Leishmaniasis is a tropical infection transmitted to humans by the female sandfly (Phlebotomus argentipes). Leishmaniasis is widely prevalent in the Eastern states of India namely Bihar, Jharkhand, Uttar Pradesh and West Bengal having a hot and humid climate.

The emergence of Carbapenem-resistant Enterobacteriaceae (CRE)is a public health concern worldwide. It is associated with increased mortality due to limited antibiotics available to treat CRE infections. The aim of this study was to understand the epidemiology of CRE infections, associated mortality, and available treatment options. All patients with CRE isolated in blood culture were identified between December 2011 and October 2019. Risk factors and mortality associated with each risk factor at 14 and 30 days were determined.55 cases of CRE bloodstream infections were isolated, with a median age of 56 years. Eighty-four percent of patients received treatment in the ICU. All cases were caused by Klebsiella pneumonia. The rate of resistance to the tested antibiotics was as follows: meropenem 92% (50/54), imipenem 75% (40/53), etrapenam 95% (19/20), Amikacin 71% (37/52), cotrimoxazole 73% (40/53), Gentamicin 47% (25/53) and colistin 7% (3/41). Major risk factors associated were the presence of a urinary catheter (84%), central venous catheter (78%), mechanical ventilation (74%) and post-surgery (67%). Mortality at 14 days and 30 days was 41%, and 52%, respectively. Univariate analysis showed that 14 days mortality was higher in patients with central venous catheter (P=0.01). Charlson's comorbidity index was associated with an increased risk of death at 30 days (P=0.04). There was no statistically increased survival in those treated with combination therapy at 30 days (P=0.5). The mortality of CRE infections seems to be high and optimal therapy is not yet well defined. Combination therapy is not associated with increased survival in this cohort of patients.

Objective: (1) To identify and characterize bacterial isolates causing blood stream infection in children. (2) To determine the antibiotic sensitivity pattern of isolates obtained. Materials And Methods: Study design: Descriptive study. Study population: Blood samples collected from pediatric patients aged upto 12 years who are admitted in Government Medical College Kottayam, with clinical features of blood stream infection. Sampling methodology: The sample size of suspected blood stream infection is 345. All pediatric patients with clinical features suggestive of blood stream infection in the study period satisfying inclusion and exclusion criteria will be included in the study. The identification of bacterial pathogens and antimicrobial susceptibility tests were done by conventional and automated methods like VITEK system. Results: Out of 345 study sample population, 46 were culture positive, of which 21(45.7%) were Gram negative isolates and 20(43.4%) were Gram positive. Major isolates obtained were Klebsiella spp (15%), Methicillin Resistant Coagulase negative Staphylococci (15%), followed by Staphylococcus aureus (13%), Coagulase negative Staphylococci (8%) and Acinetobacter baumannii (8%). Klebsiella pneumoniae was resistant to most of the antibiotics tested except meropenem. All isolates of Coagulase negative Staphylococci and Staphylococcus aureus were susceptible to vancomycin and linezolid. Conclusion: Gram negative organisms were predominant pathogens in blood stream infections. Klebsiella pneumoniae, Coagulase negative Staphylococci, Staphylococcus aureus were the most commonly isolated pathogens. Amikacin along with the third generation cephalosporins should be used for empirical treatment of Gram negative sepsis. Vancomycin and linezolid can be used for Gram positive pathogens.

Hemangioendothelioma is the term used to name those vascular neoplasms that show a borderline biological behavior, intermediate between entirely benign hemangiomas and highly malignant angiosarcomas. Although originally spindle cell hemangioendothelioma was proposed as a specific clinicopathologic variant of hemangioendothelioma, currently, it is considered as an entirely benign lesion, and thus, the name spindle cell hemangioma seems to be the most accurate for this lesion. Authentic hemangioendotheliomas involving the skin and soft tissues include Papillary intralymphatic angioendothelioma (also known as Dabska tumor), Retiform hemangioendothelioma, Kaposiform hemangioendothelioma, Epithelioid hemangioendothelioma, Pseudomyogenic hemangioendothelioma (also known as epithelioid sarcoma-like hemangioendothelioma), and Composite hemangioendothelioma. Each of these neoplasms exhibit characteristic histopathologic features.

