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Background:Vitamin B12 deficiency is thought to be uncommon in the eastern parts of India including Bengal and the eastern states as compared to the northern and southern parts of India. The importance of cutaneous features in relation to vitamin B12 deficiency is not well described in literature.Aim:To know the clinical profile of vitamin B12 deficiency in this region and to find out if there is any relationship between dermatologic manifestations with vitamin B12 deficiency.Materials and Methods:All symptomatic patients of anemia requiring blood transfusions who had either raised mean corpuscular volume (MCV) or bicytopenia/pancytopenia on complete blood count or were symptomatic in the form of skin hyperpigmentation were screened for vitamin B12 deficiency.Results:Twenty-five patients were tested for vitamin B12 deficiency. Of them 19 patients were found to be having vitamin B12 deficiency.Conclusions:Vitamin B12 deficiency is not uncommon in the eastern parts of India, contrasting the previous thoughts that it was uncommon in this area, though larger studies are required to know it better. This study included only those requiring blood transfusions, thus a much higher prevalence is expected in this area. Patients with vitamin B12 deficiency do present with severe anemia requiring blood transfusions and often have skin hyperpigmentation.

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Background and Objective:Dengue, an acute viral disease, transmitted by Aedes mosquitoes, has a variable clinical spectrum ranging from asymptomatic infection to life-threatening dengue hemorrhagic fever and dengue shock syndrome. However, neurological complications, in general, are unusual but have been observed more frequently in the recent past, and some studies highlighted varied neurological complications during the course of illness. Although dengue is classically considered a nonneurotropic virus, there is increasing evidence for dengue viral neurotropism. In this study, we have evaluated clinico-radiological profile and outcome of nine serologically confirmed dengue patients having varied manifestations of central nervous system (CNS) involvement.Materials and Methods:All the consecutive patients presented with neurological complications with positive serology for dengue infection (IgM positivity) in Department of Medicine, in a tertiary care hospital in Eastern India from August 2013 to October 2014 were included in the study. These patients were subjected to a detailed clinical evaluation, laboratory assessment including complete hemogram, coagulation profile, liver function test, serum electrolytes, and routine CSF (Cerebrospinal Fluid) study with the exclusion of other common neuroinvasive pathogens.Results:Out of 9 patients with neurological complications associated with confirmed dengue infection, 2 (22%) patients had dengue encephalopathy, 5 (56%) patients have dengue encephalitis, 1 (11%) patient had dengue meningitis, and 1 (11%) patient had postdengue immune-mediated CNS involvement.Conclusion:This case series reaffirms the occurrence of varied CNS manifestations in dengue virus infection and underlines the importance of inclusion of dengue in the differential diagnosis of acute encephalitis syndrome.

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Kernohan's notch is one of the commonly described false localizing signs in clinical neurology. The lesion has been clearly demonstrated by MRI and is shown as hyperintense lesion of the cerebral peduncle on T2-weighted images. The lesion is best demonstrated on coronal imaging. We describe the lesion in a 56-year-old male with chronic subdural hematoma. The neurological sings disappeared after evacuation of the SDH.