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Chandra J, Manglani M, Aneja S, Vinayan KP, Sinha A, Mandal P, Mishra D, Seth R, Kinjawadekar U. The Indian Academy of Pediatrics and Directorate General of Health Services, Government of India White Paper on Transition of Care for Youth with Special Health Care Needs. Indian Pediatr 2024; 61:475-481. [PMID: 38517005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
Over the years, survival of children with chronic diseases has significantly improved and a large proportion of them now are entering into adulthood. Transition of Care (ToC) of such patients with having childhood onset of chronic diseases to the adult health care system is well organized in developed countries, although it is an emerging concept in India. In situations where the systems for ToC are not in place, such cases are fraught with unsatisfactory health outcomes. With proper ToC in place, these patients are likely to receive uninterrupted care by the adult care physicians and hence reach their full potential. This document highlights the need, rationale and way forward for ToC of youth with special health care needs (YSHCN) across the country. It also describes the standard operating procedures to develop the ToC at a hospital level for clinicians and administrators.
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Affiliation(s)
- Jagdish Chandra
- Department of Pediatrics, Employees State Insurance Corporation Medical College and Hospital (ESIC MCH), Faridabad, Haryana. Correspondence to: Dr Jagdish Chandra, B 1007, Sea Show CGHS, Plot Number 14, Sector 19B, Dwarka, New Delhi, 110075, India.
| | - Mamta Manglani
- Municipal Corporation of Greater Mumbai (MCGM) Comprehensive Thalassemia Care, Pediatric Hematology-Oncology and Bone Marrow Transplantation Centre, Mumbai, Maharashtra, India
| | - Satinder Aneja
- Formerly at Department of Pediatrics, Lady Hardinge Medical College, New Delhi, India
| | - K P Vinayan
- Department of Pediatric Neurology, Amrita Institute of Medical Sciences, Cochin, Kerala, India
| | - Aditi Sinha
- Department of Pediatrics, Ail India Institute of Medical Sciences, New Delhi, India
| | - Piali Mandal
- Department of Pediatrics, Kalawati Saran Children's Hospital and Lady Hardinge Medical College, New Delhi, India
| | | | - Rajeev Seth
- Vice President North Zone, Indian Academy of Pediatrics (IAP), 2023
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Hossain S, Hossain S, Avesta A, Nene A, Maresca R, Aneja S. Development and Validation of MRI Imaging Biomarkers for Prostate Cancer Using Deep Learning. Int J Radiat Oncol Biol Phys 2023; 117:e393. [PMID: 37785320 DOI: 10.1016/j.ijrobp.2023.06.1517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Given the increasing number of treatment options for patients with localized prostate cancer (PCa), there is a need for biomarkers to aid in risk stratification. Specifically, novel biomarkers can aid in the identification of high-risk phenotypes among similar patients in traditional NCCN risk groupings. One promising area for development is using pre-treatment prostate MRI to identify imaging biomarkers to identify prostate cancer patients at highest risk for recurrence. We hypothesized that deep learning could be leveraged to identify imaging biomarkers of aggressive PCa from pre-treatment prostate MRIs. MATERIALS/METHODS Our study included 1,020 patients treated at our institution between 2010-2022. Given pathologic extraprostatic extension (EPE) and seminal vesicle invasion (SVI) are associated with higher risk of treatment failure, we hypothesized that deep learning models which identified radiographic EPE and SVI would provide non-invasive imaging biomarkers associated with PCa prognosis. We trained two separate deep learning models using convolutional neural networks to predict SVI and EPE respectively. The model inputs were T2W prostate MRIs (n = 894) and models consisted of 8 convolutional layers. Dropout, L2 regularization, and data augmentation were used to improve model generalizability and reduce overfitting. Discriminatory ability of each model was measured using AUC on a blinded external test set of 221 patients. To assess the clinical utility of our imaging biomarkers, log-rank tests were used to evaluate biochemical free survival (BFS) for patients classified as high risk to patients classified as low risk. Biochemical failure was defined as post-treatment PSA >0.1 for patients who underwent radical prostatectomy (RP) or PSA >2ng/ml above nadir for patients receiving radiation therapy. RESULTS Within our cohort of 1,020 patients the median age was 66 with a median follow up of 4 years. 49.3% (n = 503) underwent RP and 50.7% (n = 517) received EBRT. 4% (n = 41) were low risk, 62.4% (n = 636) were intermediate risk, and 33% (n = 337) were high risk based on NCCN criteria. Deep learning models showed good discriminatory ability for both EPE (AUC 0.66) and SVI (AUC 0.74). Both imaging biomarkers showed prognostic ability to identify high risk prostate phenotypes. Patients deemed high risk based on EPE classifier had worse BFS (median 5 vs 9 years, p<.001). Similarly, patients classified as high risk based on SVI also showed worse BFS (median 5 vs 9 years, p = 0.024). Among intermediate risk patients, EPE biomarker showed an ability to identify high risk phenotypes (median 6 vs 9 years, p = 0.024). CONCLUSION Deep learning classifiers of prostate MRIs demonstrated the ability to stratify high-risk prostate cancer phenotypes beyond traditional risk paradigms. Imaging biomarkers represent a non-invasive method to help aid in the personalization of treatment for patients with localized prostate cancer and identify patients who potentially require treatment escalation.
