December 2017

SPECIAL SUPPLEMENT ON NEUROLOGY

Largest

Crcuaed

MedcalJouna nnda

Dr K KAggarwa Na ional President MA

Dr R N Tandon

Dr Dil p Kumar Dutta Honorary Edi or JIMA

Kakali Sen Honorary Secretary J MA

CONTENTS

Editorial:

Lateonsettreatableneurologicaldiseases

— Dilip Kumar Dutta, Shyamal Kumar Das........................5

ReviewArticle:

LateOnsetHeadache— Debashish Chowdhury Ashish Kumar Duggal .........................................................6

OriginalArticles:

Teenagepregnancycomplicationsandoutcomesina tertiarycarehospital—Shivani Agarwal, Sangita Nangia Ajmani, Pooja Verma, Vibha Tandon ........13

PredictorsofIn-hospitalcomplicationsin patientsofposteriorcirculationischemicstrokes

—astudyfromatertiarycarecentreinEastern India— Biman Kanti Ray Alak Pandit, Satish Lahoti, Adreesh Mukherjee, Pradip Kumar Chowdhury ................................................18

Clinicalprofileandoutcomeofelderlypatientswith epilepsyinaNeurologytertiarycarecentrein EasternIndia — Alak Pandit, Adreesh Mukherjee, Meghraj Singh Patel, Goutam Gangopadhyay, Biman Kanti Ray ...............................................................23

ObservationalStudy:

Postpartuminsertionofintrauterinecontraceptive deviceinateachinghospitalinKalyani, WestBengal:oneyearreview— Banasree Bhadra, Sougata Kumar Burman, Ranita Roy Choudhury..............26

Case Reports:

Acaseofataxia— Subhadeep Banerjee, Apratim Chatterjee, Partha Ghorai, Gautam Ganguly......29

Acaseoflowbackpain Jayanta Ghosal, Samar Biswas .....................................31

PictorialCME:

AdenomaSebaceum&AshleafSpots — Ankit Shrivastav ..........................................................34

Guideline:

Antiretroviraltherapy-anUpdate— B B Rewari ..............35

Volume 115 Number 12 Kolkata December 2017 3

DrugCorner:

Acuteischemicstroke:newermedications....our dutytoprovideandpatientsrighttoreceive

— Subhadeep Gupta, Tanuka Mondal, Biman Kanti Ray, Apurba Mukherjee ...........................39

CaseoftheMonth:

AllthatwheezesisnotAsthma

— Shyam Krishnan, Raja Dhar ....................................41

LetterstotheEditor:

Replyfromauthor: Mediquiz:

Subhadeep Banerjee, Apratim Chatterjee, Partha Ghorai, Gautam Ganguly ..................................43

Special Supplement on NEUROLOGY

Review Articles:

Neurologicalinfectionsintheelderly

— Imran Rizvi, Ravindra Kumar Garg .......................44

Recurrenttransientlossofconsciousnessinelderly

— L J Basumatary, L Bharadwaj, A K Kayal ................51

Parkinson’sdisease:diagnosisandmanagement

— Shweta Prasad, Pramod Kumar Pal .......................56

Criticalcareofacutestroke— Vineeta Singh, Anand Vaishnav ...........................................................66

EpidemiologyofstrokeinIndia

— Apratim Chatterjee, Gautam Das,

T N Kundu, Sibabrata Banerjee, Swati Kumar .............71

Socialaspectsofdementia:Indianscenario

— Souvik Dubey, Gautam Das, Subhankar Chatterjee, Atanu biswas, Swati Pal ..........76

CaseReport:

Paraneoplasticcerebellarataxiaastheinitial manifestationofoccultfallopiantubecarcinoma

acasereport— Arghya Deb, Souvik Dubey

Atanu Biswas, Biman Kanti Roy, Shyamal Kumar Das ....................................................81

Dr

JOURNAL OF THE INDIAN MEDICAL ASSOCIATION

Founder Hony Editor : Sir Nilratan Sircar

Hony Editor : Dr Dilip Kumar Dutta

Founder Hony Business Manager : DrAghore Nath Ghosh

Ex-officio Members : Dr Santanu Sen, Hony Jt Finance Secretary, IMA (Hqs), Kolkata