A drastic increase in mucormycosis and other opportunistic infections was observed during the Covid-19 pandemic owing to multisystem involvement and related Immunosuppression. This retrospective study was carried out among SARS-COV-2 infected patients having invasive fungal infections [IFI] admitted to a tertiary care hospital in the southern part of India, for one year from August 2020. Among a total of 115 suspected cases, 54 patients were diagnosed to have IFI, during or immediately after Covid 19 disease. The most common fungal pathogens isolated were Mucorales (57.4%) followed by Aspergillus spp. (20.3%), Candida spp. (9.2%) and mixed infections (13.1%). Important predisposing factors identified were diabetes mellitus (70.7%), prolonged use of corticosteroids (85%), and administration of broad-spectrum antibiotics (90%). The predominant species identified among the diagnosed mucormycosis cases were Rhizopus spp. (54%) and Mucor spp. (25%); the site of involvement was paranasal sinus (70.1%), and rhino-orbital in 48.7% of the cases. Increased incidence of invasive Aspergillus infection in COVID-19 was seen mainly among ICU patients on ventilators, with Covid-19 induced lung damage. Common presentations were Chronic Pulmonary Aspergillosis, Rhino sinusitis, and Asthma. Of the total IFI, 9.2 % were caused by Candida spp. Of which 75% were due to Non- albicans candida species. Candidemia was the major presentation observed (90%). Of the patients with IFI, 90 % of them recovered, and the rest of them (7.4%) succumbed to infection. Of the patients with rhino-orbital mucormycosis who survived, 10 (39 %) had facial disfigurement and 11 (45 %) had a loss of vision.

Neurofibroma is a benign tumor characterized by perineural fibroblast proliferation. It is common in the head and neck region but rare in the oral cavity. Most of these lesions are asymptomatic but sometimes may be associated with pain and paraesthesia. Neurofibromas with atypical features are quite rare and only a few cases are reported in literature. Here is a case of a female patient presented with pain and swelling in the anterior maxilla, which was clinically diagnosed as a periapical cyst. Radiographic evaluation of the lesion revealed dilated incisive canal and a Nasopalatine duct cyst was suspected. The patient was advised to take antibiotics for one week. The symptoms were sustained in the follow-up visit and an incision biopsy was made. Microscopic examination revealed pleomorphic spindled and round cells. Immunohistochemistry was performed to identify the origin of these pleomorphic cells. Based on the histopathological examination, special staining, and immunohistochemistry, we concluded the diagnosis as neurofibroma with atypical features. The current case emphasizes the significance of clinical, radiological, histopathological, and immunohistochemical evaluation of oral lesions. The presence of atypical features in Neurofibroma must be considered cautiously as as it is more prone to progress into Malignant Peripheral Nerve Sheath Tumor (MPNST).

Background: G6PD is the rate limiting enzyme in the pentose phosphate pathway that protects human cells from oxidative stress. G6PD deficiency is one of the most common enzymopathies in humans, affecting an estimated 400 million individuals worldwide. The main objective of our study is to Compare diagnostic accuracy of screening qualitative G6PDH assay with standard quantitative assay. Methodology and Results: This is 2 years study comprising 250 confirmed cases of G6PD deficiency by UDILIPSE G6PD quantitative assay. Of which 210 were boys and 40 were girls. 40 cases were reported as false Normal by G6PDH screening assay in boys and 28 in girls. Discussion: Our results were comparable to studies conducted by Mohammed islam, Daae LN et al., Bancone G et al., Kahn M et al., Conclusion: It can be safely concluded that male patients with suspected G6PD deficiency can be screened for G6PDH assay and if tests are indeterminate then can be proceed to quantitative assay. For female patients it is recommended to omit screening test and can directly perform quantitative G6PDH assay in order not to miss G6PD deficient carriers.

Rapid delivery of specimens is crucial in today's clinical laboratories, and pneumatic tube systems are commonly utilized for this purpose. The validation of sample stability through pneumatic tube system (PTS) is essential. The use of Pneumatic Tube System can improve specimen turnaround time; allowing more effective time management of the porters by reducing the need to physically take specimens from one department to another. Prior to use, the Pneumatic tube system must be validated to ensure the reliability of laboratory test results, particularly those impacted by movement, such as lactate dehydrogenase (LDH), aspartate aminotransferase (AST), potassium (K+), complete blood count (CBC), particularly hemoglobin and coagulation tests. The most common way of validating pneumatic tube systems is to compare blood samples transported by pneumatic tube systems to blood samples transported by hand. High speeds and rapid acceleration of blood samples can increase the risk of hemolysis and negatively affect sample quality and test results. Moreover, the installation and design of each pneumatic tube system exhibit unique characteristics that are exclusive to each individual institution. The established protocol necessitated the use of either a human courier or pneumatic tube technology in order to transport a collection of replicated samples to the laboratory. Comparative research will be conducted on a sample size of twenty healthy adult volunteers to assess the integrity of the sample. The main objective of our study was to evaluate the effects of PTS transportation on laboratory results and whether is there any difference as compared to hand courier method.