Suicide pacts are uncommon and mainly committed by male–female pairs in a consortial relationship. The victims frequently choose methods such as hanging, poisoning, using a firearm, etc; however, a case of a suicide pact by drowning is rare in forensic literature. We report a case where a male and a female, both young adults, in a relationship of adopted “brother of convenience” were found drowned in a river. The victims were bound together at their wrists which helped with our conclusion this was a suicide pact. The medico-legal importance of wrist binding in drowning cases is also discussed in this article.

A 25-year-old male was found dead in a water drum inside the bathroom of his house one morning. Autopsy revealed a fatal right wrist cut, superficial cuts on middle phalanx of left index finger and features of ante mortem drowning. Investigation revealed the victim was an alcoholic and was depressed due to financial problems. On the previous night, under the influence of alcohol, he first tried to commit suicide by cutting wrist with razor blades, but death was not immediate. He then attempted electrocuting himself by touching a live wire, inside the bathroom, which failed and finally he drowned in a water drum. The victim had left a message, written with his blood on the floor of the room, reflecting his suicidal intentions. In complex suicide, many bizarre methods are used, but this combination of methods is unusual and not found in available forensic literature.

Background: Salmonella enterica serovar Hvittingfoss, a member of the non-typhoidal Salmonella group, is an important foodborne serovar most frequently identified in regions (Australia, Belgium, and the United States) with active surveillance systems. This serovar has been implicated in outbreaks of foodborne illness. Soft cheese, crab cocktail, beef, and rock melon are commonly involved in these outbreaks. Although the definitive host of this serovar is not yet established, Salmonella Hvittingfoss can be found in wild animals (Feral pigs), bird populations (Bar-tailed godwit, Plumed whistling ducks, White-naped crane, and Sharp-tailed sandpiper), and domestic birds like chickens. Case presentation: We report the first case of Salmonella enterica serovar Hvittingfoss causing acute gastroenteritis in a 52-year-old male labourer and agriculturist from a rural area of Mysuru, South India. This is the first documented case of Salmonella Hvittingfoss causing acute gastroenteritis in India. Conclusions: While non-typhoidal Salmonella infections typically resolve on their own, they can be particularly dangerous for certain demographics, such as children, the elderly, and those with compromised immune systems. Therefore, studying the different serotypes of these infections in both clinical and subclinical cases is crucial for targeting effective surveillance, hygiene practises, and food safety measures that can mitigate their impact on public health.

Salmonella enterica serovar Typhi and Paratyphi have been imputed in the causation of enteric fever. Cardiovascular and extraintestinal Salmonella infections have been documented among immunocompromised individuals. Rarely these pathogens are ascribed in the causation of extraintestinal infections among immunocompetent hosts due to hematogenous seeding. We report a case of anterior chest wall abscess with osteomyelitis in an immunocompetent adult by Salmonella paratyphi A without any prior predisposing conditions or gastrointestinal symptoms. The patient underwent incision and drainage of the loculated pus and the involved costochondral junction was curetted. Medical management was guided by automated antibiotic susceptibility testing. Patient responded well to treatment and was discharged with no residual morbidities. Prompt diagnosis complements appurtenant treatment and thereby averts defunct consequential sequelae. Article published online: 10 July 2023 © 2023. The Indian Association of Laboratory Physicians. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/) Thieme Medical and Scientific Publishers Pvt. Ltd. A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

: Carbapenem-resistant Enterobacterales (CRE) are a significant public health threat due to their resistance to antibiotics, leading to serious infections, increased healthcare expenses, and higher mortality rates. Accurate identification of CRE is essential for effective treatment and infection control. Phenotypic methods like the modified Carbapenemase Inactivation Method (mCIM) and the EDTA-Carbapenem Inactivation Method (eCIM) are practical approaches for identifying production carbapenemase. As a result, the current study aims to analyse the efficacy of phenotypic carbapenem inactivation approaches in detecting carbapenem-resistant Gram-negative bacteria isolated from blood culture specimens, as well as the synergy of ceftazidime-avibactam and aztreonam in treating such infections. This laboratory based prospective study was adopted to evaluate the efficacy of phenotypic carbapenem inactivation methods in detecting carbapenem-resistant Gram-negative bacteria isolated from blood culture specimens and assess the synergy of ceftazidime-avibactam and aztreonam in treating these infections.: Gram-negative bacteria isolated from positive blood cultures were evaluated for carbapenemase activity using mCIM and eCIM, respectively. Synergy testing was conducted using ceftazidime-avibactam and aztreonam to evaluate potential therapeutic benefits. Among 383 blood cultures, 153 (39.94%) were MDROs, predominantly (57.5%). Of these, 123 (81%) were carbapenem-resistant. The mCIM and eCIM tests identified 67 (54%) serine carbapenemase and 54 (45.5%) metallo beta-lactamases. Synergy testing with ceftazidime-avibactam and aztreonam showed positive results in 43 (68.25%) of the 63 CZA-resistant isolates.: The study confirms that mCIM and eCIM tests effectively detect carbapenemase production in blood culture isolates, identifying 54% serine carbapenemases and 45.5% metallo beta-lactamases. Additionally, synergy testing with ceftazidime-avibactam and aztreonam demonstrated a 68.25% success rate in CZA-resistant isolates, indicating a promising treatment option for these resistant infections.