{"id":6714,"date":"2023-06-12T05:03:30","date_gmt":"2023-06-12T05:03:30","guid":{"rendered":"https:\/\/www.kauveryhospital.com\/ima-journal\/?page_id=6714"},"modified":"2025-04-09T09:29:59","modified_gmt":"2025-04-09T09:29:59","slug":"ima-journal-june-2023","status":"publish","type":"page","link":"https:\/\/www.kauveryhospital.com\/ima-journal\/ima-journal-june-2023\/","title":{"rendered":"IMA Journal &#8211; June 2023"},"content":{"rendered":"<p class=\"caps\">[vc_row][vc_column][vc_empty_space height=&#8221;35px&#8221;][vc_column_text]<\/p>\n<h1 class=\"ttc\" style=\"text-align: center; color: #c01c7b;\"><strong>IMA Journal &#8211; June 2023<\/strong><\/h1>\n<p>[\/vc_column_text][\/vc_column][\/vc_row][vc_row][vc_column][vc_custom_heading text=&#8221;Message from Team IMA Chennai Kauvery Alwarpet Branch&#8221; font_container=&#8221;tag:h2|text_align:center|color:%239a286d&#8221; google_fonts=&#8221;font_family:PT%20Sans%3Aregular%2Citalic%2C700%2C700italic|font_style:700%20bold%20regular%3A700%3Anormal&#8221;][vc_row_inner css=&#8221;.vc_custom_1618206149394{border-radius: 5px !important;}&#8221;][vc_column_inner el_class=&#8221;blog-col1&#8243; width=&#8221;1\/3&#8243;][vc_column_text]<img loading=\"lazy\" decoding=\"async\" class=\"alignleft wp-image-6621\" src=\"https:\/\/www.kauveryhospital.com\/ima-journal\/wp-content\/uploads\/2023\/05\/Dr-S-S-254x300.jpg\" alt=\"\" width=\"110\" height=\"130\" srcset=\"https:\/\/www.kauveryhospital.com\/ima-journal\/wp-content\/uploads\/2023\/05\/Dr-S-S-254x300.jpg 254w, https:\/\/www.kauveryhospital.com\/ima-journal\/wp-content\/uploads\/2023\/05\/Dr-S-S.jpg 561w\" sizes=\"auto, (max-width: 110px) 100vw, 110px\" \/><\/p>\n<p style=\"font-weight: 400;\">Dear colleagues,<\/p>\n<p>Greetings and Best wishes from IMA Chennai Kauvery Alwarpet branch.<\/p>\n<p>This month\u2019s articles are specially compiled by the Department close to my heart.<\/p>\n<p>The Department Internal Medicine is the pillar of strength in any institution and Medicine is the foundation of any clinician irrespective of their field .<\/p>\n<p>At Kauvery we are a proud Department with five DNB post graduates and the vast clinical exposure they get is evident with articles published. We extend our thanks them for their contributions.<\/p>\n<p style=\"font-weight: 400;\">Long Live IMA.<\/p>\n<p><em>Yours in IMA service,<\/em><br \/>\n<strong>Dr S Sivaram Kannan<\/strong><br \/>\nPresident[\/vc_column_text][\/vc_column_inner][vc_column_inner el_class=&#8221;blog-col1&#8243; width=&#8221;1\/3&#8243;][vc_column_text]<img loading=\"lazy\" decoding=\"async\" class=\"alignleft wp-image-6617\" src=\"https:\/\/www.kauveryhospital.com\/ima-journal\/wp-content\/uploads\/2023\/05\/Dr-B-R-150x150.jpg\" alt=\"\" width=\"110\" height=\"121\" srcset=\"https:\/\/www.kauveryhospital.com\/ima-journal\/wp-content\/uploads\/2023\/05\/Dr-B-R-274x300.jpg 274w, https:\/\/www.kauveryhospital.com\/ima-journal\/wp-content\/uploads\/2023\/05\/Dr-B-R.jpg 613w\" sizes=\"auto, (max-width: 110px) 100vw, 110px\" \/><\/p>\n<p>Kauvery hospital has been successfully running Medical DNB programmes for the last three years.<\/p>\n<p>This issue brings you articles written by these enthusiastic post-graduates who share their enriching clinical experience.<\/p>\n<p>Long live IMA.<\/p>\n<p>Yours in IMA service,<br \/>\n<strong>Dr. Bhuvaneshwari Rajendran<\/strong><br \/>\nSecretary.[\/vc_column_text][\/vc_column_inner][vc_column_inner el_class=&#8221;blog-col1&#8243; width=&#8221;1\/3&#8243;][vc_column_text]<img loading=\"lazy\" decoding=\"async\" class=\"alignleft wp-image-6619\" src=\"https:\/\/www.kauveryhospital.com\/ima-journal\/wp-content\/uploads\/2023\/05\/Dr.-R.-B-251x300.jpg\" alt=\"\" width=\"110\" height=\"132\" srcset=\"https:\/\/www.kauveryhospital.com\/ima-journal\/wp-content\/uploads\/2023\/05\/Dr.-R.-B-251x300.jpg 251w, https:\/\/www.kauveryhospital.com\/ima-journal\/wp-content\/uploads\/2023\/05\/Dr.-R.