Publications by authors named "Kothari N"

Introduction: Delirium is a syndrome commonly seen in intensive care unit (ICU) patients. It is characterized by acute changes in mental status, inattention, disorganized thinking, and altered level of consciousness. Due to its higher prevalence in mechanically ventilated ICU patients, it is crucial to recognize it early and implement standardized evidence-based protocols for preventing it in regular practice.

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Nosocomial bloodstream infections with multidrug-resistant microorganisms have become a common health threat in intensive care settings worldwide. Understanding antimicrobial resistance and the outcomes of these infections is crucial for addressing this issue. This study aimed to investigate the burden, antimicrobial resistance, and 28-day outcomes of nosocomial bloodstream infections in the intensive care unit.

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Cystic fibrosis (CF) is a hereditary disorder characterized by mutations in the CFTR gene, leading to impaired chloride ion transport and subsequent thickening of mucus in various organs, particularly the lungs. Despite significant progress in CF management, current treatments focus mainly on symptom relief and do not address the underlying genetic defects. Stem cell and gene therapies present promising avenues for tackling CF at its root cause.

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Background: We compared the modified ROX index and ROX index scores in earlier predictions of high-flow nasal oxygen (HFNO) therapy outcomes in patients with acute respiratory failure.

Methods: We conducted a prospective observational study on 151 acute respiratory failure patients initiated on HFNO therapy. The primary objective of this research was to compare the modified ROX index and ROX index to investigate which score predicted HFNO treatment outcome earlier.

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Article Synopsis
  • * A total of 103 adult patients with CRAB-related VAP were analyzed, comparing outcomes between those treated with dual and triple antibiotic combinations involving sulbactam.
  • * Results indicate that the triple therapy (sulbactam, polymyxin B, and minocycline) significantly reduced 28-day mortality and improved other health markers compared to the dual therapy, suggesting it may be a more effective treatment option.
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  • A study was conducted to investigate the effectiveness of mecillinam and pivmecillinam against urinary tract infection (UTI) bacteria in the U.S. from 2017 to 2020, highlighting its potential as a treatment option.
  • Mecillinam showed high susceptibility rates (94.9%) among UTI-causing Enterobacterales, especially against extended-spectrum beta-lactamase (ESBL)-positive strains (98.2%).
  • The findings support the clinical development of mecillinam as a promising first-line therapy for uncomplicated UTIs, especially when other common antibiotics showed higher resistance rates.
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Mishra S, Kothari N, Sharma A, Goyal S. Author Response: Oxygen Delivery Devices in Postoperative Patients: Proper Selection of Patients Matters! Indian J Crit Care Med 2024;28(8):803.

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Background: No research has been conducted to compare long-axis in-plane and short-axis out-of-plane techniques for ultrasound-guided posterior tibial artery cannulation in adults. This study compared these two procedures for cannulating the posterior tibial artery.

Methods: This prospective randomized trial included 236 adult patients undergoing general anesthesia who required arterial cannulation.

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Artificial intelligence is an ever-growing modality revolutionizing the field of medical science. It utilizes various computational models and algorithms and helps out in different sectors of healthcare. Here, in this scoping review, we are trying to evaluate the use of Artificial intelligence (AI) in the field of pediatric anesthesia, specifically in the more challenging domain, the pediatric airway.

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Article Synopsis
  • The authors respond to a discussion on various methods of oxygen delivery for post-operative patients experiencing hypoxemia, emphasizing the limitations of traditional nasal prongs.
  • They advocate for a broader exploration of alternative oxygen delivery systems that may offer improved outcomes in critical care settings.
  • The article highlights the importance of individualized patient care and the need for evidence-based practices in managing post-operative hypoxemia effectively.
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Huntington's disease (HD) is an autosomal dominant disease caused by the expansion of cytosine-adenine-guanine (CAG) repeats in one copy of the gene (mutant HTT, mHTT). The unaffected gene encodes wild-type HTT (wtHTT) protein, which supports processes important for the health and function of the central nervous system. Selective lowering of mHTT for the treatment of HD may provide a benefit over nonselective HTT-lowering approaches, as it aims to preserve the beneficial activities of wtHTT.

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Background: Plants have been used for ages in traditional medicine, and it is exciting to perceive how recent research has recognized the bioactive compounds liable for their beneficial effects. Green synthesis of metal nanoparticles is a hastily emergent research area in nanotechnology. This study describes the synthesis of silver nanoparticles (AgNPs) using and leaf extract and its thrombolytic activity.

