Stroke is one of the leading causes of mortality and disability. It can be rarely caused by cardiac myxoma. Sometimes stroke may be its first clinical manifestation. Here we report a case of posterior circulation stroke in left atrial myxoma. A 45-year-old female patient presented with a history of recurrent episodes of dizziness and headache of three months duration. Neurological examination showed impaired tandem gait. Magnetic resonance imaging (MRI) of the brain revealed infarction in the left posteroinferior cerebellar hemisphere. Echocardiography of the patient revealed a large left atrial mass suggestive of atrial myxoma and an ejection fraction of 60%.The patient was operated on for atrial myxoma two days after the diagnosis, and histopathology confirmed the diagnosis. Postoperatively she remained well and was managed on anti-platelet drugs. Atrial myxoma should be considered as a possible differential while evaluating a case of cardioembolic stroke, and echocardiography detects the presence of an atrial myxoma. It is also essential that atrial myxomas are managed early to prevent recurrent strokes.

Background: The craniovertebral junction (CVJ) is a crucial region of the spine designed for optimal movements of head and is also a frequent site for various pathological processes. The importance of knowing the CVJ parameters in normal population cannot be overstated when instrumentation and correction of deformities in this region is so frequently being performed. There is paucity of data defining the craniometrics of CVJ osteology in Indian population on the literature search. Accordingly, we present a study in an attempt to quantitate the normal craniometric indices for anatomically normal CVJ in Indian population and compare them with the existing literature from other regions. Aims and Objectives: The aims of this study were to quantitate the normal craniometric indices for anatomically normal CVJ in Indian population and compare them with the existing literature from other regions. Materials and Methods: Two hundred and forty computed tomography (CTs) belonging to Indians were looked at over a 6-month period retrospectively. These patients had normal CVJs and were ordered imaging for other health reasons. A total of eight parameters were analyzed for each CT. Results: There were 166 (69.2%) males and 74 (30.8%) females in our study. The values (in mm) were as follows: anterior atlantodental interval (AADI), 1.78±0.42; PADI (posterior atlantodental interval), 18.12±1.97; distance of tip of odontoid process to chamberlain’s line, –2.73±2.63; distance of tip of odontoid process to McGregor’s line, –2.29±2.79; distance of tip of odontoid process to McRae’s line, –5.91±1.4; Clivus-canal angle, 160.82°±7.14°; basion dens interval, 5.6±1.45; and powers ratio, 0.71±0.07. No patient had an odontoid process extending beyond the McRae’s line. Males were more likely to have higher AADI and PADI values than females. Our study shared significant differences between the other studies (even the studies where an Indian population was used) except one. The AADI, from our study, did not vary significantly when compared to the AADI from a Chinese study. Conclusion: Due to the significant differences from our study and the available literature, a greater compilation of studies belonging to different races will be required to understand the flexibility of the CVJ metrics.

Systemic lupus erythematosus (SLE) is a multi-organ autoimmune disease, with the skin being the second most affected organ after the joints. We present a unique case of a 44-year-old female who presented with an acute flare of SLE and the concurrent onset of keratoderma on both lower limbs. She presented with highgrade fever, arthralgia, and generalized edema of four months duration. A general physical examination revealed pallor and scaly hyperpigmented plaques on both lower limbs, which was confirmed to be keratoderma on histopathological examination. Blood investigations revealed pancytopenia, elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), and positive titers for anti-nuclear antibody (ANA) and anti-Po ribosomal P proteins (RPP) antibodies. Immunosuppressive medications and topical keratolytics were used to treat her successfully. Post medical management, she showed significant improvement in her symptoms. On follow-up, the patient had a complete resolution of the symptoms and remained well. This case demonstrates keratoderma as a rare incidental finding in a patient with SLE flare. Understanding SLE's various cutaneous manifestations are critical for holistically diagnosing and treating the disease.

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Background: Our study assessed the knowledge, attitude and practice towards COVID-19 and its’ psychological impact during the rise in COVID-19 cases and the subsequent implementation of lockdown in India.Methods: We distributed an online questionnaire to 500 people between March 2020 to April 2020. We measured knowledge about COVID-19, attitude regarding the virus, practices, preventive measures and psychological responses.Results: Out of the 500 responses, 64.6% (323) were women and 35.4% (177) were males and all the participants had completed high school. 95% (475) of the respondents had ≥75% knowledge, 86.8% (434) had positive attitudes, 98.2% (491) followed adequate preventive measures, 14.2% (71) reported moderate to extremely severe depression, 13.6% (68) reported moderate to extremely severe anxiety and 6.6% (33) reported moderate to extremely severe stress.Conclusions: Knowledge, attitude and practice scores varied across age, sex, level of education and occupation (p<0.001). Higher knowledge was found to be associated with better attitudes and practices (p=0.08). The rise in COVID-19 cases and deaths in India and the subsequent implementation of lockdown had an impact on the psychological health of the respondents. Better knowledge scores indicated better psychological health in terms of anxiety and stress but yielded higher depressive symptoms which were not statistically significant.