TL 2022 Vol 3 issue 1 Jan - Feb 2022

TRENDSLETTER

Official Newsletter of INDIAN MEDICAL ASSOCIATION, TAMBARAM

PUBLISHED BY IMA TBM COPYRIGHT OF IMA ISSUE 1: MAY 2020
TAMBARAM

PUBLISHED BY IMA TBM COPYRIGHT OF IMA TBM Volume 3: Issue1: Jan – Feb 2022

INDIAN MEDICAL ASSOCIATION

TAMBARAM BRANCH

IMA TNSB BUILDING, DOCTORS COLONY,
BHARATHI NAGAR 1ST MAIN ROAD,
TAMBARAM, CHENNAI – 600045

CELL: 99410 10375
Email :[email protected]

IMA PRAYER
May everybody be happy
May everybody be healthy
May everybody be free from pain
May everybody be free from sorrow
May we be the healing cure beyond every greed & lure

IMA TAMBARAM OFFICE BEARERS – (2021 – 2022)

List of Working Committee members IMA Tambaram – 2022

Post Name Cell No

Branch President Dr. Umaiyal Murugesan 9444152485
Hony. Secretary Dr. Sai Meenakshi T N 9444005337
Hony. Treasurer Dr. Jamuna Rani S 9884060903

Vice President Vice Presidents 8754584641
Dr. Kavitha Lakshmi K
Vice President 9444117868
Vice President Dr. Kayal Subburam T 9841817700
Dr. Rukmani Mohankumar

Joint Secretary Dr. Ejilarassy V (North) 9443345149
Joint Secretary Dr. Arul Anne Rose (East) 9952961051
Joint Secretary Dr. Bhuvaneswari G (West) 9444257341
Joint Secretary Dr. Shobana Priya K (South) 9176428240

AMS Chairman AMS Wing 9840248776
AMS Secretary Dr. Hariharan V S 9884444346
Dr. Shakthesh K 8754485354
9176630021
Dr. Jaletha Helan (East) 9943618065

Dr. Sangeetha Raja (South) 9841021564

Dr. S. Vijayalakshmi (GM)
(West)

Dr. Jaya Nandhini (North)

NHB Wing Chairman NHB Wing 9444046115
NHB Wing Secretary Dr. Saravanakumar S 8190000918
Dr. Nandakumar C 9003172262

Dr. Shanthi Gunasekaran 9840016650
(West) 9941480008

Dr. S.R. Subasri (North) 9381000111

Dr. Karthik PandianDeepam
(South)

Dr. Diviney Mary Chandra
(East)

WDW Chairperson WDW Wing 9444409849
WDW Secretary Dr. Kiruthika Devi R S 9940411917
Dr. Sri Sudha K 9382133175

Dr. S. Vijayalakshmi - 9176485500
9444140971
Poonamalee (North)

Dr. Quartzita Melofer (South)

Dr. S. Varalakshmi (East)

CGP Wing Chairperson CGP Wing 8754433175
CGP Wing Secretary Dr. Premalatha T 9841263838
Dr. Kenga Devi P
Dr. N. Mythili (North) 9790807808

INDIAN MEDICAL ASSOCIATION, TAMBARAM Page 3

AQC Chairperson Dr. Maheswari 9840784569
AQC Secretary 9445252751
Dr. Manimegalai R S
Anti Quackery Committee 9380661233
8056273531
Dr. S. Karpagavalli 6383861824
Dr. Karthik, SK Clinic

Dr. Chitraleka (West)

Fine Arts Committee Chairperson Fine Arts Committee 9840166947
Dr. V. Padma 9952982102
Dr. Pavithra R (West) 9791938792
Dr. Sri Nandini (East) 9940043046
Dr. Suhashini Karnal C (North) 9962393389
Dr. Kala P

Sports & Fitness Committee 9941920362
Sports & Fitness Committee Chairman Dr. Pandian M 9840337833
Sports & Fitness Committee Secretary Dr. Selvaganapathy M (East) 9600154021
9944431189
Dr. SriPriya T (West)

Dr. Vanithakumari (South)

Magazine Committee Chairperson Magazine Committee 9444222814
Dr. Rachula Daniel 9715825098
Dr. Gowthaman N 9894059857
Dr. Vindhiya (North) 9488043782
Dr. Annith Kumar V (West) 9941920337
Dr. Haemnath P (East) 9790963461
Dr. Kalyani praba (South)

Ethics Committee Chairperson Ethics Committee 9566032323
Dr. Poorani Manoharan 9840544920
Dr. Ramya Karthikeyan (North) 9444050414
Dr. Joseph Xavier (South)

Insurance Committee - PPLSSS / FSS 1 and FSS 2 / NPPS

Insurance Committee Chairman Dr. Karthikeyan R 9965578935

Insurance Committee Secretary Dr. S. Chitralakshmi 9003172262

IT Wing Dr. M. Vinoth

CENTRAL COUNCIL STATE COUNCIL REPRESENTATIVES
REPRESENTATIVES
Dr. Karunanidhi V Dr. Kayal Subburam T
Dr. M. Balasubramaniam Dr. Amutha Karunanidhi Dr. Karthikeyan R
Dr. Capt. G. Raghavelu Dr. Manamohan Dr. Kavitha Lakshmi K
Dr. Ravisankar T N Dr. Annamalai A L Dr. Kiruthiga Devi R S
Dr. Karunanidhi V Dr. Kasi S Dr. Joseph Jensing Babu
Dr. Amutha Karunanidhi Dr. Yesodha L Dr. Shakthesh K
Dr. Murugan G Dr. Murugan G Dr. Jamuna Rani S
Dr. Kasi S Dr. Nirmal Fredrick T
Dr. Nirmal Fredrick T Alternate State Council
Dr. Perumal T Members
Dr. Umaiyal Murugesan Dr. Saravanakumar S
Dr. Yesodha L Dr. Rachula Daniel Dr. Vinoth M
Dr. Kayal Subburam T Dr. Ejilarassy V
Dr. Sri Sudha K

INDIAN MEDICAL ASSOCIATION, TAMBARAM Page 5

IMA TAMBARAM : TRENDSLETTER - EDITORIAL BOARD

Dr. Umaiyal Murugesan Dr. Sai Meenakshi T N Dr. Jamuna Rani S
President Hony. Secretary Hony. Finance Secretary

Dr. Rachula Daniel Dr.Somasekar R Dr. Ruckmani A
Editor Associate Editor Associate Editor

Dr. Jayakumar B Dr. Annith Kumar V M Dr. Major Saminathan
Joint Editor, Joint Editor, Joint Editor,

Dr. Surya V Dr. Capt. Raghavelu G Dr.Sankaranarayanan L
Joint Editor, Advisory Board Advisory Board

Dr. Sankaranarayanan
L

As

Dr.T. Nirmal Fredrick Dr. Kasi S Dr. Ravisankar T N
Advisory Board Advisory Board Advisory Board

Dr. Prasanna Raju Dr. Gowthaman N Dr. Kalyani Prabha Dr. Vindhya K
Joint Editor Secretary Joint Editor Joint Editor

