Search

Introduction: Hemiplegia due to cerebral stroke is associated with various dermatological co-morbidities, arising out of motor, sensory and autonomic dysfunctions. Aim: To find out the different dermatological conditions prevalent in patients of hemiplegia secondary to cerebral Stroke. Materials and Methods: An observational cross-sectional study was conducted in the Department of Neurology in collaboration with the Department of Dermatology at Hi-Tech Medical College and Hospital, Bhubaneswar, Odisha from July 2017 to June 2020. Patients with hemiplegia of more than one month duration were included. The skin findings present before the neurological insult and patients with systemic conditions like atopic dermatitis, diabetes mellitus and thyroid disorders causing skin changes were excluded. Relevant tests for diagnostic confirmation of the skin lesions were done wherever needed. The software Statistical Package for the Social Sciences (SPSS) version 16.0 was used for the statistical analysis. Results: Study included 411 patients of cerebral stroke. A total of 382 (92.9%) patients were found to have dermatological manifestation. (Male:Female ratio 2.6:1). A total of 549 and 128 skin conditions were diagnosed in the paralysed and non paralysed limbs respectively. The common dermatological conditions diagnosed in the affected limbs were, xerosis {371 (97.12%)}, tinea corporis/cruris {61 (15.97%)}, onychomycosis {31 (8.12%)}, tinea pedis {28 (7.33%)} and nail abnormalities {27 (7.07%)} patients. Conclusion: Knowledge of various dermatological conditions associated with hemiplegia helps in early intervention and better management during rehabilitation phase of patients with hemiplegia. [ABSTRACT FROM AUTHOR]

Context: Familial amyloidotic polyneuropathy (FAP) is often misdiagnosed as other neuropathic illnesses.Aim: To highlight the diagnostic "odyssey" in three families of Indian origin with FAP.Settings and Design: Cross-sectional, hospital-based study.Subjects and Methods: Clinical, radiological, and histological features as well as causes for delayed diagnosis were analyzed in genetically confirmed patients with FAP.Statistical Analysis: Descriptive.Results: Age at evaluation ranged from 24 to 42 years and symptom duration from 1 to 10 years. Referral diagnoses included: (i) in patients 1 and 2-familial dysautonomia, Shy-Drager syndrome, and spino-cerebellar ataxia with seizures, (ii) in patient 3-chronic inflammatory demyelinating polyradiculoneuropathy, and (iii) in patient 4-porphyria. In addition, patients 1 and 2 developed leptomeningeal involvement that was mistaken for tubercular meningitis. Reasons for missed diagnosis included: clinician's lack of awareness, not paying sufficient attention to family history, presence of laboratory distractors such as elevated urinary porphyrins, lack of meticulous search for amyloid in the biopsy, and not performing specific stain for amyloid viz. Congo red. Evidence of amyloid in histological studies of nerve and skin supported by genetic variations in transthyretin gene clinched the diagnosis. The variants identified in our cohort included p.Gly73Glu, p.Val71Ala, and p.Val50Met.Conclusion: Lack of awareness and meticulous work-up by clinicians and pathologists contributed to delayed diagnosis of FAP. It is important to establish an accurate diagnosis as these patients may be candidates for upcoming therapies. [ABSTRACT FROM AUTHOR]

The Role models of effective leadership in Indian insurance sector have often been used to analyse or design existing cases. In this paper we go one step further by developing role models that match a future scenario. We combine knowledge from futures studies and the experience that we have in analysing existing role models, with the development of role models in the insurance sector. We have chosen the insurance sector because it is a sector where innovation is a cumbersome affair. In view of the importance of the leadership in this field, the inability to innovate presents a problem to other parties in the insurance value chain, such as insurers, but also to the increasingly knowledgeable and emancipated customers. Customers expect customer friendly processes supported by IT at the front office end, and a flexible management of the insurance process at the back office end. It is important, then, for managers to be able to meet the requirements from their environment. Here it is necessary to review the leaders of insurance sector with ideas on how they response regarding behavioral fitness and managerial behavior. [ABSTRACT FROM AUTHOR]

Erythrokeratodermas are a rare group of genetic disorders presenting early in childhood as erythematous, hyperkeratotic plaques on the skin. There may be associated neurological involvement. A 12‑year‑old boy presented with symmetric keratotic plaques on the body since infancy. Psoriasis and pityriasis rubra pilaris were ruled out after histopathological examination of the skin. We are reporting a case of progressive symmetric erythrokeratoderma with classical lesions but can be missed due to unawareness. [ABSTRACT FROM AUTHOR]

The article describes the case of a 56-year-old woman who developed mucinous infiltrating adenocarcinoma of stomach. The patient presented with headache and intermittent projectile vomiting for 10 days. She underwent treatment with low molecular weight heparin, antiepileptics and anti edema measures. After one month of neurological stabilisation, a subtotal gastrectomy with lymph node resection was performed.

Introduction: The diagnosis of systemic sclerosis is mostly clinical and is identified by the various cutaneous changes. The cutaneous changes in systemic sclerosis are already well established and supported by a large number of studies and textbooks. Very few literatures describe foot findings in patients with systemic sclerosis. This study was aimed at identifying the various changes in plantar aspect of foot of patients with systemic sclerosis., Methods: All patients diagnosed with systemic sclerosis were recruited. Apart from clinical examination, X - ray of both feet was done in all the patients., Results: A total of 52 patients were recruited in the study period. Most of the patients (86.54%) were females and the mean age at presentation was 34.19 years. A history of Raynaud's phenomenon was present in 47(90.38%) patients. The foot findings were digital pitted scars in 44(84.61%) patients, macular hyperpigmentation in 40(76.92%) patients and corns in weight bearing areas were found in 40 (76.92%) cases., Conclusions: In our study corn was a common finding in the foot of patients of systemic sclerosis which has not been routinely documented., (© Journal of the Association of Physicians of India 2011.)