Anthrax is a zoonotic disease and is caused by Bacillus anthracis which is a Gram-positive, nonmotile, spore-forming rod, found in soil. The spores can remain viable for decades. Transmission occurs naturally in humans by direct contact with infected animals or the contaminated animal products. Anthrax is a major health problem in eastern and southern India, with a significant human incidence because the disease is poorly controlled. Here, we discuss such a case of naturally occurring fatal anthrax in North-East India. A 48-year-old man from Assam presented with seizures, hematemesis, and fever. Apart from altered mental status and nonreactive pupils, his cutaneous and systemic examination was unremarkable. Noncontrast computed tomography head showed multiple hemorrhages. Blood and cerebrospinal fluid showed heavy growth of anthrax Bacilli. He was started on specific antibiotics after the reports, but unfortunately, the patient succumbed to infection. Due to high prevalence of anthrax in the endemic regions, a high degree of suspicion is required to clinch the diagnosis. Early initiation of therapy before developing the intracranial hemorrhagic complications might result in a better outcome. Careful history for a possible exposure to animal carcass or a suspected animal death due to anthrax will also help in early diagnosis of the disease and effective therapy.

Diarrhoea by definition is the passage of unusually loose or watery stools, at least three times in a period of 24 hours. However, the consistency is a more reliable indicator of diarrhoea rather than the frequency of stools. 5 Diarrhoea is due to infections caused by a wide range of organisms which include bacteria, viruses and protozoans, such as rotavirus and Escherichia coli. 58% of deaths due to diarrhoea have been attributed to unsafe ABSTRACT Background: Diarrhoea is an important communicable disease which can be prevented by proper hygiene and other simple practical measures. We assessed the knowledge, attitude and practices among mothers regarding childhood diarrhoea in a secondary care hospital in Dimapur, Nagaland. Methods: Cross-sectional observational study conducted over a period of one year including 449 mothers in the age group <45 years with atleast one child under 5 years of age using an interviewer administered, pilot tested, semistructured questionnaire under the following as categories demography, knowledge, attitude and practices. Results: 97.8% had good knowledge regarding causes and prevention of diarrhoea, 65% had good knowledge regarding the management of diarrhoea while 31% mothers had moderate knowledge. 98% mothers had good attitude but only 17.8% had good practice scores. Multivariate regression analysis showed education > class 10 and residence in urban area were significantly associated with good knowledge and education >class 10, age of mothers ≥29 years, employed mothers, family income Rs. ≥28000 were significantly associated with good practice. Conclusions: Good knowledge and attitude regarding diarrhoea prevention and management among our study population did not translate to good practice. These could also be due to the lower knowledge about management of diarrhoea. Widespread prevalence of wrong practices in the community like irrational use of antibiotics could also have resulted in low practice scores. The gaps between knowledge and attitude and practices among the mothers need to be addressed.