-B.jpg 562w\" sizes=\"auto, (max-width: 110px) 100vw, 110px\" \/><\/p>\n<p style=\"font-weight: 400;\">Dear friends<\/p>\n<p>Happy to present this month\u2019s IMA journal to you.<\/p>\n<p>The complete platter in this edition is from the department of Internal Medicine.<\/p>\n<p>We thank all our DNB post graduates for these wonderful presentations.<\/p>\n<p>Kauvery hospitals is proud to nurture such young doctors for their post graduate training who are the health pillars of our future society.<\/p>\n<p><em>With regards<\/em><br \/>\n<strong>Dr. R. Balasubramaniyam<\/strong><br \/>\nEditor[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][\/vc_column][\/vc_row][vc_row][vc_column][vc_row_inner][vc_column_inner][vc_empty_space][\/vc_column_inner][\/vc_row_inner][vc_row_inner el_class=&#8221;blog-col&#8221; css=&#8221;.vc_custom_1617009566389{border-radius: 5px !important;}&#8221;][vc_column_inner width=&#8221;1\/3&#8243;][vc_single_image image=&#8221;6829&#8243; img_size=&#8221;large&#8221; alignment=&#8221;center&#8221;][\/vc_column_inner][vc_column_inner width=&#8221;2\/3&#8243;][vc_custom_heading text=&#8221;A Case of Myocarditis \/ Inflammatory Cardiomyopathy&#8221; font_container=&#8221;tag:h2|text_align:left|color:%239a286d&#8221; google_fonts=&#8221;font_family:PT%20Sans%3Aregular%2Citalic%2C700%2C700italic|font_style:700%20bold%20regular%3A700%3Anormal&#8221;][vc_column_text]<\/p>\n<p style=\"text-align: justify;\">A 56-year-old male, known hypertensive on Tab. Amlodipine 5 mg OD, presented to our emergency department with history of cough with expectoration \u2013 mucoid whitish sputum for 2 days, bilateral leg swelling, scrotal swelling and abdominal distension for 2-3 days, decreased urine output for 2-3 days, shortness of breath (NYHA Grade 2 to 3) with orthopnea for 2-3 days. He had history of high grade intermittent fever for 3 days, 1 week back for which he took supportive medications (afebrile for 1 week). He had no history of chest pain, palpitation, syncope, sweating, giddiness, abdominal pain, vomiting, diarrhea, rhinitis, sore throat, myalgia, arthralgia, rashes at presentation or the preceding month. His pulse rate was 90\/min, blood pressure- 130\/90 mmHg, respiratory rate \u2013 22\/ min, SpO2- 99% in room air, temperature- 98F, capillary blood glucose \u2013 122 mg\/dl. On examination, he was conscious, oriented to time, place and person, afebrile.<\/p>\n<p><a class=\"read-more-link nm\" href=\"https:\/\/www.kauveryhospital.com\/ima-journal\/ima-journal-june-2023\/a-case-of-myocarditis-inflammatory-cardiomyopathy\/\">Read Full Article<\/a>[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_row_inner el_class=&#8221;blog-col&#8221; css=&#8221;.vc_custom_1617009566389{border-radius: 5px !important;}&#8221;][vc_column_inner width=&#8221;1\/3&#8243;][vc_single_image image=&#8221;6825&#8243; img_size=&#8221;large&#8221; alignment=&#8221;center&#8221;][\/vc_column_inner][vc_column_inner width=&#8221;2\/3&#8243;][vc_custom_heading text=&#8221;Case of Jejunal Diverticular Bleed&#8221; font_container=&#8221;tag:h2|text_align:left|color:%239a286d&#8221; google_fonts=&#8221;font_family:PT%20Sans%3Aregular%2Citalic%2C700%2C700italic|font_style:700%20bold%20regular%3A700%3Anormal&#8221;][vc_column_text]<\/p>\n<p style=\"text-align: justify;\">63 years old female known case of diabetes mellitus and systemic hypertension presented with complaints of abdominal pain, loose stools for 5 days. On examination BP \u2013 140\/80\/PR-86 bpm\/SPO2 \u2013 98 percent. Per abdomen examination showed tenderness in umbilical region, no guarding and rigidity. Other system examination were normal. Blood investigation showed elevated WBC counts [14500], CRP [53], RFT and LFT were normal. She was started on intravenous antibiotics and other supportive measures. In the view of persistent abdominal pain CT abdomen with oral contrast was done which showed multiple diverticulosis along the stomach, dueodenum, jejunum, ascending and descending colon. On third day of admission she developed per rectal bleeding which was massive\/painless and bright red in colour.