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Affiliation(s)
- S Hossain
- Department of Therapeutic Radiology, Yale School of Medicine, New Haven, CT; Center for Outcomes Research and Evaluation (CORE), New Haven, CT
| | - S Hossain
- Department of Therapeutic Radiology, Yale School of Medicine, New Haven, CT; Center for Outcomes Research and Evaluation (CORE), New Haven, CT
| | - A Avesta
- Center for Outcomes Research and Evaluation (CORE), New Haven, CT; Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT
| | - A Nene
- Department of Therapeutic Radiology, Yale School of Medicine, New Haven, CT; Center for Outcomes Research and Evaluation (CORE), New Haven, CT
| | - R Maresca
- Department of Therapeutic Radiology, Yale School of Medicine, New Haven, CT; Center for Outcomes Research and Evaluation (CORE), New Haven, CT
| | - S Aneja
- Department of Therapeutic Radiology, Yale School of Medicine, New Haven, CT; Center for Outcomes Research and Evaluation (CORE), New Haven, CT
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Mange A, Singh C, Theriault BC, Hansen JE, An Y, Aneja S, Chiang VL. Selected-Lesion Stereotactic Radiosurgery in Treatment of Patients with Multiple Brain Metastases: A Single Institution Retrospective Study. Int J Radiat Oncol Biol Phys 2023; 117:e135. [PMID: 37784701 DOI: 10.1016/j.ijrobp.2023.06.939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Stereotactic Radiosurgery (SRS) has been increasingly used as first and subsequent-line treatments for brain metastases. While the appropriate cut-off number of lesions for SRS is still being debated nationally in patients with multiple brain metastases, some institutions use an alternate approach particularly for patients with >10-15 lesions. Selected-lesion SRS (SL-SRS) is where only a subset of lesions are chosen for initial SRS treatment leaving small and clinically inconsequential lesions for treatment using alternate or delayed treatments. This study aims to investigate the patient selection criteria, patient and tumor characteristics and analyze the outcomes in patients receiving SL-SRS for brain metastases at our institution. MATERIALS/METHODS Clinical data from patients treated using the SL-SRS approach from 2012-2022 at our institution were retrospectively reviewed. Patients were divided into cohorts based on overall survival from time of SL-SRS treatment and indications for using SL-SRS. We compared the patient characteristics (age, histology, KPS, dsGPA), tumor characteristics (cumulative tumor volumes, tumor dose, number of brain metastases found, number of metastases treated), treatment characteristics (chemotherapy, immunotherapy, previous SRS/ radiation, previous WBRT) and the reason for decision to recommend SL-SRS across these cohort. RESULTS A total of 102 patients were treated using the SL-SRS approach. Indications for using SL-SRS were immunotherapy trial (n = 40), CNS penetrating drug options available (n = 18), patient refusing WBRT (n = 6), palliative after prior WBRT/SRS (n = 28), WBRT planned to follow SRS (n = 9). 31 patients were alive at 12 months and 21 patients at 24 months. In patients surviving <12 months - the most common indications for SL-SRS were CNS palliation in the setting of progressive disease after prior WBRT or SRS. Patients in this group had median KPS< = 60 and had predominantly non-small cell carcinoma primary diagnosis. In those patients surviving >12 months - the most common indication for SL-SRS was participation in CNS-penetrant agent clinical trials without WBRT. Patients in this group were more likely to be female, had a median KPS of 90, had predominantly diagnoses of melanoma. Following the SL-SRS treatment, 14 patients required further SRS and 4 patients went on to WBRT in the >12-month survival group. No patients died of CNS progression alone. 10 patients survived 24 months without requiring further CNS radiation. CONCLUSION In our institution, SL-SRS has predominantly been used either as palliative treatment at time of disease progression or to facilitate entry onto clinical trial with immunotherapy or potentially CNS-penetrant agents. The latter indication resulted in 47.6% patients surviving >24 month without the need for additional radiation to the CNS and therefore SL-SRS should be considered a feasible, safe and effective alternative to either WBRT or SRS treatment of all radiographically visible brain metastases.
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Affiliation(s)
- A Mange
- Yale School of Medicine, New Haven, CT
| | - C Singh
- St. Jude Children's Research Hospital, Memphis, TN
| | | | - J E Hansen
- Department of Therapeutic Radiology, Yale School of Medicine, New Haven, CT
| | - Y An
- Department of Therapeutic Radiology, Yale School of Medicine, New Haven, CT
| | - S Aneja
- Department of Therapeutic Radiology, Yale School of Medicine, New Haven, CT
| | - V L Chiang
- Department of Neurosurgery, Yale School of Medicine, New Haven, CT
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Kaul A, Bansal N, Sharma P, Aneja S, Mahato MP. Association of Screen Time Usage and Physical Activity With Overweight and Obesity Among School-Going Children in Uttar Pradesh. Cureus 2023; 15:e47690. [PMID: 38021929 PMCID: PMC10674046 DOI: 10.7759/cureus.47690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2023] [Indexed: 12/01/2023] Open
Abstract
Background Being overweight during childhood refers to excess weight for a given height, while obesity denotes excess body fat. These conditions stem from surplus calorie intake and insufficient physical activity. Escalating pediatric obesity is linked to modern sedentary lifestyles, marked by increased screen time, reduced exercise, and poor diets. Once believed to be a concern in affluent nations, obesity now affects developing countries like India due to changing eating habits and urbanization. Despite limitations in measurement tools, such as body mass index (BMI) and waist circumference, recognizing sedentary behaviors such as prolonged screen time is pivotal. The rapidly rising prevalence of pediatric obesity has become a major public health concern; therefore, we conducted this study to determine the prevalence and association of screen time usage with being overweight in school-going children (aged 8-15 years). Methodology This observational, cross-sectional study was conducted in Greater Noida, Uttar Pradesh over 18 months (January 2019 to June 2020) after obtaining institutional ethical committee approval. Participants were 8 to 15-year-old students from three co-educational secondary schools in the region. Children with motor or developmental disabilities were excluded. Written informed parental consent and school permission were secured. Anthropometric measurements included weight (SECA 874 U scale) and height (SECA213 stadiometer), which were used to calculate BMI. Overweight/obesity status followed the Indian Academy of Pediatrics guidelines. A validated questionnaire assessed screen time, and a validated Physical Activity Questionnaire measured physical activity. Both questionnaires were administered twice to validate data. SPSS version 23.0 (IBM Corp., Armonk, NY, USA) was used for data analyses (descriptive, t-test, analysis of variance (ANOVA) test, and chi-square test). P-values <0.05 were considered significant. Results This study involved 604 participants. Among them, 47.7% had a normal BMI, 37.4% were overweight, and 14.9% were obese. Most participants (97.4%) reported screen time of over 60 minutes daily, while 2.6% reported lower screen time. ANOVA revealed significant differences in daily (F = 16.014, p < 0.001) and weekly (F = 16.175, p < 0.001) screen time among BMI categories. Low physical activity was prevalent (97.7%). ANOVA showed significant variations in physical activity scores and durations (p < 0.001), with normal-weight individuals exhibiting higher levels. Conclusions The rising prevalence of overweight among children underscores the need for early intervention strategies, emphasizing the importance of reducing screen time and promoting increased physical activity. These measures are critical in addressing the growing challenge of being overweight during childhood and its potential long-term health implications.
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Affiliation(s)
- Abha Kaul
- Pediatrics, School of Medical Sciences and Research, Greater Noida, IND
| | - Neha Bansal
- Pediatrics, School of Medical Sciences and Research, Greater Noida, IND
| | - Prakhar Sharma
- Pediatrics, School of Medical Sciences and Research, Greater Noida, IND
| | - Satinder Aneja
- Pediatrics, Lady Hardinge Medical College, New Delhi, IND
| | - M P Mahato
- Pediatrics, School of Medical Sciences and Research, Greater Noida, IND
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Avesta A, Hui Y, Aboian M, Duncan J, Krumholz HM, Aneja S. 3D Capsule Networks for Brain Image Segmentation. AJNR Am J Neuroradiol 2023; 44:562-568. [PMID: 37080721 PMCID: PMC10171390 DOI: 10.3174/ajnr.a7845] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 03/11/2023] [Indexed: 04/22/2023]
Abstract
BACKGROUND AND PURPOSE Current autosegmentation models such as UNets and nnUNets have limitations, including the inability to segment images that are not represented during training and lack of computational efficiency. 3D capsule networks have the potential to address these limitations. MATERIALS AND METHODS We used 3430 brain MRIs, acquired in a multi-institutional study, to train and validate our models. We compared our capsule network with standard alternatives, UNets and nnUNets, on the basis of segmentation efficacy (Dice scores), segmentation performance when the image is not well-represented in the training data, performance when the training data are limited, and computational efficiency including required memory and computational speed. RESULTS The capsule network segmented the third ventricle, thalamus, and hippocampus with Dice scores of 95%, 94%, and 92%, respectively, which were within 1% of the Dice scores of UNets and nnUNets. The capsule network significantly outperformed UNets in segmenting images that were not well-represented in the training data, with Dice scores 30% higher. The computational memory required for the capsule network is less than one-tenth of the memory required for UNets or nnUNets. The capsule network is also >25% faster to train compared with UNet and nnUNet. CONCLUSIONS We developed and validated a capsule network that is effective in segmenting brain images, can segment images that are not well-represented in the training data, and is computationally efficient compared with alternatives.
