Himalayan Institute of Medical Sciences
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Item Draft-genome sequencing of multidrug-resistant hypervirulent Klebsiella pneumoniae from neonatal septicaemia at SRHU, Dehradun, India(Microbiology Resource Announcements, 2026-07-06) Sarkar, IndraniMultidrug resistance makes the Gram-negative bacterium Klebsiella pneumoniae a growing threat and a major contributor to neonatal sepsis. At SRHU, Dehradun, India, we discovered four hypervirulent multidrug-resistant strains from bloodstream infections in neonates, highlighting their clinical significance and treatment and infection control implications.Item Prevalence and patterns of workplace violence against doctors of North India: a cross-sectional study(Frontiers, 2026-05-04) Vyas, Shaili; Singh, Abhinav et al.Background: Workplace violence (WPV) against physicians represents an esca lating global concern, with significant implications for India. This phenomenon substantially undermines the mental health, professional morale, and clinical performance of healthcare providers. A comprehensive understanding of the prevalence, patterns, and contextual factors associated with WPV is essential to develop evidence-based prevention and mitigation strategies. Methods: A cross-sectional study was conducted with 200 physicians (100 employed at a tertiary care teaching hospital and 100 in private healthcare settings) in Dehradun, Uttarakhand, North India. Data were collected using a pretested, self-administered questionnaire assessing experiences of workplace violence, contributing factors, physicians’ perceptions, and recommended pre ventive measures. Both descriptive and inferential statistical analyses were per formed using SPSS version 23. Results: Workplace violence was reported by 75% of the respondents (95% confidence interval [CI]: 68.9–81.0%), with verbal abuse representing the most prevalent form (59.33%; 95% CI: 51.4–67.1%). Violence occurred more frequently among male physicians, particularly in private healthcare settings and surgical specialties. A majority of incidents occurred during junior residency and were perpetrated by patients’ relatives (68%) or organized groups (mobs). Notably, only 18% of cases were formally reported by police authorities. Conclusion: Workplace violence was highly prevalent among physicians in Uttarakhand, with verbal abuse and mob-related incidents constituting the pre dominant manifestations. Urgent interventions, including enhanced security measures, structured physician-patient communication programs, and stringent legal enforcement, are necessary to establish a safer and more supportive work ing environment for healthcare professionals.Item A Scoping Review to Evaluate Different Treatments Used in Advanced Nonsmall‑cell Lung Cancer in India(Wolters Kluwer, 2026-04-18) Semwal, Jayanti; Juyal, Ruchi et al.Nonsmall‑cell lung cancer (NSCLC) accounts for nearly 85% of all lung cancers and represents a major global health burden. In India, treatment strategies must be optimized through a customized approach that considers genetic and environmental differences. Objectives: To provide evidence from Indian RCTs with valuable insights into effective and cost effective treatment options. Materials and Methods: This review, conducted according to the Cochrane Handbook guidelines, identified 179,960 studies across databases—PubMed (26,383), Google Scholar (17,100), ScienceDirect/Embase (136,458), and the Clinical Trials Registry of India (19). Results: After screening, 11 primary studies involving 3,470 patients were included. Treatment regimens studied included platinum‑based chemotherapy (carboplatin and cisplatin), taxanes (paclitaxel and docetaxel), epidermal growth factor receptor tyrosine kinase inhibitors (EGFR TKIs), and combination therapies. Carboplatin and cisplatin were the most frequently used agents; gefitinib plus cisplatin showed better efficacy in EGFR‑mutated patients; pemetrexed plus carboplatin was more tolerable than paclitaxel plus carboplatin; and chemoimmunotherapy demonstrated superior survival outcomes compared to chemotherapy alone. Targeted therapies such as EGFR TKIs were equally effective with fewer toxicities. Conclusion: In conclusion, platinum‑based chemotherapy remains the mainstay of NSCLC treatment, but patient tolerance, mutational status, and toxicity profiles must be carefully considered. Chemoimmunotherapy and EGFR TKIs are promising alternatives with improved results, while personalized treatment approaches and novel drug combinations should be the focus of future research.Item Building Palliative Care Capacity in North India: A Multicenter Approach(Elsevier, 2026-02-02) Kashyap, Komal; Ratre, Brajesh Kumar et al.In low-resource settings like Northern India, palliative care providers often lack adequate training, institutional support, and interdisciplinary collaboration that are indispensable for effective implementation. Objectives This article highlights strategies to build palliative care capacity through education, interdisciplinary collaboration, and system-level interventions in Northern India. The article describes a palliative care capacity-building project executed from 2023 through 2025. It presents scalable approaches to overcome barriers to palliative care, enhance palliative care competencies, and expand palliative care infrastructure. Material and Method The project proceeded in three phases and began with the selection and development of nine centers of excellence (Phase I), followed by associating each center with ten district hospitals to embed palliative care within the region (Phase II). Phase III focused on palliative care training for providers in 90 district hospitals. The project assessed capacity and quality improvements at the centers and evaluated providers' palliative care knowledge post-training in the district hospitals. Results The centers of excellence reported substantial capacity and continued improvements in palliative care delivery throughout the project. Physicians and nurses affiliated with the district hospital showed significant and lasting knowledge gains after palliative care training. Conclusion These results demonstrate significant progress in palliative care capacity with the region, but they, also, underscore the need for ongoing efforts in training, research, and systematic record-keeping. The project’s success in its three phased approach illustrates the potential for education, collaboration, and system-level support to strengthen palliative care capacity.Item ARIMA based projection of infant mortality rate by the year 2030: a comparative analysis of India and Madhya Pradesh(SCOPUS, 2025) Abhinav Bahuguna; Akanksha Uniyal; Vidisha VallabhBackground Infant mortality is an important predictor of a government’s commitment to its people. Global infant deaths have declined since past decades but at a pace that leaves much to be desired. India’s declining pattern of trends is encouraging but the low performance of individual states like Madhya Pradesh (MP) indicates an urgent need for policy revision and implementation. Methods This paper forecasts the Infant mortality rate (IMR) of India and MP by the year 2030 through autoregressive integrated moving average (ARIMA) model after obtaining stationarity by differencing the series of IMR once. The Akaike’s information criterion and Bayesian information criterion have been used for the selection of best ARIMA model amongst other existing choices. The model diagnostics through Ljung and Box test shows absence of autocorrelation in the residuals (p>0.05). Results The findings through ARIMA(3, 1, 0) foretell a declining IMR from 27 to 20 per thousand live births (from 2021 to 2030) in India. Similarly, MP is expected to experience reduction in infant deaths from 44 to 39 per thousand live births (from 2021 to 2030). The deployed model is well fitted as mean absolute percentage error lies below 5%. During 2010–20, India and MP witnessed a decadal reduction of 40% and 31% in IMR, respectively. From the year 2010 onwards, India experienced the highest annual reduction of 8.1% in IMR during 2015–16. Similarly, MP encountered a decrease of 6.5% in IMR recently (2019–20), which is the highest declining annual IMR in the state during past ten years. Conclusions The projected figures on IMR are satisfactory for policy makers at national level, but MP is still miles away to achieve acceptable IMR as compared to the country’s IMR. The state requires more attention and focus on exploring reasons and identifying underlying factors responsible for higher IMR across its demographic structure including socio-economic characteristics.