Akhil Dhanesh Goel

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Background: Cannulation of the internal jugular vein (IJV) is traditionally performed in the supine position; however, during surgeries in the prone position, it may become necessary to obtain central venous access because of unexpected blood loss. Methods: This prospective, randomized, open-label, non-inferiority trial was conducted at an academic medical center between May 2024 and June 2025. A total of 192 adult patients requiring IJV cannulation were enrolled and randomly assigned to two groups: the supine (S) group and the prone (P) group. All procedures were performed using an ultrasound (USG)-guided short-axis, out-of-plane approach. The primary outcome was to compare first-attempt success between the supine and prone positions. Secondary outcomes included comparisons of access time, guidewire insertion time, catheterization time, number of attempts, and associated complications. Results: The first-attempt success rate was 90.62% in the supine position compared with 77.08% in the prone position (absolute risk difference, 13.54%; two-sided 90% CI, 4.95–22.13%), indicating that the non-inferiority of prone vs supine was not demonstrated. The prone group had considerably longer access, guidewire insertion, and catheterization times than the supine group ( P < 0.0001). However, despite these statistically significant differences, successful cannulation was achieved in both groups. The complication rates were similar across the two groups ( P = 0.688). Conclusion: In this study, USG-guided IJV cannulation in the prone position did not meet the pre-specified criterion for non-inferiority compared with the supine approach. It was nonetheless achievable in all patients in the hands of skilled practitioners, suggesting its use as a rescue option rather than as a comparable alternative.

Background: With HIV increasingly managed as a chronic condition under antiretroviral therapy, assessing quality of life (QOL) has become integral to patientcentered care. This study evaluated QOL across multiple domains and identified sociodemographic and clinical determinants among people living with HIV (PLHIV) in western Rajasthan. Methods: A crosssectional study was conducted (March 2024–2025) among PLHIV attending a government ART center in Jodhpur. QOL was measured using the WHOQOLHIV BREF (Hindi version, pretested for reliability). Determinants were examined using descriptive statistics and logistic regression. Results: Among 551 participants (mean age 42.8 ± 12.4 years), the mean overall QOL score was 14.1 ± 2.0. The physical domain scored highest, while social relationships scored lowest. In adjusted models, age >30 years, occupation, and symptomatic HIV status were significant predictors of poor QOL. Spousal absence showed a particularly strong association with diminished independence, underscoring the importance of social support. Viral suppression was modestly linked to better psychological QOL, though the effect size was small. Conclusion: Clinical stage, age, occupation, and spousal support emerged as key determinants of QOL among PLHIV in Jodhpur. These findings highlight the need for integrated interventions that combine medical management with psychosocial counselling and communitybased support to address the multifaceted needs of PLHIV.

Depression, anxiety and stress occur at disproportionately higher rates among people living with HIV (PLWH) compared to the general population. Although antiretroviral therapy (ART) has extended survival, these psychological morbidities remain a critical public health concern. This study aims to estimate the prevalence of depression, anxiety, and stress among PLWH in Western Rajasthan, India, and to identify key sociodemographic and clinical predictors influencing their mental health status. A cross-sectional study was conducted among 551 PLWH attending two government ART centres between March 2024 and March 2025, using consecutive sampling. Mental health status was assessed through faceto-face administration of the validated Hindi version of the Depression Anxiety and Stress Scale-21 (DASS-21) by trained interviewers. Binary logistic regression was applied to calculate odds ratios (OR) with 95% confidence intervals (CIs), followed by multivariable adjusted analyses.