Dr. Haemnath P Dr. Moses Rajamani
Joint Editor Joint Editor

EDITORIAL TEAM OFFICE BEARERS 2022 - 2023

INDIAN MEDICAL ASSOCIATION, TAMBARAM Page 7

TABLE OF CONTENTS

SL.NO TITLE AUTHOR PAGE
Dr. Umaiyal Murugesan
1 President’s Message Dr. T.N. Sai Meenakshi 9
2 Secretary’ Report Dr. Rachula Daniel 10 - 13
2 From the Editor’s Desk Dr. T. Nirmal Fredrick 14 - 15
3 World Glaucoma Week Dr. R. Somasekar 16 - 21
4 Update - Covid guidelines in Paediatrics Dr. Ruckmani A 22 - 23
5 Skin and its Care in Elderly Dr. Kalyani Praba 24 - 29
6 Students Section: MCQs Dr. Surya Ramesh
7 Updates in Reproductive Medicine Dr. Vignesh Krishna G M 30
8 Uterocutaneous Fistula - Case Report Dr. Rachula Daniel 31 - 34
9 Events and News: Republic Day Celebration Dr. Vindhiya K 35 - 36
10 Investiture Ceremony Dr. Gowthaman 37 - 41
11 Induction Program Dr. Giridharan V 42 - 45
12 Photography Section Dr. Jayakumar B 46 - 48
13 Tamil Poem Collections
14 Events / Photogallery 49
15 National News 50
16 Academy of Medical Specialities 51
17 College of General Practitioners 52 - 53
18 Birthday’s and Wedding Anniversaries 54
19 Donations 55
20 New Members’Welcome 56 - 57
21 Bank Account Details 58
22 Advertisement Tariff 59
60
61

Coverpage photograph : Dr. Giridharan V : Caption – Aim for the stars

President’s Message

It gives me great pleasure to give me my message to this beautiful Trends
Letter Magazine . As the President of this esteemed organisation it gives
me great pleasure to pen my views . I am noticing the concept of the
Magazine has changed over the years and now it is an E-Magazine,
which is comprising of all the activities of our Indian Medical Association,
Tambaram Branch and also is serving as a platform to showcase the various activities done by our
members in various fields. Academics is given the fore most importance, so we have lot of articles
from our members getting published here regularly.

Also we have our members other arena of interests like Poems, Kavithai, Paintings etc. and any
activities which our members feels they want to showcase, we actually request them to do it in this
platform as this has a very active circulation among 1000 members in our own branch and also it is
circulated at State level and in Central level we are getting reviews over this magazine. I really
congratulate this team headed by Dr. Rachula Daniel, Editor for bringing this E-Magazine every two
months in a great form.

Dr. UMAIYAL MURUGESAN
PRESIDENT, IMA TAMBARAM
FOUNDER SECRETARY – KANCHEEPURAM OBSTETRIC & GYNAECOLOGICAL SOCEITY

INDIAN MEDICAL ASSOCIATION, TAMBARAM Page 9

SECRETARY REPORT

Dear fellow brothers & sisters of IMA,

February -2022

11.02.2022-11.03.2022

I AM HONOURED & PREVILEGED TO DELIVER THE SECRETARY ‘S MESSAGE OF THE
PRESTIGIOUS IMA, TAMBARAM.

I AM DELIGHTED TO BE PART OF THIS Majority WOMEN TEAM 2022-2023 OF IMA
TAMBARAM. AT THE OUTSET I appreciate ALL the WING & COMMITEES EFFICIENT MEMBERS.
The LOVE, DEDICATION & COMMITMENT OF THE ENTIRE WORKING COMMITTEE WOuLD BRING
LAURELS TO IMA TAMBARAM.

I RECALL WITH GRATITUDE THE SELF-less , ENTHUSIASTIC & GENEROUS SERVICE
RENDERED BY our OWN SENIOR LEGENDARY MEMBERS WHO HAVE BULIT A GOLDEN CASTLE OF
IMA TAMBARAM,” UNITY IS STRENGTH”. FOR SURE WE SHALL WORK IN UNITY & CARRY
FORWARD THE LEGACY. ITS AN OCCASION FOR us to thank god for THE BLESSINGS
SHOWERED ON US.

WE HAD OUR Investiture CEREMONY ON THE 11TH OF FEBRUARY. HON. THIRU. R.
PALAINISAMY , OUR STATE TNSB PRESIDENT WAS THE CHIEF GUEST. OUR Guests OF HONOUR
WERE DR.SENTHAMIL PARI , OUR PRESIDENT ELECT, DR. saravanan, VICE PRESIDENT ,nz.

EVEN BEFORE INVESTITURE , AFTER ELECTION RESULTS WERE DECLARED OUR MADAM
PRESIDENT WAS KIND ENOUGH TO ORGANISE NUMBER OF PREPARATORY MEETINGS. ROAD MAPS
FROM ALL THE WINGS & COMMITTEES were WELL PLANNED. THE SAME WAS DELIVERED BY
OUR PRESIDENT DR. UMAYAL MURUGESAN. On the day of investiture , VOTe of thanks
WAS GIVEN BY OUR FINANCE SECRETARY DR. JAMUNA.WE HAD A NICE PHOTOSHOOT WITH ALL
THE COMMIITEE MEMBER.

ON 13TH OF FEB WE HAD OUR INDUCTION TRAINING PROGRAMME. MOST OF THE WORKING
COMMITTEE MEMBERS ATTENDED THE MEEING. THE FACULTIES WERE OUR SENIOR MC MEMBERS
CAPTIAN DR.G.Raghavelu. dr.M. balasubramaniyam , DR.T.N. Ravishankar , DR.NIRMAL
fredrick . WE WERE ALL CLEARLY EXPLAINED THE rights & RESPONSIBILITIES.

ON 15TH OF FEB , WE HAD WDW PLANNING COMMITTEE MEETING FOR THE UPCOMING
WOMENS DAY CELEBRATIONS. THE MEETING WAS ATTENDED BY BRANCh PRESIDENT dr.
umaiyal murugesan , SECRETARY dr. t.n. saimeenakshi , Wdw CHAIRMAN dr.r.s.
kiruthika devi , secretary dr. srisudha & zonal CO-ORDINATORS dr. vARALAKSHMI,
finEARTS secretary dr. pavithra . ACTION PLAN WAS WORKED UP INCLUDING BUDGET FOR
THE OCCASION

Ima tambaram cgp wing under the chairmanship of dr.premalatha &
SECRETARY DR. GANGADEVI ALONG WITH coordinatORS dr. manimegalai , DR. MYTHILI
CONDUCTED health AND cancer awareness talk & camp for staff of kalIeswari
company ( gold winner ) with guest speakers : dr.t.n. ravishankar past ima tnsb
president & dr. umaiyal murugesan, OUR ima president, tambaram on 23.02.2022.

On 26.02.2022 cgp wing chairman dr. premalatha organized a mega
HEALTH CAMP AT PONMAR VILLAGE UNDER THE “ AON GAANV CHALO “ PROjECT,
cancer awareness talk, was given by our branch president dr. umaiyal
murugesan.

