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Results This study recruited 110 patients with PD on levodopa therapy. Thirty-one (28.1%) out of 110 had LID. Of these, 25 patients (80.6%) had on-time dyskinesia, 19 patients (61.3%) had off-time dystonia, and 13 patients (41.9%) had diphasic dyskinesia. Majority had only mild-to-moderate dyskinesia. Incapacitating dyskinesias were during off time, primarily affecting the foot. learn more Age, disease duration, disease severity, duration of treatment, and total dose of levodopa were found to be predictors of LID. Multivariate regression analysis showed younger age and longer duration of levodopa treatment to be independent predictors for LID. Conclusions LID is fairly common in PD though not severely disabling. Patients with younger age of onset, longer disease duration, and severe disease were more likely to get early LID. We observed the lower prevalence of LID when initiating at lower doses and slow titration of levodopa. Copyright © 2006-2019 Annals of Indian Academy of Neurology.Background Stroke results in significant caregiver burden and strain. Objective The main objectives of this study is to assess the burden and its consequences in caregivers of stroke patients and to determine the associated factors to caregivers’ burden. Methods A cross-sectional study was conducted over 1 year on 70 consecutive patients who attended the Shree Krishna Hospital, Karamsad stroke clinic. Demographic and clinical characteristics of all patients were recorded after obtaining the consent. The modified rankin scale and Barthel index were administered to the patient, whereas Caregiver strain index, Caregiver burden scale, Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, and Kuppuswami scale were administered to the patient’s caregiver. Descriptive statistics were used to portray demographic and clinical profiles. Correlation coefficients were used to assess the association between different scales, and t-test was applied to assess association of caregivers’ burden with different categorical variables. Results The mean age was 60 years for patients and 47 years for caregivers. Nearly 72.8% of patients were male, whereas 57% of caregivers were female. The mean caregiver burden scale score was 28.26. Caregivers’ burden decreased with increase in stroke duration (P = 0.01), increase in education level (P = 0.054), and upper socioeconomic status (P = 0.02). Caregivers’ burden increased with caring for male gender (P = 0.18), being a female caregiver (P = 0.31), longer caregiver hours (r = 0.51), and increased patient disability (P less then 0.01). A strong correlation existed between caregivers’ burden and depression (0.72); anxiety and depression (0.84); caregivers’ burden and caregiver strain index (0.72). Conclusions A structured and targeted caregiver intervention is urgently needed to relieve caregivers’ burden and related psychological comorbidities in an Indian setup. Copyright © 2006-2019 Annals of Indian Academy of Neurology.Objectives Patients with muscle-specific kinase (MuSK)-positive myasthenia are generally considered to have a grave prognosis. We present our experience of patients with myasthenia with different antibody status. This is followed by a short discourse on previous studies and the current view on MuSK-positive myasthenia, focusing on the associated prejudice. Materials and Methods This study compares 23 patients with MuSK-positive myasthenia with 55 patients with acetylcholine receptor-positive myasthenia and 9 patients with double-seronegative myasthenia at a tertiary level center. Results We did not find any significant difference in terms of clinical characteristics, treatment response to immunosuppressants, long-term prognosis, and quality of life. Conclusion Seropositivity for antibodies should not be used in isolation to guide the management or predict the prognosis. Undue negative prognostication may affect the morale of patient. Clinical features and response to therapy in addition to antibody status must be considered before planning therapy. Copyright © 2006-2019 Annals of Indian Academy of Neurology.Background and Purpose The present study aims to evaluate the role of blood pressure variability (BPV) as a target therapeutic risk factor for poor outcome of ischemic stroke by finding the association between the two and by finding the population attributable risk (PAR) of BPV compared to other baseline outcome predictors. Methods A prospective observational study was carried out at GMCH, Nagpur, India from January to June 2019 in 75 patients diagnosed with acute ischemic stroke. BP was recorded hourly for the first 24 hours of admission and base line factors were collected along with measurement of stroke severity. BPV was measured by index of average real-time variability (ARV) while discharge outcome was measured by Barthel Index. Results 36.5% of patients had poor outcome at discharge. A significant association was found between 24-hr ARV of systolic BP and poor outcome (P = 0.002, 95% CI = 2.22-23.5). Five factors were found to be independent outcome predictors on multiple logistic regression (OR, 95% CI) age (1.07, 1.03-1.10), NIHSS score (1.12, 1.04-1.27), on admission SBP (5.12, 4.01-16.23), on admission RBS (2.23, 1.92-6.49) and 24 Hr ARV-SBP (9.65, 3.02-20.1). The PAR of 24 hr ARV-SBP was 23.6%, second only to NIHSS score (26.4%). Conclusions Reduction in BP variability might have a beneficial impact on the outcome of patients with acute ischemic stroke. There is further scope to explore optimum therapeutic strategies to minimize BPV in the management of acute ischemic stroke. Copyright © 2006-2020 Annals of Indian Academy of Neurology.Background Apomorphine is an option for continuous dopaminergic therapy in Parkinson’s disease (PD). However, its effects in varied populations are limited due to its availability. Objective To assess the efficacy and outcomes of apomorphine in Indian patients. Materials and Methods Retrospective analysis of PD patients who underwent apomorphine response test (ART), along with the subset, who went on to apomorphine pumps. Results Twenty-nine confirmed PD patients underwent ART and all PD patients showed good clinical response. 19 subjects developed adverse events which included nausea (n-15, 51.7%), vomiting (n-10, 34.4%), sleepiness (n-08; 27.5%), yawning (n-07, 24.1%), postural hypotension (n-03, 10.3%), dizziness (n-03, 10.3%), and profuse sweating (n-01, 3.4%). Apomorphine pumps were initiated in six subjects, with significant clinical improvement. Adverse events on pump included subcutaneous nodules, nausea, hypersexuality. Two among them subsequently discontinued the pump primarily due to financial constraints.