editor
Abstract
Acute rejection remains a formidable impediment to long-term renal allograft survival despite significant therapeutic advancements. We report a case of a 36-year-old female, post ABO-compatible living-related renal transplantation, who presented with insidious graft dysfunction. Histopathological evaluation revealed features consistent with acute T-cell mediated rejection (TCMR) Grade 1B, accompanied by moderate acute tubular injury. The patient was managed with pulse corticosteroids followed by anti-thymocyte globulin (ATG). This case underscores the deceptive subtlety of clinical presentation and emphasizes the indispensable role of early biopsy and prompt immunosuppressive escalation in preserving graft integrity.
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6 years old male child, who was apparently normal a month back, developed progressive tiredness and breathlessness. He was treated locally and as he did not improve, evaluated and found to be in severe renal failure hence referred to us.
Initial lab parameters revealed severe azotemia (Urea – 326 mg%, creatinine 7.59 mg/dl) with severe anemia (Hb 4.2 g/dl). His platelets were low (49,000 /mm3) and LDH was high 6132 u / l. He was initiated on dialysis immediately and further evaluation was carried on.
Diabetic kidney disease (DKD) is the leading cause of chronic kidney disease (CKD) and end-stage kidney disease worldwide, affecting nearly 30–40% of patients with diabetes mellitus. The term DKD is broader than “diabetic nephropathy (DN)”: DN refers specifically to the classic histopathologic lesion complex attributable to diabetes on renal biopsy, whereas DKD includes any chronic kidney disease occurring in a diabetic patient, whether or not biopsy-proven classical diabetic lesions are present. This distinction is increasingly important because many diabetic patients have reduced eGFR without albuminuria, mixed lesions, or superimposed non-diabetic kidney disease (NDKD).
INTRODUCTION
Antibody-mediated rejection (ABMR) is a major cause of graft dysfunction and loss in renal transplantation. It is characterized by donor-specific antibodies (DSAs), complement activation, and microvascular injury. Despite advances in immunosuppression, ABMR remains difficult to treat and is associated with poor long-term outcomes.
Meliodosis is bacterial infection caused by gram negative bacillus called Burkholderia pseudomallei. It is endemic in tropical and subtropical regions of world. Clinical manifestations can vary which include pneumonia, abscess, joint infection, non-healing ulcer and sometimes severe sepsis requiring ICU admission. This article narrates our encounter with a neuromeliodosis which presents as acute transverse myelitis.
