Background: India experienced a massive outbreak of dengue fever in the 2012-2013 period and this outbreak shows significantly different distribution across India. It also envisaged the hidden weakness of prevention and control program of vector-borne diseases. Aim and Objective: This study was designed to characterize the clinical and demographical profiles of this outbreak in a tertiary-level hospital of greater Kolkata. Materials and Methods: A descriptive hospital-based observational study was conducted among diagnosed dengue fever patients admitted at a tertiary-level hospital during the dengue outbreak in the 2012-2013 period. The clinical, biochemical, and demographic data of those patients were collected and recorded in a planned structured format. Results: The data of a total 382 dengue patients were analyzed. Out of these 382 patients, 67.8% are males and 42.1% belongs to 20-40 years age group. The mean and median ages of the study group were 37.39 (±17.70) years and 35 years, respectively. The mean (±SD) duration of hospital staying was 4.9 (±1.90) days. Out of these patients, 19.4% had hemorrhagic rash throughout the body, 13.2% presented with hemorrhage, and 8.6% were comorbid with typhoid immunoglobulin M (IgM) positive. Clinical shock, peripheral edema, and pulmonary edema were documented in 6.3%, 2.6%, and 5.3% of the patients, respectively. Ultrasonography (USG) abdomen test revealed that 15% of the patients had thick-walled gallbladder, while 11.27% had ascites. Out of the 382 patients, 26.3% (101) presented with pleural effusion, and 10.5% patient's platelet count went below 35,000. The alanine transaminase (ALT), alkaline phosphatase, and lipase level were abnormally increased in 82.7%, 17.1%, 29.6% patients, respectively. Conclusion: Suburban as well as rural area's people, mainly the young males, were mostly affected in this outbreak. Enteric fever was found with comorbid infection among a few dengue patients. Some patients documented with deferent complications, which were managed by early diagnosis and supportive treatment.

Aim: There are conflicting data regarding the incidence of metabolic abnormalities in human immunodeficiency virus (HIV)-naive patients on antiretroviral therapy (ART). Also, recommendations for the monitoring of fasting lipid and glucose by major world bodies is annually while this study demonstrates that significant changes occur in as early as 6 months. Design: The incidence and pattern of metabolic complications have been studied in a case series study design at a tertiary care center through 1 year of ART. Materials and Methods: One hundred and twenty patients were followed for 1 year after initiating ART. Data collection and categorization were done according to the statistical software application such as mean comparison and one-way analysis of variance (ANOVA) using the statistical software IBM-SPSS (version 19 Chicago Inc.) assuming the significance at 95% of confidence interval (CI). Results: At the baseline, total mean cholesterol was 162.25 mg/dL, triglyceride (TG) was 126.57 mg/dL, Low-density lipoprotein cholesterol (LDL-c) was 99.14 mg/dL and high-density lipoprotein cholesterol (HDL-c) was 36.96 mg/dL. At 6 months total cholesterol (TC), LDL-c, TG, and HDL-c increased by 12.49%, 15.01%, 14.93%, and 08.27%, respectively, and at 12 months these increased by 22%, 22.67%, 56.39%, and 14.98%, respectively, (P < 0.05). At the baseline, the mean fasting blood glucose (FBG) was 83.78 mg/dL while at 6 months and 12 months, the mean FBG was 88.18 mg/dL and 93.03 mg/dL, respectively, (P < 0.05). FBG was impaired in 11.9% and 17.8% of the patients at 6 months and 12 months, respectively. Diabetes was diagnosed in 4% of the patients at 12 months. Conclusion: ART has significant metabolic complications such as dyslipidemia, glucose intolerance, and increased body mass index (BMI) and requires proper monitoring and dose adjustment.

Aim: To evaluate safety of simultaneous Laparoscopic cholecystectomy (LC) and Retroperitoneoscopic live donor nephrectomy (RPLDN). Materials and Methods: We have retrospectively reviewed 400 patients who have undergone RPLDN. Ten patients underwent a combination of RPLDN and LC. Ten patients underwent a combination of RPLDN and LC. Results: Mean operative time was 141.1 ± 27.47 min (range 95-170 min), with a mean estimated blood loss (EBL) of 61.1 ± 18.33 mL (range 30-80 mL). No blood transfusions were required. No short- or long-term complications were found. Mean hospital stay was 2.6 ± 0.84 days (range 2-4 days). Mean follow-up period was 1.8 ± 0.71 years (range 1-3 years). Conclusion: From our results, we conclude that simultaneous RPLDN and LC are safe.