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Affiliation(s)
- A Avesta
- From the Department of Radiology and Biomedical Imaging (A.A., M.A., J.D.)
- Department of Therapeutic Radiology (A.A., Y.H., S.A.)
- Center for Outcomes Research and Evaluation (A.A., Y.H., H.M.K., S.A.)
| | - Y Hui
- Department of Therapeutic Radiology (A.A., Y.H., S.A.)
- Center for Outcomes Research and Evaluation (A.A., Y.H., H.M.K., S.A.)
| | - M Aboian
- From the Department of Radiology and Biomedical Imaging (A.A., M.A., J.D.)
| | - J Duncan
- From the Department of Radiology and Biomedical Imaging (A.A., M.A., J.D.)
- Departments of Statistics and Data Science (J.D.)
- Biomedical Engineering (J.D., S.A.), Yale University, New Haven, Connecticut
| | - H M Krumholz
- Center for Outcomes Research and Evaluation (A.A., Y.H., H.M.K., S.A.)
- Division of Cardiovascular Medicine (H.M.K.), Yale School of Medicine, New Haven, Connecticut
| | - S Aneja
- Department of Therapeutic Radiology (A.A., Y.H., S.A.)
- Center for Outcomes Research and Evaluation (A.A., Y.H., H.M.K., S.A.)
- Biomedical Engineering (J.D., S.A.), Yale University, New Haven, Connecticut
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Hooli S, King C, McCollum ED, Colbourn T, Lufesi N, Mwansambo C, Gregory CJ, Thamthitiwat S, Cutland C, Madhi SA, Nunes MC, Gessner BD, Hazir T, Mathew JL, Addo-Yobo E, Chisaka N, Hassan M, Hibberd PL, Jeena P, Lozano JM, MacLeod WB, Patel A, Thea DM, Nguyen NTV, Zaman SM, Ruvinsky RO, Lucero M, Kartasasmita CB, Turner C, Asghar R, Banajeh S, Iqbal I, Maulen-Radovan I, Mino-Leon G, Saha SK, Santosham M, Singhi S, Awasthi S, Bavdekar A, Chou M, Nymadawa P, Pape JW, Paranhos-Baccala G, Picot VS, Rakoto-Andrianarivelo M, Rouzier V, Russomando G, Sylla M, Vanhems P, Wang J, Basnet S, Strand TA, Neuman MI, Arroyo LM, Echavarria M, Bhatnagar S, Wadhwa N, Lodha R, Aneja S, Gentile A, Chadha M, Hirve S, O'Grady KAF, Clara AW, Rees CA, Campbell H, Nair H, Falconer J, Williams LJ, Horne M, Qazi SA, Nisar YB. In-hospital mortality risk stratification in children aged under 5 years with pneumonia with or without pulse oximetry: A secondary analysis of the Pneumonia REsearch Partnership to Assess WHO REcommendations (PREPARE) dataset. Int J Infect Dis 2023; 129:240-250. [PMID: 36805325 PMCID: PMC10017350 DOI: 10.1016/j.ijid.2023.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 02/01/2023] [Accepted: 02/05/2023] [Indexed: 02/17/2023] Open
Abstract
OBJECTIVES We determined the pulse oximetry benefit in pediatric pneumonia mortality risk stratification and chest-indrawing pneumonia in-hospital mortality risk factors. METHODS We report the characteristics and in-hospital pneumonia-related mortality of children aged 2-59 months who were included in the Pneumonia Research Partnership to Assess WHO Recommendations dataset. We developed multivariable logistic regression models of chest-indrawing pneumonia to identify mortality risk factors. RESULTS Among 285,839 children, 164,244 (57.5%) from hospital-based studies were included. Pneumonia case fatality risk (CFR) without pulse oximetry measurement was higher than with measurement (5.8%, 95% confidence interval [CI] 5.6-5.9% vs 2.1%, 95% CI 1.9-2.4%). One in five children with chest-indrawing pneumonia was hypoxemic (19.7%, 95% CI 19.0-20.4%), and the hypoxemic CFR was 10.3% (95% CI 9.1-11.5%). Other mortality risk factors were younger age (either 2-5 months [adjusted odds ratio (aOR) 9.94, 95% CI 6.67-14.84] or 6-11 months [aOR 2.67, 95% CI 1.71-4.16]), moderate malnutrition (aOR 2.41, 95% CI 1.87-3.09), and female sex (aOR 1.82, 95% CI 1.43-2.32). CONCLUSION Children with a pulse oximetry measurement had a lower CFR. Many children hospitalized with chest-indrawing pneumonia were hypoxemic and one in 10 died. Young age and moderate malnutrition were risk factors for in-hospital chest-indrawing pneumonia-related mortality. Pulse oximetry should be integrated in pneumonia hospital care for children under 5 years.
