Comparison of Surgical, Functional and Radiological Outcomes following Integrated Screw and Nail System (ISNS)Versus Helical-Blade Anti- rotation Proximal Femoral Nail (PFNA2) in Trochantreic fractures - a Randomised Control Trial. - NIL

Start Date04 Apr 2025

Sponsor / Collaborator

Pondicherry Institute of Medical Sciences

CTRI/2024/07/069781

/ Not yet recruitingPhase 4

Comparison of standard clinical assessment based decision with Quantitative Neuromsucular monitor guidance for evaluation of the adequacy of neuromuscular recovery before tracheal extubation and Its Impact on Postoperative spirometry in Patients Undergoing General anaesthesia. - NIL

Start Date01 Aug 2024

Sponsor / Collaborator

Pondicherry Institute of Medical Sciences

100 Clinical Results associated with Pondicherry Institute of Medical Sciences

0 Patents (Medical) associated with Pondicherry Institute of Medical Sciences

1,281

Literatures (Medical) associated with Pondicherry Institute of Medical Sciences

01 Jun 2025·Microbial Pathogenesis

Unveiling the potential of a novel drug efflux pump inhibitor to combat multidrug resistance in ESKAPEE pathogens, with a focus on Acinetobacter baumannii

Article

Author: Prashanth, K ; Sawant, Ajit Ramesh ; Coumar, Mohane Selvaraj ; P, Shashikala ; Brindangnanam, Pownraj ; Ashokkumar, Krishnan ; Sriraghavan, Kamaraj

ESKAPEE (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacter spp. and Escherichia coli) is a group of nosocomial pathogens with alarming antibiotic resistance, representing a paramount public health menace. Their multidrug resistance (MDR) is often due to hyperactive drug efflux transporters (DETs) exporting antibiotics from bacterial cells. Fortunately, a breakthrough has been made by the synthetic molecule KSA5_1 (8,10-dimethyl-1,6,11-triazatetracene-5,12-dione). In vitro combination assays of KSA5_1 with antibiotics (colistin, ciprofloxacin, gentamicin) showed excellent reductions in minimum inhibitory concentrations (MICs), as much as 512-fold, against clinical MDR isolates such as Enterococcus faecium, Staphylococcus aureus and Acinetobacter baumannii. Surprisingly, KSA5_1 was more effective than the standard efflux pump inhibitor PAβN in inhibiting ciprofloxacin efflux from A. baumannii, primarily targeting the overexpressed AdeG gene, a key DET protein. Molecular docking and simulations indicated the improved binding of KSA5_1 to AdeG with a suggestion of tight DET inhibition. KSA5_1 also possessed good drug-like profiles. The improved physicochemical profile of the compound and the potential to increase the efficacy of antibiotics by inhibiting DETs offer KSA5_1 an exciting lead to combat antimicrobial resistance (AMR). The new approach promises to address the challenging issue of MDR among ESKAPEE pathogens and has the potential to restore the efficacy of existing antibiotics to combat the AMR crisis.

11 Mar 2025·Circulation

Abstract P3155: Socio-Demographic Disparities in the Management Modalities of Pulmonary Embolism Amongst COVID-19 Patients: A Retrospective Population-Based Study

Author: Paredes Romero, Enrique ; Khinvasara, Nidhi ; Patel, Urvish ; Asif, Kainat ; Agarwal, Ritu ; Savoiverekar, Siddhi ; Sajeev, Malavika ; Parvataneni, Tarun ; Vyasa, Jay ; Prasannakumary, Rithi ; Yerrababugari, MohammedAfzal ; Kalmani, Vishal ; Kondamuri, Naga Sai Ragha Manpreet ; Sakariya, Dhrumil Chhaganbhai