On 24.02.2022 we had our handing over of accounts to the current
sitting team by our previous team in the presence of our senior ima patron
dr.m. balasubramaniyam, dr.kasi, our past ima president ima tbm.

On 24.02.2022 , General awareness & training for paramedic on early
detection of cancer was conducted @ sayee speciality Hospital padappai under the
aegic of IMA, Tambaram.

On 25.02.2022, our academic activity was robust with 10 speakers
presenting interesting cases in various specialities well assorted &
organised by our academic committee headed by Dr. Kavithalakshmi, vice
president. Dr. V.S. Hariharan, AMS wing chairman , Dr. Arul Anne Rose, Joint
secretary East Zone. The CSM was very successful attended by 94 members
in the presence of our senior leaders & founder patron Dr. Christudas sir
at Cosh Hospital, Tambaram.

Pplss cheque was handed to the family of dr.r.n.m.francis on 25.02.2022.
CANCER SCREENING / PAP SMEAR CAMP WAS CONDUCTED IN THE FOLLOWING
HOSPITALS UNDER THE AEGIs OF IMA TAMBARAM.

1. DR.RUKMANI MOHANKUMAR / VICE PRESIDENT AT SUNDAR HEALTH CENTRE ON
19.02.2022.

2. DR. RAMYA KARTHIKEYAN AT bhanu hospital on 26.02.2022.
3. Dr. kiruthigadevi , wdw chairman at babu hospital on 24.02.2022.
4. Dr. umayal murugesan at sri kumaran hospital on 26.02.2022
5. Sayee speciality hospital dr.sai meenakshi on 24.02.2022

March-2022

 Internal audit was conducted by the audit committee on 01.03.2022 at ima
hall by ic chairman dr. c. sanakaranarayanan, dr. amutha karunanithii
& dr. kasi.

 Handed over the fss cheque of 17,80,000 to mrs. Leela francis wife of
dr.r.n.m.francis at his residence on 02.03.2022 in the presence of capt.
dr.g.raghavelu , our senior legendary ima past president

 On 02.03.2022 Dr. umaiyal murugesan, dr. t.n.sai meenakshi, dr.
kiruthikadevi had been to the police commissioner office to invite mrs.
Ravi ips, tambaram police commissioner to flag off the rally on

INDIAN MEDICAL ASSOCIATION, TAMBARAM Page 11

06.03.2022 – “RALLY TO STOP VIOLENCE” AGAINST THE women to commemorate
THE wOMEN’S DAY CELEBRATION.

 On 03.03.2022 dr.vindhya,ima tambaram of our working committee
consultant paediatrician had been to the little flower convent higher
secondary school for deaf, Chennai-18 she did awareness camp & gave a
talk on menstrual hygiene to the children

 On 04.03.2022 pap smear camp was conducted at vani hospital by dr.
umaIyal murugesan.

 On 06.03.2022, a mega rally was conducted police commissioner mr.ravi
flagged off the rally. Our tnsb ima president dr.palanisamy, immediate
past national president dr.jayalal , our senior ima patrons graced the
rally . senior hc lawyer & social awareness inspiring activist
dr.adhilakshmi gurumoorthy walked the entire 3 km distance created
awareness to the public to stop the violence against women/ girls with
her slogans motivating all of us

 On 06.03.2022 – umaIyal murugesan president, dr.t.n.saimeenakshi secretary,
attended the leadership training training programme AT GRT GRAND ,CHENNAI.
Aaon gaanv chalo project on 08.03.2022 conducted health camp at orathur
village.about 10 pap smears were done.breast examination was done for 20
patients by sayee speciality hospitals, padappai On 09.03.2022 conducted
health & cancer awareness camp was conducted at vaipur village by sayee
speciality hospital, padappai

 On 10.03.2022 conducted pap smear camp at sayee speciality hospital,
padappai.

 On 12.03.2022 world kidney day celebrations was held with another robust
academic feast by our ams team headed by dr.hariharan& dr.shakthesh .it was
well organized with captivating topics. The discussion was very apt for the
well assorted audience of different specialities, the talk was well focused at
the primary care level. The very essence was almost 10 of our ima tambaram
nephrologists ran the academic session headed by our legendary dr.edwin
Fernando sir. We thank god for, we at ima tambaram are blessed with
superfluous academic resources. I wholeheartedly acknowledge rela
institute of medical sciences for their splendid support & sponsor for this
event. We had two speakers from rela, dr.ravi spoke about eus guided
endotheraphy on medical gastro. It was quite informative. Dr.naveen ,
nephrologists, rela was dynamic on dias with his talk on covid & kidney as well
as interactions.

 On 13.03.2022 morning ima tambaram with tnoa, mcoa conducted a rally for the
glaucoma awareness week, with many of our ima doctors running& walking 10

km. the rally was flagged off by the tambaram corporation commissioner
dr.elangovan. all the finishers were felicitated adorning them with medals.
This event was well organized by tambaram ophthalmic society headed by dr.
rachu la, dr.nirmal Fredrick, founder president,tos. Kudos to the organizers &
enthusiastic participants who have made this event a grand success.

 On 13.03.2022 six of us from ima tambaram , wdw national advisor dr.yasodha ,
president dr.umaIyal murugesan ,secretary dr.t.n.sai meenakshi , wdw
chairman dr.kiruthigadevi, secretary dr. srisudha, dr.varalakshmi, attended
THE STATE INTERNATIONAL wOMEN’S Day celebration at thirupur.

 On 15.03.2022 we the ima tambaram with the cgp wing got an opportunity to
serve the children at juvenile home(govt.observatory home for girls) and
vigilance home for adults.Our president dr.umaiyal murugesan addressed the
gathering regarding personal, menstrual hygiene and answered all their
doubts individually. There by the medical crew includes myself along with dr.
kayal subburam and dr.rosy aruna and assisting team of 7 members. including
dr. agarwal eye hospital who partnered with us eye screening. The ima crew
also did general ,skin and ent screening to all the children and gave them
appropriate MEDICINES. WITH THE HELP of some sponsors , we provided fruits,
snacks and gifts to those childrens and adults.

DR. SAI MEENAKSHI T N
HONY. SECRETARY, IMA TAMBARAM

INDIAN MEDICAL ASSOCIATION, TAMBARAM Page 13

FROM THE EDITOR’S DESK

Greetings from Trendsletter !

“Follow effective actions with quiet reflection. From the quiet
reflection will come even more effective action.” Peter Drucker
As you are aware, Trendsletter has received the prestigious State Appreciation Award for
Exemplary performance in e- Journal and Dr. M. Balasubramaniam Award for Best News
Bulletin - IMA Chennai Tambaram Branch for the year 2021.
We extend our special thanks to Dr. T. Nirmal Fredrick who spearheaded and guided us in
the making of Trendsletter and News bulletins.
Our Trendsletter Editorial Board Meeting was held on 7th Jan 2022 at 9.30 pm, which was
attended by – Dr. T. Nirmal Fredrick, Dr. Rachula Daniel, Dr. Somasekhar, Dr. Rukmani,
Dr. B. Jayakumar, Major. Dr. Saminathan , Dr. Gowthaman and Dr. Surya Ramesh.
As we shared our experiences in bringing out 10 Editions of Trendsletter for the years
2020-2021, we felt happy to have done well and are all set to move ahead to do even
better.

