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Introduction: Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disorder of motor neurons. Spread of pathology to other brain areas leads to development of non-motor symptoms (NMSs). These usually remain undiagnosed because of overwhelming motor problem and are responsible for significant distress to the patient. Our objective was to explore the burden of various NMSs of patients with ALS, compare between limb-onset and bulbar-onset patients, and to correlate with severity and duration of disease. Methods: Fifty patients with ALS diagnosed according to revised El Escorial Criteria and 50 healthy controls were included in this study. They were assessed with NMS Questionnaire, Beck's Depression Inventory, Center for Neurologic Study-Lability Scale, Drooling Frequency and Severity Scale, Epworth Sleepiness scale, Bengali Mental State Examination, and Frontal Assessment Battery and relevant statistical analyses were carried out. Results: The patients with ALS had significantly increased prevalence of almost all NMSs compared to controls. There was also significant increase in depression, suicidal ideation, pseudobulbar affect, and daytime sleepiness in patients with ALS. The bulbar onset subgroup had significantly increased daytime drooling, dysphagia, nausea and vomiting, whereas the limb onset subgroup reported increased frequency of leg swelling. Executive dysfunction was detected in 24% of patients with ALS and 9.8% had mild cognitive impairment. Weight loss, frequency of falling, insomnia, unpleasant nocturnal leg sensations, difficulty having sex, depression, and cognitive impairment increased significantly with an increase in severity of the disease. Conclusion: NMSs were significantly more prevalent in patients with ALS. Some NMSs worsened with advancement of the disease.

Abstract:Objectives: We wanted to find out the change and pattern of hematological disturbances in patients suffering from malaria and whether the hematological disturbances had any correlation with morbidity in them. Materials and methods: In a retrospective, observational study, first 100 admitted malaria patients in a tertiary medical institute in Kolkata, was taken from August 2009 to July 2011 and their demographic, clinical and laboratorial records were noted and analysed. Results: Seventy-one patients (71%) had anemia, ninety patients (90%) had thrombocytopenia, twenty-six patients (26%) had leucopenia and two patients (2%) had leukocytosis. Vivax malaria patients had lower platelet count than their falciparum counterparts, whereas falciparum malaria patients had lower hemoglobin, packed cell volume and higher total leukocyte count; all these hematological disturbances were found to be correlated with higher morbidity in patients suffering from malaria. Conclusion: In patients suffering from malaria, there was high incidence of hematological disturbances which was changing pattern and also correlated with morbidity.

Background:Most of the studies on hypokalemic periodic paralysis (HOPP) in India and abroad had described secondary causes as the origin of the disease. We had observed a series of HOPP cases clustered within 40 kilometers around Bankura, a district town of West Bengal, Eastern India. The aim of our study was to probe into the clinical, biochemical and electrophysiological details of the cases, which were found to be idiopathic. Material and Methods: 32 idiopathic HOPP cases, attending the neurology OPD or admitted in Bankura Sammilani Medical College & Hospital (BSMCH), were selected from October 2006 to May 2008. All the secondary causes of HOPP were excluded. The patients were evaluated and the data was analyzed. Results: Cases were clustered within a 40-kilometer radius from Bankura town, location of BSMCH. Male: female = 4.3:1. Median age of onset was 23.5 years (4-50 years). Median number of attacks was 2.5, (1 to 70); duration 3 hours -6 days, median 3 days. Strenous physical activity was most common precipitating factor. 25% had bulbar symptoms, 9.4% had bladder dysfunction and 46.9% had diminished to absent deep tendon reflexes. Mean serum potassium = 2.45 mEq/L (1.4 -3.1 mEq/L). Conclusion: We had observed a group of idiopathic HOPP cases within a relatively small area in a short span of time in contrast to most other Indian studies, where the share of idiopathic aetiology is comparatively smaller. This underscores the importance of a larger study with genetic analysis on the aetiology of the idiopathic HOPP in this area.