Presentation includes visceral leishmaniasis, cutaneous leishmaniasis, PKDL and Mucocutaneous leishmaniasis.
Guidelines by WHO and National Vector Borne Disease Control Programme, India
A comprehensive description of leischmaniasis with its types, transmission, epidemiology, pathogenesis, prevention and control. It also includes details regarding lab diagnosis, disease agent, vector and host.
A comprehensive description of leischmaniasis with its types, transmission, epidemiology, pathogenesis, prevention and control. It also includes details regarding lab diagnosis, disease agent, vector and host.
Classification of species, The definitive, intermediate host, mode of infection, life cycle of malaria. Plasmodium falciparum, cerebral malaria, the pathogenesis of malaria, clinical features, algid malaria, black water fever, Lab diagnosis- microscopic, QBC, Thick and thin smears, Fluorescent microscopy.
Non-microscopic - Molecular methods PCR, Antigen dectection
Treatment- NVBDCP, prevention
Cryptococcosis also called as Torulosis is a subacute or chronic fungal infection caused by Cryptococcus neoformans. It leads to compications such as fatal meningoencephalitis. It is an opportunistic infection in HIV-infected patients. The PPT discuss on the morphology of the fungus, pathogenesis, laboratory diagnosis and treatment.
A mosquito-borne viral disease occurring in tropical and subtropical areas.
Spreads by animals or insects
Requires a medical diagnosis
Lab tests or imaging often required
Short-term: resolves within days to weeks
Those who become infected with the virus a second time are at a significantly greater risk of developing severe disease.
Symptoms include high fever, headache, rash and muscle and joint pain. In severe cases there is serious bleeding and shock, which can be life threatening.
Treatment includes fluids and pain relievers. Severe cases require hospital care.
Non-Gonococcal urethritis. main causative organisms are Chlamydiae, Mycoplasma, Ureaplasma. various other bacteria and viruses can cause this. this powerpoint is made in systemic manner and will be helpful for Postgraduate students.
A basic description of Leishmania spp. along with Old and New world Leishmaniasis regarding Parasite morphology, Life Cycle, Pathogenesis, Clinical manifestations, Laboratory Diagnosis and Treatment.
Classification of species, The definitive, intermediate host, mode of infection, life cycle of malaria. Plasmodium falciparum, cerebral malaria, the pathogenesis of malaria, clinical features, algid malaria, black water fever, Lab diagnosis- microscopic, QBC, Thick and thin smears, Fluorescent microscopy.
Non-microscopic - Molecular methods PCR, Antigen dectection
Treatment- NVBDCP, prevention
Cryptococcosis also called as Torulosis is a subacute or chronic fungal infection caused by Cryptococcus neoformans. It leads to compications such as fatal meningoencephalitis. It is an opportunistic infection in HIV-infected patients. The PPT discuss on the morphology of the fungus, pathogenesis, laboratory diagnosis and treatment.
A mosquito-borne viral disease occurring in tropical and subtropical areas.
Spreads by animals or insects
Requires a medical diagnosis
Lab tests or imaging often required
Short-term: resolves within days to weeks
Those who become infected with the virus a second time are at a significantly greater risk of developing severe disease.
Symptoms include high fever, headache, rash and muscle and joint pain. In severe cases there is serious bleeding and shock, which can be life threatening.
Treatment includes fluids and pain relievers. Severe cases require hospital care.
Non-Gonococcal urethritis. main causative organisms are Chlamydiae, Mycoplasma, Ureaplasma. various other bacteria and viruses can cause this. this powerpoint is made in systemic manner and will be helpful for Postgraduate students.
A basic description of Leishmania spp. along with Old and New world Leishmaniasis regarding Parasite morphology, Life Cycle, Pathogenesis, Clinical manifestations, Laboratory Diagnosis and Treatment.