We had the online preparatory meeting of Magazine Committee at 9.00 pm on 31 Jan 2022,
attended by Chairperson- Magazine Committee – Dr. Rachula Daniel, Zonal secretaries

Magazine Committee – Dr. Annith and Dr. Haemnath, President – Dr. Umaiyal Murugesan,
Secretary - Dr. Sai Meenakshi and Treasurer – Dr. Jamuna Shaktesh, Joint secretaries –
Dr. Ejillarasy, Dr. Shobana, Dr. Anne Vivek and Dr. Bhuvaneshwari, to discuss few ideas
which we will strive to implement in the next couple of years.

1. To get more of our members involved in Trendsletter by way of their articles, reviews
and advertisements.

2. Ensure our IMA zonal coordinators to send our magazine to all IMA members through
their e- mails and individually on their personal whats app numbers.

3. To include few more social pages like Family time , Fitness section, Kids section to
encourage involvement of children of our Branch members.

4. To work on print - copies of Trendsletter - As quality of our magazine is at its best and
has been receiving national recognition, printed copies will be a way forward.

5. The articles from AMS activities may be channelled to Trendsletter for benefit of
readers.

6. Interesting Case Scenarios section to be started. Best submissions will be awarded
prizes.

7. Current pages of Trendsletter will continue and reporting of National level events will
also be done periodically.

With these points in mind, come, let's work together to take Trendsletter to greater heights !

Long live IMA ! Jai Hind!

Dr. Rachula Daniel MD DO AFIH
Editor - Trendsletter
Chairperson : Magazine Committee , IMA Tambaram

INDIAN MEDICAL ASSOCIATION, TAMBARAM Page 15



INDIAN MEDICAL ASSOCIATION, TAMBARAM Page 17



INDIAN MEDICAL ASSOCIATION, TAMBARAM Page 19



PHOTO QUIZ:
Speciality : Ophthalmology

What is the diagnosis ?

Send in your answers to [email protected] . Winning entries will be
rewarded and the answer will be published in next issue.

INDIAN MEDICAL ASSOCIATION, TAMBARAM Page 21

UPDATE - COVID GUIDELINES IN
PAEDIATRICS

INDIAN MEDICAL ASSOCIATION, TAMBARAM Page 23

SKIN AND ITS CARE IN
ELDERLY

Dr.A.Ruckmani
“Those who respect the elderly pave their own road toward success”- – African proverb

There cannot be anything nobler than taking care of those who cared for us. The elderly must be
respected and honored and seen as the assets of a country for their knowledge and wisdom. As the
African proverb tells us, in the wisdom of the elderly lies the future wellbeing of a people.

According to the “National Policy on Older Persons” of the Indian government, a “senior citizen” is
defined as a person who has attained the age of 60 years or above.

Aging is natural and physiological. Healthy ageing is defined by WHO as “the process of developing
and maintaining the functional ability that enables well-being in older age.” “Functional ability”
refers to the ability to meet basic needs; to continue to learn and make decisions; to be mobile; to
build and maintain relationships; and to contribute to society” (1).

Functional ability depends on how healthy the older person is. Around 75% of the elderly in India
are suffering from chronic diseases which include hypertension, ischemic heart diseases, Diabetes
mellitus, dyslipidemia, psychological disorders and degenerative disorders like Parkinson’s disease
and demential disorders.

The skin disorders that occur in the elderly could be either due to pathological or physiological
changes. The most common disorders due to aging include xerosis, pruritus, pigment disorders and
non-cancerous skin lesions like seborrheic keratoses. The pathological diseases other than metabolic
disorders include, infectious diseases such as dermatophytosis, eczemas and less common cancerous
growths - Basal cell carcinoma and melanoma.

As skin being the external and the largest organ of the body, the changes become easily visible.
When it becomes symptomatic as in senile pruritus, eczemas and dermatophytosis, medical treatment
is sought for either by the patient or the family members. But to what extent medical help is taken
depends on

 The awareness of the patient regarding skin changes and the maintenance of healthy skin in
old age

 Attitude of the patient /caretakers
 Educational and economic status of the patient and caretakers

 Availability and accessibility of medical care

The population of elderly people in India is expected to reach 158.7 million in 2025 (United Nations
Department of Economic and Social Affairs, 2008), and surpass the population of children below 14
years by 2050 (2).

Considering the growing elderly population, creating awareness of skin care and disseminating
knowledge about skin structure and function is essential. Originally the word, skin meant “animal
hide” (3) or the integument of an animal (human or non-humans) and subsequently it referred to the
natural covering of fruits and vegetables also. It is also used as a verb, meaning “to strip” or “peel
off” (4).

The human skin hides the human body giving it a shape. It is the largest organ of the body,
constituting about 15% of the total adult body weight. As it is continuous with the mucous
membrane at the orifices, it also continues with the internal epithelial lining of the body. The skin
performs many functions such as protecting the body against external physical, chemical, biological
and immunological assaults as well as preventing excess water loss maintaining thermoregulation.

Skin is composed of three layers: the epidermis, the dermis, and subcutaneous tissue. The epidermis,
being the outer layer, consists of keratinocytes, which synthesize the protein keratin and protects the
organism. The middle layer, dermis, is made up of collagen, the structural protein. Underneath the
dermis lies the subcutaneous tissue containing the lipocytes. The thickness of these layers varies
depending on the region of the body. The epidermis is thinnest in the eyelids, about 0.1 mm and
thickest in the palms and soles, approximately 1.5 mm whereas the dermis is thickest on the back (5).
The structure and functionality of the skin change with the age of an individual.

The fetal skin has the unique property of scarless healing attributed to its higher content of
glycosaminoglycans, hyaluronic acid and chondroitin sulfate than the adult skin. Glucoso
aminoglycans play a major role in scarless wound healing (6).

The infant skin, develops following the transition of fetus from an aqueous to terrestrial environment
and is different from the fetal skin in structure, composition and function. The thinner and more
permeable subcutaneous tissue loses water more quickly than adult skin, and hence more prone to
dryness. Moreover, the baby skin contains low levels of natural moisturizing factors (NMFs), lipids
and melanin. The lower level of NMFs could also contribute to its proneness for dryness.

The acidic nature of the baby skin contributes to its antimicrobial properties making the skin resistant
to colonization by pathogenic bacteria and on the other, while enhancing the activity of the enzymes

INDIAN MEDICAL ASSOCIATION, TAMBARAM Page 25

that break-down the desmosomes weakening the skin barrier. Because of these differences, baby skin
is more susceptible to dryness and diseases such as atopic dermatitis and nappy dermatitis (7).

As age advances, the skin undergoes both structural and functional changes influenced by intrinsic
(genetic, metabolic and hormonal) and extrinsic (pollution, light exposure, chemicals, toxins) factors
leading to the following changes (8-10):

 Lack of the skin’s ability to function as the barrier/ interface between internal and external
environments.

 Xerosis – attributed to reduced water content or sebum secretion, altered keratinization
process and lipid level in the stratum corneum.

