It is a case report on a very rare type of Leigh Syndrome (LS) that is adult-onset subacute necrotizing encephalopathy which generally begun during adolescence or early adulthood. It is characterized by degeneration of the CNS, severe failure of oxidative metabolism, vision impairment, impairment of respiratory, heart and kidney function. According to some resources incidence of occurring LS is 1 in 40,000 new born and unusually in adult hood. Characteristics lesion in basal ganglia associated with demyelination. Primary feature includes: subacute relapsing encephalopathy with cerebral and brain-stem signs presenting during infancy. Additional feature includes: basal ganglia lucencies. The prognosis for LS is very poor. Patients lacking mitochondrial complex IV activity and deficiency in pyruvate dehydrogenase have worst prognosis and die within a few years. Patients with partial deficiencies have better prognosis and can live up to 6 to 7 years of age. Some have survived to their mid-teenage years.

Background: The Government of India started the Janaushadhi Scheme in 2008 to control individuals' expenditure by providing low-cost generic medicines for health benefits. Hence, this study aims to study the real-world effectiveness of Jan Aushadhi generic antihypertensive medicines at a Pradhan Mantri Bhartiya Janaushadhi Kendra and also to assess knowledge and attitude toward generic drugs. Methods: This study was done in Pradhan Mantri Bhartiya Janaushadhi Kendra. Participants who were hypertensive and on at least one antihypertensive drug from Pradhan Mantri Bhartiya Janaushadhi Kendra were enrolled in the study. All the participants received three blood pressure (BP) measurements, i.e., two manual readings and an average of two taken. One digital reading is followed by questionnaires, which help assess patients' knowledge and attitude using Pradhan Mantri Bhartiya Janaushadhi Kendra medicines. All the participants were evaluated for baseline, 1st-month, 2nd-month, and 3rd-month follow-up visits. The baseline, 1st-month, 2nd-month, and 3rd-month data were compared using paired t-test and Cochran's q-test. Results: The important findings were a considerable reduction in BP compared to the baseline, 1st-month, 2nd-month, and 3rd-month follow-up. Approximately half of the patients (53.36%) know the difference between generic and brand medicines. A significant proportion of the participants believe that taking Janaushadhi medication reduces the cost. Hence, considerable improvement was evidenced in all outcome measures. Conclusion: A significant reduction in systolic and diastolic BP was achieved for all the hypertension stages, providing the authentication that most hypertensive patients may benefit from low-cost generic Jan Aushadhi medicines.