Post Kala-azar Dermal Leishmaniasis (PKDL) is a chronic but not life-threatening disease; patients generally do not demand treatment, deserve much more attention because PKDL is highly relevant in the context of Visceral Leishmaniasis (VL) elimination. There is no standard guideline for diagnosis and treatment for PKDL. A species-specific PCR on slit skin smear demonstrated a sensitivity of 93.8%, but it has not been applied for routine diagnostic purpose. The study was conducted to determine the actual disease burden in an endemic area of Malda district, West Bengal, comparison of the three diagnostic tools for PKDL case detection and pattern of lesion regression after treatment. The prevalence of PKDL was determined by active surveillance and confirmed by PCR based diagnosis. Patients were treated with either sodium stibogluconate (SSG) or oral miltefosine and followed up for two years to observe lesion regression period. Twenty six PKDL cases were detected with a prevalence rate of 27.5% among the antileishmanial antibody positive cases. Among three diagnostic methods used, PCR is highly sensitive (88.46%) for case confirmation. In majority of the cases skin lesions persisted after treatment completion which gradually disappeared during 6–12 months post treatment period. Reappearance of lesions noted in two cases after 1.5 years of miltefosine treatment. A significant number of PKDL patients would remain undiagnosed without active mass surveys. Such surveys are required in other endemic areas to attain the ultimate goal of eliminating Kala-azar. PCR-based method is helpful in confirming diagnosis of PKDL, referral laboratory at district or state level can achieve it. So a well-designed study with higher number of samples is essential to establish when/whether PKDL patients are free from parasite after treatment and to determine which PKDL patients need treatment for longer period. A significant number of PKDL patients have been detected in the endemic areas of Malda who would remain undiagnosed without active mass surveys. Such active survey is required in other endemic areas of the country to attain the ultimate goal of eliminating Kala-azar from this part of the world by reducing the source of infection. PCR-based method is helpful in confirming diagnosis of PKDL, which is not applicable at field level. A referral laboratory at district or state level can be a solution to the problem. Since PKDL cases do not have a fatal outcome, treatment administration of these cases can be deferred until confirmed results are obtained, which requires about 7 days’ time. The detection of leishmanial DNA in skin lesions during successive treatment courses is essential to establish whether/ when PKDL patients are parasite free during/after treatment and to determine which PKDL patients need treatment for a longer period.

Introduction: Similar presenting manifestations in early phase and lack of awareness of aetiology of acute febrile illness (AFI) are major challenges in management of AFI. Material and Methods: This was a retrospective observational cross-sectional study conducted in the Department of Microbiology, NRS Medical College, from 1 July 2022 to 30 June 2023 in serologically diagnosed febrile patients attending the outpatient department or admitted. Clinical and epidemiological data and laboratory parameters were recorded in a pretested structured questionnaire study tool, and collected data were analysed on MS-Excel sheets with various charts and tables. Results: A total of 1711 serologically diagnosed febrile patients showed preponderance of dengue (38.3%), followed by leptospirosis (25%), scrub typhus (23.9%), malaria (12.6%), and enteric fever (1.92%). A majority of cases were male, less than 40 years of age, and from the rural population (73.2%), except in malaria (urban = 79.6%). The mean duration of fever was 9 days. Febrile cases were recorded maximum during the monsoon and postmonsoon periods (66.5%). The common manifestations are fever, headache (46.2%), pain abdomen (7.8%), nausea, and vomiting (9.4%). Thrombocytopenia with bleeding manifestation was higher in dengue (18%) cases. Mortality in dengue cases was recorded with multiorgan dysfunction syndrome (MODS). Scrub typhus cases showed seizure (8.3%) and altered sensorium (5%) due to fatal meningoencephalitis. Fatality in leptospirosis was mostly due to acute kidney injury (29.5%) and Weil’s disease (4.4%). Conclusion: Misdiagnosis or incorrect diagnosis and delay in initiation of appropriate treatment results in increased morbidity and mortality in AFI. Determination of epidemiological features and clinical manifestations of AFI along with timely correct diagnosis will benefit clinicians in proper treatment initiation, thereby reducing morbidity and mortality.

In India combination of artesunate + sulphadoxine-pyrimethamine has been implemented for uncomplicated falciparum malaria since 2010. We observed the impact of this intervention in urban Kolkata by analyzing data of Malaria Clinic from 2001 to 2013. In Kolkata P. vivax is perennial whereas P. falciparum infection is seasonal. Before ACT implementation P. falciparum percentage was as high as 50% which steadily decreased during four successive years post intervention. No change was observed in case of vivax cases. ACT is probably an effective measure in reducing falciparum malaria cases. Any artemisinin derivative combination should be explored in vivax malaria to reduce the overall malaria burden.

Background: Non-fermenting Gram-negative bacilli (NFGNB) were initially considered non-pathogenic contaminants but now have emerged as major pathogens because of increased isolation from clinical samples and emerging resistance to common antibacterial agents. Objectives: The study aims to determine the magnitude of NFGNB in clinical samples received at the Department of Microbiology, Nil Ratan Sircar Medical College, Kolkata, for a period of one year. Material and Methods: The samples were processed according to standard procedures; for identification and antibiotic susceptibility test, Vitek 2 Compact (Biomerieux^©) was used. Results: Out of 725 bacterial isolates, 169 (23.31%) NFGNB were identified during the entire study period. Pseudomonas spp. (n = 84) was isolated most frequently, followed by Acinetobacter spp. (n = 73), Burkholderia cepacia (n = 7), and Stenotrophomonas maltophilia (n = 5). Both Pseudomonas spp. and Acinetobacter spp. showed greater susceptibility to piperacillin-tazobactam and poor susceptibility against cefepime. Conclusion: It is necessary to identify these drug resistant pathogens in healthcare setup. The antibiotic susceptibility pattern of these pathogens needs to be monitored to guide clinicians in better patient care and management by initiating proper antibiotic therapy.