Tuberculosis is a raging problem round the globe. Eradicating TB is a herculean task but is possible is efforts from all corners from the world. The diagnostics have taken a big leap and with effective medications, our dream of TB free world may come true. But unlimited efforts are need to reach our goal.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
The Gram stain is a fundamental technique in microbiology used to classify bacteria based on their cell wall structure. It provides a quick and simple method to distinguish between Gram-positive and Gram-negative bacteria, which have different susceptibilities to antibiotics
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Best Ayurvedic medicine for Gas and IndigestionSwastikAyurveda
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Current Strategies in Diagnosis & Treatment of Leishmaniasis
1. Current Strategies in
Diagnosis & Treatment
of Leishmaniasis
Dr. Sayan Chakraborty
JR-3, Dept. of Tropical Medicine,
School of Tropical Medicine, Kolkata
Email: dr.sayan@gmail.com
2. Epidemiology
• Neglected tropical disease
• Incidence: 2 million/year
• Population exposed: 350 million
• Types: VL; PKDL; CL; MCL
• Endemic areas:
VL: Indian subcontinent, East Africa, South America
(Brazil), Mediterranean region, Middle east, Central Asia,
China
PKDL: Indian subcontinent
CL: Middle east, Pakistan, Brazil, Columbia, Algeria
MCL: New world only (South America)
5. Transmission
• Routes:
Bite of infected Sandfly
Injection drug users
Congenitally
Blood transfusion
Organ transplant
Lab accidents
Contact with active lesions of CL
• Vectors:
Phlebotomus
Lutzomyia
6. Transmission
Reservoirs
L. donovani Humans
L. infantum Dogs, wild foxes, crab-eating foxes, jackals,
wolves, racoon dogs
L. major Great gerbill, Fat Sand Jird (Africa)
L. ethiopica Hyraxes
L. guyanensis
L. panamensis
Sloths
L. amazonensis Spiny rat
L. mexicana Climbing rat
L. laisoni Paca
L. naiffi Armadillo
8. Pathogenesis
VL: Disease of mononuclear phagocytic system
• Affects spleen, L.n. & bone marrow (rarely intestine, lung,
skin)
• Granulomata by proliferation of activated macrophages
• ↑ IL-1, IL-6, IL-8, IL-12, IL-15, IFN-γ, TNF-α
CL:
• Localised self healing lesions: epidermal & dermal infiltrate of
histiocytes with amastigotes, lymphocytes & plasma cells
• Non-healing forms: diffuse granuloma with amastigote laden
macrophages (no lymphocytes in DCL)
• Leishmania recidivans: hypersensitive tuberculoid granuloma
with Langhans giant cells with small nos. of lymphocytes and
plasma cells
9. Clinical Features - VL
Most severe form; aka Kala-azar, Dum dum Fever, Black fever
• Incubation period: Avg 2-6 months (10 days to 2 years)
• Symptoms: Fever, fatigue, weakness, loss of appetite &
weight, dragging sensation in left upper abdomen
• Signs: Hepatosplenomegaly, lymphadenopathy, Pallor,
tachycardia & bipedal edema s/o CHF; Hyperpigmentation
• Complications: mainly due to pancytopenia
Anemia: normochromic normocytic; due to chronic disease,
bone marrow suppression, bleeding, hypersplenism
Infections: pneumonia, diarrhoea, otitis media, TB
Bleeding: due to thrombocytopenia & altered hepatic
coagulation factors; epistaxis, gum bleeding, purpura,
menorrhagia
CHF due to severe anemia
10. Special clinical forms - VL
Asymptomatic & Sub-clinical Infections: 8.9 : 1 in India
Post Kala-Azar Dermal Leishmaniasis:
• Chronic rash due to L. donovani in
Asia & East Africa (rarely seen in
HIV/VL co-infection by L. infantum
treated with Sb5+)
• Usually occurs months to years
after treatment of VL with Sb5+
(uncommon with Ampho B)
• Hypopigmented maculae over
papulae to nodules; starts from
face then expands to other parts
(Grades I, II, III)
11. Clinical Features - CL
• aka Delhi boil, Oriental sore, Baghdad boil, Tropical
sore, Aleppo boil, Chiclero’s ulcer, Bouton de Biskra or
Uta
• Sandfly bite → Papule → Painless red nodule → Central
necrosis f/b fall of crust → Ulcer with indurated edge
• Morphology:
Wet sore with healing granuloma: L.mexicana, L.
guyanensis, L. brazilensis, L. major
Dry & squamous lesion: L. tropica, L. peruviana
Flat plaques or hyperkeratotic lesions: Old world CL
Nodular with little inflammation:
L. infantum, L. aethiopica
12. Clinical Features - CL
No systemic symptoms or signs
Lymphangitic dissemination: mainly in L. guyanensis, L.
