December 2017

SPECIAL SUPPLEMENT ON NEUROLOGY

Dr

Largest Circulated Medical Journal in India

JIMA

Official Publication of the Indian Medical Association

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JOURNAL OF THE INDIAN MEDICAL ASSOCIATION, VOL 115, NO 12,

DECEMBER 2017

Dr K K Aggarwal

Dr R N Tandon

Dr Dilip Kumar Dutta

Dr Kakali Sen

National President IMA

Honorary Secretary General, IMA

Honorary Editor, JIMA

Honorary Secretary, JIMA

Volume 115 u Number 12 u Kolkata u December 2017

CONTENTS Drug Corner : u Acute ischemic stroke : newer medications....our duty to provide and patients right to receive — Subhadeep Gupta, Tanuka Mondal, Biman Kanti Ray, Apurba Mukherjee ...........................39

Editorial : u Late onset treatable neurological diseases — Dilip Kumar Dutta, Shyamal Kumar Das ........................5 Review Article : u Late Onset Headache — Debashish Chowdhury, Ashish Kumar Duggal .........................................................6

Case of the Month : u All that wheezes is not Asthma — Shyam Krishnan, Raja Dhar ....................................41

Original Articles : u Teenage pregnancy complications and outcomes in a tertiary care hospital — Shivani Agarwal, Sangita Nangia Ajmani, Pooja Verma, Vibha Tandon ........13 u Predictors of In-hospital complications in patients of posterior circulation ischemic strokes — a study from a tertiary care centre in Eastern India — Biman Kanti Ray, Alak Pandit, Satish Lahoti, Adreesh Mukherjee, Pradip Kumar Chowdhury ................................................18 u Clinical profile and outcome of elderly patients with epilepsy in a Neurology tertiary care centre in Eastern India — Alak Pandit, Adreesh Mukherjee, Meghraj Singh Patel, Goutam Gangopadhyay, Biman Kanti Ray ...............................................................23

Letters to the Editor : u Jyotirmoy Pal, Pradip Kumar Chowdhury.....................42 Reply from author : u Maitreyee Bandyopadhyay ............................................42 Mediquiz : Subhadeep Banerjee, Apratim Chatterjee, Partha Ghorai, Gautam Ganguly ..................................43

Special Supplement on NEUROLOGY Review Articles : u Neurological infections in the elderly — Imran Rizvi, Ravindra Kumar Garg .......................44 u Recurrent transient loss of consciousness in elderly — L J Basumatary, L Bharadwaj, A K Kayal ................51 u Parkinson’s disease : diagnosis and management — Shweta Prasad, Pramod Kumar Pal .......................56 u Critical care of acute stroke — Vineeta Singh, Anand Vaishnav ...........................................................66 u Epidemiology of stroke in India — Apratim Chatterjee, Gautam Das, T N Kundu, Sibabrata Banerjee, Swati Kumar .............71 u Social aspects of dementia : Indian scenario — Souvik Dubey, Gautam Das, Subhankar Chatterjee, Atanu biswas, Swati Pal ..........76

Observational Study : u Postpartum insertion of intrauterine contraceptive device in a teaching hospital in Kalyani, West Bengal : one year review — Banasree Bhadra, Sougata Kumar Burman, Ranita Roy Choudhury ..............26 Case Reports : u A case of ataxia — Subhadeep Banerjee, Apratim Chatterjee, Partha Ghorai, Gautam Ganguly......29 u A case of low back pain —Jayanta Ghosal, Samar Biswas .....................................31 Pictorial CME : u Adenoma Sebaceum & Ashleaf Spots — Ankit Shrivastav ..........................................................34

Case Report : u Paraneoplastic cerebellar ataxia as the initial manifestation of occult fallopian tube carcinoma : a case report — Arghya Deb, Souvik Dubey, Atanu Biswas, Biman Kanti Roy, Shyamal Kumar Das ....................................................81

Guideline : u Antiretroviral therapy-an Update — B B Rewari ..............35 3

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JOURNAL OF THE INDIAN MEDICAL ASSOCIATION, VOL 115, NO 12,

DECEMBER 2017

JOURNAL OF THE INDIAN MEDICAL ASSOCIATION Founder Hony Editor Hony Editor Founder Hony Business Manager Ex-officio Members

: : : :

Hony Secretary Hony Associate Editors

: :

Assistant Secretary

:

