Organophosphorus compounds are chemical agents in widespread use throughout the world, mainly in agriculture. In developing countries organophosphorus (OP) poisoning is a commonly encountered problem. Here we present a rare case of OP poisoning with angioedema as the presenting feature. Prompt treatment of these cases will help in reducing the morbidity and mortality.

Wernicke’s encephalopathy (WE) is an unrecognized nutritional deficiency which often goes unnoticed. WE is clinically often composed of a triad including nystagmus, ophthalmoplegia and altered mental status. Although this triad practically is present only in a handful of cases1 it is also described as an acute neuropsychiatric presentation of thiamine deficiency. Early diagnosis and prompt treatment are of utmost importance here as it can prevent chronic brain damage which is often the end effect of thiamine deficiency. Wernicke’s encephalopathy is most commonly found in patients with chronic alcoholism, less frequent in non-alcoholic patients. In non-alcoholic patients, Wernicke’s encephalopathy might develop due to erosion of upper portion of gastrointestinal tract or secondary to intractable vomiting, inadequate dietary intake or malabsorption. Other causes include malignancies (gastric cancer, leukaemia, lymphoma), hyperemesis, anorexia, thyroid conditions.1,2 Wernicke’s encephalopathy is caused due to thiamine (B1) deficiency. B1 is a water-soluble vitamin which acts as a co-factor for carbohydrate metabolism. It is also important for neuronal cell function.2 This vitamin can’t be synthesised in the human body and thus dietary intake play a very important role. Symptoms of thiamine deficiency Include - Nystagmus, ataxia, encephalopathy, mental confusion. Early onset includes symptoms like: - headache, irritability, fatigue and abdominal discomfort. Prophylactic thiamine supplementation forms a major treatment for patients at risk for developing refeeding syndrome (RFS). RFS is an underdiagnosed condition which is characterised by potential shift in the fluid and electrolytes.

COVID-19, the novel corona virus disease of 2019 pandemic caused by the SARS-CoV-2 virus has imminently threatened all of us having significant morbidity and mortality all around the world. Upper respiratory tract infection, pneumonia, severe acute respiratory distress syndrome, multiorgan failure or even death can be the manifestation of COVID-19.  However, ‘n’ number of cardiac complications including acute myocardial injury, myocarditis, arrhythmia, pericarditis, decompensated heart failure and cardiogenic shock has been described so far. We report the first systematic and comprehensive echocardiographic evaluation of patients requiring hospitalization for COVID-19 infection. It was found that 32% of patients with COVID-19 have normal echocardiography. Out of all unavoidable cardiac complications in covid-19, due to pulmonary parenchymal and vascular disease, Right Ventricular (RV) dilation with or without dysfunction is the most frequent abnormality in patients who earlier had normal heart function. So, one of predictor of mortality in COVID-19 patients might be a RV function evaluation. The right ventricle dysfunction is at high risk in COVID-19 patients just because of its pathophysiological relevance. RV dysfunction is potentially resulting due to cytokines with its negative inotropic effects, directly angiotensin converting enzyme 2-mediated cardiac injury, acute respiratory distress syndrome and pulmonary embolism. They all are increasing preload and provoking RV failure. So, decrease in mortality and improvement in patient outcomes in COVID-19 patients can be achieved by early detection and management of right ventricle dysfunction. There is lack of data from the central India, so the study is being conducted.

Infectious mononucleosis (IM) caused by Epstein–Barr virus is a self-limiting condition and usually carries a benign course. It is usually seen in adolescents and young adults. However, complications can occur in a small percentage of patients such as splenic rupture, myocarditis, and meningitis. Tracheal obstruction as a result of IM is extremely rare. In this case report, we highlighted a rare complication of nearly fatal tracheal obstruction in a young patient of IM that was managed timely by emergency tracheostomy.