panamensis, L. braziliensis & L. major
• Lymphangitic cord palpable with small painless nodules
containing parasites
D/D: Sporotrichosis, Nocardiosis, M. marinum, Anthrax,
Tularemia
Evolution: Chronic, spontaneous cure
in months to years with disfiguring
scars (Chiclero’s ulcer in external ear)
and discoloration of skin
13. Special clinical forms - CL
DCL: Severe form of CL;
• Caused by L. aethiopica, L. amazonensis,
L. mexicana; Resistant to therapy
• Multiple, slowly progressive, relapsing
& remitting nodules or plaques without
ulceration, very rich in parasites
• In HIV/Leishmania co-infection:
may be caused by L. braziliensis, L. major,
L. infantum, L. donovani
• D/D: Lepromatous leprosy due to
leonine facies
14. Special clinical forms - CL
Leishmania Recidivans:
• Chronic form due to L. tropica & L. braziliensis
• Usually located on face
• Central healing surrounded by peripheral constantly enlarging
active part (1-2 years after acute lesion)
• Mimics lupus vulgaris; Small no. of parasites present
• Exaggerated cell mediated response
15. Clinical Features - MCL
• Aka Espundia; caused by L. braziliensis & other new world spp
• Primary cutaneous lesion → Variable time of latency →
Mucosal lesions (local spread or metastatic)
• Nasal congestion, epistaxis → Ulceration & perforation of
nasal septum → Tapir nose
• Mucosa of palate (Escomel cross) and lips involved later;
tongue spared. Palatal perforation may occur; Painless
• Laryngeal extension → Dysphonia, metallic cough, obstruction
causing acute dyspnea
• In advanced stage, nose & lips may totally
disappear; nasal & oral cavity connect into
a single hole
• D/D: Paracoccoidomycosis & Malignancy
16. Leishmaniasis & HIV
• 2-5.6% of VL patients may be HIV +ve in India (NVBDCP)
• Re-inforce each other in detrimental manner; impair response
to ART (which can cause PKDL)
• Co-infected patients are highly infectious to sandflies
• Viscerotropic & Dermotropic distinction less valid in co-
infection
• Atypical presentations in patients with CD4 < 200/uL;
cutaneous, mucosal, GI or pulmonary disease; parasite may be
present in lung, pleura, whole of GIT & skin.
• Lower frequency of splenomegaly; Higher frequency & degree
of pancytopenia
• Due to high parasite load, aspirates are more sensitive in
detecting parasites than in immunocompetent.
17. Leishmaniasis & HIV … Contd
• Sensitivity of serological tests like rK39 ↓
• Latex agglutination test: high sensitivity in detecting Ag
in the urine of co-infected patients
• VL is now an AIDS defining illness (WHO); So ART should
be started irrespective of CD4 count.
• 79 to 97% of co-infected patients will relapse (NVBDCP)
• ART should be started 7-10 days after initiating t/t of VL
(NVBDCP)
• Inf Ampho B total dose 40 mg/kg (4 mg/kg on days 1-5,
10, 17, 24, 31, 38) and repeat same dose on relapse
18. Leishmaniasis & HIV … Contd
• Secondary Prophylaxis:
1. Amphotericin B lipid complex 3–5 mg/kg/dose every 3 weeks
for 12 months
2. Liposomal amphotericin B 3–5 mg/kg/dose every 3–4 weeks
3. Pentavalent antimonials 20 mg Sb5+/kg/dose every 3–4
weeks and Pentamidine 4 mg/kg/dose [300 mg for an adult]
every 3–4 weeks
• Prophylaxis could be suspended,
provided that the CD4+ count is
maintained at > 200 cells/μl for > 6 months
19. Diagnosis - VL
Clinical diagnosis: suspect in a patient with
• fever > 2 weeks
• splenomegaly &/or
• weight loss
who lives in or has returned from an endemic area
Routine blood work: isolated or combined presence of
• Anaemia
• Leukopenia
• Thrombocytopenia
• Polyclonal hypergammaglobulinaemia
reinforces clinical suspicion
20. Diagnosis - VL
Parasitological diagnosis: Amastigote form by microscopy of
tissue aspirates → classical confirmatory test
• Sensitivity of aspirates: Spleen (93–99%); Bone marrow (53–86%);
Lymph node (53–65%)
• Stain: Giemsa, Wright’s or Leishman
• Culture of Promastigote:
Novy-MacNeal-Nicolle (NNN),
United States Army Medical Research Unit (USAMRU),
Modified Tobie,
‘Sloppy Evans’
Semi-solid Locke blood–agar.
21. Diagnosis - VL
• Contraindications for Splenic aspiration to be excluded:
(NVBDCP)
1. Hg level is not < 3.0 g/dL
2. No bleeding tendency & not jaundiced
3. Not at an advanced stage of pregnancy
4. Prothrombin time is not > 5 seconds longer than control or
platelet count is not < 40,000/mm3
5. Patient (in case of children) cannot lie still
6. The spleen palpable at least 3 cm below the costal margin
on expiration
7. Vital signs (BP and pulse) are not prohibitive for performing
the procedure
22. Diagnosis - VL
Immunological diagnosis:
• IFAT: Indirect Fluorescence Antibody testing
• ELISA
• Counter-current Immuno-electrophoresis
• Indirect hemagglutination
• Immunoblot techniques
• Easy to use in fields:
o Direct agglutination test
o rK39 ICT
o Dot-ELISA
o Fast agglutination screening test
2 Limitations:
1. Relapse of VL cannot be diagnosed (Ab persists many years)
2. Asymptomatic individuals harbour Ab in endemic areas
23. rK39 Strip test
• Rapid diagnostic test; Immunochromatographic test
• > 90% specificity and sensitivity
• Results read in 10 minutes in field
• Detects antibodies in blood (even in urine- not validated)
• Test line coated with rK39 antigen – 39-amino acid repeat that
is part of kinesin-related protein in L.chagasi
• Control line region: Chicken anti-protein A.
