Name: Dr.Rajeev Jayadevan
Hospital: Sunrise Hospital Cochin Kerala
Specialties: Gastroenterology, General Practice / Family Medicine
The concept of sepsis has changed considerably over the years. Newer methods of diagnosis and prognostic markers are discussed in this lecture by Dr Abby Cyriac focusing on sepsis especially in the cirrhotic patient. Click on images for highlights. This is part of Cochin IMA’s lecture summary series that will help other doctors enjoy the content of CME programs.
As part of Cochin IMA’s academic initiative, the summary of medical conferences will be published on JCP-IMA. As the abstract exceeds 600 characters, it is being published as an image. This abstract is from NAPCON 2019, the recently concluded National Pulmonology Conference Cochin. Click on images to view the summary.
As part of Cochin IMA’s academic initiative, the summary of medical conferences will be published on JCP-IMA. As the abstract exceeds 600 characters, it is being published as an image. This abstract is from CA Cervix prevention CME by Amrita Medical College on 13.12.19. A version for the general public also is published on IMAlive. Click on images to view the summary.
A 27 year-old woman with acne came with painful swallowing of ten days duration, not responding to Ranitidine prescribed by her GP. The pain was located in the mid chest. She denied medication intake. Upper GI endoscopy revealed a tiny 3 mm ulcer in the mid Esophagus. It was difficult to detect, and required careful examination. On later questioning the patient recalled taking Doxycycline recently for acne after consulting a dermatologist.
As part of Cochin IMA’s academic initiative, the summary of CME programs will be published on JCP-IMA. As the abstract exceeds 600 characters, it is being published as an image. This abstract is from Cochin IMA monthly CME: Uro- Oncology by Dr Ginil Kumar from 27.11.19
As part of Cochin IMA’s academic initiative, the summary of CME programs will be published on JCP-IMA. As the abstract exceeds 600 characters, it is being published as an image. This abstract is from Cochin IMA monthly CME: Gynae Oncology by Dr Anupama Rajanbabu from 27.11.19
A 36 year old man came to Gastroenterology outpatient clinic today with three year history of upper abdominal pain, having sought multiple opinions and investigations. The pain was quite severe, intermittent, band-like and disabling. Examination revealed a few healed scars along the costal margin. On asking, he revealed a history of chicken pox in childhood, and a bout of herpes zoster 3 years ago. No tests were ordered today. He was started on Pregabalin for post herpetic neuralgia.
Several high-quality academic conferences are being held. However, the benefits are largely restricted to those who attend. The general public and other doctors rarely receive the scientific updates presented at the conference. To rectify this knowledge gap, IMA Cochin has taken the initiative to obtain a plain English summary for each academic conference. This will be circulated among doctors. See attached images.
A 70 year old man who was on long-term repeat prescription of Fexofenadine (Allegra) for nasal allergy was seen at medical OP clinic by Dr M. The treatment line he followed was to alleviate symptoms, and reduce the medication burden. The patient was counselled to do steam inhalations regularly, and to use Pheniramine (Avil) only on PRN basis. The patient, although sceptical at first, was able to soon discontinue his long-term medications, and wrote to the chairman of the institute praising the doctor’s approach. The patient remarked that doctors seldom try to reduce the number of medications.
A 46-year-old man with ulcerative colitis of 10 year duration came in for surveillance colonoscopy. He had discontinued medication mesalamine and azathioprine on his own, for no apparent reason for the past six months. Even though he had no symptoms now, his surveillance colonoscopy revealed active left-sided colitis with rectal sparing. Right colon was normal (see photos) His previous colonoscopy a year ago had been normal. He was restarted on medications, and counselled again about compliance with treatment.
Two patients, 38F and 48 M, were seen within the past two weeks and diagnosed with gastric and duodenal ulcers respectively. Both of them gave a history of pain occurring around 2-3 AM. Epigastric pain is a common problem, and ulcer is a frequently suspected diagnosis. However, most patients with epigastric pain do not have ulcer. It is therefore important to know the types of pain that indicate the presence of an underlying ulcer. None of the patients with daytime epigastric pain seen in the past month had ulcer on endoscopy. However, both the patients with 2-3 AM pain had ulcer.
An 82-year-old man presented it to gastroenterology OP clinic with bloating and hiccups following a physically strenuous trip to a place of worship the day prior. He had no coronary risk factors. Sinus tachycardia of 100 with ectopic beats, and a systolic murmur were found. He was suspected to have ischaemic heart disease and referred to cardiology immediately. He was diagnosed with acute coronary syndrome, NSTEMI with acute left heart failure. Troponin-I was elevated at 200.4. He was treated with diuretics, heparin and antiplatelet treatment, on which he improved rapidly.
A 28 year old woman presented with recurrent vomiting of several years duration. There were no other gastrointestinal symptoms. She had no neurological symptoms. There were no allergies. Her blood tests showed a TSH of 75 and a low T4 of 2.98. She was started on Thyroxine.
A 39 year old woman, a resident of Canada presented recently in India with fecal and flatus incontinence after she was given Botox 20 U x 2 doses in 1 year ago in Canada. It was done for an anal fissure. She had apparently had a normal colonoscopy prior. There are no signs of spontaneous improvement yet. This complication has affected her ability to work and overall quality of life.