 Development of thin, atrophic, wrinkled and dry skin
 Significant reduction in fibrillin structures and type VII (Col-7), which may contribute to

wrinkles by weakening the bond between dermis and epidermis
 Approximately 1% of the collagen content per unit area of the skin is known to decline per

year.
 Glycosaminoglycans (GAGs) are among the primary dermal skin matrix constituents

assisting in binding water.
 Progressive loss of skin elasticity leads to sagging
 Deceleration of epidermal turnover rate and prolongation of cell cycle cause slower wound

healing and less desquamation of skin.
 The susceptibility of skin to infection increases as the pH of the skin surface increases with

age.
 The perception of superficial pain is diminished both in intensity and speed increasing the

risk of thermal injury; however deep tissue pain may increase.
 A reduction in lipid content inhibits the permeability of some topical medications.
 Allergic and the inflammatory response get blunted decreasing the ability of the skin to repair

wounds.
These functional changes have the potential to cause significant morbidity in the elderly
patient causing troublesome diseases including eczema, contact and allergic dermatitis,
seborrheic dermatitis, autoimmune diseases with cutaneous manifestations, seborrheic
keratoses, and various forms of neoplasms, such as basal and squamous cell carcinoma and
malignant melanoma.

Skin aging occurs also due to extrinsic factors such as excessive exposure to sunlight and UV
radiation. Reactive oxygen species generated by UV rays cause damage to the DNA. Skin

wrinkling and pigmentary changes thus occur due to photo-aging. Prevention or delaying of
skin aging could delay the occurrence of aging-related skin diseases. To delay /prevent aging
of skin, the following measures can be taken.

General measures:
Drinking adequate liquids;
Avoiding diuretics, if possible, in consultation with the physician

To prevent photo damage:
 Avoiding excessive exposure to sun light;
 Using sunscreens to prevent or reduce exposure to UV radiation;
 The use of retinoids can inhibit collagenase production and promote collagen
synthesis;
 Neutralizing free radicals by using systemic antioxidants containing carotenoids,
vitamin C, vitamin E and preparations containing the trace elements, copper and
selenium.

For the elderly people awareness programs have to be conducted highlighting the skin
changes and the need to adopt probable measures mentioned above to delay aging and
prevent the occurrence of age-related skin problems.

We tend to consider senile changes natural and ignore them. Many patients report to skin
clinics mainly for treatment of pruritus. In addition to prescribing emollients and anti-
histamines, the elderly have to be provided emotional support and reassurance. Cleansing
agents and bath soaps/ solutions should be selected on the basis of individual need after
assessing the nature of the skin of the person.

Attitude of the patient /care takers

The aging population is a major concern all over the world. In India, the joint family system
has been in practice for a long time and the children in these families consider it their
responsibility to take care of their aging parents. However, as the joint family system is on
the decline in recent times, the family structure is either fragmenting or changing for the
worse. Consequently, the parents are compelled to live either separately, or depend on their
neighbours for any assistance. Among those who live with their families, 60% face physical
and mental abuse, 66% are very poor and 39% are either abandoned or live alone (11). Under
such circumstances, the aged can hardly pay attention to the health of their skin. Hence, it is
necessary to focus on the physical, mental and social well-being of the elders. To meet these

INDIAN MEDICAL ASSOCIATION, TAMBARAM Page 27

needs, community care centres and old-age homes have emerged in India to offer the geriatric
population an opportunity to live with dignity. The caretakers in these institutions, and also in
the families should be educated not only on the general health of the elderly but also on skin
health.

Educational and economic status of the elderly and their caretakers:

In India, the percentage of the elderly in the total population is 10.1 per cent in 2021, and in
another ten years this population is expected to increase by 3 percent. Unless the elderly
people are educated, they cannot care for their skin adequately. Therefore, the high literacy
rate of the population (69% in 2017) is not an indicator of adequate health and skincare. For
proper skincare, necessary information on skin care has to be provided to the target
population in the regional language.

The economic status of the elderly determines the extent of care given to the geriatric
population. Aged pensioners may find it easier to meet their expenses than the non-
pensioners. Moreover, if an older person is suffering from life-threatening co-morbidities,
skin care may not be given the importance it deserves, unless the condition of the skin
contributes to life risk.

Availability and accessibility of the medical care:

Thepharmacyfacilityand skincare products may not be available in remote and rural places.
Unless skincare facilities are extended to the rural areas, the rural elderly will continue to
consider skincare unimportant.

To summarize, it is observed that the fetal skin which can heal without scarring develops into infant
and adult skin which heals by scarring. The skin has many protective functions which decline as
age advances. Maintaining healthy skin will delay the aging process and age-related skin disorders.
However, skincare among the elderly will remain a neglected domain unless we conduct awareness
programs and make available skincare facilities to the needy population.

REFERENCES

1. https://www.who.int/news/item/17-12-2020-who-launches-baseline-report-for-decade-of-
healthy-ageing, accessed on 24.9.21.

2. Raju S. Ageing in India in the 21st Century: A Research Agenda. Mumbai: The Harmony
Initiative; 2006. Available: http://harmonyindia.org/hdownloads/Monograph_FINAL.pdf.

3. https://www.etymonline.com/word/skin
4. https://www.merriam-webster.com/dictionary/skin
5. Paul A.J. Kolarsick, BS, Maria Ann Kolarsick, MSN, ARNP-C, and Carolyn Goodwin,

APRN-BC, FNP Anatomy and Physiology of the Skin, 9S Skin cancer
6. Coolen NA, Schouten KC, Middelkoop E, Ulrich MM. Comparison between human fetal and

adult skin. Arch Dermatol Res. 2010;302(1):47-55. doi:10.1007/s00403-009-0989-8.
7. https://www.communitypractitioner.co.uk/features/2010/10/anatomy-skin
8. Ganceviciene R, Liakou AI, Theodoridis A, Makrantonaki E, Zouboulis CC. Skin anti-aging

strategies. Dermatoendocrinol. 2012;4(3):308-319. doi:10.4161/derm.22804.
9. Farage MA, Miller KW, Elsner P, Maibach HI. Functional and physiological characteristics

of the aging skin. Aging Clin Exp Res. 2008 Jun;20(3):195-200. doi: 10.1007/BF03324769.
PMID: 18594185.
10. White-Chu EF, Reddy M. Dry skin in the elderly: complexities of a common problem. Clin
Dermatol. 2011 Jan-Feb;29(1):37-42. doi: 10.1016/j.clindermatol.2010.07.005. PMID:
21146730.

