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Gastrointestinal Mucormycosis (GIM) is a rare life-threatening angio-invasive infection. The classic risk factors include immunosuppression and metabolic derangement. Usually, there are classical risk factors in patients affected by Ileocecal mucormycosis. Few case reports have shown the absence of salient clinical presentation of mucormycosis in prolonged hospitalisation. The presence of association of mucormycosis in patients of typhoid infection is rare. Here, we present a case of invasive ileal mucormycosis occurring as a sequel to typhoid infection which lacked the typical risk factors for mucormycosis., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2021, Kaur et al.)

We present the case of an enterovesical fistula (EVF) caused by ischemic enteritis. Ischemic enteritis is caused either by mesenteric macrovasculature occlusion or any pathophysiologic vasospasm of the microvasculature. In other words, ischemic enteritis (IE) occurs when the inflow of blood to the small intestines is reduced. The frequency of ischemic enteritis is less as compared to ischemic colitis because of the vast blood supply to the small intestine. It is the first case to be reported in the medical literature to date. EVF is a rare entity. It is a pathological connection between the bowel loops and the urinary bladder. EVF is a result of an underlying disease or injury. EVF is mostly caused by diverticular diseases, carcinoma colon, Crohn's, and inflammatory bowel disease, iatrogenic, appendicitis, carcinoma cervix, etc. Due to the formation of this abnormal connection, contents of the intestines, including the air, food content, etc., are usually found in the urine. Patients usually present with the complaint of irritative urinary tract symptoms and recurrent urinary tract infection (UTI). Surgical management is the mainstay of treatment although medical management is tried for those who cannot bear to undergo surgery., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2021, Pradhan et al.)

Coastal water quality assessment is important to maintain a healthy environment for various uses including fisheries and recreation. Microbial populations are used as biological indicators of contamination to monitor water quality and are considered by the government to be one of the critical features for issuing safety guidelines. Different bacterial groups (pathogenic, vibrio and faecal) from five major recreational beaches of Chennai, India, were monitored for the assessment of coastal water quality. Faecal coliforms (FC) were high at all the beaches, with up to 4.2 × 10 5  CFU/mL and exceeding the normal standard limits of 100 CFU/100 mL set by the Central Pollution Control Board (CPCB) of India. Rainfall was found to have a role in the variability and distribution of indicator and pathogenic bacteria. The seasonal dry period witnessed elevated FC, while dilution in the wet period reduced Escherichia coli-like organisms (ECLO). High microbial counts were detected near the beach situated close to the river mouth, mainly due to discharges of untreated domestic sewage and industrial wastes. Similarly, the biological oxygen demand (BOD) was also high, 0.32 to 10.32 mg/L. Dissolved inorganic nitrogen (DIN) ranged from 2.21 to 134.53 μmol/L and inorganic phosphate (IP) ranged from 0 to 57.53 μmol/L. These values indicated the presence of significant untreated sewage in the coastal water. This study revealed that Chennai coastal waters carry high levels of faecal and pathogenic bacteria, detrimental for recreational and other contact activities. The quantitative and qualitative analyses will be useful for modelling and prediction of coastal water quality and management of other recreational beaches in India.

