IMA Journal – November 2021

Message from Team IMA Chennai Kauvery Alwarpet Branch

Dear colleagues

Greetings and best wishes from IMA Chennai Kauvery Branch.

On behalf of our branch I wish to Congratulate Dr. NRTR Thiagarajan, Dr. Senthamil Pari and Dr. Abul Hassan and other newly elected state office bearers.

I wish them all a successful tenure and assure our fullest cooperation.

Long live IMA

Yours in IMA service,
Dr S Sivaram Kannan

The month of November is our monsoon season and this year we saw very heavy downpour with flooding in many areas.

These events make us question our responsibilities towards environment and the imminent climate change and its impact on our daily lives.

The world conference on climate change -COP26 took place in Glasgow this month with countries taking a pledge to reduce fossil fuel use and cut down CO2 emissions. Every citizen needs to be aware of climate change and act responsibly.

Enjoy this month’s IMA issue.

Long live IMA.

Yours in IMA service,
Dr. Bhuvaneshwari Rajendran

Dear friends

Happy to meet you all through the next edition of our IMA journal.

My sincere thanks to all consultants, post graduates and our Editorial team for getting this edition on time.

It is amazing to see the high end clinical activity that happens through every department in our hospital.

Stay safe during these rainy days.

Long live IMA.

With regards
Dr. R. Balasubramaniyam

Overactive Bladder (OAB) - Beyond the Basics

As the subtle hues of pink which shade the month of October aid in helping us remember our dues to the fairer sex, among these are the urological afflictions commonly affecting women. The common misconception is that urological issues arise only in men. Women, in fact, in addition to most of the common conditions, have a few ailments that trouble them more (as with almost all conditions, certain gender predilections are known). Among them are urinary tract infections and overactive bladders. While it is known that women bear the unfortunate onslaught of urinary infections more than men, overactive bladders have come to become more prominent in the last few years.
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Evaluation of Postoperative Medical Management of Osteoporosis in Patients with Vertebral Compression Fracture

Background Information:

Osteoporotic vertebral fracture (OVF), a common condition in the geriatric population presents with a broad spectrum of symptoms from mild discomfort to disabling pain. Likewise, the treatment options are also aplenty depending on the clinic-radiological features. Medical management of osteoporosis is mandatory after any kind of surgical management of OVF to prevent further fractures in the spine as well as the appendiceal skeleton. Even in conservatively managed patients, medical management of osteoporosis is pivotal in improving the outcome.
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Catheter Guided Thrombolysis in Acute Deep Vein Thrombosis

Venous thromboembolism includes Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE) and is a common occurrence at about 1 per 1000 adults per year. With the current pandemic, though accurate data is not available, there seems to be a rise in the number of cases. Complications include life threatening PE and long term complications like post phlebitis sequelae. Early diagnosis, prompt management, and the introduction and use of newer treatment modalities like clot aspiration and lysis techniques, as and when indicated, can prevent long term complications and improve the long term quality of life.

Case History

A 35-year-old gentleman presented to the emergency with pain and swelling of the left leg for the past six days.

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Otomastoiditis With Petrous Apicitis & Cavernous Sinus Thrombosis


A 3 year old boy presented with fever, swelling of the right eye and altered sensorium.


T2 hyper and T1 hypointense fluid intensity signals were seen within the right mastoid air cells and middle ear cavity along with patchy areas of T2 hyperintensity involving the right petrous apex. Foci of restricted diffusion with low ADC values in the right parasellar region and the region of the right cavernous sinus. Subtle foci of T2 and flair hyperintensity around the right ICA cavernous segment with bulging of the lateral wall of the right cavernous sinus.
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Genicular nerve Radio frequency ablation - A novel approach for chronic OA knee pain

Introduction :

Knee osteoarthritis is one of the leading causes of pain and disability among aged people. As age advances the morbidity was further scaled up with other associated comorbid conditions. Hence early steps to alleviate the knee pain could benefit the functional improvements and quality of life in those patients. The various non-surgical treatment available for symptomatic knee OA includes weight loss management, physical and aquatic therapy, bracing, non-steroidal anti-inflammatory drugs, intra articular cortisone, hyaluronic acid, PRP injections and finally genicular RF ablation (GNRFA).
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Recurrent Atrial Fibrillation In Pregnancy - Case Report


Atrial fibrillation (AF) is the most dreaded complication of Mitral Stenosis which is commonly caused by Rheumatic heart disease. The great clinical challenge of managing women with recurrent AF during pregnancy and continuing pregnancy till the third trimester with good fetal salvageability involves the multi-disciplinary team in a tertiary care centre.


Mrs.X, 32 years k/c of Mitral Stenosis caused by Rh Heart Disease underwent Mitral Commisurotomy in 2012.

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Rare Case Of Intracranial Hemorrhage - Emergency Management


A 53 years gentleman, with known rheumatoid arthritis presented to the ER with complaints of:

  • Sudden onset of right upper limb weakness and right lower limb weakness after intense activity.
  • A history of clenching of teeth for approximately 3 seconds followed by drowsiness.
  • A history of 2 episodes of vomiting containing food particles, non-bilious and non-bloodstained.

There was no associated history of headache, visual disturbances or trauma.
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