Novel antibiotic class promising against invasive infections caused by carbapenem-resistant Acinetobacter: Study

Switzerland: A team of researchers from Swiss drugmaker Roche have identified a novel class of antibiotics that target a highly drug-resistant and deadly bacterial pathogen.

In the research published in Nature, Claudia Zampaloni, Roche Innovation Center Basel, F. Hoffmann-La Roche, Basel, Switzerland, and colleagues described the identification and optimization of tethered macrocyclic peptide (MCP) antibiotics. These antibiotics target carbapenem-resistant Acinetobacter baumannii (CRAB) by inhibiting one of the building blocks of the bacterium’s hard-to-penetrate outer wall.

They further found the high effectiveness of a clinical candidate from this class called zosurabalpin (RG6006) at treating CRAB isolates both in vitro and in mouse models of infection.

“This chemical class is a promising treatment paradigm for patients with invasive infections due to CRAB, for whom current treatment options are inadequate,” the researchers wrote. They additionally identified LptB2FGC as a tractable target for antimicrobial drug development.

Carbapenem-resistant Acinetobacter baumannii has emerged as a major global pathogen having limited treatment options. In patients over 50 years old, no new antibiotic chemical class with activity against A. baumannii has been reached. Dr. Zampaloni and colleagues report the identification and optimization of tethered macrocyclic peptide antibiotics with potent antibacterial activity against CRAB.

CRAB is considered one of the leading antibiotic resistance threats by both the Centers for Disease Control and Prevention and the World Health Organization and a priority for antibiotic development, with mortality estimates for invasive infections ranging from 40% to 60% and limited treatment options.

Beyond carbapenems, CRAB infections are often resistant to multiple other antibiotics, leaving patients with limited treatment options. However, A baumannii has a tough outer membrane (like other gram-negative bacterial pathogens) blocking the entry of most antibiotics, making it a difficult target for antibiotic developers.

Collectively, these data support the hypothesis that antibacterial activity is mediated through a new target.

“MCP displayed a highly similar phenotypic profile across several tested compounds while differentiating from other known antibiotic classes,” they wrote. “Taken together, these data support the hypothesis that antibacterial activity is mediated through a new target.”

According to the researchers, tethered MCPs, identified through the screening of about 45,000 compounds, solve the problem by blocking the transport of lipopolysaccharide (LPS) from the inner membrane to the outer membrane, which is requisite for the formation of an outer membrane and antibiotic resistance.

A process called bacterial phenotypic fingerprint profiling revealed that a cluster of the identified MCP shared this mode of action.

“Collectively, these data demonstrate the zosurabalpin’s potential as an antibiotic and human clinical trials have been initiated to further develop this compound to provide a treatment option for invasive infections caused by CRAB,” the researchers wrote.

Reference:

Zampaloni, C., Mattei, P., Bleicher, K., Winther, L., Thäte, C., Bucher, C., Adam, J., Alanine, A., Amrein, K. E., Baidin, V., Bieniossek, C., Bissantz, C., Boess, F., Cantrill, C., Clairfeuille, T., Dey, F., Di Giorgio, P., Du Castel, P., Dylus, D., . . . Bradley, K. A. (2024). A novel antibiotic class targeting the lipopolysaccharide transporter. Nature, 1-6. https://doi.org/10.1038/s41586-023-06873-0

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18F-FDG-PET/CT helps in prediction of brain metastasis in melanoma patients

Malignant melanoma is known for its aggressive nature and disproportionately high mortality rate among skin-related malignancies and is the third most common cancer to metastasize to the brain. A recent retrospective study published in the Journal of Cancers unveiled the potential breakthrough in prediction of brain metastases in melanoma patients.

18F-FDG PET/CT is a powerful imaging modality for detecting melanoma metastases, this study evaluated its prognostic value in the context of brain metastases. The limitation of 18F-FDG PET/CT, an unfavorable tumor-to-background uptake ratio in the brain, prompted researchers to explore its potential as a prognostic tool.

This retrospective analysis included a total of 201 melanoma patients with pathology-proven cases between 2008 and 2021. The baseline assessments included histopathology, 18F-FDG PET/CT, and brain MRI. A median follow-up of six years was conducted that revealed intriguing associations.

Among the clinical variables, the initial M-stage and TNM-stage were significantly associated to the occurrence of brain metastasis.18F-FDG PET/CT parameters, specially regional metastatic lymph node uptake values, prominent SULmax (pSULmax) and prominent SUVmean (pSUVmean), demonstrated significant links with the outcome.

The cumulative incidences observed following 1, 5, and 10 years were 10%, 31%, and 35.2%, respectively. The notable significance were the correlations between pSULmax and pSUVmean and the occurrence of brain metastases, where higher values corresponded to a swifter development of brain metastases.

This outcomes not only highlight the potential of baseline 18F-FDG PET/CT in predicting brain metastasis but also emphasize the importance of follow-up and complementary evaluations, like the MRI brain for melanoma patients with high total metabolic activity.