Organic matter (OM) composition changed due to land use ─ land cover (LULC) and hydrology modification, has distinctive linkage towards sustainable environment management in tropical river systems. It is crucial in small river systems, which experience delay of freshwater flow to the estuaries due to headwater damming, also LULC alteration along the entire basin. In order to understand this fundamental linkage in tropical Zuari river-estuary (ZRE), we analyzed multi-proxy data of organic carbon to total nitrogen ratio (C org /N), stable organic carbon isotope (δ 13 C org ) and lignin phenols measured in seasonally collected suspended particulate matter (SPM) and sediment samples. Results highlighted about moderate seasonality of OM tracers, with a significant effect of LULC alteration, which nevertheless a striking feature in monsoon-fed river-estuaries of peninsular India. Particulate C org export from ZRE estimated to be 20 × 10 3  kg yr -1 , was much lower as compared to tropical river-estuary systems elsewhere. OM fraction from vascular plant (mangroves) contributed to SPM and sediment was 15% and 40%, respectively, calculated using a Bayesian mixing calculation through Stable isotope analysis in R (SIAR). Presence of mudflat LULC in the estuarine region notably caused 20% decrease in C org and 60% increase in lignin phenol (Λ8) as compared to their limits in upstream. This is although mudflat accounts only 3% of ZRE catchment. The degree of shifts in OM tracers highlights towards efficient entrapment, transformation and/or utilization of riverine OM in the mudflats of ZRE. Accelerated human induced LULC dampens the seasonality of OM characteristics and flow is highlighted through this study, which is essential towards sustainable environmental management practice in small rivers of India and World., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Introduction: Globally 3.5 billion people have access to internet and most of them are young adults and adolescents. In South Asia, Bhutan has the highest proportion of population with internet access at 37% in 2016. Many studies in Asia have reported significantly high level of internet addiction among college going students. In this light, this study was designed to estimate the prevalence of internet addiction and other co-morbidities., Methods: This cross sectional study included 823 first year and final year students aged 18-24 from six colleges in Bhutan. A self-administered questionnaire consisting of three parts was utilized for data collection. The data was entered and validated in Epidata and analyzed using STATA/IC 14., Results: The prevalence of moderate and severe internet addiction was 282 (34.3%) and 10 (1%) respectively. Positive correlations between internet addiction and psychological well-being (r= 0.331 95% CI: 0.269, 0.390), between Internet Addiction score and years of internet usage (r=0.104 95% CI: 0.036, 0.171), age and years of using internet (r= 0.8 95% CI: 0.012, 0.148) were observed. The commonest mode of internet use was martphone 714 (86.8%). The use of computer laboratory (aPR 0.80, 95%CI: 0.66, 0.96) and internet use for news and educational purposes (aPR 0.76, 95%CI: 0.64, 0.9) showed protective effects., Conclusions: The prevalence of internet addiction is high among the college going students in Bhutan. This warrants timely interventions to address the problems of internet addiction.

Sporotrichosis caused by the fungus Sporothrix schenckii has been widely reported from the northern Himalayan belt and the north eastern region of India. Three autochthonous cases of lymphocutaneous sporotrichosis from east and south districts of Sikkim are reported. Fluid aspirate from the nodulo-ulcerative lesions were sent for cytology and fungal culture. S. schenckii was isolated on culture and cytological examination in all three cases showed granulomatous reaction. Thermal dimorphism was demonstrated and animal pathogenicity testing was performed. Saturated solution of potassium iodide was used for treatment and the last case was treated with itraconazole and potassium iodide. Awareness of this disease and an extensive environmental study is required to understand the actual burden of this disease.

A 30 year old woman presented with symptoms of bladder stone. At operation, in addition to a big bladder stone, a fistula from the bladder to an ovarian dermoid tumor, was found. The cause of the fistula formation remains obscure.

In Patan Hospital, Kathmandu, 4600 single live births were analysed concerning birth weight in relation to gestational age. At term, the median birth weight of females was 2900 g and of males 3010 g. Compared with Norwegian newborns, the birthweights of Nepali babies were lower for all corresponding gestational lengths. The differences increased with gestational age. Fundal height was lower in Nepali than in Norwegian pregnant women for all periods of pregnancy. An increase in the differences between Norwegian and Nepali women was also noted. Hematocrit values of Nepali women who did not take supplementary iron, correspond well to findings in Norwegian women without iron supplementation. Only a slight degree of hemoconcentration was noted towards term. For Norwegian women with iron supplementation the hematocrit values were much higher, with a tendency towards hemoconcentration near term. In Nepal the average woman probably has small iron stores, and without iron supplementation the hematocrit values will remain low throughout the pregnancy. The high altitude does not seem to cause hemoconcentration in pregnancy to a greater extent than at lower altitude. Hemoconcentration is therefore not a major causative factor of the lower birth weights.