Acute myocardial infarction (AMI) following a centipede bite has been very rarely reported. Here, we describe a 22 year-old man who had ST-segment elevation AMI after a centipede bite. He presented with typical chest pain, electro and echocardiographic abnormalities, and elevated cardiac enzymes with normal coronary angiography. The probable mechanisms were described. Practitioners treating centipede bites shall not consider it lightly, as centipede envenomation may produce a variety of systemic and local manifestations in susceptible individuals.

Smart City Healthcare (SHC 2 ) system is applied in monitoring the patient at home while it is also expected to react to their needs in a timely manner. The system also concedes the freedom of a patient. IoT is a part of this system and it helps in providing care to the patients. IoTbased healthcare devices are trustworthy since it almost certainly recognizes the potential intensifications at very early stage and alerts the patients and medical experts to such an extent that they are provided with immediate care. Existing methodologies exhibit few shortcomings in terms of computational complexity, cost and data security. Hence, the current research article examines SHC 2 security through Light Weight Cipher (LWC) with Optimal S-Box model in PRESENT cipher. This procedure aims at changing the sub bytes in which a single function is connected with several bytes' information to upgrade the security level through Swam optimization. The key contribution of this research article is the development of a secure healthcare model for smart city using SHC 2 security via LWC and Optimal S-Box models. The study used a nonlinear layer and single 4-bit S box for round configuration after verifying SHC 2 information, constrained by Mutual Authentication (MA). The security challenges, in healthcare information systems, emphasize the need for a methodology that immovably concretes the establishments. The methodology should act practically, be an effective healthcare framework that depends on solidarity and adapts to the developing threats. Healthcare service providers integrated the IoT applications and medical services to offer individuals, a seamless technology-supported healthcare service. The proposed SHC 2 was implemented to demonstrate its security levels in terms of time and access policies. The model was tested under different parameters such as encryption time, decryption time, access time and response time in minimum range. Then,

We report the development of low flow priapism in three patients related to simultaneous consumption of sildenafil with pomegranate (Punica granatum) (POM) juice. There were no other concurrent diseases, intake of drugs, and chemicals or other risk factors in these patients. We want to create awareness among patients and practitioners for recognition and timely intervention. Probable mechanisms are highlighted.

s u m m a r y Successful removal of a live fish impacted in the hypopharynx of a 65-year-old male is reported to emphasize the importance of the speed with which it has to be recognized and intervened. The present report also highlights the altered sensory perception in the oral cavity of elderly people as a potential risk factor for airway obstruction due to a foreign body. Moreover, the possibility of a foreign body has to be suspected, if an elderly patient without any cardiorespiratory illness presents with an acute onset of progressive respiratory distress.

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