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Scrub typhus is an acute febrile illness caused by Orientia tsutsugamushi. It is known from various parts of India. However Central India was naive to any epidemics of scrub typhus with occasional and sporadic occurrence now and then. This part of India witnessed an outbreak of scrub typhus in the months of August and September 2018. Therefore present research was carried out with an objective to study the clinical profile and treatment outcome in scrub typhus patients in central India.In this study, total 140 patients with an acute febrile illness diagnosed as scrub typhus by positive IgM antibodies against O. tsutsugamushi were enrolled, over a period of two months (August to October 2018). All relevant data were recorded and analyzed.Among 140 cases, 52.14% patients reported from urban area and 47.85% patients from rural area. The mean age of patients was 43.75±16.82 years, ranged from 12-83 years with female predominance (male: female-1:1.37). Fever (100%), cough (38.57%) breathlessness (27.85%), altered sensorium (9.28%) and headache (7.85%) were the predominant clinical features. Eschar was seen in 33 patients (23.57 %). Renal (73; 52.14%) and hepatic dysfunction (68; 48.57%) was the commonest followed by respiratory dysfunction (59; 42.14%). All patients (except pregnant patients) were treated with oral or inj doxycycline. Seventeen patients needed mechanical ventilation and five patients required dialysis. Total 24 (17.14%) patients died during the study period.Scrub typhus has become a leading infectious disease in central India and an important cause of infectious fever. An increasing awareness of this disease coupled with prompt management will go a long way in reducing both morbidity and mortality from this disease.

Background: High levels of mean platelet volume (MPV), as an indicator of larger, more reactive platelets resulting from an increased platelet turnover, may represent a risk factor for overall vascular mortality and other cardiovascular events, including myocardial infarction (MI). The present study was undertaken to see the predictive value of MPV in accessing the clinical outcomes in acute myocardial infarction, (AMI).Methods: Total consecutive 114 cases of AMI admitted to intensive care unit were enrolled in the study and were compared with the equal number of age and gender-matched controls. The clinical evaluation of cases was done at admission and on day 7 in terms of a) Cardiogenic shock, b) Arrhythmia and c) Effect of thrombolysis. Patients were classified according to tertile of baseline MPV.Results: The mean age of cases was 55.56±12.19 years. Males (66.67%) were outnumbering females (33.33%) in cases and controls showing male to female ratio of 2:1. Mean MPV was 10.2±1.27fl in cases and 7.26±0.79fl in controls which was statistically significant. Correlation of MPV with cardiogenic shock, arrhythmia and mortality was significant. Correlation of MPV with risk factor shows that diabetes was the only risk factor significant in AMI. Multiple logistic regression of risk factors with mortality in AMI shows that high MPV and obesity was found to be independently associated with mortality in AMI.Conclusions: Mean platelet volume is simple, easily available and cheap method. Serial estimation of MPV is a predictor of adverse clinical outcome in AMI so treating doctor can be more vigilant.

Background: Critical amount of urinary albumin excretion has long been reported to be one strong predictor of cardiovascular events in hypertensive patients. Very few studies have been conducted till now depicting correlation of microalbuminuria and target organ damage in patients with essential hypertension, except cardiovascular events. We evaluated the prevalence of microalbuminuria in patients with essential hypertension and its relationship with target organ damage.Methods: Total 120 patients of essential hypertension were studied. Prevalence of urinary albumin excretion and its correlation to target organ damage (left ventricular hypertrophy, retinopathy and stroke) was analysed. Urinary albumin excretion was assessed by turbidimetry method and microalbuminuria was assessed by urine albumin to creatinine ratio.Results: Microalbuminuria was found to be present in 57.7% patients. Target organ damage was observed in 62.5% (75) patients, out of which 78.66% patients had associated microalbuminuria (p