• The membrane coated with dye conjugate (protein A colloidal
gold conjugate)
• False positives: in Hepatitis and TB.
• False negatives: in HIV
• RDT positive for years after t/t of VL. Not useful in the
diagnosis of relapse.
24. Diagnosis - VL
Antigen-detection tests:
• Latex agglutination test for heat-stable, low-relative
molecular-mass carbohydrate Ag in urine
• Good specificity but low-to-moderate sensitivity in East Africa
and on the Indian subcontinent
• More appropriate for HIV/Leishmania co-infection
DNA PCR (Qualitative or Quantitative):
• In blood, tissue aspirates, urine, buccal swabs
• Most sensitive and specific
• Positive in asymptomatic individuals of endemic areas
• Restricted to referral hospitals and research centres
25. Diagnosis - PKDL
• Diagnosis is mainly clinical; with h/o VL or stay in endemic
area
• Confirmed by finding parasites in skin biopsy or scraping of
skin slit; higher detection when taken from nodular lesions
than papular or macular lesions.
• Skin biopsies: histopathology, immunohistochemistry, culture,
PCR (also in slit skin specimens; more sensitive)
• Serological tests (direct agglutination test, ELISA and the rK39
rapid diagnostic test) usually positive; limited value, positive
result may be due to Ab persisting after a past VL.
• Serology helpful when other diseases (e.g. leprosy) are
considered in the D/D or previous h/o VL is uncertain
26. Diagnosis - CL
Parasitological diagnosis:
• Sample obtained by scraping/ slit skin smear/ FNA/ Bx
• Culture on NNN medium for species identification
DNA PCR: improves diagnostic sensitivity & allows species
identification
Immunological diagnosis:
• Usually no detectable antibody response in L. major or L.
tropica infections
27. Diagnosis - MCL
• Suspect MCL in patients with typical mucosal
lesions and a h/o CL
• Difficult to get samples for parasitological
diagnosis (bleed on contact & difficult to
administer anesthesia)
• Scarce parasites in mucosal lesions (strong local
immune reaction)
• Positive serology (IFAT or ELISA) increase clinical
suspicion.
• DNA PCR – more sensitive tool
45. Precautions
• Pentavalent Antimonials: Anorexia, N & V, abdominal pain, metallic
taste, arthralgia, myalgia, acute pancreatitis (in HIV), hepatitis, QT
prolongation (then to VT)
• Amphotericin B: fever with chill and rigor, thrombophlebitis,
myocarditis, hypokalemia, AKI
• Paromomycin: Nephrotoxic, Ototoxic to fetus
• Pentamidine: IDDM, Hypoglycemia, Unexplained shock
• Miltefosine: D & V, hepatotoxicity, renal insufficiency, teratogenic
Contraindications:
• Women during pregnancy & lactation
• Married women of child-bearing age who refuse to give an undertaking
of refraining from pregnancy during the treatment period and
two/three months after completion of treatment
• HIV positive serology
• Infants < 2 years
46. During Pregnancy
• Amphotericin B deoxycholate and lipid
formulations are the best therapeutic options
• Pentavalent antimonials: spontaneous abortion,
preterm deliveries and hepatic encephalopathy
in the mother and vertical transmission (C).
• Paromomycin: Ototoxicity in the fetus is the
main concern.
• Pentamidine is contraindicated during the first
trimester
• Miltefosine is potentially embryotoxic and
teratogenic
47. Prevention & Control
2nd gen VACCINE
• Leish-111f + MPL-SE, reached clinical trials.
• Being evaluated for the immunotherapy of PKDL in the Sudan,
in phase- 1–2 trials in Peru and in a phase-1 trial in India.
Canine leishmaniasis vaccines: in Brazil
Immunochemotherapy and therapeutic vaccines:
• Convit vaccine: autoclaved L. mexicana mixed with BCG
• Mayrink vaccine: killed L. amazonensis vaccine
along with/without chemotherapy
48. Prevention & Control
Sandfly control:
• Destruction of breeding sites
• Insecticide residual spraying (IRS): DDT/Synthetic pyrethroids
• Insecticide treated materials: ITNs
Reservoir Control: Test-and-Treat
Case Detection & Management:
Active and passive surveillance (mainly of PKDL & HIV-VL co-
infection)