Advances in sepsis: Lecture summary Dr Abby Cyriac

Dr.Rajeev (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.

UNUSUAL CAUSE FOR PERIANAL PAIN

Dr.Seenaj (Medicine, )

49 years old lady known case of Idiopathic Thrombocytic purpura on regular follow up complained about vague pain and discomfort in the perianal area associated with constipation for the last 3 days. She also said about the feeling of something being present inside the anal region. Even though the examination was normal she was taken up for a lower GI scopy and a foreign body was removed. There was absolutely no history of trauma

Conference Summary: National Pulmonology conference NAPCON

Dr.Rajeev (Gastroenterology, General Practice / Family Medicine, )

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.

Cold case in hot environment

Dr.Akash (Medicine, )

Soldier posted in Srinagar came with B/L LL edema of 2 days and numbness itching pain redness. H/o trekking in snow with boots and socks drenched in cold water.O/E there was local swelling warmth tenderness decreased touch pain temperature with normal pulses.Labs revealed elevated CRP AST>ALT, CK. He was started on IV antibiotics, IV fluids, NSAIDS .TT was given.He showed improvement in clinical and lab parameters. With the history labs Trench foot was considered .It is caused by prolonged exposure to wet cold but non freezing condition (0-15C). It is a clinical diagnosis

Paraneoplastic syndromes-a diagnostic dilemma

Dr.Shyamala (Medicine, )

71 year old Male, a reformed smoker since 10 years,presented with repeated admissions for symptomatic hyponatremia to different centers. He had been investigated for common causes including endocrine conditions. At admission,Na +was 104.During examination, patient was noted to have clubbing. Chest xray was not helpful.but a CT thorax revealed the hidden culprit-a malignant lesion in the left lung.The case has been handed over to the oncologist

Paraneoplastic syndromes-a diagnostic dilemma

Dr.Shyamala (Medicine, )

71 year old Male, a reformed smoker since 10 years,presented with repeated admissions for symptomatic hyponatremia to different centers. He had been investigated for common causes including endocrine conditions. At admission,Na +was 104.During examination, patient was noted to have clubbing. Chest xray was not helpful.but a CT thorax revealed the hidden culprit-a malignant lesion in the left lung.The case has been handed over to the oncologist

Hyponatremia - keep endocrine causes in mind during evaluation

Dr.Mini (Endocrinology, )

A 60 year old male presented with the third episode of symptomatic hyponatremia within a span of 10 months. Prior to the first episode , he had been on hydrochlorothiazide - losartan combination for hypertension and this was subsequently changed to Telmisartan-Cilnidipin combination. TSH was 1.09. During the current episode, TSH was 1.48 and T4 was 4.03(low) suggestive of secondary hypothyroidism. An MR imaging showed a pituitary macroadenoma with suprasellar and bilateral parasellar extension.

Fistulated Colonic carcinoma

Dr.Kanakambaran (General Surgery, )

A case of carcinoma of sigmoid colon fistulating into jejunum diagnosed by Be Enema is presented. The contrast from large bowel which has imged the jejunum suggestive of fistula which can be due to Crohn's disease, tuberculosis or malignancy. Here since filling defect is suspected in the colon possibility of carcinoma colon fistulating into jejunum was considered, proved by laparotomy. Another condition when jejunum is imaged by Ba Enema happens, in one of the very rare complications of the most popular operation for chronic duodenal ulcer upto 1980s-- GASTRO JEJUNO COLIC FISTULA.