Dr Santosh Kumar Mandal, Hony Joint Secretary, IMA (Hqs), Kolkata

Hony Secretary : Dr Kakali Sen

HonyAssociate Editors : DrAmitabha Bhattacharya

Dr Dipanjan Bandyopadhyay

Assistant Secretary : Dr Gopal Das

OFFICE BEARERS OF IMA (HQs)

National President

Dr K KAggarwal

Honorary Secretary General

Dr R N Tandon

Immediate Past National President

Dr S SAgarwal (Rajasthan)

National President-Elect (2017-2018)

Dr Ravi S Wankhedkar (Maharashtra)

National Vice-Presidents

Dr RoyAbhram Kallivayalil (Kerala)

Dr K Prakasam (Tamil Nadu)

Dr Mahendra Choudhary (Gujarat)

Dr Parmanand Prasad Pal (Bihar)

Honorary Finance Secretary

Dr V K Monga (Delhi)

Honorary Joint Secretaries

Dr Vinod Khetarpal (Delhi)

DrAnil Goyal (Delhi)

DrAshwini Kumar Dalmiya (Delhi)

Dr Santosh Kumar Mandal (Bengal)

Dr B B Gupta (Delhi)

Honorary Assistant Secretaries

Dr Dinesh Sahai (Delhi)

DrAmrit Pal Singh (Delhi)

Honorary Joint Finance Secretaries

Dr Manjul Mehta (Delhi)

Dr Santanu Sen (Bengal)

IMACGP(Chennai)

Dean of Studies

Dr V C Shanmuganandan (Karnataka)

Honorary Secretary

Dr R Gunasekaran (Tamil Nadu)

IMAAMS (Hyderabad)

Chairman

Dr Joseph Mani (Kerala)

Honorary Secretary

Dr Sadanand Rao Vulese (Telangana)

IMAAKN Sinha Institute (Patna)

Director

Dr Sarbari Dutta (Bengal)

Honorary Executive Secretary

Dr Raman Kumar Verma (Bihar)

JIMA(Calcutta)

Honorary Editor

Dr Dilip Kumar Dutta (Bengal)

Honorary Secretary

Dr Kakali Sen (Bengal)

Your Health (Calcutta)

Honorary Editor

DrAshok Kumar Chatterjee (Bengal)

Honorary Secretary

Dr Meenakshi Gangopadhyay (Bengal)

IMAN.S.S.S. (Ahmedabad) Chairman

Dr Kirti M Patel (Gujarat)

Honorary Secretary

DrYogendra S Modi (Gujarat)

IMAN.P.P.Scheme (Thiruvananthapuram)

Chairman

Dr Krishna M Parate (Maharashtra)

Honorary Secretary

Dr JayakrishnanAV (Kerala)

Apka Swasthya (Varanasi)

Honorary Editor

Dr Vivek Kumar (Uttar Pradesh)

Honorary Secretary

Dr Sanjay Kumar Rai (Uttar Pradesh)

IMAHospital Board of India

Chairman

Dr R VAsokan (Kerala)

Honorary Secretary

Dr Jayesh M Lele (Maharashtra)

IMANational Health Scheme

Chairman

DrAshok SAdhao (Maharashtra)

Honorary Secretary

DrAlex Franklin (Kerala)

IMANational Pension Scheme

Chairman

Dr Sudipto Roy (Bengal)

Honorary Secretary

Dr K V Devadas (Kerala)

To become editor of Journal of Indian MedicalAssociation, it was a great dream come true to me. My whole hearted thanks to respected and beloved National leader DrKetanDesaiwhohasentrustedmetonominateinsuchposition.

My whole hearted thanks to Dr K K Aggarwal, National President, Dr Ravi Wankhedkar, President Elect, Dr R N Tandon, Hony Secretary General, IMAHQ who alwaysgivenmeinspirationtomaketheJIMAexcellent.Mysincererespecttoallpast presidents of IMAwho not only helped me but also inspired me, to put best research papersinJournal.

I have put my efforts to include important topics like how to predict and prevent child and maternal death, cerebral palsy, cervical cancer, heart disease, diabetes and neurological disorders which may help our doctors in their respective field & clinical practice.

At last thanks from my core of my heart to Dr Sudipto Roy, Past National President, Dr Santanu Sen, Hony Jt Finance Secretary, IMA HQ and Dr Kakali Sen, Hony Secretary, JIMA along with editorial board and office staffs for their suggestions, motivationandencouragementhowtoimproveJIMA.

LongliveJIMA.

DrDilipKumarDutta HonyEditor,JIMA