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IMA Journal – July 2025
Message from Team IMA Chennai Kauvery Alwarpet Branch
Dear Colleagues,
Greetings from IMA Chennai Kauvery Alwarpet Branch !
As we step into July, our hearts are filled with pride and gratitude as we celebrate Doctor’s Day—a day to honour the compassion, dedication, and resilience that define our noble profession. Let us take this moment to appreciate each other and recommit ourselves to the values that make medicine not just a career, but a lifelong calling.
This month’s journal features insightful articles contributed by our colleagues. My heartfelt thanks to all of them for their valuable contributions.
I encourage all members to take time to read, reflect, and share feedback.
Yours in IMA service,
Dr S Sivaram Kannan
President
Dear IMA members,
Kauvery IMA always strives to keep the quest for knowledge alive and kicking.
This month, we have a magazine with articles from various specialities to do just that.
Enjoy.
Long live IMA.
Yours in IMA service,
Dr. Bhuvaneshwari Rajendran
Secretary
Dear friends,
Our next edition of IMA Journal is with you now.
Kauvery hospital Alwarpet is doing scientifically advanced patient care across specialities.
We bring it to you every month some of those interesting patient management stories.
Kindly go through and give your feedback and suggestions.
Thankful to all authors and to our branding team.
With regards
Dr. R. Balasubramaniyam
Editor
RENAL ARTERY STENOSIS
CASE HISTORY:
An elderly gentleman on maintenance hemodialysis since 3-4 years, was admitted last week with complaints of breathing difficulty. He was admitted in ICU and treated with NIV support and dialysis, after which he settled. His cardiac function was evaluated and found to have LV dysfunction.
A Case of Tertiary Hyperparathyroidism Presenting as Brown Tumors
Case Summary:
Mrs. X, a 33-year-old woman, developed systemic hypertension and proteinuria during the third trimester of her pregnancy in 2014. She delivered preterm via LSCS and continued to have elevated creatinine (2.0 mg/dL). Renal biopsy revealed mesangial proliferative glomerulonephritis with chronicity.
Pyrexia Of Unknown Origin: Fever Not Always = Infection
Case Presentation:
A 67-year-old male presented with persistent fever for 2 weeks and fatigue. He had a history of fistula in ano, post-fistulectomy three weeks prior, with preoperative Hb of 11 g/dL. One week post-surgery, he developed intermittent fevers, and outside investigations revealed pancytopenia. There were no localizing symptoms. No h/o intake of drugs causing pancytopenia.
Palpitation In A Post Renal Transplant Scenario
History:
Mr N, 46 years old gentle man with End Stage Renal Disease, due to chronic hypertension underwent live related renal transplantation on 1.12.2023. His renal donor was his wife. It was a blood group incompatible transplantation. His blood group was O and his wife’s blood group was A. He underwent pre transplantation desensitization that included Rituximab, plasmapheresis and conventional triple immuno suppression comprising of Tacrolimus, Mycophenolate and steroids.
Acute Limb Ischemia – Time Is Money
Introduction
Acute limb ischemia (ALI) is one of the medical emergencies where time literally is money. Prompt diagnosis and intervention within the golden hours (6-8) before the tissues become irreversibly damaged ensure the best outcome for the patient.
In most cases, the symptoms of ALI are severe and the signs characteristic. However, failure to do a proper clinical examination or elicit relevant history may cause missed diagnoses of ALI.
Management of a patient with paraquat poisoning – A case report
Abstract
Paraquat is a widely used herbicide known for its high toxicity and limited antidotal options. Accidental or intentional ingestion can lead to multiorgan failure and death, primarily due to pulmonary fibrosis. This case report presents a young adult male admitted to our ICU with acute Paraquat poisoning.
Case of evanescent ureterocele: cyst within a cyst.
Introduction:
Evanescent ureterocele refers to a transient or intermittently visible ureterocele, which may collapse or disappear spontaneously- either on its own or during voiding. It can be missed if not imaged at the right time or under dynamic conditions. It appears as a transient filling in the bladder during ureteral jet activity.