11. A 2015-16 All India Senior Citizens’ Confederation (AISCCON) survey.
12. http://mospi.nic.in/sites/default/files/reports_and_publication/statistical_publication/social_st

atistics/WM17Chapter3.pdf

INDIAN MEDICAL ASSOCIATION, TAMBARAM Page 29

STUDENT SECTION : QUIZ

Dr.P.Kalyani Praba MBBS., MD

Associate Professor – Physiology : SRM MCH & RC

1. A 55-year-old man with a history of atrial fibrillation develops a sudden sharp pain in
his right leg. He presents to the emergency department, where he is found to have a
cold right foot and calf, as well as nonpalpable pulses below the knee. The patient is
taken to the operating room approximately 8 hours after the onset of the pain. He
undergoes an embolectomy of a popliteal artery clot without complication. In the
recovery room, however, he begins complaining of intense right foot and calf pain
that continues to escalate. Palpable posterior tibial and dorsalis pedis pulses are
present bilaterally. The most effective treatment of this condition is

a) Limb elevation
b) Re-exploration of popliteal artery
c) IV sedation and mechanical ventilation
d) Fasciotomy
e) Plaster of Paris immobilization
f) Venous Doppler assessment

2. Rheumatoid Arthritis most common Part of Spine affected:
A. Upper cervical spine
B. Lower cervical spine
C. Dorsal spine
D. Lumbar spine

3. Purely epiphyseal lesion before skeletal maturity is:
A. Giant cell tumor
B. B. Chondroblastoma
C. Osteoblastoma
D. Osteosarcoma

4. Shepherd crook deformity is seen in
A. Fibrous dysplasia
B. Adamantinoma
C. Non ossifying fibroma
D. Fibrous cortical defect

5. Jones fracture is

A. Avulsion fracture of base of fifth metatarsal
B. Bimalleolar fracture of the ankle
C. Burst fracture of 1st cervical vertebra
D. Avulsion fracture of base of first metatarsal

UPDATES IN REPRODUCTIVE
MEDICINE

Dr.P.Surya MBBS., DGO., FIARM., FMAS., DMAS.,
Consultant Obstetrician, Gynaecologist, Fertility Specialist, Laparoscopic Surgeon,
Nakshatra Men, Women & Fertility Clinic

INTRODUCTION:

Reproductive medicine is a field of medicine that deals with male and female reproduction.
Though there are lot of researches and advancements to make the couple to achieve their
dream, still there are few couples who couldn’t. Because, Human implantation is a highly
complex and multifactorial process. Successful implantation requires the presence of a
healthy embryo, a receptive endometrium, and a synchronized molecular dialogue between
the two, as well as immune tolerance/protection from the host(1). “Right soil-Right seed- at
Right time – makes the plant to grow successfully”. Here are few recent advances which is
helping the couple to deliver a baby with their own gametes.

Endometrial Receptivity Array (ERA):

ERA is a form of invasive biopsy of the endometrium at the time of presumed window of
implantation (WOI). It can be done as an office procedure without an anaesthesia using a
pipelle. Endometrial sampling is sent for analysis. ERA consists of a customized microarray
based on the transcriptomic signature of human ER when the human endometrium is
receptive to blastocyst implantation. ERA contains 238 genes that are differentially
expressed between these profiles (2). The results classifies an endometrial sample as
“receptive” or “nonreceptive.” The “nonreceptive” ERA is further classified as prereceptivity
or postreceptive giving an exact status of the endometrium at the time of biopsy. Women
then undergo personalized embryo transfer (pET) where the frozen– thawed embryo
transfer is timed according to the receptive status as identified by ERA. Consistent with the
modern trend to personalize medical care, ERA has the capacity to offer an individualized
approach or the identification of the Window of implantation (WOI) and embryo transfer.
Unlike prior attempts to characterize endometrial receptivity through histological sampling,
sonography, or hormonal markers, ERA may help identify the WOI with greater objectivity
and less inter-cycle variability (3)

Preimplantation genetic testing – Aneuploidy/ Monosomy(PGT-A/PGT-M):

Preimplantation genetic testing is a technique that provides a practical alternative to prenatal
diagnosis and termination of pregnancy of couples who are at substantial risk of transmitting
serious genetic disorder to their offspring. For PGT-A/PGT-M, assisted reproductive technologies
(ART) are used to generate embryos in vitro and a polar body or a cell is removed as a biopsy either
before fertilization or later in embryo development (at cleavage or blastocyst stage). This biopsy is
used as a tissue representative of the whole embryo and is analysed for the presence of a specific
genetic abnormality using next generation sequencing (NGS) technique. Embryos found to be
unaffected are replaced into the uterus. In recent days, blastocyst is most commonly used tissue for
the biopsy(4). PGT-A/PGT-M provides an alternative way forward, not only for couples at risk of

INDIAN MEDICAL ASSOCIATION, TAMBARAM Page 31

having a child with a severe or life threatening abnormality, but also for couples who are unable to
establish a viable pregnancy due to recurrent miscarriages(5).

Sperm DNA Fragmentation Index (DFI):

Sperm DFI was assessed by the sperm chromatin structure assay (SCSA). The
SCSA will be done by a commercially available kit and the sperm DFI was performed
according to the manufacturer’s instruction. There are many potential factors associated
with increased sperm DFI which includes age, abstinence time, spermatogenesis and
maturation, seminal plasma lipids and reproductive hormones levels. However, the potential
effects of seminal plasma lipids and reproductive hormones on sperm DNA damage need
still to be demonstrated by a larger randomized controlled studies(6). Meta-analyses were
conducted to investigate the relationship of sperm DNA fragmentation on pregnancy
outcome using in-vivo fertilization, IUI and routine IVF/ICSI. These meta-analyses show that
the Sperm Chromatin Structure Assay infertility test was significantly predictive for reduced
pregnancy success using - IUI and routine IVF and to a lesser extent ICSI fertilization(7).

Platelet rich plasma(PRP):

Successful embryo implantation requires good quality embryo but also needs a
receptive endometrium. Receptivity is basically assessed by endometrial thickness and the
pattern using ultrasonography. In our clinical practice, we daily verify that an adequate
endometrial growth is reached for successful implantation. For few women, adequate
endometrial thickness is not reached due to the damage of the basalis layer of the
endometrium. In order to come over this issue, PRP has been used to improve
endometrium thickness and performance. Around 0.5-1 mL PRP was introduced to the
uterine cavity under ultrasound guidance using Wallace catheter about 36 h before
undergoing frozen embryo transfer. As the Platelets contain significant amount of growth
factors7 that have positive effects on local tissue repair and improvement in the endometrial
thickness(8).

Stem cell therapy:

Infertility due to endometrial receptivity & gamete deficiency resulting from genetic
defects does not benefit the couple through ART with their own gametes. However, most
couples seeking infertility treatment wish to have their own genetically related issues
resolved, which could be less invasive and more cost-effective compared to ART. In this
respect, stem cells have shown new hope to overcome the issues related to infertility in the
form of cell-based therapies in various experimental preclinical and clinical models.
Examples for this type of clinical conditions are Asherman’s syndrome, Azoospermia,
premature ovarian insufficiency(POI), endometriosis, etc.