This study deepens the understanding of melanoma progression and also improves possibilities of targeted and timely interventions by potentially transforming the melanoma management.

Source:

Kalantari, F., Mirshahvalad, S. A., Hoellwerth, M., Schweighofer-Zwink, G., Huber-Schönauer, U., Hitzl, W., Rendl, G., Koelblinger, P., Pirich, C., & Beheshti, M. (2023). Prognostic Value of Baseline 18F-FDG PET/CT to Predict Brain Metastasis Development in Melanoma Patients. In Cancers (Vol. 16, Issue 1, p. 127). MDPI AG. https://doi.org/10.3390/cancers16010127

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Obeticholic Acid may Improve outcomes in NASH-Related Liver Fibrosis

A new study published in Journal of Hepatology confirms the efficacy of Obeticholic Acid (OCA), a novel farnesoid X receptor agonist and antifibrotic agent against non-alcoholic steatohepatitis (NASH).

The Phase III REGENERATE trial originally reported results from an 18-month liver biopsy analysis involving OCA. The treatment demonstrated its efficacy, prompting further investigation. In this study, the potential of OCA was reaffirmed, providing hope for those battling this debilitating liver condition.

The study aimed to validate the previous findings and gather additional data to support OCA’s effectiveness. A diverse panel of three pathologists independently evaluated digitized whole-slide images using the NASH Clinical Research Network scoring system. The primary endpoints were either an improvement of at least one stage in fibrosis without worsening of NASH or NASH resolution without worsening of fibrosis.

Among 931 participants, OCA demonstrated its potential with 22.4% achieving an improvement in fibrosis without NASH worsening, compared to only 9.6% on a placebo. Furthermore, 6.5% of those on OCA achieved NASH resolution without fibrosis progression, compared to 3.5% on the placebo.

Not only did OCA showcase its efficacy, but it also demonstrated a high degree of safety and tolerability. The study included data from 2,477 participants, and the incidence of treatment-emergent adverse events (TEAEs) and serious TEAEs was not substantially different across treatment groups. The most common TEAE reported was pruritus. Moreover, rates of hepatic, renal, and cardiovascular events were low and comparable across treatment groups.

These findings highlight OCA’s potential to significantly impact the lives of patients with NASH-related liver fibrosis. Preventing fibrosis from progressing to cirrhosis or even reversing it is a critical goal in NASH treatment. OCA’s antifibrotic effects, proven effectiveness, and favorable safety profile offer hope for patients dealing with this challenging condition.

Source:

Sanyal, A. J., Ratziu, V., Loomba, R., Anstee, Q. M., Kowdley, K. V., Rinella, M. E., Knapple, W., Lawitz, E. J., Abdelmalek, M. F., Shiff, S. J., Sawhney, S., Capozza, T., … Younossi, Z. M. (2023). Results from a new efficacy and safety analysis of the REGENERATE trial of obeticholic acid for treatment of pre-cirrhotic fibrosis due to non-alcoholic steatohepatitis. Journal of Hepatology, 79(5), 1110–1120. https://doi.org/10.1016/j.jhep.2023.07.014

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Frequent Self-monitoring of Blood sugar improves glycemic control in Non-insulin-Treated diabetes Patients

Frequent Self-monitoring of Blood sugar improves glycemic control in Non-insulin-Treated diabetes Patients suggests a new study published in the Journal of General Internal Medicine

Self-monitoring of blood glucose (SMBG) is a useful tool in diabetes management, but its efficacy and optimal application in type 2 diabetes (T2D) patients treated without insulin have been controversial. We aimed to evaluate the efficacy of SMBG in controlling blood glucose levels in non-insulin-treated T2D patients and to determine the optimal frequency and the most appropriate population to benefit from SMBG.

Eligible publications from January 2000 to April 2022 were retrieved from PubMed, Embase, Cochrane Library, and ClinicalTrials.gov databases. Randomized controlled trials comparing SMBG with no SMBG or structured SMBG (S-SMBG, SMBG with defined timing and frequency of glucose measurements) were included. Meta-analyses and sub-analyses were performed to assess the efficacy, optimal frequency, and most appropriate population for SMBG. Risk of bias was assessed regarding randomization, allocation sequence concealment, blinding, incomplete outcome data, selective outcome reporting, and other biases.

Results:

Twenty-two studies involving 6204 participants were identified, including 17 comparing SMBG with no SMBG and 4 comparing SMBG with S-SMBG. SMBG reduced HbA1c (MD -0.30%, 95% CI -0.42 to -0.17) compared with no SMBG, and S-SMBG performed better than SMBG (MD -0.23%, 95% CI -0.38 to -0.07). Subgroup analyses showed that HbA1c control was better with SMBG at 8-11 times weekly (MD -0.35%, 95% CI -0.51 to -0.20) compared with other frequencies and with lifestyle adjustments (MD -0.37%, 95% CI -0.50 to -0.23) than with no adjustments. No significant differences in HbA1c were observed between baseline HbA1c subgroups (≤ 8% and > 8%, P = 0.63) and between diabetes duration subgroups (≤ 6 years and > 6 years, P = 0.72), respectively.

