Objective:The aim was to find the incidence of acute encephalitis syndrome (AES) secondary to scrub infection and to observe the clinical, biochemical, radiological profile, and outcomes in these patients.Materials and Methods:A total of 20 consecutive patients of AES were evaluated for scrub infection using scrub typhus immunoglobulin M enzyme linked immuno-sorbant assay positivity along with the presence or absence of an eschar. Clinical profile, routine laboratory tests, cerebrospinal fluid (CSF) analysis, and neuroimaging were analyzed. Patients were treated with doxycycline and followed-up.Results:Among 20 consecutive patients with AES, 6 (30%) were due to scrub infection. They presented with acute onset fever, altered sensorium, seizures. Eschar was seen in 50% of patients. CSF done in two of them was similar to consistent with viral meningitis. Magnetic resonance imaging brain revealed cerebral edema, bright lesions in the putamen and the thalamus on T2-weighted and fluid-attenuated inversion recovery sequences. Renal involvement was seen in all patients. All patients responded well to oral doxycycline.Conclusion:AES is not an uncommon neurological presentation following scrub typhus infection. It should be suspected in all patients with fever, altered sensorium, and renal involvement. Oral doxycycline should be started as early as possible for better outcomes.

The invention of beta (β)-blockers culminated in a new era in the treatment of cardiovascular diseases (CD), and changed the course of pharmacology research for years to come. Since the introduction of propranolol into clinical practice in 1964, β-blockers enjoyed a special place in the clinicians’ armamentarium against CDs, especially for patients with ischemic heart diseases, and are still one of the most extensively used therapeutic drugs in both cardiac and non-cardiac ailments. Current uses of β-blockers in CDs include ischemic heart diseases, hypertension, cardiac arrhythmias, and heart failure. Other substantial non-cardiac uses include glaucoma, migraine, situational anxiety, benign essential tremors, and cardiac symptoms of thyrotoxicosis. This review covers some of the evolutionary changes of clinical uses of β-blockers, the rationale for their use, some recent controversies surrounding their use for treatment of hypertension, and advantages of newer additions to the group.

Background Localization of atrioventricular accessory pathways (AP) from Electrocardiogram (ECG) is crucial for successful ablation. We analyzed the value of limb lead 2 versus 3 QRS vector discordance on surface ECG among right‐sided pathways. Methods Data from consecutive patients undergoing successful ablation of manifest AP were analyzed. They were categorized into two groups—Gr I: Endocardial ablation from anterior and anterolateral tricuspid annulus (TA, 10−1 o'clock, right anterolateral [RAL]); Gr II: Ablation outside this region (1−10 o'clock of TA). Inferior lead discordance (ILD) was defined as positive QRS complex (monophasic R, Rs) in lead 2 with negative/equiphasic QRS vector in lead 3 (rS, S, RS). Maximally pre‐excited ECGs during electrophysiology study were compared for presence of ILD. Result Among total 22 cases (Age 36 ± 18 years, 12 males), ILD was noted in 4/4 cases of Gr I. It was absent among 17/18 cases of right‐sided AP in Gr II. The only case in Gr II having ILD was ablated near 8 o'clock (posterolateral). In contrast to the other four cases, aVF was negative, along with lead 3. A close differential was mid‐septal AP (MSAP). However, the MSAP had absence of r in V1 and lead 2 having rS/RS complex in contrast to strongly positive QRS in RAL pathways. The sensitivity and specificity of ILD for RAL are 100% and 95%, respectively. The positive, negative predictive value, and accuracy are 80%, 100%, and 95%, respectively. Conclusion Positive QRS complex in lead 2 with negative QRS in lead 3 in maximally pre‐excited ECG is often predictive of anterior and anterolateral location among right‐sided pathways.

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A spectrophotometric study of mebendazole is described. At specific reactant concentrations, mebendazole forms a 2 : 1 complex with potassium bismuth(1ll) iodide for which Beer's law is obeyed for up to 0.3-2.1 mg-% of mebendazole. The orange complex formed in acetone at pH 5.32 and 30 k 2 "C gives a A , , , .at 430 nm; under these conditions the colour of the complex is reasonably stable. The proposed method gives accurate and reproducible results, besides being much more sensitive than the United States Pharmacopeia method, which uses a larger amount of mebendazole.