<\/p>\n<p><a class=\"read-more-link nm\" href=\"https:\/\/www.kauveryhospital.com\/ima-journal\/ima-journal-june-2023\/case-of-jejunal-diverticular-bleed\/\">Read Full Article<\/a>[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_row_inner el_class=&#8221;blog-col&#8221; css=&#8221;.vc_custom_1617009566389{border-radius: 5px !important;}&#8221;][vc_column_inner width=&#8221;1\/3&#8243;][vc_single_image image=&#8221;6742&#8243; img_size=&#8221;large&#8221; alignment=&#8221;center&#8221;][\/vc_column_inner][vc_column_inner width=&#8221;2\/3&#8243;][vc_custom_heading text=&#8221;Young Adult with Pancytopenia&#8221; font_container=&#8221;tag:h2|text_align:left|color:%239a286d&#8221; google_fonts=&#8221;font_family:PT%20Sans%3Aregular%2Citalic%2C700%2C700italic|font_style:700%20bold%20regular%3A700%3Anormal&#8221;][vc_column_text]<\/p>\n<p style=\"text-align: justify;\">24 years old male came with complaints of shortness of breath, loss of weight (5 kg) and appetite, recurrent fever for the past 1 month. Patient had history of giddiness and palpitations for 1 month there was history of generalised fatiguability for 2 months. Family history revealed aplastic anemia\/ AML in elder sibling who died at the age of 14 years. There was history of leukemia in cousin who died at the age of 6 years. On examination, patient had tachycardia, pallor and hepatosplenomegaly. Basic blood investigations revealed \u2013 Hb:3 g\/dl, WBC: 1300\/cu.mm (N-40, L-50, M-10, B-0), platelet count: 92000\/ cu.mm. Serum LDH level was 405 U\/L. RBC indices, renal function tests, live function tests, coagulation profile, vitamin B12 levels, and urine routine were normal. ANA, direct coombs test, CMV IgM, Parvovirus B19 IgM, Hepatitis B and HIV serology were negative. Peripheral smear revealed pancytopenia with more than 20% blasts.<\/p>\n<p><a class=\"read-more-link nm\" href=\"https:\/\/www.kauveryhospital.com\/ima-journal\/ima-journal-june-2023\/young-adult-with-pancytopenia\/\">Read Full Article<\/a>[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_row_inner el_class=&#8221;blog-col&#8221; css=&#8221;.vc_custom_1617009566389{border-radius: 5px !important;}&#8221;][vc_column_inner width=&#8221;1\/3&#8243;][vc_single_image image=&#8221;6827&#8243; img_size=&#8221;large&#8221; alignment=&#8221;center&#8221;][\/vc_column_inner][vc_column_inner width=&#8221;2\/3&#8243;][vc_custom_heading text=&#8221;Disseminated Fungal and Becterial Septicemia&#8221; font_container=&#8221;tag:h2|text_align:left|color:%239a286d&#8221; google_fonts=&#8221;font_family:PT%20Sans%3Aregular%2Citalic%2C700%2C700italic|font_style:700%20bold%20regular%3A700%3Anormal&#8221;][vc_column_text]<\/p>\n<h2><strong>Case Report:<\/strong><\/h2>\n<p style=\"text-align: justify;\">A 63 year old male, a known case of type 2 Diabetes Mellitus, Systemic Hypertension and chronic IgG4 pancreatitis for past 3 years on oral steroids presented to ER with complaints of fever on &amp; off associated with productive cough with left eyelid drooping and loss of left eye vision since 10 days. He was diagnosed with IgG4 Pancreatitis on Oct 2020 and started on steroids. On arrival, patient was conscious, oriented, febrile, icteric, tachypneic and tachycardic with bilateral extensive crepitations on auscultation. On examination of left eye, eyelid was drooping and pupil not reactive with extraocular movements full. Patient was admitted in ICU with a provisional diagnosis of fungal pneumonia\/ ARDS. CT chest showed focal consolidation with central honeycomb\/ bird nest appearance in left UL anterior segment (Fig 1). Patient was started on Inj.