SMBG was effective for controlling HbA1c in non-insulin-treated T2D patients, although lacking detailed monitoring design. Better outcomes were seen with SMBG at 8-11 times weekly and lifestyle adjustment based on SMBG results.

Reference:

Zou Y, Zhao S, Li G, Zhang C. The Efficacy and Frequency of Self-monitoring of Blood Glucose in Non-insulin-Treated T2D Patients: a Systematic Review and Meta-analysis. J Gen Intern Med. 2023 Feb;38(3):755-764. doi: 10.1007/s11606-022-07864-z. Epub 2022 Nov 20. PMID: 36403159; PMCID: PMC9971532.

Keywords:

Frequent, Self-monitoring, Blood sugar, improves, glycemic, control, Non-insulin-Treated, diabetes, Patients, Zou Y, Zhao S, Li G, Zhang C, frequency; glycemic control; non-insulin; self-monitoring of blood glucose; type 2 diabetes, Journal of General Internal Medicine

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Higher ambient temperature tied to increased hypoglycemia risk in older insulin users

USA: A recent study published in Diabetes Care has revealed an increased hypoglycemia risk in extreme heat among older adults (aged ≥ 65 years) with diabetes who received insulin.

“Higher ambient temperature was associated with increased risk of serious hypoglycemic events in two national samples of older insulin users,” the researchers reported.

The thermoregulatory response is often compromised in older adults with diabetes, making them vulnerable to extreme heat. Soko Setoguchi, Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, and colleagues aimed to measure the association between ambient heat and hypoglycemia-related emergency department visits or hospitalization in insulin users.

For this purpose, the researchers evaluated the association between ambient heat and hypoglycemia in about 2 million and 283,000 patients (aged 65-100 years) with diabetes from the United States and Taiwan, respectively, who received insulin.

A serious hypoglycemic event was defined as a primary visit to the emergency department (ED) or an unplanned inpatient admission for hypoglycemia from June 1 to September 30. Medication use was determined by at least one prescription dispensing insulin within 90 days of the index event.

Cases of serious hypoglycemia were identified among adults using insulin aged ≥65 in Taiwan (via the National Health Insurance Database) and the US (via Medicare Part A/B/D-eligible beneficiaries) from 2016 to 2019. The odds of hypoglycemia were estimated by heat index (HI) percentile categories using conditional logistic regression with a time-stratified case-crossover design.

The study led to the following findings:

  • Among insulin users overall, 32,461 and 10,162 older adults from the United States and Taiwan, respectively, experienced a hypoglycemic event.
  • The risk for a serious hypoglycemic event was about 40% higher among insulin users on days with an HI ≥ 99th percentile than 25-74th percentile (unadjusted odds ratio, 1.38)
  • On days with a low HI (< 25th percentile), the risk for hypoglycemia among insulin users decreased.
  • No substantial differences were observed in the risk for hypoglycemic events and HI by climate region in either country, such as between the US Northeast and Southwest.

“Our finding of increased risk of hypoglycemia-related ED visits in older adults using insulin and exposed to extreme heat emphasizes the need for patients and providers to be aware and cautious that extreme heat may raise the risk of hypoglycemia,” the authors wrote.

The study limitations include individuals with hypoglycemia who were older and had more comorbidities, so the authors suggest using caution before the results can be generalized to broader populations. The authors were also unable to capture variables that can modify the risk for serious hypoglycemia, such as exercise, outdoor activity and diet.

Reference:

Aayush Visaria, Shu-Ping Huang, Chien-Chou Su, David Robinson, John Read, Chuan-Yao Lin, Rachel Nethery, Kevin Josey, Poonam Gandhi, Benjamin Bates, Melanie Rua, Ashwagosha Parthasarathi, Arnab K. Ghosh, Yea-Huei Kao Yang, Soko Setoguchi; Ambient Heat and Risk of Serious Hypoglycemia in Older Adults With Diabetes Using Insulin in the U.S. and Taiwan: A Cross-National Case-Crossover Study. Diabetes Care 2023; dc231189. https://doi.org/10.2337/dc23-1189

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Preconception stress in women undergoing fertility treatment tied to higher blood sugar during pregnancy

USA: A new study in the Journal of the Endocrine Society showed that maternal stress during preconception was associated with higher blood glucose levels, especially among women using intrauterine insemination to conceive and women of higher socioeconomic status.

Stress during pregnancy is known to influence health outcomes, but the study from Mass General Brigham researchers suggests that stress levels before pregnancy are also important to evaluate. Investigators at Massachusetts General Hospital and Brigham and Women’s Hospital analyzed the link between self-reported stress immediately before conception among women seeking fertility care and blood glucose levels, a marker of heart health. 