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Affiliation(s)
- Shubhada Hooli
- Division of Pediatric Emergency Medicine, Texas Children's Hospital/Baylor College of Medicine, Houston, United States of America
| | - Carina King
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden and Institute for Global Health, University College London, London, United Kingdom
| | - Eric D McCollum
- Global Program in Respiratory Sciences, Eudowood Division of Pediatric Respiratory Sciences, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, United States of America and Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States of America
| | - Tim Colbourn
- Institute for Global Health, University College London, London, United Kingdom
| | | | | | - Christopher J Gregory
- Division of Vector-Borne Diseases, US Centers for Disease Control and Prevention, Fort Collins, United States of America
| | - Somsak Thamthitiwat
- Division of Global Health Protection, Thailand Ministry of Public Health-US Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
| | - Clare Cutland
- African Leadership in Vaccinology Expertise (Alive), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Shabir Ahmed Madhi
- South African Medical Research Council: Vaccines and Infectious Diseases Analytics Research Unit, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - Marta C Nunes
- South African Medical Research Council: Vaccines and Infectious Diseases Analytics Research Unit, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases Unit, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Tabish Hazir
- The Children's Hospital, (Retired), Pakistan Institute of Medical Sciences (PIMS), Islamabad, Pakistan (deceased)
| | - Joseph L Mathew
- Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Emmanuel Addo-Yobo
- Kwame Nkrumah University of Science & Technology/Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Noel Chisaka
- World Bank, Washington DC, United States of America
| | - Mumtaz Hassan
- The Children's Hospital, Pakistan Institute of Medical Sciences (PIMS), Islamabad, Pakistan (deceased)
| | - Patricia L Hibberd
- Department of Global Health, Boston University School of Public Health, Boston, United States of America
| | | | - Juan M Lozano
- Florida International University, Miami, United States of America
| | - William B MacLeod
- Department of Global Health, Boston University School of Public Health, Boston, United States of America
| | - Archana Patel
- Lata Medical Research Foundation, Nagpur and Datta Meghe Institute of Medical Sciences, Sawangi, India
| | - Donald M Thea
- Department of Global Health, Boston University School of Public Health, Boston, United States of America
| | | | - Syed Ma Zaman
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Raul O Ruvinsky
- Dirección de Control de Enfermedades Inmunoprevenibles, Ministerio de Salud de la Nación, Buenos Aires, Argentina
| | - Marilla Lucero
- Research Institute for Tropical Medicine, Manila, Philippines
| | - Cissy B Kartasasmita
- Department of Child Health, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | | | - Rai Asghar
- Rawalpindi Medical College, Rawalpindi, Pakistan
| | | | - Imran Iqbal
- Combined Military Hospital Institute of Medical Sciences, Multan, Pakistan
| | - Irene Maulen-Radovan
- Instituto Nacional de Pediatria Division de Investigacion Insurgentes, Mexico City, Mexico
| | - Greta Mino-Leon
- Children's Hospital Dr Francisco de Ycaza Bustamante, Head of Department, Infectious diseases, Guayaquil, Ecuador
| | - Samir K Saha
- Child Health Research Foundation and Dhaka Shishu Hospital, Dhaka, Bangladesh
| | - Mathuram Santosham
- International Vaccine Access Center (IVAC), Department of International Health, Johns Hopkins University, Baltimore, United States of America
| | | | - Shally Awasthi
- King George's Medical University, Department of Pediatrics, Lucknow, India
| | | | - Monidarin Chou
- University of Health Sciences, Rodolph Mérieux Laboratory & Ministry of Environment, Phom Phen, Cambodia
| | - Pagbajabyn Nymadawa
- Mongolian Academy of Sciences, Academy of Medical Sciences, Ulaanbaatar, Mongolia
| | | | | | | | | | | | - Graciela Russomando
- Universidad Nacional de Asuncion, Departamento de Biología Molecular y Genética, Instituto de Investigaciones en Ciencias de la Salud, Asuncion, Paraguay
| | - Mariam Sylla
- Gabriel Touré Hospital, Department of Pediatrics, Bamako, Mali
| | - Philippe Vanhems
- Unité d'Hygiène, Epidémiologie, Infectiovigilance et Prévention, Hospices Civils de Lyon, Lyon, France and Centre International de Recherche en Infectiologie, Institut National de la Santé et de la Recherche Médicale U1111, CNRS Unité Mixte de Recherche 5308, École Nationale Supérieure de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Jianwei Wang
- Chinese Academy of Medical Sciences & Peking Union, Medical College Institute of Pathogen Biology, MOH Key Laboratory of Systems Biology of Pathogens and Dr Christophe Mérieux Laboratory, Beijing, China
| | - Sudha Basnet
- Center for Intervention Science in Maternal and Child Health, University of Bergen, Norway and Department of Pediatrics, Tribhuvan University Institute of Medicine, Nepal
| | - Tor A Strand
- Research Department, Innlandet Hospital Trust, Lillehammer, Norway
| | - Mark I Neuman
- Division of Emergency Medicine, Boston Children's Hospital, Harvard Medical School, Boston, United States of America
| | | | - Marcela Echavarria
- Clinical Virology Unit, Centro de Educación Médica e Investigaciones Clínicas, Mar del Plata, Argentina
| | | | - Nitya Wadhwa
- Translational Health Science and Technology Institute, Faridabad, India
| | - Rakesh Lodha
- All India Institute of Medical Sciences, New Delhi, India
| | - Satinder Aneja
- School of Medical Sciences & Research, Sharda University, Greater Noida, India
| | - Angela Gentile
- Department of Epidemiology, "R. Gutiérrez" Children's Hospital, Buenos Aires, Argentina
| | - Mandeep Chadha
- Former Scientist G, ICMR National Institute of Virology, Pune, India
| | | | - Kerry-Ann F O'Grady
- Australian Centre for Health Services Innovation, Queensland University of Technology, Kelvin Grove, Australia
| | - Alexey W Clara
- Centers for Disease Control, Central American Region, Guatemala City, Guatemala
| | - Chris A Rees
- Division of Pediatric Emergency Medicine, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, United States of America
| | - Harry Campbell
- Centre for Global Health, Usher Institute, The University of Edinburgh, Edinburgh, Scotland
| | - Harish Nair
- Centre for Global Health, Usher Institute, The University of Edinburgh, Edinburgh, Scotland
| | - Jennifer Falconer
- Centre for Global Health, Usher Institute, The University of Edinburgh, Edinburgh, Scotland
| | - Linda J Williams
- Centre for Global Health, Usher Institute, The University of Edinburgh, Edinburgh, Scotland
| | - Margaret Horne
- Centre for Global Health, Usher Institute, The University of Edinburgh, Edinburgh, Scotland
| | - Shamim A Qazi
- Department of Maternal, Newborn, Child, and Adolescent Health (Retired), World Health Organization, Geneva, Switzerland
| | - Yasir Bin Nisar
- Department of Maternal, Newborn, Child, and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland.
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George LJ, Singh P, Aneja S, Singh R, Solanki RS, Seth A. Insulin Resistance in children on Sodium Valproate - A hospital based cross-sectional study in Indian children. Trop Doct 2023; 53:91-96. [PMID: 36321168 DOI: 10.1177/00494755221134141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Our objective was to compare the point prevalence of insulin resistance (IR) in children taking sodium valproate (VPA) and phenytoin sodium (PS) monotherapy for >1 year. 150 children, aged 6-18 years, were categorized (50 each) into - group A (VPA), group B (PS) and group C (healthy controls age-sex matched with group A). Groups were compared for metabolic complications and risk factors assessed. The point prevalence of IR and non-alcoholic fatty liver disease was significantly higher in children on VPA (12% and 34% respectively) than on PS and healthy controls, regardless of age, sex, pubertal and nutritional status. The presence of central obesity, acanthosis, hypertension, dyslipidaemia was significantly associated with IR but none showed an independent association on multivariate analysis. Therapy with VPA makes children susceptible to metabolic complications. Close monitoring will facilitate early detection and timely intervention.