<\/p>\n<p><a class=\"read-more-link nm\" href=\"https:\/\/www.kauveryhospital.com\/ima-journal\/ima-journal-june-2023\/disseminated-fungal-and-becterial-septicemia\/\">Read Full Article<\/a>[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_row_inner el_class=&#8221;blog-col&#8221; css=&#8221;.vc_custom_1617009566389{border-radius: 5px !important;}&#8221;][vc_column_inner width=&#8221;1\/3&#8243;][vc_single_image image=&#8221;6823&#8243; img_size=&#8221;large&#8221; alignment=&#8221;center&#8221;][\/vc_column_inner][vc_column_inner width=&#8221;2\/3&#8243;][vc_custom_heading text=&#8221;A Case Report of Sequential Post-Covid-19 Vaccine Autoimmune Syndromes (Hyperinflammatory Syndrome, Multifocal Avascular Necrosis, Undifferentiated Arthritis) in Non-Identical Twins \u2013 \u2018Opening Up of the Pandora\u2019s Box\u2019&#8221; font_container=&#8221;tag:h2|text_align:left|color:%239a286d&#8221; google_fonts=&#8221;font_family:PT%20Sans%3Aregular%2Citalic%2C700%2C700italic|font_style:700%20bold%20regular%3A700%3Anormal&#8221;][vc_column_text]<\/p>\n<p style=\"text-align: justify;\">The development of any untoward event following vaccination is considered as post vaccine adverse event, though it need not be a causal relationship. Autoimmune syndromes can occur post vaccination with molecular mimicry being the main hypothesis proposed. Similar events have been reported post Covid-19 vaccination and we hereby report a case of non-identical twins (19 year old girl and boy) with serial development of unrelated autoimmune syndromes post booster dose of Covid-19 vaccine (ChAdox1). Initially, four days after the administration of vaccine both developed high grade fever. They were admitted and evaluated for the same. They had pancytopenia with elevated inflammatory markers and all the infectious work up were negative.<\/p>\n<p><a class=\"read-more-link nm\" href=\"https:\/\/www.kauveryhospital.com\/ima-journal\/ima-journal-june-2023\/a-case-report-of-sequential-post-covid-19-vaccine-autoimmune-syndromes-hyperinflammatory-syndrome-multifocal-avascular-necrosis-undifferentiated-arthritis-in-non-identical-twins\/\">Read Full Article<\/a>[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_row_inner el_class=&#8221;blog-col&#8221; css=&#8221;.vc_custom_1617009566389{border-radius: 5px !important;}&#8221;][vc_column_inner width=&#8221;1\/3&#8243;][vc_single_image image=&#8221;6768&#8243; img_size=&#8221;large&#8221; alignment=&#8221;center&#8221;][\/vc_column_inner][vc_column_inner width=&#8221;2\/3&#8243;][vc_custom_heading text=&#8221;Highlights @ Kauvery&#8221; font_container=&#8221;tag:h2|text_align:left|color:%239a286d&#8221; google_fonts=&#8221;font_family:PT%20Sans%3Aregular%2Citalic%2C700%2C700italic|font_style:700%20bold%20regular%3A700%3Anormal&#8221;][vc_column_text]Dr Vishnu our DNB Resident of Nephrology department presented an interesting case of false positive Cross match in an ABO Incompatible Renal Transplant patient from Kauvery hospital in the National Conference organised by Madras Medical Mission Immunology Update. It went well and was appreciated by all the national faculty.<\/p>\n<p><a class=\"read-more-link nm\" href=\"https:\/\/www.kauveryhospital.com\/ima-journal\/ima-journal-june-2023\/highlights-at-kauvery-june-23\/\">Read Full Article<\/a>[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_row_inner el_class=&#8221;blog-col&#8221; css=&#8221;.vc_custom_1617009566389{border-radius: 5px !important;}&#8221;][vc_column_inner width=&#8221;1\/3&#8243;][vc_single_image image=&#8221;6365&#8243; img_size=&#8221;large&#8221; alignment=&#8221;center&#8221;][\/vc_column_inner][vc_column_inner width=&#8221;2\/3&#8243;][vc_custom_heading text=&#8221;Quiz Of The Month&#8221; font_container=&#8221;tag:h2|text_align:left|color:%239a286d&#8221; google_fonts=&#8221;font_family:PT%20Sans%3Aregular%2Citalic%2C700%2C700italic|font_style:700%20bold%20regular%3A700%3Anormal&#8221;][vc_column_text]A 27-year-old female,known case of endometriosis,came with swelling in right inguinal region<\/p>\n<p><strong>Ultrasound<\/strong><\/p>\n<p>There is a well-defined hypoechoic tubular fluid-filled structure measuring ~\u00a0\u00a06.6 x 1.4 cms in the right groin extending laterally along the inguinolabial region. No solid component\/ septations noted within the lesion.