Sir Nilratan Sircar Dr Dilip Kumar Dutta Dr Aghore Nath Ghosh Dr Santanu Sen, Hony Jt Finance Secretary, IMA (Hqs), Kolkata Dr Santosh Kumar Mandal, Hony. Joint Secretary, IMA (Hqs), Kolkata Dr Kakali Sen Dr Amitabha Bhattacharya Dr Dipanjan Bandyopadhyay Dr Gopal Das

OFFICE BEARERS OF IMA (HQs) National President Dr K K Aggarwal Honorary Secretary General Dr R N Tandon

IMA CGP (Chennai) Dean of Studies Dr V C Shanmuganandan (Karnataka) Honorary Secretary Dr R Gunasekaran (Tamil Nadu)

National President-Elect (2017-2018) Dr Ravi S Wankhedkar (Maharashtra)

IMA AMS (Hyderabad) Chairman Dr Joseph Mani (Kerala) Honorary Secretary Dr Sadanand Rao Vulese (Telangana)

National Vice-Presidents Dr Roy Abhram Kallivayalil (Kerala) Dr K Prakasam (Tamil Nadu) Dr Mahendra Choudhary (Gujarat) Dr Parmanand Prasad Pal (Bihar)

IMA AKN Sinha Institute (Patna) Director Dr Sarbari Dutta (Bengal) Honorary Executive Secretary Dr Raman Kumar Verma (Bihar)

Honorary Finance Secretary Dr V K Monga (Delhi)

JIMA (Calcutta) Honorary Editor Dr Dilip Kumar Dutta (Bengal) Honorary Secretary Dr Kakali Sen (Bengal)

Immediate Past National President Dr S S Agarwal (Rajasthan)

Honorary Joint Secretaries Dr Vinod Khetarpal (Delhi) Dr Anil Goyal (Delhi) Dr Ashwini Kumar Dalmiya (Delhi) Dr Santosh Kumar Mandal (Bengal) Dr B B Gupta (Delhi) Honorary Assistant Secretaries Dr Dinesh Sahai (Delhi) Dr Amrit Pal Singh (Delhi) Honorary Joint Finance Secretaries Dr Manjul Mehta (Delhi) Dr Santanu Sen (Bengal)

Your Health (Calcutta) Honorary Editor Dr Ashok Kumar Chatterjee (Bengal) Honorary Secretary Dr Meenakshi Gangopadhyay (Bengal) IMA N.S.S.S. (Ahmedabad) Chairman Dr Kirti M Patel (Gujarat) Honorary Secretary Dr Yogendra S Modi (Gujarat)

IMA N.P.P.Scheme (Thiruvananthapuram) Chairman Dr Krishna M Parate (Maharashtra) Honorary Secretary Dr Jayakrishnan A V (Kerala) Apka Swasthya (Varanasi) Honorary Editor Dr Vivek Kumar (Uttar Pradesh) Honorary Secretary Dr Sanjay Kumar Rai (Uttar Pradesh) IMA Hospital Board of India Chairman Dr R V Asokan (Kerala) Honorary Secretary Dr Jayesh M Lele (Maharashtra) IMA National Health Scheme Chairman Dr Ashok SAdhao (Maharashtra) Honorary Secretary Dr Alex Franklin (Kerala) IMA National Pension Scheme Chairman Dr Sudipto Roy (Bengal) Honorary Secretary Dr K V Devadas (Kerala)

JOURNAL OF THE INDIAN MEDICAL ASSOCIATION, VOL 115, NO 12,

DECEMBER 2017

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JOURNAL OF THE INDIAN MEDICAL ASSOCIATION, VOL 115, NO 12,

DECEMBER 2017

JOURNAL OF THE INDIAN MEDICAL ASSOCIATION, VOL 115, NO 12,

DECEMBER 2017

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JOURNAL OF THE INDIAN MEDICAL ASSOCIATION, VOL 115, NO 12,

DECEMBER 2017

JOURNAL OF THE INDIAN MEDICAL ASSOCIATION, VOL 115, NO 12,

DECEMBER 2017

Activities Report

To become editor of Journal of Indian Medical Association, it was a great dream come true to me. My whole hearted thanks to respected and beloved National leader Dr Ketan Desai who has entrusted me to nominate in such position.

My whole hearted thanks to Dr K K Aggarwal, National President, Dr Ravi Wankhedkar, President Elect, Dr R N Tandon, Hony Secretary General, IMA HQ who always given me inspiration to make the JIMA excellent. My sincere respect to all past presidents of IMA who not only helped me but also inspired me, to put best research papers in Journal.

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, motivation and encouragement how to improve JIMA. Long live JIMA. Dr Dilip Kumar Dutta Hony Editor, JIMA

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