Background and aims Initially, novel severe acute respiratory syndrome coronavirus (SARS-CoV-2) was considered primarily a respiratory pathogen. However, with time it has behaved as a virus with the potential to cause multi-system involvement, including neurological manifestations. Cerebral venous sinus thrombosis (CVT) has increasingly been reported in association with coronavirus infectious disease of 2019 (COVID-19). Here, we have shed light upon CVT and its possible mechanisms in the backdrop of the ongoing COVID-19 pandemic. Methods In this review, data were collected from PubMed, EMBASE and Web of Science, until March 30, 2021, using pre-specified searching strategies. The search strategy consisted of a variation of keywords of relevant medical subject headings and keywords, including “COVID-19”, “SARS-CoV-2”, “coronavirus”, and “cerebral venous sinus thrombosis”. Results COVID-19 has a causal association with a plethora of neurological, neuropsychiatric and psychological effects. CVT has gained particular importance in this regard. The known hypercoagulable state in SARS-CoV-2 infection is thought to be the main mechanism in COVID-19 related CVT. Other plausible mechanisms may include vascular endothelial dysfunction and altered flow dynamics. Conclusions Although there are no specific clinical characteristics, insidious or acute onset headache, seizures, stroke-like, or encephalopathy symptoms in a patient with, or who has suffered COVID-19, should prompt the attending physician to investigate for CVT. The treatment of COVID-19 associated CVT does not differ radically from the therapy of CVT without the infection, i.e. urgent initiation of parenteral unfractionated heparin or low molecular weight heparin followed by conventional or mostly newer oral anticoagulants.

Background: Hepatic encephalopathy can be reversed by correcting precipitating factors and efficiently managed by lactulose and or rifaximin. Aims and Objective: The aim of this study to compare the effectiveness of three different modes of treatment in our study populations. Materials and Methods: Ninety patients of decompensated chronic liver diseases were selected and randomised to treat with either lactulose or rifaximin or both lactulose and rifaximin (30 patients in each group) for 7 days. Clinical outcome and short term mortality were noted in each group of treatment. This study was to review the comparison of the effectiveness of Rifaximin (1200mg/day , in 3 divided doses ) alone or in combination with Lactulose (60gram/day ,in divided doses) or Lactulose (60gram/day) alone to reduce the short term mortality and clinical improvement in hepatic encephalopathy of any grade of any cause in adult (>18 years) admitted patients of decompensated chronic liver diseases. Result: Clinical improvement was noted in all three modes of treatment but there is no statistically significant difference in clinical improvement of hepatic encephalopathy when compared amongst each of three modes of treatment. There was obvious reduction of short term mortality or clinical down gradation of hepatic encephalopathy grade after 7 days treatment using lactulose or rifaximin or combined lactulose and rifaximin but there was no statistically significant difference in this regard among these three modes of treatment. Conclusion: All three modes of treatment are equally effective though combination therapy is little better.

Background: Intestinal parasitic infections (IPI) are recognized as neglected tropical diseases. Inadequacy of epidemiological data reporting the prevalence of intestinal parasites among the general population prompted this retrospective study conducted among the Departments of Medicine and Microbiology of two medical colleges.Methods: All the symptomatic patients were examined for IPI.  831 parasite positive stool samples were included for the study. The age range of the patients were above 18 years. Stool specimens were processed using formol-ether concentration technique. Routine microscopic examination (saline and Lugol’s iodine mounts) were carried out for ova, cysts or parasites. The sample was partly preserved in 10% formal saline and later concentrated and fixed with methanol before staining by modified Ziehl Neelsen stain. Results: Out of the 831 positive samples, E. histolytica was predominant with 337 (40.55%) of all cases. The next in order were Giarrdia lamblia 216 (25.99%), A. lumbricoides with 173 (20.81%), E. vermicularis with 43 (5.17%), A. duodenale with 23 (2.76%), H. nana with 19 (2.28%), S. stercoralis with 17 (2.04%) and Taenia with 3 (0.36%). 134 patients had double parasites isolated, while only 3 had triple parasitic infestation.Conclusion: Present study showed a preponderance in gender towards males (59.4%) than females (40.5%). Larger sample size and more surveillance studies will help to establish effective measures and evidence-based approaches to curb the parasitic proliferation in this region.

Introduction:Acute Myocardial infarction is one of the leading causes of morbidity and mortality worldwide. Cardiogenic Shock is the leading cause of death in patients hospitalised for acute MI. Although there is substantial evidence for a benefit of reperfusion therapy for ST elevation MI, the best treatment strategy for patients with non-ST segment elevated MI is less well defined. Outcome and prognosis differs with the presence or absence of ST segment elevation. Most of the studies have been done on urban population. Objective: To determine the frequency and profile of Non-ST elevated MI. Any differences in profile in a Rural population with different social and economic structure will also be documented. Methods: In this descriptive crosssectional study conducted in Medicine department, Malda Medical College &Hospital,WestBengal,India 100 patients of non STEMI are selected by using consecutive non probability sampling technique. After taking ethical clearance from Institution and consent from patients and their relatives, 100 patients of non STEMI are enrolled as per inclusion and exclusion criteria. They are evaluated for cardiogenic shock on the basis standard clinical examination and are managed as per protocol. All relevant data are recorded in predesigned proforma. Results: Out of 100 patients, 68 are male and 32 are female. Mean age of the patients is 60 + 1.26 years and majority of them are in the age group of 61-70 years(41%). 5% patients of non STEMI developed cardiogenic shock and majorities are male and more than 50% of patients with cardiogenic shock with non STEMI are above 70 years old. Conclusion: Frequency and Profile is comparable to other studies. This rising trendin a rural population of a developing country is due to probably more urbanisationrelated to change in food habits and life style changes.

No abstract