Dear Colleagues,
Welcome to the October issue of IMA Kauvery Newsletter.
As we celebrate Navarathri and the festive spirit of this season, I extend my warm wishes to you and your families for health, knowledge and prosperity.
May this auspicious time bring renewed hope, positivity and strength to all of us in our shared journey of healing and service.
This issue features practical updates in Nephrology, General Medicine and Anaesthesia, curated to be relevant for your daily practice.
My sincere thanks to , all authors, reviewers and our executive committee for their efforts.
Wishing you and your loved ones a joyful and healthy festive season.
Yours in IMA service, Dr S Sivaram Kannan President
Greetings from IMA Kauvery!
As we welcome October and celebrate Navarathri, I extend my heartfelt wishes to each of you and your families.
This festival reminds us of the triumph of knowledge over ignorance and strength over challenges — values that resonate deeply with our profession.
In this issue, we bring you focused and practice-oriented insights in Nephrology, General Medicine and Anaesthesia — designed to add value to your clinical work.
I thank all our authors and team members for their dedicated efforts in shaping this edition.
May this season bring you good health, peace and continued inspiration in service.
Yours in IMA service, Dr. Bhuvaneshwari Rajendran Secretary
Welcome to the October issue of IMA Kaveri Newsletter.
On the auspicious occasion of Navarathri, I extend my warm wishes to you and your families. May these nine days of strength, wisdom and compassion inspire us in our mission of healing and service.
This issue features practical updates in Nephrology, General Medicine and Anaesthesia. I hope you find it useful for your clinical practice.
Thank you to all authors, reviewers and the executive committee for their support.
Wishing you a happy and healthy Navarathri!
With regards Dr. R. Balasubramaniyam Editor
Abstract
A 23-year-old woman presented with high-grade fever associated with chills and rigors for two days, along with dysuria, left-sided flank pain radiating from the loin to the groin, nausea, and vomiting. In a young adult presenting with an acute febrile illness, the initial differential diagnosis included dengue, malaria, scrub typhus, leptospirosis, enteric fever, and lower respiratory tract infection (LRTI), in addition to urinary tract infection (UTI). The presence of dysuria and characteristic unilateral flank pain subsequently provided a localising clue towards the urinary tract. She was diagnosed with Escherichia coli pyelonephritis associated with an obstructing left vesicoureteric junction (VUJ) calculus and a congenital duplicated left ureter. Empirical antimicrobial therapy with cefoperazone-sulbactam (Magnex) was initiated initially. Urine culture and sensitivity subsequently demonstrated extended-spectrum beta-lactamase
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Case Report
A 58-year-old post-menopausal woman with a 10-year history of systemic hypertension presented with intermittent left shoulder pain and progressive dyspnea (NYHA class IV) for 3 days. There was no fever, palpitations, pedal edema, cough, or oliguria. A significant recent emotional stressor in the form of bereavement was noted.
ABSTRACT
Acute Type A aortic dissection is a time-critical cardiovascular emergency with a broad clinical spectrum. Although sudden severe chest or back pain is the classical presentation, neurological or malperfusion symptoms may be the initial manifestation and can lead clinicians toward alternative diagnoses. We report the case of an 82-year-old man, a known case of hypertension, who presented to the Emergency Department with sudden-onset bilateral lower-limb numbness after a sequence of stretching, walking, generalized discomfort and subsequent rest. On arrival he was profoundly hypotensive with a blood pressure of 70/40 mmHg, while remaining conscious with a Glasgow Coma Scale score of 15/15.
Mixed Antibody-Mediated and Chronic Active T-Cell-Mediated Rejection • Case Summary
What must be correlated
DSA, tacrolimus/cyclosporine lsvsJs, immunosuppression adherence, BK-virus PCR, prior biopsy findings and the renal function trajectory. C4d alone should not be treated as sufficient for definitive ABMR classification.
Abstract:
Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis can present with diverse pulmonary manifestations and may closely mimic severe respiratory infection. Interstitial lung disease (ILD), particularly a fibrotic pattern, is increasingly recognized in association with myeloperoxidase (MPO)-ANCA–positive vasculitis. Early recognition of the pulmonary–renal syndrome is crucial to prevent irreversible kidney injury.