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Affiliation(s)
- Lydia James George
- MD, Senior Resident, Department of Pediatrics, LHMC, New Delhi, India.,MD (Pediatrics), Assistant Professor, Department of Pediatric Cardiology, Trivandrum Medical College, Trivandrum, India
| | - Preeti Singh
- MD (Pediatrics), Associate Professor, Department of Pediatrics, 28856Lady Hardinge Medical College, New Delhi, India
| | - Satinder Aneja
- MD (Pediatrics), Rtd, Former Director Professor and Head, Department of Pediatrics, 28856Lady Hardinge Medical College (LHMC), New Delhi, India
| | - Ritu Singh
- MD (Biochemistry), Director- Professor and Head, Department of Biochemistry, 28856Lady Hardinge Medical College (LHMC), New Delhi, India
| | - R S Solanki
- MD (Radio-diagnosis), Director- Professor and Head, Department of Radio- Diagnosis, 28856Lady Hardinge Medical College (LHMC), New Delhi, India
| | - Anju Seth
- MD (Pediatrics), Director- Professor, and Head Department of Pediatrics, 28856Lady Hardinge Medical College (LHMC), New Delhi, India
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Martin H, Falconer J, Addo-Yobo E, Aneja S, Arroyo LM, Asghar R, Awasthi S, Banajeh S, Bari A, Basnet S, Bavdekar A, Bhandari N, Bhatnagar S, Bhutta ZA, Brooks A, Chadha M, Chisaka N, Chou M, Clara AW, Colbourn T, Cutland C, D'Acremont V, Echavarria M, Gentile A, Gessner B, Gregory CJ, Hazir T, Hibberd PL, Hirve S, Hooli S, Iqbal I, Jeena P, Kartasasmita CB, King C, Libster R, Lodha R, Lozano JM, Lucero M, Lufesi N, MacLeod WB, Madhi SA, Mathew JL, Maulen-Radovan I, McCollum ED, Mino G, Mwansambo C, Neuman MI, Nguyen NTV, Nunes MC, Nymadawa P, O'Grady KAF, Pape JW, Paranhos-Baccala G, Patel A, Picot VS, Rakoto-Andrianarivelo M, Rasmussen Z, Rouzier V, Russomando G, Ruvinsky RO, Sadruddin S, Saha SK, Santosham M, Singhi S, Soofi S, Strand TA, Sylla M, Thamthitiwat S, Thea DM, Turner C, Vanhems P, Wadhwa N, Wang J, Zaman SMA, Campbell H, Nair H, Qazi SA, Nisar YB. Assembling a global database of child pneumonia studies to inform WHO pneumonia management algorithm: Methodology and applications. J Glob Health 2022; 12:04075. [PMID: 36579417 PMCID: PMC9798037 DOI: 10.7189/jogh.12.04075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Background The existing World Health Organization (WHO) pneumonia case management guidelines rely on clinical symptoms and signs for identifying, classifying, and treating pneumonia in children up to 5 years old. We aimed to collate an individual patient-level data set from large, high-quality pre-existing studies on pneumonia in children to identify a set of signs and symptoms with greater validity in the diagnosis, prognosis, and possible treatment of childhood pneumonia for the improvement of current pneumonia case management guidelines. Methods Using data from a published systematic review and expert knowledge, we identified studies meeting our eligibility criteria and invited investigators to share individual-level patient data. We collected data on demographic information, general medical history, and current illness episode, including history, clinical presentation, chest radiograph findings when available, treatment, and outcome. Data were gathered separately from hospital-based and community-based cases. We performed a narrative synthesis to describe the final data set. Results Forty-one separate data sets were included in the Pneumonia Research Partnership to Assess WHO Recommendations (PREPARE) database, 26 of which were hospital-based and 15 were community-based. The PREPARE database includes 285 839 children with pneumonia (244 323 in the hospital and 41 516 in the community), with detailed descriptions of clinical presentation, clinical progression, and outcome. Of 9185 pneumonia-related deaths, 6836 (74%) occurred in children <1 year of age and 1317 (14%) in children aged 1-2 years. Of the 285 839 episodes, 280 998 occurred in children 0-59 months old, of which 129 584 (46%) were 2-11 months of age and 152 730 (54%) were males. Conclusions This data set could identify an improved specific, sensitive set of criteria for diagnosing clinical pneumonia and help identify sick children in need of referral to a higher level of care or a change of therapy. Field studies could be designed based on insights from PREPARE analyses to validate a potential revised pneumonia algorithm. The PREPARE methodology can also act as a model for disease database assembly.
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Affiliation(s)
- Helena Martin
- Centre for Global Health, Usher Institute, Edinburgh Medical School, University of Edinburgh, Edinburgh, United Kingdom
| | - Jennifer Falconer
- Centre for Global Health, Usher Institute, Edinburgh Medical School, University of Edinburgh, Edinburgh, United Kingdom
| | - Emmanuel Addo-Yobo
- Kwame Nkrumah University of Science and Technology/Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Satinder Aneja
- School of Medical Sciences and Research, Sharda University, Greater Noida, India
| | | | - Rai Asghar
- Rawalpindi Medical College, Rawalpindi, Pakistan
| | - Shally Awasthi
- King George’s Medical University, Department of Pediatrics, Lucknow, India
| | - Salem Banajeh
- Department of Paediatrics and Child Health, University of Sana’a, Sana’a, Yemen
| | - Abdul Bari
- Independent newborn and child health consultant, Islamabad, Pakistan
| | - Sudha Basnet
- Center for Intervention Science in Maternal and Child Health, University of Bergen, Norway,Department of Pediatrics, Tribhuvan University Institute of Medicine, Nepal
| | - Ashish Bavdekar
- King Edward Memorial (KEM) Hospital Pune, Department of Pediatrics, Pune, India
| | - Nita Bhandari
- Center for Health Research and Development, Society for Applied Studies, India
| | | | - Zulfiqar A Bhutta
- Institute for Global Health and Development, Aga Khan University, Pakistan
| | - Abdullah Brooks
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Mandeep Chadha
- Former Scientist, Indian Council of Medical Research (ICMR), National Institute of Virology, Pune, India
| | | | - Monidarin Chou
- University of Health Sciences, Rodolphe Mérieux Laboratory, Phom Phen, Cambodia,Ministry of Environment, Phom Phen, Cambodia
| | - Alexey W Clara
- Centers for Disease Control, Central American Region, Guatemala City, Guatemala
| | - Tim Colbourn
- Institute for Global Health, University College London, London, United Kingdom
| | - Clare Cutland
- South African Medical Research Council, Vaccines and Infectious Diseases Analytics Research Unit, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa,Department of Science and Technology/National Research Foundation, South African Research Chair Initiative in Vaccine Preventable Diseases, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Marcela Echavarria
- Clinical Virology Unit, Centro de Educación Médica e Investigaciones Clínicas, Argentina
| | - Angela Gentile
- Department of Epidemiology, “R. Gutiérrez” Children's Hospital, Buenos Aires, Argentina
| | - Brad Gessner
- Pfizer Vaccines, Collegeville, Pennsylvania, USA
| | - Christopher J. Gregory
- Division of Vector-borne Diseases, US Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Tabish Hazir
- Retired from Children Hospital, Pakistan Institute of Medical Sciences, Islamabad, Pakistan
| | - Patricia L. Hibberd
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | | | - Shubhada Hooli
- Section of Pediatric Emergency Medicine, Texas Children’s Hospital, Baylor College of Medicine, Houston, Texas, USA
| | - Imran Iqbal
- Department of Paediatrics, Combined Military Hospital Institute of Medical Sciences, Multan, Pakistan
| | | | - Cissy B Kartasasmita
- Department of Child Health, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - Carina King
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden,Institute for Global Health, University College London, London, United Kingdom
| | | | - Rakesh Lodha