“Stress prevalence has increased over the years, particularly for couples who are not able to conceive naturally,” said corresponding author Lidia Mínguez-Alarcón, PhD, MPH, Bpharm, a reproductive epidemiologist in the Brigham’s Channing Division of Network Medicine and co-investigator of the Environment and Reproductive Health (EARTH) study. “We wanted to evaluate how this stress affects health during pregnancy, which can affect both the mother and child in the long term.”

Mínguez-Alarcón and colleagues analyzed data from the EARTH study conducted at the Massachusetts General Hospital Fertility Center from 2004 to 2019 for 398 women between 18 and 45 years of age. The women self-reported preconception-perceived stress at study entry. Additional clinical characteristics and sociodemographic information, including family and medical history, consumer products use and smoking history, were either collected by the study staff through medical records or questionnaires.

Women had a median age of 35 years at study entry, and most were of white ethnic background (83 percent), reported never smoking (78 percent), and were at least college educated (64 percent). Three hundred of the women conceived using medically assisted technologies like intrauterine insemination (IUI) or in vitro fertilization (IVF). During IUI, sperm is injected directly into the uterus while IVF is a multi-step technology that involves retrieving an egg for fertilization in a lab before transfer back to the uterus. Glucose testing was done at a median of 26 weeks into pregnancy and taken one hour after the women drank a 50 gram glucose solution. A blood sugar that was equal to or less than 140 mg/dL was considered normal.

Researchers found that blood sugar levels, a measure of cardiovascular health, were abnormally high in 82 of the women involved. Previous studies have shown that women with a history of gestational diabetes (GD) during pregnancy are at increased risk of developing type 2 diabetes as well as cardiovascular problems later in life, including heart artery calcification.

The team found that women who experienced higher preconception stress had higher mean glucose levels. In addition, women who conceived through IUI had both higher stress and blood sugar levels than those who conceived through IVF. The study also found that women of higher socioeconomic status had higher levels of preconception stress and blood glucose levels during their pregnancy. Median family income was used to measure socioeconomic status.

“Professional women with higher incomes and attained education levels may be employed in demanding, time-intensive jobs and are often also responsible for balancing demands in the workplace with household duties and childcare,” Mínguez-Alarcón said. “It has previously been shown that women with a higher education level experience greater levels of job stress. Given that education level is positively associated with salary, this explanation may apply to women with higher incomes as well.”

Still, findings are limited since the study comprises a group of mostly white women of high socioeconomic status seeking fertility care. Self-reporting perceived stress may also result in participant bias. Future research can investigate additional variables like sleep quality or neighborhood safety as well as the effect of preconception stress on the baby’s health.

“Our results are of public health importance given the increasing rates of stress over the years and its effect on cardiovascular health,” Mínguez-Alarcón said. “Women can try to lower their stress levels through a variety of strategies like being more active, avoiding alcohol and drugs, eating healthy and avoiding isolation. Given the scarce literature in this field, our study has the potential to start important discussions.” 

Reference:

Lidia Mínguez-Alarcón, Olivia Chagnon, Aya Tanaka, Paige L Williams, Tamarra James-Todd, Jennifer B Ford, Irene Souter, Kathryn M Rexrode, Russ Hauser, Jorge E Chavarro, Preconception Stress and Pregnancy Serum Glucose Levels Among Women Attending a Fertility Center, Journal of the Endocrine Society, Volume 8, Issue 1, January 2024, bvad152, https://doi.org/10.1210/jendso/bvad152.

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Low-dose quadruple therapy promising for hypertension management

The mixed-methods process evaluation of the Quadruple Ultra‐Low‐Dose Treatment for Hypertension USA (QUARTET USA) clinical trial examines the perceptions of patients and healthcare professionals on the use of low-dose quadruple therapy (LDQT) as a novel approach for managing hypertension.

A study published in the Journal of the American Heart Association, JAHA, has concluded that LDQT is well-accepted by patients and healthcare professionals for managing hypertension due to its improved blood pressure control and safety. To achieve LDQT’s widespread adoption, stepped-care combinations, treatment protocols, and cost barriers, including insurance coverage and transportation, must be addressed.

A survey was conducted on all 62 patients enrolled in the QUARTET USA trial, and a subsample of 13 patients and 11 healthcare professionals were interviewed. At enrollment, 68% of participants (mean age 51.7 years) reported that their health relied on blood pressure medications, and 48% worried about these medicines.

At the end of the trial, 80% of patients were satisfied with LDQT, 96% felt the benefits of taking LDQT outweighed the drawbacks, and 96% found LDQT to be convenient. Both patients and healthcare professionals found LDQT acceptable because it reduced patients’ pill burden and improved medication adherence. Healthcare professionals noted that a limitation of LDQT was the inability to titrate doses. To promote LDQT implementation, steps such as introducing stepped-care combinations and treatment protocols, including it in clinical practice guidelines, and eliminating patient cost barriers can be taken.

