Introduction: Scrub typhus is endemic in eastern and southern Asia, islands of western Pacific and Indian Ocean. The causative organism is a gram-negative bacterium, Orientia tsutsugamushi. Eschar in scrub typhus helps in early diagnosis and treatment, however the eschar positivity rates vary greatly. An eschar in an acute febrile patient from tsutsugamushi triangle is an important sign. The presence of eschar and IgM ELISA positivity can be used to detect majority of scrub typhus cases. Materials and methods: It is a hospital based observational study. This study state the epidemiologic and clinical profile of eight scrub typhus positive patients who were admitted in Base Hospital Delhi Cantonment (BHDC) during August–October 2018. Case series and result: Fever was the chief presenting complaint among all patients. Five patients had associated myalgia, headache and two patients had abdominal pain. One patient had cough and breathlessness which required intensive care. Eschar, the pathognomic feature of scrub typhus was present in all cases. Overall, the most common area of an eschar was groin followed by the abdomen. Conclusion: Presence of eschar is the key to clinical diagnosis of scrub.

Exercise elicits a wide variety of hormonal responses critical for metabolism and consequent tissue growth and development. It is imperative to understand that when we exercise there are acute endocrine responses and subsequent chronic endocrine conditioning. The acute response depends upon the frequency, intensity, and duration of physical exercise. Chronic endocrine conditioning is attained after a long duration of exercises and the magnitude of this conditioning is dependent on persistence, duration, attainment of neuroendocrine responses, and skeletal muscle response which releases myokines. There is ample amount of evidence now to believe muscle as an endocrine organ. Exercise activates various molecular mechanisms in the muscle which alters various endocrine and metabolic milieu inside the muscle. This review aims to provide evidence-based narration of peculiar anabolic and catabolic hormonal responses to exercise and revisit the mechanistic explanation of this occurrence. This review has analyzed the differential endocrine adaptation in aerobic and anaerobic exercises.

Introduction: The global emergence of antimicrobial resistance among gram-negative (GN) species is a major public health concern. The emergence of pan-resistant superbugs has further led to a serious threat to global public health security. The infections with these bacterial strains are associated with prolonged hospitalization, disseminated infections, and mortality. Newer therapeutic strategies are urgently needed to be explored to avoid the problems of developing further resistance. Aim and objective: Testing of a novel antibiotic combination regimen to investigate the effectiveness in in vitro sensitivity testing against pan-resistant superbugs. Materials and methods: In this prospective cross-sectional study, all pan-resistant, non-repeat, consecutive gram-negative bacteria identified through Vitek 2 compact (Biomerieux, France) automated microbiology system from intensive care unit, acute medical wards, and acute surgical wards were selected. And a novel derivative combination antimicrobial ceftriaxone 30 μg + sulbactam 15 μg + EDTA (CSE) was tested on pan-resistant microbes for possible susceptibility through Kirby–Bauer disk diffusion on Mueller–Hinton agar. Results: Ceftriaxone + sulbactam + EDTA was found effective in vitro against pan-resistant GN bacterial strains (56.94%). Among these pan-resistant GN bacterial strains, pan-resistant Klebsiella and Proteus strains were found highly susceptible (91% and 87%, respectively) to CSE. Discussion: Ceftriaxone + sulbactam + EDTA can be effective in treating pan-resistant GN bacterial strains as evident by in vitro susceptibility testing. Multiple centers involving both laboratories and patient care centers are required to coordinate and perform such types of studies to further augment the present knowledge and developing therapeutic options for these resistant superbugs.

Aim and objective: To assess the pattern of Internet use, to classify levels of Internet addiction, and to find out possible associated factors related to Internet addiction Materials and methods: This cross-sectional study was conducted in 2018 on undergraduate students of a medical college. The participants were asked to fill a questionnaire that had two parts. Part 1 was a semi-structured self-administered questionnaire pertaining to sociodemographic profile and characteristics of the Internet and computer use, and part 2 contained Internet addiction scale to evaluate internet addiction level of these students. The data collected were analyzed using appropriate statistical methods. Results: In all, 70.6% of undergraduate medical students had some degree of Internet addiction. The factors statistically associated with Internet addiction were gender, place of living, login status, purpose of Internet use, average Internet use per day, and expenditure on Internet usage. Conclusion: According to this study, the prevalence of internet addiction was high among medical students. We recommend controlling Internet addiction by building healthy living environment around these students, promoting other activities like book reading and sports, and providing counseling to those with addiction. Clinical significance: Internet addiction is a budding health problem and more so in college students.

Aim and objective: To report a rare case observed in the Department of Anatomy at a Medical College in Northern India during routine cadaveric dissection for first-year medical students. Background: Many anomalies of spleen have been reported which include multilobulated spleen, persistent lobulation, accessory spleen, asplenia, ectopic spleen, polysplenia, splenunculi, wandering spleen, and splenogonadal fusion. These splenic anomalies may be associated or may not be associated with other anomalies. Case description: We found an enlarged spleen with two accessory splenunculi of different sizes, lying separately, with no connection between them. Independent branches from left gastrosplenic artery were seen to be suppling each splenenculus. The enlarged spleen was completely covered by the left lobe of liver at its superior border. Conclusion: Accessory spleens or splenunculi have clinical significance in cases of splenomegaly, splenic trauma, and lymphadenopathy observed during clinical or imaging studies. Clinical significance: During the procedure of splenectomy, splenic lobules should be looked for and should be removed if present. In cases of ruptured primary spleen, accessory spleen can be preserved as splenic tissue.

Hydrogen peroxide (H₂O₂) is used by surgeons due to its oxygen releasing effervescent properties to locate internal openings in fistulous tracts. The oxygen released is known to cause embolism when it enters venous circulation, particularly when it is forced into a closed cavity. The obstruction it causes to the blood flow can cause circulatory and ventilatory failure. It manifests clinically by rapid fall in EtCO₂, hypotension, rise in central venous pressure (CVP), and fall in oxygen saturation. We present a case of a male patient who underwent fistulectomy under a saddle block and later developed air embolism when H₂O₂ was forcefully pushed at the site of surgery.

Celebratory firing/happy firing is considered to be a symbol of power and masculinity. In India, it is culturally accepted in many parts during a wedding procession. The present article describes a case of death of a teenager who sustained gunshot injury while attending her relative's marriage and succumbed to death and describes the prevalence of such customs existing in the society and the various measures taken by the government and policy makers to prevent such acts and to protect every life which is lost to activities that bring only momentary pleasure.

Plagiarism is wrongful appropriation and an unethical activity and is one of the most common forms of scientific misconduct and academic dishonesty that leads to rejection of many nursing research articles and retraction of the published articles. The reported cases of plagiarism are just the tip of the iceberg, and it is the responsibility of nursing educators, authors, and editors to formulate a zero tolerance against plagiarism. We need to reduce the engagement of students in dishonest behaviors and the potential transfer of this dishonest behavior to the clinical setting. This article discusses various types of plagiarism, its causes, detection of plagiarism, and the responsibility of nursing educators, authors, and editors in preventing/reporting plagiarism in articles they come across. It also emphasizes on regular use of plagiarism detection tools and formulation of anti-plagiarism committees which will ensure publication ethics.

As the demands on medical professionals and healthcare infrastructure increase, the introduction of automation via robotics is inevitable. Robotics originated in science fiction literature and from there industrial robotic arms, and more recently surgical robotic devices have been created. In this article, we examine the types of robots, their development, and upcoming projects.