- All India Institute of Medical Sciences, New Delhi, India
| | | | - Marilla Lucero
- Research Institute for Tropical Medicine, Manila, Philippines
| | | | - William B MacLeod
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Shabir Ahmed Madhi
- Faculty of Health Sciences, University of the Witwatersrand, Johannesburg
| | - Joseph L Mathew
- Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Irene Maulen-Radovan
- Instituto Nactional de Pediatria Division de Investigacion Insurgentes, Mexico City, Mexico
| | - Eric D McCollum
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA,Global Program in Respiratory Sciences, Eudowood Division of Pediatric Respiratory Sciences, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, USA
| | - Greta Mino
- Department of Infectious diseases, Guayaquil, Ecuador
| | | | - Mark I Neuman
- Division of Emergency Medicine, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | | | - Marta C Nunes
- South African Medical Research Council, Vaccines and Infectious Diseases Analytics Research Unit, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa,Department of Science and Technology/National Research Foundation, South African Research Chair Initiative in Vaccine Preventable Diseases, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Pagbajabyn Nymadawa
- Mongolian Academy of Sciences, Academy of Medical Sciences, Ulaanbaatar, Mongolia
| | - Kerry-Ann F O'Grady
- Australian Centre for Health Services Innovation, Queensland University of Technology, Kelvin Grove, Australia
| | | | | | - Archana Patel
- Lata Medical Research Foundation, Nagpur and Datta Meghe Institute of Medical Sciences, Sawangi, India
| | | | | | - Zeba Rasmussen
- Division of International Epidemiology and Population Studies (DIEPS), Fogarty International Center (FIC), National Institute of Health (NIH), USA
| | | | - Graciela Russomando
- Universidad Nacional de Asuncion, Departamento de Biología Molecular y Genética, Instituto de Investigaciones en Ciencias de la Salud, Asuncion, Paraguay
| | - Raul O Ruvinsky
- Dirección de Control de Enfermedades Inmunoprevenibles, Ministerio de Salud de la Nación, Buenos Aires, Argentina
| | - Salim Sadruddin
- Consultant/Retired World Health Organization (WHO) Staff, Geneva, Switzerland
| | - Samir K. Saha
- Child Health Research Foundation, Dhaka, Bangladesh,Dhaka Shishu Hospital, Dhaka, Bangladesh
| | - Mathuram Santosham
- International Vaccine Access Center (IVAC), Department of International Health, Johns Hopkins University, Baltimore, Maryland, USA
| | | | - Sajid Soofi
- Department of Pediatrics and Child Health, Aga Khan University, Pakistan
| | - Tor A Strand
- Research Department, Innlandet Hospital Trust, Lillehammer, Norway
| | - Mariam Sylla
- Gabriel Touré Hospital, Department of Pediatrics, Bamako, Mali
| | - Somsak Thamthitiwat
- Division of Global Health Protection, Thailand Ministry of Public Health – US Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
| | - Donald M Thea
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | | | - Philippe Vanhems
- Unité d'Hygiène, Epidémiologie, Infectiovigilance et Prévention, Hospices Civils de Lyon, Lyon, France,Centre International de Recherche en Infectiologie, École Nationale Supérieure de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Nitya Wadhwa
- Translational Health Science and Technology Institute, Faridabad, India
| | - Jianwei Wang
- Chinese Academy of Medical Sciences & Peking Union, Medical College Institute of Pathogen Biology, MOH Key Laboratory of Systems Biology of Pathogens and Dr Christophe Mérieux Laboratory, Beijing, China
| | - Syed MA Zaman
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Harry Campbell
- Centre for Global Health, Usher Institute, Edinburgh Medical School, University of Edinburgh, Edinburgh, United Kingdom
| | - Harish Nair
- Centre for Global Health, Usher Institute, Edinburgh Medical School, University of Edinburgh, Edinburgh, United Kingdom
| | - Shamim Ahmad Qazi
- Consultant/Retired World Health Organization (WHO) Staff, Geneva, Switzerland
| | - Yasir Bin Nisar
- Department of Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization (WHO), Geneva, Switzerland
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Jr JHL, Verma N, Moore N, Park H, Aneja S. Predictors of Early Polymetastasis after Comprehensive Local Therapy for Synchronous Oligometastatic NSCLC. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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10
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Jain P, Aneja S, Cunningham J, Arya R, Sharma S. Treatment of benzodiazepine-resistant status epilepticus: Systematic review and network meta-analyses. Seizure 2022; 102:74-82. [DOI: 10.1016/j.seizure.2022.09.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 09/06/2022] [Accepted: 09/25/2022] [Indexed: 10/31/2022] Open
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11
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Wallington D, Verma N, Laird J, Aneja S, Park H, Yang D. Comparison of Diagnostic PET and 4D CT-Based Tumor Delineation for Oligometastatic Lung Tumors. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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12
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Gollamudi J, Sartain SE, Navaei AH, Aneja S, Kaur Dhawan P, Tran D, Joshi J, Gidudu J, Gollamudi J, Chiappini E, Varricchio F, Law B, Munoz FM. Thrombosis and thromboembolism: Brighton collaboration case definition and guidelines for data collection, analysis, and presentation of immunization safety data. Vaccine 2022; 40:6431-6444. [PMID: 36150973 DOI: 10.1016/j.vaccine.2022.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 09/01/2022] [Indexed: 01/27/2023]
Abstract
This is a Brighton Collaboration case definition of thrombosis and thromboembolism to be used in the evaluation of adverse events following immunization, and for epidemiologic studies for the assessment of background incidence or hypothesis testing. The case definition was developed by a group of experts convened by the Coalition for Epidemic Preparedness Innovations (CEPI) in the context of active development of SARS-CoV-2 vaccines. The case definition format of the Brighton Collaboration was followed to develop a consensus definition and defined levels of certainty, after an exhaustive review of the literature and expert consultation. The document underwent peer review by the Brighton Collaboration Network and by selected expert reviewers prior to submission.
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Affiliation(s)
- Jahnavi Gollamudi
- Department of Medicine, Section of Hematology, Baylor College of Medicine, Houston, TX, USA
| | - Sarah E Sartain
- Department of Pediatrics, Section of Hematology/Oncology, Baylor College of Medicine, Houston, TX, USA
| | - Amir Hassan Navaei
- Pediatric Critical Care, Transfusion Medicine & Coagulation, Pediatrics and Pathology & Immunology Departments, Texas Children's Hospital, Baylor College of Medicine, 6701 Fannin St, Suite WB110, Houston 77021, TX, USA
| | - Satinder Aneja
- Department of Pediatrics, School of Medical Sciences & Research, Sharda University, Gr Noida, India
| | | | - Dat Tran
- Oregon Health Authority, Public Health Division, Acute and Communicable Disease Prevention Section, Portland, OR, USA
| | - Jyoti Joshi
- International Centre for Antimicrobial Resistance Solutions (ICARS), Orestads Boulevard 5, 2300 Copenhagen, Denmark
| | - Jane Gidudu
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Elena Chiappini
- Meyer University Hospital, Department of Health Science, University of Florence, Florence, Italy
| | | | - Barbara Law
- SPEAC, Brighton Collaboration, Independent Consultant, Vancouver, BC, Canada
| | - Flor M Munoz
- Department of Pediatrics, Section of Infectious Diseases, and Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, USA.