Our study is the first to investigate the effectiveness of low-dose quadruple therapy on hypertension control rates in an urban federally qualified health centre network. Treatment satisfaction was high. Scalable interventions are needed to address inequitable blood pressure control rates across diverse contexts. If clinical trial evidence supports the efficacy of low-dose quadruple therapy and patient cost barriers are eliminated, health care professionals would prescribe it, they concluded further.

The major strength of this study is the inclusion of a diverse patient population, they said.

Reference:

Olutobi A. Sanuade et al. Process Evaluation of a Double‐Blind Randomized Controlled Trial to Assess the Efficacy and Safety of a Quadruple Ultra‐Low‐Dose Treatment for Hypertension Within a Federally Qualified Health Center Network (QUARTET USA). Journal of the American Heart Association. 2024;13:e032236

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Topical emollient improves xerosis and QoL in atopic dermatitis

Use of topical emollient alone can improve xerosis and quality of life in patients with atopic dermatitis suggests a new study published in the Journal of Drugs in Dermatology.

Repairing the epidermal barrier is critically important in atopic dermatitis (AD), but the effect of moisturizer on quality of life (QOL) is not well characterized.

A study was done to assess whether the use of a moisturizer improves QOL in atopic patients with xerosis.

Thirty-five (35) adults with xerosis and AD received a moisturizer designed for AD to apply daily for three months. Adherence was assessed with electronic monitors. Quality of life (QOL) was assessed with the Dermatology Life Quality Index (DLQI) at baseline and follow-up.

Results: Mean adherence to the moisturizer was 46%. Dryness improved from 1.9 at baseline to 1.4 at follow-up (P=0.02). DLQI improved from 3.3 at baseline to 1.5 at 3 months (P=0.005). The “feeling self-conscious or embarrassed due to their skin condition” DLQI item improved from 0.79 at baseline to 0.14 at 3 months (P=0.0009).

Moisturizers are the foundation of AD treatment. Even non-medicated topical emollients can improve QOL in patients with AD.

Reference:

Katherine A. Kelly BSa, Madison K. Cook BSa, Rohan Singh BSa, Patrick O. Perche BSa, Esther A. Balogh MDa, Irma M. Richardson MHAa, Steven R. Feldman MD PhDa. Topical Moisturizer Use Meaningfully Reduces Disease Severity in Atopic Patients With Xerosis. Journal of Drugs in dermatology. December 2023 | Volume 22 | Issue 12 | e51 | Copyright © December 2023

Keywords:

Use, topical, emollient, alone, can, improve, xerosis, quality of life, patients, atopic dermatitis, Katherine A. Kelly BSa, Madison K. Cook BSa, Rohan Singh BSa, Patrick O. Perche BSa, Esther A. Balogh

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AIIMS Raipur Releases guidelines for PhD Admissions, details

Raipur: All India Institute of Medical Sciences (AIIMS Raipur) has released the guidelines for PhD admission to be followed.

The PhD degree awarded by the Institute shall be designated as Doctor of Philosophy of the All India Institute of Medical Sciences, Raipur. The certificate shall not indicate the subject or specialty PhD Courses at AIIMS Raipur are full-time courses.

Admission to PhD courses conducted at the Institute is made once a year on merit, on an India basis by holding an entrance examination by the Institute. All vacant seats shall be advertised in national dailies in the month of February/March for the July Session which shall commence approximately from 1st July each year, the last date of joining being 31st August.

Advertisement of number of seats –

Every department should send a request regarding the number of seats to be advertised in each session. The faculty member should also indicate the number of PhD students already enrolled under him/her.

The department should also submit a list of all PhD candidates registered in the department along with the list of Chief Guide and also specify the number of candidates registered under a Chief Guide. This shall also include In-House candidates, if any.

All this information and the number of seats available in various departments will be available on the AIIMS, Raipur website.

In the departments where the full strength of students are getting admitted in postgraduate courses (MD/MS/DM/M.Ch/MPT/MPH), each individual faculty member shall be permitted to be the Chief Guide of maximum 2 PhD students at any given point of time, while in those departments where the full strength of students are not getting admitted in postgraduate courses, each individual faculty member shall be permitted to be the Chief guide of maximum 5 PhD students.

One seat shall be advertised for the In-house Candidates per department, in addition to those advertised for External candidates.

General Criteria –

Candidates holding Medical Qualifications –

Must possess a Medical degree or a Postgraduate degree in the subject concerned or equivalent qualification included in any one of the Schedules to the Indian Medical Council Act, 1956 (102 of 1956) and National Medical Commission Act, 2019 or recognized by the respective regulatory bodies. and candidates who have obtained MBBS/BDS/MD/MS/MDS degrees are eligible to apply.

Candidates holding non-medical qualifications –

1. Candidates who have obtained a Master’s Degree in any subject recognized by UGC colleges/institutes recognized by the respective regulatory bodies/UGC are eligible.

2. Candidates holding an M.Sc. degree in the Nursing speciality will also be eligible for PhD admission.

3. Candidate possessing Masters’s Degree through distance learning course shall not be eligible.

Minimum aggregate marks to be obtained in the Qualifying Degree Examination –

Candidates who have obtained their qualifying degree scoring at least 55% marks in aggregate shall be eligible to apply for the PhD entrance examination.