1- Asherman’s syndrome: It is a condition in which there is an interuterine adhesions
due to the damage of the basalis layer of endometrium. The use of stem cells
derived from bone marrow, autologous menstrual blood, as well as mesenchymal
stem cells(MSCs) for the replenishment of endometrium, has been worked out in
various animal models as well as clinical studies(9). It was observed that endometrial
MSCs derived from menstrual blood could improve fertility in an animal model of
damaged endometrium (10). Various studies reported that women with Ashermen’s
Syndrome attained regular menstruation and endometrial regeneration following
transplantation of menstrual-blood-derived stem cells

2- Premature Ovarian Insufficiency (POI): The average age of Menopause is 52yrs and
around 1-2% of the women undergo premature menopause either due to genetic
reason, endometriosis or post surgery. Stem cell therapy is bog boon for these
women to achieve pregnancy with their own gametes. Hence, the successful
demonstration of ovarian stem cells both in experimental animal and human models
might bring revolution in the potential therapy for restoration of infertility in patients
with POI (11)

3- Azoospermia: Azoospermia is a condition characterized by the absence of mature
morphologically normal and functional sperm in the ejaculate, contributes
approximately 15% of infertility solely related to male. Based on the history, detailed
physical examination, hormonal assay and genetic testing, azoospermia can be
divided into two subtypes: obstructive (OA) and nonobstructive (NOA) azoospermia.
OA may be treated by surgical intervention. However, NOA results in testicular
failure, which could be due to pathology primarily in the testis or secondary due to
decreased release of gonadotropin from the pituitary. Spermatogonial Stem Cell
(SSC) transplantation could not be replicated in humans because of challenges
associated with the identification of SSCs in the testes, lack of proper culture and
preservation protocol for SSCs, and safety concerns for the recipients following
transplantation(12). Other than SSCs, embryonic and adult stem cells were
demonstrated to have the ability to be differentiated to germ cells(13) and have the
ability to fertilize in animal models.

Conclusion:

To conclude, the field of reproductive medicine is vast and getting updated every day.
Keeping in mind the ethical, legal, financial and safety concerns of the healthy childless
couples, personalised treatment options must be offered to each of them. Counselling is the
key for the assisted reproductive technology and the couple has to be given the priority and
time to choose the treatment option.

“Primum non nocere“

References:

1-Cha J et al, Mechanisms of implantation: strategies of successful pregnancy. Nat
Med.2012;18:1754-1767.

2-A Kan et al, The role of the endometrial receptivity array (ERA) in patients who have
failed euploid embryo transfers. J Assist Reprod Genet. 2019 Apr; 32(4): 543–545.

3-J Tan et al, The role of the endometrial receptivity array (ERA) in patients who have failed
euploid embryo transfers,J Assist Reprod Genet. 2018 Apr; 35(4): 683–692.

4-Hayden Anthony Homer, Preimplantation genetic testing for aneuploidy(PGT-A):The
bology, the technology and the clinical outcomes. Australian and NewZealand Journal of
Obstetrics and Gynaecology. Vol 59(2):Feb 2019;317-324.

5-ClaireBasille et al, Preimplantation genetic diagnosis: State of the art. European Journal
of Obstetrics & Gynecology and Reproductive Biology: Volume 145, Issue 1, July 2009,
Pages 9-13

INDIAN MEDICAL ASSOCIATION, TAMBARAM Page 33

6-Jin-Chun Lu1 et al, Analysis of human sperm DNA fragmentation index (DFI) related
factors: a report of 1010 subfertile men in China. Reproductive Biology and Endocrinology
(2018) 16:23.

7-DONALDEVENSON ET AL, META-ANALYSIS OF SPERM DNA FRAGMENTATION USING
THE SPERM CHROMATIN STRUCTURE ASSAY; REPRODUCTIVE BIOMEDICINE
ONLINE:VOLUME 12, ISSUE 4, 2006, PAGES 466-472

8-RUDKIN GH ET AL, GROWTH FACTORS IN SURGERY. PLAST RECONSTR
SURG. PUBMED;1996;97(2):469–476.

9-Gan, L.; Duan, H.; Xu, Q.; Tang, Y.-Q.; Li, J.-J.; Sun, F.-Q.; Wang, S. Human amniotic
mesenchymal stromal cell transplantation improves endometrial regeneration in rodent
models of intrauterine adhesions. Cytotherapy 2017, 19, 603–616.

10-Domnina, A.; Novikova, P.; Obidina, J.; Fridlyanskaya, I.; Alekseenko, L.;
Kozhukharova, I.; Lyublinskaya, O.; Zenin, V.; Nikolsky, N. Human mesenchymal stem cells
in spheroids improve fertility in model animals with damaged endometrium. Stem Cell Res.
Ther. 2018, 9, 50

11-. Johnson, J.; Canning, J.; Kaneko, T.; Pru, J.K.; Tilly, J.L. Germline stem cells and
follicular renewal in the postnatal mammalian ovary. Nature 2004, 428, 145–150.

12-Vij, S.C.; Sabanegh, E., Jr.; Agarwal, A. Biological therapy for non-obstructive
azoospermia. Expert Opin. Biol. Ther. 2018, 18, 19–23.

13-Hou, J.; Yang, S.; Yang, H.; Liu, Y.; Liu, Y.; Hai, Y.; Chen, Z.; Guo, Y.; Gong, Y.; Gao,
W.-Q. Generation of male differentiated germ cells from various types of stem cells.
Reproduction 2014, 147, R179–R188.

UTEROCUTANEOUS FISTULA - CASE REPORT

DR.G.M.VIGNESH KRISHNA.,MD.,RD.,
CONSULTANT RADIOLOGIST, INDIAN SCAN, TAMBARAM

CLINICAL HISTORY:
A 35-year-old Para 2, Living 2, previous 2 LSCS patient with no co-morbidities, had presented with
complaints of painful swelling at the LSCS scar site since past two years. The swelling was often
associated with serous and bloody discharge from the scar for the last two months.

RADIOLOGICAL INVESTIGATION:
USG revealed normal thickness of endometrium with the endometrial cavity communicating with a
complex hypoechoic collection located anterior to the uterus.

MRI of the pelvis revealed an acutely retroflexed, anteverted uterus adherent to the anterior
abdominal wall. Heterogenous signal intensities with multiple hemorrhagic foci noted in anterior
abdominal wall, the recti muscles and subcutaneous plane. A fistulous tract was seen extending from
the uterine endometrium to the anterior abdominal wall.

Img: SAG T2WI & Axial T1FS reveal the presence of uterocutaneous fistula and scar endometriosis

An endometriotic mass was seen intra-operatively which was
found to be adherent to the anterior abdominal wall and
anterior wall of the uterus. Because of the extensive
adhesions, hysterectomy with bilateral salpingectomy was

INDIAN MEDICAL ASSOCIATION, TAMBARAM Page 35

performed along with excision of the endometriotic tissue and fistulectomy. HPE proved the
diagnosis of endometriosis.

DISCUSSION
 Uterine fistulae usually develop as a complication following pelvic surgeries (esp. caesarian

section), infection and inflammatory conditions.
 Recently, the frequency of UCFs post-caesarian section has declined as a result of the reduction

in classical incisions for caesarian section.
 Uterocutaneous fistula may be pre-operatively diagnosed using methylene blue injection via the

cervix during HSG, at hysteroscopy or on a CT study following instillation of contrast into
fistulous tract. However, the above-mentioned methods are of invasive nature.
 Non-invasive nature, precise detection & localization of the fistulous tract and accurate
delineation of surrounding soft tissue are the advantages of MRI in cases of UCFs and
endometriosis.

