VLADIMIR Putin was seen once again furiously gripping a table for support during a meeting as his veins bulged amid ongoing rumours about his health.
Russia's leader has been at the centre of a storm of speculation with various reports alleging he is sick - potentially suffering cancer or Parkinson's.
Every single one of Putin's public appearances is now being dissected as the aging leader - who turns 70 in October - appears to look frialer and weaker than ever before.
Kremlin officials consistently deny there is anything wrong with him, but the weakened Putin these days appears to be a far cry from his efforts to be seen as the world's strongman.
The mad tyrant has been seen with his legs covered with a thick blanket at a parade, and appeared to shake uncontrollably during a meeting with Belarusian dictator Alexander Lukashenko.
And one of the most striking videos showed Putin slouching, twitching his feet and appearing to steady himself by gripping a table as he met with his defence chief Sergei Shoigu.
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Putin has now been seen in the same room, at the same table, once again appearing to cling onto the edge.
No video of the meeting has yet been released, but the photos show the puffy faced leader looking like he is holding on for dear life.
His veins furiously bulge across his hand amid his death grip.
And in another picture, a very clear visible dimple is seen on his thumb from the sheer pressure of where he has been clinging on.
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Bulging veins can be a sign of blood clots or autoimmune disease - but are also a natural sign of advanced age.
Putin was sitting down for a meeting with RusNano State Corporation CEO Sergey Kulikov in Moscow.
He sat with his feet planted flat on the ground and reclining deep into his plush chair, while Kulikov leans forward cross legged.
Putin table grip has previously been described as a sign he is having to "keep himself propped up".
And there have been reports Kremlin officials are limiting the length of Vlad's meetings due to fears for his health.
Putin has reportedly been ordered by his doctors not to make any "lengthy" public appearances.
And it comes as Putin was reportedly given "urgent medical assistance" last week after being struck down by a "sharp sickness".
"This is not a portrait of a healthy Putin but one appearing increasingly feeble and barely able to hold himself upright at a small conference table," Professor Erik Bucy, a body language expert from Texas Tech University, previously told The Sun Online
"Putin’s legs also appear quite thin, as if he may be suffering from weight or muscle loss from an unannounced malady.
"Bloating in his face reinforces an unhealthy appearance, especially compared to photographs and video of the Russian premiere from a few years ago."
The professor added: "It’s an astonishingly weakened Putin compared to the man we observed even a few years ago."
And meanwhile Putin's annual Q&A TV appearance was suddenly postponed indefinitely despite it being announced just days before.
The tyrant is said to have fallen ill while talking to his military chiefs and suffered "sharp sickness, weakness and dizziness" as he got up from his desk after a 90-minute virtual session.
The unconfirmed claims appeared on the General SVR channel on the messaging app Telegram, which is purportedly run by a Kremlin insider.
It said that Putin "needed urgent medical assistance" from doctors.
The channel said this sudden "dizziness" spell was the real reason Vlad's "Direct Line" live broadcast had been axed.
The General SVR channel has made repeated claims in the past about Putin's alleged medical problems, including cancer and Parkinson's disease.
These claims, which the channel says are based on inside intelligence, are impossible to verify - especially amid the fog of war around Ukraine.
And experts remain skeptical about those who try to diagnose Putin based on still images and video.
Moscow has waded into the rumours, as Kremlin spokesman Dmitry Peskov said: “It’s absolute nonsense.
"Everything is fine with the president.”
Professor David Clarke however told Sky News that be believes Putin "looks alright" - and refutes claims you can diagnose someone view looking at photos.
He said there is "no convincing evidence" that Putin is in poor health.
"On 7 October he will be 70. He is known to hit the Botox quite heavily, I always say that he's trying to embalm himself while he's still alive - he does take a lot of Botox," said Professor Clarke.
"He moves around with doctors, there's known to be a little team of doctors who are never far away, and it's said that he leaves meetings at frequent intervals to go and consult with somebody.
"I suspect that he's only a hypochondriac, to be honest."
Putin continues to prosecute a disastrous war in Ukraine which has raged for more than 100 days and seen more than 30,000 Russian troops die.
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Russia is pushing into Ukraine and seems to be determined to seize huge swathes of the east of the former-Soviet state.
But there are ongoing fears the conflict could spiral out of control and draw in the West.