Criteria for candidates already holding a PhD Degree –

Candidates who already possess a PhD Degree awarded / successfully qualified in any subject by AIIMS, Raipur / any other recognized academic institution, shall not be eligible to apply for another additional PhD degree at AIIMS, Raipur

Department-specific eligibility qualifications are enclosed in the notice below.

Criteria for Financial Support –

Candidates who are holding their own fellowship from NET/CSIR/ICMR/DBT/DST/UGC as JRF etc. to undergo PhD programme. An attested copy of the result must be attached. If the candidate fails to produce proof of his/her eligibility as per the above qualification before one week of the entrance examination, his/her candidature will not be considered and the entire responsibility for the same will lie on the candidate.

Availability of AIIMS stipend will be subject to rules of the institute –

1. Proposed: Rs.3 1,000/- per month for the first three years and then 15,000/- per month for the next two years and subject to non-availability of other funding resources. No stipend will be given beyond 5 years.

2. Subject to approval of progress by the Doctoral Committee.

3. Can be used as a stop-gap between fellowships from funding agencies.

4. Cannot be availed once thesis writing permission is granted by the Doctoral Committee / if an extension is provided beyond the stipulated period.

Eligibility criteria for admission of in-service candidates –

The program among in-house candidates is for faculty members and non-teaching technical staff only. It will not be open to senior residents.

Candidates from AIIMS Raipur –

1. Members of faculty and non-teaching technical staff can apply for registration to PhD course as in-service candidates. He/She will be exempted from appearing in the entrance examination.

2. The individual should be a regular employee of the institute and should have rendered a minimum of two years of continuous service at the institute.

3. The individual should have a minimum of 10 years of active service left in the institute at the time of application.

4. The medical faculty member should have at least 3 original research publications in Indexed journals (not case reports) during the last three years immediately preceding the date of his/her application either as a first author or as a corresponding author in peer-reviewed journals.

5. The candidate will be considered as an in-service candidate provided that the Head of the Department should certify that the work of the department will not suffer and no additional staff will be asked for.

6. The candidate seeking admission under this category will have to identify a faculty member in the same department (senior to the candidate) who is willing to be the candidate’s chief guide. The candidate should submit a letter of acceptance/undertaking from the concerned faculty member in this regard.

7. A maximum of 25% of In-House candidates at a given time should be registered as PhD candidates in a particular department.

8. The candidate seeking admission under this category will only be registered for PhD in the same department in which he/she is working.

9. These guidelines will not be applicable to other staff members employed under various research schemes which are on a tenure basis as they are not AIIMS permanent employees.

10. The faculty members who have registered himself/herself will not be eligible to guide / co-guide any other PhD candidate in the Institute till he/she completes the PhD However; he/she can continue to be a guide/co-guide for existing and new MD/MS/MDS/MPT/DM/MCh./MSc candidates.

11. If the faculty member and permanent scientist registering for a PhD is already a Chief guide to other PhD candidates, he/she should surrender the guideship to the co-guide before taking up the PhD registration for himself/herself.

12. The candidate seeking admission under this category should send a brief write-up (approx 1000 words) of the proposed project including the statement of purpose with feasibility and applicability during application for the course.

13. The candidate should also give a write-up on how his obtaining the said degree shall provide immediate and long term benefit to the candidate, department, and Institute.

Also Read:Bond Service Allotment: DMER Maharashtra Invites Online Applications From PG Degree Holders Winter 2023 Batch, details

Deputed /sponsored candidates from other institutions –

Regarding in-service candidates on deputation at AIIMS, Raipur, the candidates will be eligible to apply and will be considered on a case-to-case basis as per relevant criteria with prior permission from the Dean (Academics).

Candidate applying for admission as a sponsored/deputed candidate is required to furnish the following certificates with his/her application from his/her employer for admission to the course –

1. That the candidate concerned is an employee of the deputing/sponsoring authority and should produce a sponsorship certificate as outlined below.

2. That no financial implications in the form of emoluments/ stipend etc. will devolve upon AIIMS, Raipur during the entire period of his/her course. Such payment will be the responsibility of the sponsoring authority.

Deputation/Sponsorship of any candidate by private hospitals, institutes or nursing homes is not accepted. The sponsoring Institute should not nominate more than one candidate for a speciality. Sponsorship/deputation of candidates will be accepted only from the following –

Candidates who are permanent employees of any Central/State Government/Armed Forces or the Public Sector Undertaking/Autonomous Body can be sponsored by the respective Government/Defence Authorities or the Competent Authorities of the PSU/Autonomous Body.

Public sector colleges affiliated to universities and recognized by the MCI/UGC. In the case of a candidate appointed/sponsored by the Govt. Medical College affiliated to Universities and recognized by the Medical Council of India, a deputation/sponsorship certificate signed by the Principal of the Medical College concerned only shall be accepted.