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Schrobilgen A, Lo A, Chandani B, Foss M, Vesely N, Dunn C, Aneja S, Solomon J. 319 The utilization of 3-dimensional imaging to establish a standardized acne severity scale. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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14
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Mukherjee SB, Verma S, Sharma S, Aneja S. Diagnostic Accuracy of Parents' Evaluation of Developmental Status (PEDS), PEDS Developmental Milestones, and PEDS Combined in Indian Children Aged Less than 2 Years. Indian J Pediatr 2022; 89:459-465. [PMID: 33620632 DOI: 10.1007/s12098-020-03651-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 12/29/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To assess the diagnostic accuracy of Parent's Evaluation of Developmental Status (PEDS), PEDS Developmental Milestones (PEDS:DM) and PEDS Combined for developmental screening of Indian children aged less than 2 y. METHOD A hospital-based study of diagnostic accuracy was conducted over 17 mo. Children under 24 mo (n = 180) were enrolled after exclusion of severe illnesses or known neurodevelopment disorders. The index tools included standardized Hindi translations of PEDS and PEDS:DM. The reference tool was Developmental Assessment Scale for Indian Infants (DASII). Both were administered by blinded researchers. Parameters of diagnostic accuracy were computed. RESULTS There were 13 (7.2%) failures in PEDS, 119 (66.1%) in PEDS:DM and 119 (66.1%) in PEDS Combined. DASII identified 3 children with developmental delay. Sensitivity (Sn) [95% CI] of PEDS was 33.3 [0.8-90.6] and Specificity (Sp) 93.2 [88.5-96.5]. The Sn and Sp of both PEDS:DM and PEDS Combined were 100 [29.2-100] and 34.5 [27.5-42.0], respectively. CONCLUSIONS Hindi translations of PEDS, PEDS:DM and PEDS Combined are not suitable for developmental screening of children less than 2 y due to suboptimal diagnostic accuracy.
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Affiliation(s)
- Sharmila Banerjee Mukherjee
- Department of Pediatrics, Lady Hardinge Medical College and Associated Kalawati Saran Children's Hospital, Bangla Sahib Road, New Delhi, 110001, India.
| | - Sangeeta Verma
- Department of Pediatrics, Lady Hardinge Medical College and Associated Kalawati Saran Children's Hospital, Bangla Sahib Road, New Delhi, 110001, India
| | - Suvasini Sharma
- Department of Pediatrics, Lady Hardinge Medical College and Associated Kalawati Saran Children's Hospital, Bangla Sahib Road, New Delhi, 110001, India
| | - Satinder Aneja
- Department of Pediatrics, Lady Hardinge Medical College and Associated Kalawati Saran Children's Hospital, Bangla Sahib Road, New Delhi, 110001, India
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15
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Rees CA, Colbourn T, Hooli S, King C, Lufesi N, McCollum ED, Mwansambo C, Cutland C, Madhi SA, Nunes M, Matthew JL, Addo-Yobo E, Chisaka N, Hassan M, Hibberd PL, Jeena PM, Lozano JM, MacLeod WB, Patel A, Thea DM, Nguyen NTV, Kartasasmita CB, Lucero M, Awasthi S, Bavdekar A, Chou M, Nymadawa P, Pape JW, Paranhos-Baccala G, Picot VS, Rakoto-Andrianarivelo M, Rouzier V, Russomando G, Sylla M, Vanhems P, Wang J, Asghar R, Banajeh S, Iqbal I, Maulen-Radovan I, Mino-Leon G, Saha SK, Santosham M, Singhi S, Basnet S, Strand TA, Bhatnagar S, Wadhwa N, Lodha R, Aneja S, Clara AW, Campbell H, Nair H, Falconer J, Qazi SA, Nisar YB, Neuman MI. Derivation and validation of a novel risk assessment tool to identify children aged 2–59 months at risk of hospitalised pneumonia-related mortality in 20 countries. BMJ Glob Health 2022; 7:bmjgh-2021-008143. [PMID: 35428680 PMCID: PMC9014031 DOI: 10.1136/bmjgh-2021-008143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 03/20/2022] [Indexed: 11/27/2022] Open
Abstract
Introduction Existing risk assessment tools to identify children at risk of hospitalised pneumonia-related mortality have shown suboptimal discriminatory value during external validation. Our objective was to derive and validate a novel risk assessment tool to identify children aged 2–59 months at risk of hospitalised pneumonia-related mortality across various settings. Methods We used primary, baseline, patient-level data from 11 studies, including children evaluated for pneumonia in 20 low-income and middle-income countries. Patients with complete data were included in a logistic regression model to assess the association of candidate variables with the outcome hospitalised pneumonia-related mortality. Adjusted log coefficients were calculated for each candidate variable and assigned weighted points to derive the Pneumonia Research Partnership to Assess WHO Recommendations (PREPARE) risk assessment tool. We used bootstrapped selection with 200 repetitions to internally validate the PREPARE risk assessment tool. Results A total of 27 388 children were included in the analysis (mean age 14.0 months, pneumonia-related case fatality ratio 3.1%). The PREPARE risk assessment tool included patient age, sex, weight-for-age z-score, body temperature, respiratory rate, unconsciousness or decreased level of consciousness, convulsions, cyanosis and hypoxaemia at baseline. The PREPARE risk assessment tool had good discriminatory value when internally validated (area under the curve 0.83, 95% CI 0.81 to 0.84). Conclusions The PREPARE risk assessment tool had good discriminatory ability for identifying children at risk of hospitalised pneumonia-related mortality in a large, geographically diverse dataset. After external validation, this tool may be implemented in various settings to identify children at risk of hospitalised pneumonia-related mortality.