EVENTS AND NEWS

73rd Republic Day Celebrations at IMA HQs Building by IMA Tambaram

INDIAN MEDICAL ASSOCIATION, TAMBARAM Page 37

Inauguration of refurbished IMA Tambaram Office room and hall
Ceremony of unveiling of past IMA- Tambaram Presidents’ portraits

IMA Tambaram branch was awarded 22 Awards at the CIMACON TIMACON 2021 -
State Conference conducted on 11th Dec 2021 & 12th Dec 2021 at PSP Medical
College, Coimbatore

These Awards were distributed to the awardees on Republic Day at a gala function at the IMA
Tambaram Hall

INDIAN MEDICAL ASSOCIATION, TAMBARAM Page 39



INDIAN MEDICAL ASSOCIATION, TAMBARAM Page 41

INVESTITURE CEREMONY

The Investiture Ceremony is a special occasion where the baton is passed on to the
new team. It carries with it high hopes of great achievements, enthusiasm and
innovations ahead. Despite the Covid pandemic, great work of achievements had
been done by the past team under the stellar leadership of Dr. Nirmal Fredrick,
President of IMA tambaram branch. The occasion took place on the afternoon of
February 11th 2022. .The event was graced by Dr.P.Palaniswamy president IMA TNSB
as the chief guest for the occasion. The guest of honor were Dr. T. Senthamil Pari,
State president elect 2022 along with Dr.V.Saravanan,,IMA north zone VP. Their
presence made a special mark in the event.

Radiation oncologist, Dr.J. Surendran presented academic feast by his interesting
case scenario.

The program began with Tamil thai vaazthu sung by Fine arts team. Dr Einstein
delivered the IMA prayer to the gatherings. The President Dr. Nirmal Fredrick, gave the
welcome address. His speech mesmerized the gatherings. Secretary report was given by
Dr. Saravana Kumar. He mentioned regarding the completion of registration of IMA
building. More than 100doctors included in the IMA under their tenure.

The outgoing team was felicitated for execution and completion of the
responsibilities entrusted upon them. Later, past president Dr. Nirmal Fredrick
introduced the present president Dr. Umaiyal Murugesan, who was previously vice
president under his team. She is a dynamic and hard working gynecologist. She is
the chairman of Kumaran Hospital, Tambaram. She also held president post of
FOCSI, Kanchipuram. She started from the scratch and attained this height by her
sheer hard work. She is the apt person for the post. After the introduction,
installation happened with exchange of collars.

The team of new office bearers took pledge and oath collectively on the stage. The
ladies of the team wore a pink color saree specially designed for the occasion and
men wore blue suit. Dr.P.Palaniswamy president IMA TNSB, felicitated the gathering
with the chief guest address. He mentioned the inculcation of more women in the
present team. He appreciated that IMA tambaram owns building with the hall for
presiding the meetings. He looks forward to aim high and achieve more awards at
national level.

The guest of honor address was given by Dr. T. Senthamil Pari

The felicitations were done by Dr. T. Senthamil Pari. He welcomed the new president
Dr. Umaiyal Murugesan. Dr Sai Meenakshi as the Vice president and Dr. Jamuna Rani
S, as the Honorary finance secretary.

President Madam gave a overall view about the mission to be accomplished ahead.
She emphasized the importance of team spirit. She made a brief introduction of the
various committee, its chair person and coordinators. She gave the events to be held
for the calendar 2022 under the various committees. To improvise the performance.
The region has been divided into four zones- North, South, East and West. Each zone
is headed by Joint secretary to preside over the events. She mentioned the new
arrival of Fine arts and Ethics committee.

The program culminated with the Honorary finance secretary, Dr Jamuna Rani S
proposing the vote of thanks followed by national anthem.

INDIAN MEDICAL ASSOCIATION, TAMBARAM Page 43



INDIAN MEDICAL ASSOCIATION, TAMBARAM Page 45

INDUCTION TRAINING

An Induction training program conducted on 13-02-2022 at IMA TNSB Building, 3rd
Floor, Doctors Colony, Bharathinagar 1st Street, West Tambaram, Chennai - 600045 at
10:00AM to 01:30 PM

Around 22 Doctors Joined

A glimpse
1.Dr. Govindasamy sir
Collective leadership
Identify people and give them targets, monitor, if out of track guide them

Only branch with 4 joint secretary
Members responsible, members right

Dont cheat fellow doctors
Help fellow doctors
Communication is the key

We are not connected socially
2.Legacy of ima and wings, schems
Dr.Balasubramaniyam sir
1928 kolkata first IMA started
222members
Delhi
B C Roy

2nd largest IMA is TN
Need updates
Established College of general practioner
And,AMS,All india hospital board
,Nursing home board
,Fellow of college of general practioner
PPA in tamilnadu
Annual membership-changed to life member

Leagacy of past presidents
Practice peacefully
He explained about Family security sceme

3.History of registration our works and communication with other branches by past president
Dr. Nirmal sir
Leadership program
Leaders are developed, not born

How to communicate with other branches
We north zone
Kodambakam largest
23 branches in chennai
Email communication from ima delhi
Central directive
From state IMA
state branch
Signed by state sec, state president

Forwarded from State govt Page 47

Updating data base
Wings -data
Schems
Must inform members about the notifications for FSS PPLS. Etc
Intimate about the death

Everymonth report to state office
Notification about notifiable diseases
Biomed wastages -From branch side
Finance
Expenses
Day-to-day functioning
Leagal expert

Indian society act - for financial management in our association
We register for handling public money
Registering as trust
Giving legality, handling fund
Members updating
Audit account and money handling
Cumulative spending must not exceed 20000
Tan account maintained

Getting money -membership fees, sponsorship donations etc
Objectives
Tn society reg act

4. Rules and responsibility of office bearers by
Dr. TN Ravisankar sir
Passion
Enjoy doing
Leagacy of ima
We need Young blood with innovation
Reaching target of 1200 members
250 in FSS
Team work
Poor communication is the problem

5.Dr. Sai meenakshi
Secretary
Start with tours

6.President
Dr. Umaiyal mam
Physical meeting encouraged
We need more IMA sponsors
And further formal speeches by

Dr. Rachula danial
Dr. Hemalatha
Dr. Hariharan
Dr. Pandian
Dr. Nandhakumar and finally
Dr. Jamuna Vote of thanks

INDIAN MEDICAL ASSOCIATION, TAMBARAM



PHOTOGRAPHY SECTION

Dr. Giridharan V

Avian Photosurgeon

Last month, I was with sarus cranes for a week. The male had an injury in pharynx with a
pharyngocutaneous fistula with tongue prolapse. The bird was committed in incubating taking turns -
A sight to behold. The bird had adapted well to the injury .. I don't know whether I will in adverse
conditions. These birds taught me a lot. Sharing a few pics..

INDIAN MEDICAL ASSOCIATION, TAMBARAM Page 49

TAMIL POEM COLLECTION

DR. JAYAKUMAR B
M.B.B.S, M.S. GRL SURGERY., D.A.,F.A.I.M.S., F.C.G.P.,
KALPANA CLINIC, VELACHERRY MAIN RD, MEDAVAKKAM, CH-100