All eligible “sponsored” candidates will be called by the Institute for an entrance test.

Seats as shown in the prospectus are available for “sponsored” candidates. Sponsored candidates will be designated as “trainees”.

The subject for which the candidate is being sponsored should be clearly specified in the sponsorship form by the sponsoring authority. The candidate can be sponsored for only one subject. The applications of candidates sponsored for more than one subject will not be considered.

No “Sponsored” candidate will be paid any emoluments by the [institute during the training period. Such payments will be the responsibility of the sponsoring authority (i.e. Central/State Government or defense authorities).

Sponsored candidates must submit/send sponsorship certificates in original from their employers in the given format along with the application form to the Assistant Controller (Examinations), AIIMS, Tatibandh, Raipur – 492099, Chhattisgarh. Those who fail to do so should submit it before the date of issue of Admit Cards as mentioned under “AT A GLANCE” in the Prospectus failing which their candidature will be canceled.

Eligibility criteria for admission of Foreign Nationals/Overseas Citizen Of India (OCI) –

Foreign nationals must fill in the prescribed online application form indicating the choice of subject (only one subject) for admission to Postgraduate courses leading to the award of a PhD Programme degree.

The foreign nationals must send their Registration Form of Online application through the Diplomatic Channel. They are also required to appear in the Competitive Entrance Examination along with other candidates. An ‘Advance Copy’ is to be submitted at AIIMS, Raipur before the last date of online registration. However, the application of all such candidates will be processed only after receipt of the same through the Diplomatic Channel.

The foreign nationals will be considered against the seats advertised under the “Sponsored” category for PhD Programme. Candidates with medical degrees should be registered with MCI before they can join the said course if they are selected for the same.

Seats are not reserved in any discipline for foreign nationals (except the bilateral agreement between the Government of India and any other nation).

Nominations/No objection for the candidate should reach the Examination Section before the date of issue of the Admit Card. In case of non-receipt of the nominations/clearance/no objection from the concerned Ministry by the due date, their candidature will not be considered.

No emoluments will be paid by AIIMS, Raipur to the Foreign National candidates.

Overseas Citizens of India (OCI): OCI registered under Section 7A of the Citizenship Act 1955 are also eligible to appear in PG courses and all terms and conditions applicable for Indian Nationals will be applicable to the candidates. The candidate will submit proof of Registration as OCI under Section 7 A of Citizenship Act 1 95 5 to be eligible to appear for this test.

The guide will have the option to accept or not to accept the candidate, who opts to do PhD under that particular faculty member. The candidate may opt for only a specific faculty member.

Duties of PhD student –

Duties of PhD Students joining as External Candidates: It must be noted that the primary duty of the student in the department is to pursue his/her thesis work only, as a full-time candidate for fulfillment of the objectives of the degree requirement. However, as the student needs to have an overall idea of the functioning of the department, the Head of the Department at his/her discretion can assign the student different departmental / emergency duties on rotation.

Duties of PhD Students joining as In-house Candidates: It must be noted that the primary duty of the student in the department is to work as per his/her service conditions of appointment as faculty of AIIMS, Raipur. The rest of the time can be dedicated to research work towards fulfilling the objectives of PhD thesis work. However, a balance needs to be maintained between the dual responsibilities so that the quality and scope of PhD work remain up to the standards demanded by the Institute of National Importance (INI). Towards this end, the PhD guide can discuss with the Head of the Department of the PhD student to decide the modalities under exceptional situations when the responsibilities of departmental work and PhD research work overlap so that the quality and scope of PhD work are not compromised.

Duration of the course –

The duration of the course i.e. the period of registration shall be the time from the date of registration to the submission of the thesis. This shall be followed by Post-submission evaluation and award of degree. The minimum period of registration for all the candidates who are registered for a PhD shall be three years, i.e., the thesis cannot be submitted before three years. The maximum period of registration shall not exceed five years. Extension beyond the period of 5 years can be given under exceptional circumstances for a maximum period of 6 months on the recommendation of the Doctoral Committee and final approval by the Dean (Academics)/Director.

Method of selection –

Selection for PhD registration will be through a two-stage performance evaluation through a common entrance test in Medical, Nursing and Allied Health Sciences. However, an In-house candidate shall not appear in the common entrance examination.

Entrance examination –

Centre for Examination: Examination will be conducted (CBT) modes.

Scheme of Examination – MCQ Questions:90, Max. Marks:90

Performance Evaluation Selection for PhD registration will be through a two-stage performance evaluation as under –

Stage I: 40 Marks (40 MCQs of I Mark each): Aptitude-related MCQs covering English (Written and verbal skills), Biostatistics, Research Methodology, etc.

Stage Il: 50 Marks (50 MCQs of I Mark each): Subject-related theory-based Multiple Choice Questions (MCQs) mainly explore broad-based basic scientific knowledge and particularly analytical aptitude for research in the subject.

