Background: India is a tropical country with a high burden of febrile zoonotic/infectious illnesses, scrub typhus being such a cause with multiple epidemics reported from different regions of the country. Objective: This study was plotted to document the clinical and diagnostic manifestations, treatment, and outcomes of scrub typhus in the sub-Himalayan region of India and to compare the results with other Indian and Asian studies. Materials and Methods: This was a retrospective observational study involving collection of data for 54 IgM ELISA-confirmed in-patient cases of scrub typhus at a tertiary care institute in Uttarakhand, India, from their case records. Results: The majority of patients were from rural background. Housewives constituted 28 (51.85%) patients. The most common symptoms were due to involvement of gastrointestinal tract in the form of abdominal pain in 39 (72.22%) and vomiting in 29 (53.7%) patients. Central nervous system involvement in the form of altered sensorium in 14 (25.9%) patients and pulmonary involvement as cough in 28 (51.85%) patients was observed. An eschar was found in 7 (12.96%) patients and upper eyelid edema in 40 (74.07%) patients. The most common laboratory abnormality documented was elevation of liver transaminases (aspartate aminotransferase > alanine aminotransferase), 40 (74.07%), and blood urea levels, 47 (87.03%). There was no difference in the clinical presentation, severity, or mortality in pregnant females when compared with nonpregnant females. One (1.45% mortality) died in our study. Conclusion: Scrub typhus is an important cause of acute febrile illness with variable, often nonspecific and multisystem involvement. Early recognition and antibiotic administration are the key to reduce complications and mortality, especially for a primary care physician.

Introduction: There is paucity of studies on infant feeding practices from the rural areas of garhwal Himalayas of the state of uttarakhand. The present study was designed to assess the infant feeding practices in Garhwal region. Infant feeding practices have significant implications on a child's health. Early nutritional status especially during the first year of life has been shown to have a significant effect on child health and development. Optimal infant feeding practices are crucial for nutritional status, growth, development, health, and ultimately the survival of infants and young children. The study of infant feeding practices is essential before formulation of any interventional programme. Settings and Design: A study was conducted in HNB Base Hospital and Teaching Institute with the aim to assess the infant feeding practices and the prevalence of malnutrition in the study population reporting at the hospital in garhwal region of uttarakhand. Methods and Material: This is an observational cross sectional study. 275 infants were included in the study. After taking informed consent, case study forms were filled by interviewing the infants' mothers. Weight, length and head circumference of each infant was also measured. The information thus obtained was compiled, tabulated and analysed statistically. Results: The study findings revealed that 46.4% infants in the age group 0-5 months were breastfed within 1 hour of birth. 52.8% infants aged 0-5 months of were exclusively breastfed. 33.6% infants in age group 0-5 months received prelacteal feeds. 53.12% infants in age group 6-8 months received solid, semi-solid or soft food, in addition to breast milk. 53.33% infants were partially or fully bottle fed. Age appropriate feeding was found in 56% infants. The percentage of wasting, stunting and underweight in 0-5 months was 33.6%,30.4% and 36.8% respectively . The percentage of wasting, stunting and underweight in 6-11 months was 28%, 26.5% and 30.7% respectively. There appeared to be an association between longer duration of exclusive breastfeeding and lower prevalence of stunting and underweight at 6 months of age. Conclusions: This study shows that undesirable infant feeding practices are still prevalent in the community. Lower prevalence of stunting and underweight was observed in infants with longer duration of exclusive breastfeeding. A comprehensive plan to address the problems in infant feeding should be formulated. Antenatal counselling of mothers should be done. Revitalization of the Baby Friendly Hospital Initiative(BHFI) in health facilities is recommended.

Child abuse is a social evil which has existed in our society since a long time. The awareness regarding the same has been minimal in developing countries. Many a times, punitive measures taken by parents to discipline their children turn out to be painful scars in their childhood resulting in stunting of their mental and social growth. Doctors and other health care workers have a very important role in identifying and reporting such issues. Law has also evolved over the recent past in safeguarding the future of our children. However, awareness regarding this issue has remained to be the same as before. During the current era of COVID, parents and children have been restricted to their homes. Livelihood of many families have been at risk. These issues have burdened the caretakers at home and absence of teachers who were otherwise their guardian angels have impacted the minds of these children adversely. Hence in this article we intend to provide good clarity about this social evil, and the rights of our children. We also wish to stress upon the duties of parents, doctors, teachers in molding these tender minds so as to get the best out of them.

Coronavirus (COVID-19) is the most dreaded pandemic of our times, which lead to a state of chaos among the mightiest nations of the world. The immune system plays a great role in response to any foreign organisms be it bacteria or viruses. Virus-based pandemics like SARS, MERS, COVID-19 have time and again been surfacing leading to mortality and morbidity worldwide. These pandemics have also resurfaced the role of public health and its modes which have been fading in the presence of lucrative hi-tech medical industry. Although Chinese system of medicine has been explored, there is still more to be done in exploring solutions from time tested Indian systems of medicine like Ayurved and Yog. Its time to rethink and explore ways to harness our immune system and look for evidence-based solutions providing the best of both medical systems to the patients, i.e., modern medicine as well as Ayurved and Yog. The present review is a narrative review wherein studies were searched from databases like PubMed, Cochrane, Scopus, and web pages. Given a paucity of studies hereby we explored existing pieces of evidence, thereby concluding that more randomized controlled trials need to be done for assessing the role of Ayurved, Yog, and other Indian systems of medicine to enrich the armamentarium in the fight against such viruses in future. Family physicians can play a vital role in not only suggesting treatment but also changes in lifestyle of the patients as well as their family. Evidence based knowledge of ancient Indian system will open a new door of integration for overall well being of patient with a scientific outlook.

Corona Virus Disease (COVID-19) was, declared a global pandemic by the World Health Organisation (WHO) on 11th March 2020, which has posed innumerable challenges for the medical fraternity. To overcome these obstacles healthcare professionals, engineers and industries like robotics, Artificial Intelligence (AI), 3 Dimension (3D) printing etc., are coming up with innovations that can assist them in administering critical care to COVID patients, restart health services for non-COVID patients, combat the spread of the disease, restart elective services and above all protect themselves while treating others. This article is a narrative review of the developments in the field of robotics and AI, improvements in ventilators and critical care facilities, measures taken to spread awareness and the need of such innovations, their benefits and effectiveness in relation to the current scenario. Articles regarding advancements during COVID months of March-May 2020 were searched on the internet and references giving medical evidence of the suitability of these innovations were added from PubMed and Google Scholar search engines, wherever necessary. Knowing the need and principles of such medical innovations which can help in improving the current practices or replace them with even better technologies are the need of the hour.

Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis (MTB). It spreads from one person to the another through the air while coughing, spitting, speaking or sneezing. TB most commonly affects lungs but it can affect any organ system. Diagnosis of TB is made on the basis of microbiological evidence of MTB on microscopic examination, cultures and chest X-rays. Poncet’s disease is a separate entity in which joints are involved in the form of joint pain and swelling without any microbiological evidence of MTB. It usually occurs in the background setting of pulmonary TB. This case focuses on importance of considering Poncet’s disease in the differential diagnosis of paediatric polyarticular arthritis in TB endemic regions or if there is a history suggestive of TB exposure and infection.