Introduction: Postoperative nutrition after pancreatoduodenectomy (PD) remains controversial. Although many centers routinely place a feeding jejunostomy tube (FJT) after PD, it is associated with morbidity. We conducted this study to compare the perioperative outcomes with and without FJT placement post‐PD. Methods: This was an open‐label randomized controlled trial, in which the FJT was placed in one arm and the nasojejunal tube (NJT) in the other. All patients with periampullary neoplasm who underwent pylorus resecting PD were included in this study. The primary outcome assessed was clinically relevant delayed gastric emptying (CR‐DGE), and the secondary outcomes were clinically relevant postoperative pancreatic fistula (CR‐POPF), postoperative complications, and hospital stay. Results: Forty patients were allocated to the FJT and NJT groups, and the two groups were comparable in baseline demographics, disease characteristics, and perioperative outcomes, including CR‐POPF rates. The FJT group had a significantly higher CR‐DGE rate (55% vs. 25%, p = 0.006), required increased use of prokinetic drugs (77.5% vs. 45%, p = 0.003), and had a longer median postoperative hospital stay (11 vs. 9 days, p = 0.007). Both groups had similar tube‐related complications. In the NJT group, 22.5% of the patients with CR‐DGE required parenteral nutrition. On multivariate analysis, the presence of FJT [adjusted odds ratio (aOR), 6.030 (1.431–25.402), p = 0.014] and intra‐abdominal collection [aOR, 7.108 (1.026–49.224), p = 0.047] were independent risk factors for CR‐DGE. Conclusion: Post‐PD placement of FJT was an independent risk factor for CR‐DGE. Hence, the routine use of the FJT can be omitted after PD without compromising postoperative morbidity and nutrition. Trial Registration: The trial was registered with the Clinical Trial Register with CTRI number: CTRI/2021/02/030942 ( https://ctri.nic.in/Clinicaltrials/advancesearchmain.php )

Introduction: Nosocomial infections, also known as Hospital-acquired infections (HAIs) pose major public health concerns, contributing to increased patient illness, death rates, and healthcare expenses. Mobile phones, which are widely used by healthcare professionals, may serve as carriers for harmful microorganisms. This study explores the potential of mobile phones to harbour pathogens and examine their possible association to the spread of nosocomial infections. Objectives: To isolate and identify microorganisms from health-care worker’s mobile devices, to evaluate the incidence of nosocomial infections in ICU patients and to determine any association between isolated microorganisms from mobile devices and patient infections. Methods: A study was conducted in ICU of tertiary care hospital. Mobile devices from HCWs were swabbed and cultured. Organisms were identified via microscopy and MALDI-TOF MS. Simultaneously, ICU patients admitted for over 48 hours were monitored for HAIs based on CDC criteria. Clinical samples were collected for microbiological analysis, and isolates from devices and patients were compared. Results: Among 177 ICU patients, 42 (23.7%) developed HAIs, predominantly VAP (27%), followed by HAP (18.6%), CRBSIs, and CAUTIs. Common pathogens included Acinetobacter baumannii, Escherichia coli and Klebsiella pneumoniae. Of 62 mobile devices analysed, skin and environmental flora were most frequently isolated. No significant association was found between device contamination and patient infections. Conclusion: Although microbial contamination of mobile devices was common, no direct link to nosocomial infections was established. The findings emphasize the importance of continuous surveillance, and education of healthcare personnel to mitigate the risk of HAIs in intensive care settings. Keywords: Nosocomial infection, Hospital acquired infections, Mobile phones, CRBSI, CAUTI.

This manuscript introduces a generative artificial intelligence (AI)-assisted prompt template designed to help users translate their self-compiled keyword lists into database-ready, syntactically correct search strategies. The template is supported by detailed, step-by-step guidance for executing and managing searches across major databases, including PubMed, Embase, Scopus, Web of Science, and the Cochrane Library. A small pilot test with three independent reviewers demonstrated that the workflow was usable and generated search strategies that ran without syntax errors. The complete two-part prompt and accompanying resources are openly available at https://github.com/ResearchCore/prompt2query.

Background: Understanding the risk factors for healthcare workers (HCWs) involved in COVID-19 care is essential for developing effective infection prevention strategies. Methodology: A case-control study, aligned with the World Health Organization UNITY protocol and using the WHO Go.Data template, was conducted in Rajasthan across three public hospitals to identify factors associated with COVID-19 infection among HCWs. Data were analyzed using SPSS v.23. Descriptive analysis included COVID-19 positivity rates, exposure frequency and duration, and Infection Prevention and Control (IPC) practice scores. Chi-square and Fisher’s exact tests (P < 0.05) were used to assess associations. Results: A total of 196 participants (50 cases and 146 controls) were enrolled. Among the cases, 54% were doctors and 42% were specifically assigned to COVID-19 care, with an average exposure duration of 8.8 ± 4.9 days over the prior 2 weeks. Notably, 36% experienced long-term face-to-face exposure. Of all variables, only hand hygiene before and after patient material contact showed a significant association with infection (P = 0.036). Conclusion: These findings underscore the need for strengthened IPC adherence, particularly hand hygiene, among HCWs in high-exposure settings.