Total Marks (Stage I + II): 90 (40+50)

Total Duration (Stage I + II): 90 Minutes

Candidates must score at least 45 marks in aggregate (stages I and II combined) to be eligible for selection.

The Special Weightage of 10 marks will be added to the total score of Stages I and those who fulfill the following criteria –

Any candidate who has qualified in any one of the following entrance tests in the last 2 years and possesses valid scores: Joint CSIR-UGC NET for JRF, [CMR-JRI’, ICMR-SRF, DBT-JRF, DBT-SRF, NBHM screening test, Graduate aptitude test (GATE), INSPIRE fellowship, UGC-JRF, UGC-SRF, CSIRJRF, CSIR-SRF, DST-JRF, DST-SRF or are sponsored/deputed candidates.

Joining –

Selected candidates will be intimated through e-mail. Thereafter, it will be assumed that he/she does not intend to join the course and the seat will be offered to the next candidate on the waiting list unless a written request for up to 15 days extension is received by the competent authority who may permit an extension of joining for this additional 15 days based on merit of each case. In case the candidate fails to join by this date, it will be assumed that he/she does not intend to join the course and the seat will be offered to the next candidate on the waiting list.

The seat will ordinarily lapse for the respective session if any candidate fails to join by intimated date, as the case may be. No further correspondence will be entertained in this regard. Apart from in-house candidates, the PhD courses can be joined only as full-time courses after getting a relieving letter from the sponsoring agency.

Medical examination – 

Medical fitness will be a pre-condition for the registration of all candidates. The candidates will be medically examined by a Medical Board, constituted by the Institute, to determine their medical fitness.

Fee –

India citizen – Rs 4125 (3 years duration) The detailed fee structure is enclosed in the notice below.

Foreign Nationals / Self-financed nominees/candidates and similar designations of Indian Govt -US Dollar 75,0001- inclusive of all Items mentioned in (i) above for the entire course, to be paid in three equal installments of USD 25,0001- each with a maximum gap of 1 year between payment of each installment. Permission to write the thesis shall be subject to full payment of the fees.

To view the notice, click on the link below –

https://medicaldialogues.in/pdf_upload/65968fe92077cphd-course-229415.pdf

Also Read:ICMR Invites Application For PhD Programme At National Institute for Pathology, details

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For epilepsy, yoga may be good for your mind

For people with epilepsy, doing yoga may help reduce feelings of stigma about the disease along with reducing seizure frequency and anxiety, according to new research published in the November 8, 2023, online issue of Neurology®, the medical journal of the American Academy of Neurology.

“People with epilepsy often face stigma that can cause them to feel different than others due to their own health condition and that can have a significant impact on their quality of life,” said study author Manjari Tripathi, MD, DM, of All India Institute of Medical Sciences in New Delhi. “This stigma can affect a person’s life in many ways including treatment, emergency department visits and poor mental health. Our study showed that doing yoga can alleviate the burden of epilepsy and improve the overall quality of life by reducing this perceived stigma.”

For the study, researchers looked at people with epilepsy with an average age of 30 in India.

Researchers measured stigma based on participants’ answers to questions such as: “Do you feel other people discriminate against you?” “Do you feel you cannot contribute anything in society?” and “Do you feel different from other people?”

Researchers then identified 160 people who met the criteria for experiencing stigma. Participants had an average of one seizure per week and on average took at least two anti-seizure medications.

Researchers then randomly assigned participants to receive yoga therapy or sham yoga therapy. Yoga therapy included exercises in loosening muscles, breathing, meditation and positive affirmations. Sham yoga consisted of exercises that mimic the same yoga exercises, but participants were not given instructions on two key components of yoga believed to induce a relaxation response: slow and synchronized breathing, and attention to the body movements and sensations during practice.

Each group received seven supervised group sessions of 45 to 60 minutes over three months. Participants were also asked to practice sessions at home at least five times a week for 30 minutes. They tracked seizures and yoga sessions in a journal. After the three months of therapy, participants were followed for another three months.

Researchers found when compared to people who did sham yoga, people who did yoga were more likely to reduce their perceived stigma of the disease. People who did yoga had an average score of seven at the start of the study and an average score of four at the end of the study, while people who did sham yoga had an increase from an average score of six at the start of the study to an average score of seven at the end.

Researchers also found that people who did yoga were more than four times as likely to have more than a 50% reduction in their seizure frequency after six months than the people who did sham yoga.

In addition, people who did yoga were more than seven times more likely to no longer have seizures than those who did sham yoga.

There was also a significant decrease in anxiety symptoms for people who did yoga versus people who did not. They saw improvements in quality of life measures and mindfulness.

“These study findings elevate the need to consider alternative therapies and activities for people with epilepsy facing stigma,” said Tripathi. “Yoga may not only help reduce stigma, but also improve quality of life and mindfulness. Plus, yoga can be easily prerecorded and shared with patients online using minimal resources and costs.”

A limitation of the study was that participants self-reported their seizure frequency and they may not have remembered all the information accurately.

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