Background: Since the discovery of Ebola in 1967, many localized outbreaks have occurred but the recent cross-border epidemic was fueled by the high level of illiteracy and some bad cultural practices. Aim: To assess the awareness, knowledge, and misconceptions of Ebola among residents of a rural community in Sokoto State, Nigeria. Materials and Methods: A cross-sectional study design was used. The study was conducted in a rural community and the participants were selected using the systematic sampling method. The data were analyzed with Statistical Package for the Social Sciences (SPSS) version 20.0. Skewed quantitative variables were summarized using median and categorical variables using frequencies and percentages. Chi-square test was performed to assess the relationship between outcome variables (knowledge of Ebola) and respondents' sociodemographic characteristics. Binary logistic regression analysis was also performed to identify the predictors of outcome variable. Results: Respondents' median age was 30 years and nearly half of the respondents (49%) had no formal education. A large proportion (88%) of the respondents was aware of Ebola and radio was their major source of information. Residents' knowledge of Ebola was low and only 13% had good knowledge. Eating bitter kola, bathing with salt water, and drinking salt water were mentioned as methods of preventing the spread of the disease. Of their socio-demographic characteristics, only the educational level attained did predict their knowledge of Ebola. Respondents without formal education [odds ratio (OR) = 0.198, P < 0.02] and secondary education (OR = 0.292, P < 0.01) were more likely to have poor knowledge. Conclusion: Although the majority was aware of Ebola, their knowledge about it was very low and misconceptions and misinformation were still not uncommon. There is a need for continuous public education and enlightenment about Ebola.

Aim: This was to describe the different types of lesions that can be found in patients with liver cirrhosis during upper gastrointestinal endoscopy. Patients and Methods: Consecutive patients with liver cirrhosis who gave their consent to participate in the study were recruited. The diagnosis of liver cirrhosis was made by clinical and radiological features and a total of 56 patients were recruited. After taking informed consent, upper gastrointestinal endoscopy was performed on all the patients. Results: The patients consisted of 43 (76.8%) males and 13 (23.2%) females. Mean age was 45.5 ΁ 13.8 years (range: 20-77 years). Analysis showed that 21 (37.5%) patients were less than 40 years of age, 16 (28.6%) were between 40 years and 49 years, and 19 (33.9%) were 50 years and above. Esophageal varices was diagnosed in 54 (96.4%) patients. The esophageal mucosal findings observed were erosions (7.1%), ulcer (1.8%), candidiasis (8.9%) while one (1.8%) patient had both esophageal erosions and candidiasis. Gastric varices were observed in 11 (19.6%) patients and the analysis showed that the most frequent form was isolated gastric varices type 1 (IGV1) was recorded in six (10.7%) patients. Portal hypertensive gastropathy (PHG) was seen in 45 (80.4%) patients. Other gastric mucosal lesions were erosions (12.5%) and ulcers (10.7%). Duodenal varices were not seen in any of the patients. Other lesions seen were duodenitis, duodenal erosions, and duodenal ulcers in one (1.8%) patient, one (1.8%) patient, and four (7.1%) patients, respectively. Conclusion: This study has revealed different pattern of lesions that can be seen in patients with liver cirrhosis apart from varices.

Leptospirosis is a zoonosis having a worldwide prevalence and has recently emerged as a major public health problem, especially in tropical and subtropical regions. Likewise, dengue is one of the major endemic health problems in the Indian subcontinent. It is a mosquito-borne arboviral infection causing considerable morbidity and mortality. Epidemiologically, mixed infections of dengue and leptospirosis are possible because similar environmental conditions are needed for the transmission of both these infections. Still, their coinfection is rarely reported in medical literature. Here, we report three such cases of dengue and leptospirosis coinfection, encountered in clinical practice during the monsoon season at Kolkata, West Bengal, India.

Among the many factors that contribute to bacterial colonization, persistence and development of infection, the ability of microorganisms to form small colony variants (SCVs) assumes great significance. Although bacteria require intrinsic virulence factors to cause pathogenesis, some of them regularly evolve mechanisms to evade immune mechanisms, become resistant to antibiotics, and sustain in the human/animal cells to cause chronic infections. This mini review highlights the recent advances in the study of SCVs.