<\/p>\n<p><a class=\"read-more-link nm\" href=\"https:\/\/www.kauveryhospital.com\/ima-journal\/ima-journal-june-2023\/quiz-of-the-month-june23\/\">Read Full Article<\/a>[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][\/vc_column][\/vc_row]<\/p>\n","protected":false},"excerpt":{"rendered":"<p>[vc_row][vc_column][vc_empty_space height=&#8221;35px&#8221;][vc_column_text] IMA Journal &#8211; June 2023 [\/vc_column_text][\/vc_column][\/vc_row][vc_row][vc_column][vc_custom_heading text=&#8221;Message from Team IMA Chennai Kauvery Alwarpet Branch&#8221; font_container=&#8221;tag:h2|text_align:center|color:%239a286d&#8221; google_fonts=&#8221;font_family:PT%20Sans%3Aregular%2Citalic%2C700%2C700italic|font_style:700%20bold%20regular%3A700%3Anormal&#8221;][vc_row_inner css=&#8221;.vc_custom_1618206149394{border-radius: 5px !important;}&#8221;][vc_column_inner el_class=&#8221;blog-col1&#8243; width=&#8221;1\/3&#8243;][vc_column_text] Dear colleagues, Greetings and Best wishes from<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-6714","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v24.0 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>IMA Journal - June 2023<\/title>\n<meta name=\"description\" content=\"IMA is bringing out another power packed issue with interesting and thought provoking articles.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.kauveryhospital.com\/ima-journal\/ima-journal-june-2023\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"IMA Journal - June 2023\" \/>\n<meta property=\"og:description\" content=\"IMA is bringing out another power packed issue with interesting and thought provoking articles.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.kauveryhospital.com\/ima-journal\/ima-journal-june-2023\/\" \/>\n<meta property=\"og:site_name\" content=\"Kauvery Hospital | Patient Newsletters | A Monthly Newsletter from your Partners in Good Health\" \/>\n<meta property=\"article:modified_time\" content=\"2025-04-09T09:29:59+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.kauveryhospital.com\/ima-journal\/wp-content\/uploads\/2021\/07\/kh-logo.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"250\" \/>\n\t<meta property=\"og:image:height\" content=\"210\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"7 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/www.kauveryhospital.com\/ima-journal\/ima-journal-june-2023\/\",\"url\":\"https:\/\/www.kauveryhospital.com\/ima-journal\/ima-journal-june-2023\/\",\"name\":\"IMA Journal - June 2023\",\"isPartOf\":{\"@id\":\"https:\/\/www.kauveryhospital.com\/ima-journal\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\/\/www.kauveryhospital.com\/ima-journal\/ima-journal-june-2023\/#primaryimage\"},\"image\":{\"@id\":\"https:\/\/www.kauveryhospital.com\/ima-journal\/ima-journal-june-2023\/#primaryimage\"},\"thumbnailUrl\":\"https:\/\/www.kauveryhospital.com\/ima-journal\/wp-content\/uploads\/2023\/05\/Dr-S-S-254x300.jpg\",\"datePublished\":\"2023-06-12T05:03:30+00:00\",\"dateModified\":\"2025-04-09T09:29:59+00:00\",\"description\":\"IMA is bringing out another power packed issue with interesting and thought provoking articles.\",\"breadcrumb\":{\"@id\":\"https:\/\/www.kauveryhospital.com\/ima-journal\/ima-journal-june-2023\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/www.kauveryhospital.com\/ima-journal\/ima-journal-june-2023\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\/\/www.kauveryhospital.com\/ima-journal\/ima-journal-june-2023\/#primaryimage\",\"url\":\"https:\/\/www.kauveryhospital.com\/ima-journal\/wp-content\/uploads\/2023\/05\/Dr-S-S.jpg\",\"contentUrl\":\"https:\/\/www.kauveryhospital.com\/ima-journal\/wp-content\/uploads\/2023\/05\/Dr-S-S.jpg\",\"width\":561,\"height\":663},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/www.kauveryhospital.com\/ima-journal\/ima-journal-june-2023\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/www.kauveryhospital.com\/ima-journal\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"IMA Journal &#8211; 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