Introduction: Pulmonary embolism (PE) affects 60 to 70 persons per 100,000 people and causes about 7 million DALYs worldwide, making it an economically onerous handicap condition in the US. COVID-19's hypercoagulation and pro-inflammatory condition increase PE risk (OR 4.4 and RR 3.1) compared to non-COVID-19 individuals. Few studies have examined modalities and disparities in use. Aims: The study's main goal was to calculate the utilization rate and predictors of utilization of PE therapy modalities (tPA/thrombolytics, mechanical thrombectomy [MT], and surgical thrombectomy [ST]), and treatment disparities in COVID-19 patients in the US. Methods: We performed a retrospective cross-sectional observational study of a nationwide inpatient sample (year 2020) in adult hospitalizations with PE to identify patients with COVID-19. ICD-10 codes were used. Using SAS 9.4, we ran a univariate analysis using the chi-square test and multivariate survey logistic regression analysis to calculate adjusted OR and 95% CI. Results: Of 172,630 PE hospitalizations, 3124 patients had COVID-19. PE patients with COVID-19 were younger (mean age 60 vs 66) with the age group of 18-44 (2.54% vs >65-year-old 1.36%), male (1.99% vs female 1.63%), and Hispanics (4.47% vs African Americans 2.71% vs White 1.35%) in comparison to non-COVID-19. PE with COVID-19 had a higher prevalence of obesity (30.72% vs 29.6%) and diabetic mallitus (12.8% vs 9.76%). Utilization of tPA (3.36% vs 3.14%), MT (7.04% vs 5.58%), and ST (0.32% vs 0.19%) were higher amongst PE with COVID-19. tPA use was higher amongst young [OR 1.47 (95%CI 1.01-2.14), females (1.54, 1.17-2.04), and patients with diabetes mellitus (1.73, 1.18-2.53). MT use was higher amongst young (1.46, 1-2.12), African Americans (1.8, 1.45-2.24) and Hispanics (2.99, 2.06-4.35) (compared to White), patients with cardiogenic shock (3.06, 1.91-4.90), ischemic stroke (3.33, 1.55-7.15), diabetes mellitus (1.29, 1.01-1.63), and obesity (2.54, 2.15-3.0). ST use was higher amongst COVID-19 (7.48, 1.94-28.88), males (17.54, 3.5-83.33), patients with AFib (7.49, 1.68-33.49), and obesity (4.75, 1.37-16.51). Conclusion: Management discrepancies among PE patients with COVID-19 include younger age, male, African American, and Hispanic, with ischemic stroke, AFib, obesity, and diabetes using more. To reduce socio-demographic differences in COVID-19 pulmonary embolism care, personalized management techniques, and equitable healthcare resources should be developed.

01 Mar 2025·IJID Regions

Klebsiella pneumoniae urinary tract infection: A multicentric study highlights significant regional variations in antimicrobial susceptibility across India

Article

Author: Sultan, Asfia ; Mohan, Balvinder ; Jardani, Amina Al ; Gupta, Aarti ; Rajaibi, Arwa Al ; Khan, Fatima ; Zadjali, Razan Al ; Farooq, Shaika ; Meena, Suneeta ; Sen, Manodeep ; Ilanchezhiyan, Nainaraj ; Mamari, Azza Al ; Balkhair, Abdullah ; Kapoor, Pawan ; Gur, Renu ; Masters, Ken ; Jain, Mannu ; Poojary, Aruna ; Taneja, Neelam ; Kanungo, Reba ; Goyal, Nisha ; Thakuria, Bhaskar ; Siddiqui, Areena H ; Dutta, Sudip ; Princess, Isabella ; Rajendradas, Rugma ; Soman, Rajeev ; John, Keith H St ; Jitendranath, Ashish ; Al Malehi, Amal ; Jabri, Zaaima Al ; Rizvi, Meher ; Mohapatra, Sarita ; Langford, Bradley ; Sami, Hiba ; Agarwal, Jyotsna ; Singh, Narendra Pal ; Khan, Maria ; Singh, Sarman ; Malhotra, Shalini ; Tahir, Hatim El ; Devi, Sheela ; Yamunadevi, Vellore Ramanathan ; Singh, Sanjeev ; Sardana, Raman

ObjectivesKnowledge of local antibiotic susceptibility rates is essential to strengthen antimicrobial stewardship programs. DASH to Protect Antibiotics (https://dashuti.com/), promotes the dissemination of focused local antibiograms in community urinary tract infection (UTI). This study mapped the susceptibility profile of Klebsiella pneumoniae from 18 Indian centers.MethodsThe centers spanned nine Indian States and three Union Territories. Urinary K. pneumoniae antibiograms from the outpatient clinic were collated and analyzed. Standardization was achieved through online training. For epidemiological purposes, five centers tested fosfomycin.ResultsOverall, low susceptibility (<60%) was observed for the standard oral antibiotics prescribed for cystitis: co-trimoxazole, 54% (36-68%); ciprofloxacin, 52% (29-55%); amoxicillin-clavulanic acid, 46%, (35-82%); nitrofurantoin, 39% (19-78%); and cefuroxime, 30% (15-62%). The rates for third- and fourth-generation cephalosporins were 49% (45-52%) and 60% (36-76%), respectively. Extended-spectrum beta-lactamases ranged from 36-61% in India. Piperacillin-tazobactam 74% (65-87%), amikacin 76% (45-91%), and meropenem 81% (61-87%) exhibited higher activity. Fosfomycin was the most active antimicrobial, with 89% (92-97%) susceptibility. K. pneumoniae susceptibility was directly linked to geographic region, log gross domestic product (P <0.001), and humidity, and low and high temperatures (P <0.05).ConclusionsOral treatment options for K. pneumoniae cystitis are rapidly decreasing. Northern and southern India showed significant differences in antimicrobial susceptibility, highlighting the importance of local antibiograms for promoting antimicrobial stewardship. For uncomplicated cystitis, co-trimoxazole (54%) may be the empirical choice. Good susceptibility to fosfomycin was observed (89%). The empirical use of fluoroquinolones, cephalosporins, and amoxicillin-clavulanic acid has been discouraged. Piperacillin-tazobactam and aminoglycosides are carbapenem-sparing agents.

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