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  • A significant percentage (16-66%) of COVID-19 patients experience abdominal symptoms, which are often detected through CT scans, but the effectiveness of these scans in diagnosing related issues is unclear.* -
  • This study reviewed data from COVID-19 patients who underwent abdominal CT scans to identify imaging signs of the virus and associated conditions, specifically COVID-19 associated Mucormycosis (CAM), including demographics and lab results.* -
  • Results showed that a majority of patients had abdominal abnormalities, particularly in the hepatobiliary and bowel areas, and there was a correlation between CT severity scores, abdominal symptoms, and elevated D-dimer levels, especially in patients needing ICU care.*
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Background There has been an explosion of commentary and discussion about the ethics and utility of using artificial intelligence in medicine, and its practical use in medical education is still being debated. Through qualitative research methods, this study aims to highlight the advantages and pitfalls of using ChatGPT in the development of clinical reasoning cases for medical student education. Methods Five highly experienced faculty in medical education were provided instructions to create unique clinical reasoning cases for three different chief concerns using ChatGPT 3.

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Background: Disabled 2 (DAB2) is a multifunctional protein that has emerged as a critical component in the regulation of tumor growth. Its dysregulation is implicated in various types of cancer, underscoring its importance in understanding the molecular mechanisms underlying tumor development and progression. This review aims to unravel the intricate molecular mechanisms by which DAB2 exerts its tumor-suppressive functions within cancer signaling pathways.

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Purpose: The current study evaluated the in vitro activities of ceftolozane/tazobactam (C/T), imipenem/relebactam (IMI/REL), and comparators against recent (2017-2021) clinical isolates of gram-negative bacilli from two countries in southern Europe.

Methods: Nine clinical laboratories (two in Greece; seven in Italy) each collected up to 250 consecutive gram-negative isolates per year from lower respiratory tract, intraabdominal, urinary tract, and bloodstream infection samples. MICs were determined by the CLSI broth microdilution method and interpreted using 2022 EUCAST breakpoints.

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The physiological transformations accompanying pregnancy, compounded by the implications of obesity, pose intricate challenges for anaesthesiologists attending to obese parturients. Obesity makes it harder to successfully provide epidural analgesia to a parturient. This narrative review explains the most recent data on the safety and complications of providing labour epidural analgesia in obese expectant mothers.

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Article Synopsis
  • - The study investigated the effectiveness of the new drug combination cefepime/enmetazobactam against Enterobacterales bacteria from Europe, analyzing 2,627 isolates collected between 2019 and 2021.
  • - Results showed that 97.9% of tested isolates were susceptible to cefepime/enmetazobactam, with a high prevalence of resistance to third-generation cephalosporins but maintained susceptibility to meropenem.
  • - The findings indicate that cefepime/enmetazobactam could potentially serve as a safer alternative to piperacillin/tazobactam for treating infections caused by resistant Enterobacterales strains.
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  • Recent advancements in aerosol therapy have prompted a study on its use in critically ill patients in Indian ICUs, noting a lack of prior research in this area.
  • The study tracked 218 patients over four weeks, revealing that a majority (72.48%) received a high volume of aerosols, predominantly bronchodilators, using jet nebulizers.
  • Findings indicate a diverse application of aerosol therapy, with minimal adjustments to ventilator settings during treatment sessions.
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In this report, we present a case of a woman currently on HIV antiretroviral therapy who presented with oral mucosal and cutaneous skin lesions with a target-like appearance following completion of a five-day course of Paxlovid™ for symptomatic COVID-19 infection. The patient was treated with intravenous steroids and oral antihistamines with mild improvement. However, she returned in one week with worsening skin lesions.

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Background: Acute hypoxemic respiratory failure is among the more commonly occurring complications in postoperative patients. Supplemental oxygen and addressing the primary etiology form the basis of its treatment.

Materials And Methods: We conducted an open-labeled randomized control trial with 90 adult patients and compared three oxygen delivery vehicles (ODV), i.

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Background: In adult patients, there has never been an evaluation of short-axis out-of-plane versus long-axis in-plane approaches of ultrasound-guided dorsalis pedis artery cannulation. This research was conducted to compare these two techniques to cannulate the dorsal pedis artery.

Methods: In this trial, 128 adult patients undergoing surgery and necessitating arterial cannulation were examined.

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