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Affiliation(s)
- Chris A Rees
- Division of Pediatric Emergency Medicine, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Tim Colbourn
- Institute for Global Health, University College London, London, UK
| | - Shubhada Hooli
- Section of Pediatric Emergency Medicine, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA
| | - Carina King
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Norman Lufesi
- Acute Respiratory Illness Unit, Government of Malawi Ministry of Health, Lilongwe, Malawi
| | - Eric D McCollum
- Global Program in Respiratory Sciences, Eudowood Division of Pediatric Respiratory Sciences, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Charles Mwansambo
- Acute Respiratory Illness Unit, Government of Malawi Ministry of Health, Lilongwe, Malawi
| | - Clare Cutland
- South African Medical Research Council: Vaccines and Infectious Diseases Analytics Research Unit, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg-Braamfontein, South Africa
| | - Shabir Ahmed Madhi
- South African Medical Research Council: Vaccines and Infectious Diseases Analytics Research Unit, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg-Braamfontein, South Africa
| | - Marta Nunes
- South African Medical Research Council: Vaccines and Infectious Diseases Analytics Research Unit, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg-Braamfontein, South Africa
| | - Joseph L Matthew
- Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | | - Noel Chisaka
- World Bank, World Bank, Washington, District of Columbia, USA
| | - Mumtaz Hassan
- Department of Pediatrics, Children's Hospital, Islamabad, Pakistan
| | - Patricia L Hibberd
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Prakash M Jeena
- Department of Paediatrics and Child Health, University of KwaZulu-Natal Nelson R Mandela School of Medicine, Durban, South Africa
| | - Juan M Lozano
- Division of Medical and Population Health Science Education and Research, Florida International University, Miami, Florida, USA
| | - William B MacLeod
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Archana Patel
- Lata Medical Research Foundation, Nagpur and Datta Meghe Institute of Medical Sciences, Sawangi, India
| | - Donald M Thea
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | | | - Cissy B Kartasasmita
- Department of Child Health, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - Marilla Lucero
- Department of Pediatrics, Research Institute for Tropical Medicine, Muntinlupa City, Philippines
| | - Shally Awasthi
- Department of Pediatrics, King George's Medical University, Lucknow, Uttar Pradesh, India
| | | | - Monidarin Chou
- Rodolph Mérieux Laboratory, Faculty of Medicine, University of Health Sciences, Phnom Penh, Cambodia
| | - Pagbajabyn Nymadawa
- Department of Pediatrics, Mongolian Academy of Sciences, Ulaanbaatar, Mongolia
| | | | | | | | | | | | - Graciela Russomando
- Departamento de Biología Molecular y Genética, Instituto de Investigaciones en Ciencias de la Salud, Asuncion, Paraguay
| | - Mariam Sylla
- Department of Pediatrics, Gabriel Touré University Hospital Center, Bamako, Mali
| | - Philippe Vanhems
- Unité d'Hygiène, Epidémiologie, Infectiovigilance et Prévention, Hospices Civils de Lyon, Lyon, France
| | - Jianwei Wang
- MOH Key Laboratory of Systems Biology of Pathogens and Dr Christophe Mérieux Laboratory, Chinese Academy of Medical Sciences & Peking Union, Beijing, China
| | - Rai Asghar
- Department of Paediatrics, Rawalpindi Medical College, Rawalpindi, Pakistan
| | - Salem Banajeh
- Department of Pediatrics, Sana'a University, Sana'a, Yemen
| | - Imran Iqbal
- Department of Pediatrics, Nishtar Medical College, Multan, Pakistan
| | - Irene Maulen-Radovan
- Division de Investigacion Insurgentes, Instituto Nactional de Pediatria, Mexico City, Mexico
| | - Greta Mino-Leon
- Infectious Diseases, Children's Hospital Dr Francisco de Ycaza Bustamante, Guayaquil, Ecuador
| | - Samir K Saha
- Child Health Research Foundation, Dhaka Shishu Hosp, Dhaka, Bangladesh
| | - Mathuram Santosham
- International Vaccine Access Center (IVAC), Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Sunit Singhi
- Department of Pediatrics, Medanta, The Medicity, Gurgaon, India
| | - Sudha Basnet
- Department of Pediatrics, Tribhuvan University Institute of Medicine, Kathmandu, Nepal
| | - Tor A Strand
- Department of Research, Innlandet Hospital Trust, Lillehammer, Norway
| | - Shinjini Bhatnagar
- Department of Maternal and Child Health, Translational Health Science and Technology Institute, Faridabad, India
| | - Nitya Wadhwa
- Department of Maternal and Child Health, Translational Health Science and Technology Institute, Faridabad, India
| | - Rakesh Lodha
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Satinder Aneja
- Department of Pediatrics, Sharda University School of Medical Sciences and Research, Greater Noida, Uttar Pradesh, India
| | - Alexey W Clara
- Central American Region, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Harry Campbell
- Population Health Sciences and Informati, The University of Edinburgh, Edinburgh, UK
| | - Harish Nair
- Centre for Global Health, Usher Institute, The University of Edinburgh, Edinburgh, Scotland
| | - Jennifer Falconer
- Centre for Global Health, Usher Institute, The University of Edinburgh, Edinburgh, Scotland
| | - Shamim A Qazi
- Department of Maternal, Newborn, Child, and Adolescent Health (Retired), World Health Organization, Geneva, Switzerland
| | - Yasir B Nisar
- Department of Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland
| | - Mark I Neuman
- Division of Emergency Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Singh DP, Singh P, Sharma S, Aneja S, Seth A. Point Prevalence of Peripheral Neuropathy in Children and Adolescents with Type 1 Diabetes Mellitus. Indian J Pediatr 2022; 89:220-225. [PMID: 34109557 DOI: 10.1007/s12098-021-03742-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Accepted: 03/16/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To assess the point prevalence of peripheral neuropathy (PN) in children with type 1 diabetes mellitus (T1DM) and to determine their predictors. METHODS In this cross-sectional study, children aged 8-18 y with T1DM on insulin therapy for > 2 y and free from acute complications were enrolled. All participants were evaluated for symptoms of PN with diabetic neuropathy symptom (DNS) score and underwent a detailed neurological examination. Assessment of nerve dysfunction was done using nerve conduction studies (NCS). The disease-related factors that increase the risk of PN were determined. RESULTS Fifty children (52% boys) were enrolled with mean age of 12.2 ± 2.8 y and duration of diabetes 5.1 ± 2.1 y. No subject had clinical evidence or DNS score suggestive of PN. Twenty-eight (56%) children demonstrated subclinical neuropathy on NCS. Proportion of children with pure motor, pure sensory, and mixed motor-sensory neuropathy was 40%, 2%, and 14%, respectively. The peroneal nerve was the most common motor nerve affected. Poor glycemic control (HbA1c > 9%) and longer duration of diabetes (> 5 y) were significantly associated with the risk of PN (p value < 0.05). CONCLUSION A large proportion of children with T1DM have subclinical PN. Poor glycemic control and longer duration of diabetes are risk factors for nerve dysfunction. Neurophysiological studies should be performed in these children to facilitate early detection.
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Affiliation(s)
- Dhirendra Pratap Singh
- Department of Pediatrics, RML Hospital, New Delhi, India.,Department of Pediatrics, Lady Hardinge Medical College and Kalawati Saran Children's Hospital, New Delhi, 110001, India
| | - Preeti Singh
- Department of Pediatrics, Lady Hardinge Medical College and Kalawati Saran Children's Hospital, New Delhi, 110001, India
| | - Suvasini Sharma
- Department of Pediatrics, Lady Hardinge Medical College and Kalawati Saran Children's Hospital, New Delhi, 110001, India
| | - Satinder Aneja
- Department of Pediatrics, Lady Hardinge Medical College and Kalawati Saran Children's Hospital, New Delhi, 110001, India.,Department of Pediatrics, Sharda University, Greater Noida, Uttar Pradesh, India
| | - Anju Seth
- Department of Pediatrics, Lady Hardinge Medical College and Kalawati Saran Children's Hospital, New Delhi, 110001, India.
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Mukherjee SB, Aneja S, Sharma S, Kapoor D. Early Childhood Development: A Paradigm Shift From Developmental Screening and Surveillance to Parent Intervention Programs. Indian Pediatr 2021; 58 Suppl 1:S64-S68. [PMID: 34687192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
A large proportion of children under the age of five years who do not attain their expected developmental potential belong to low- and middle-income countries (LMICs). The strategies used for identifying children with high risk for developmental delay/disorders include developmental screening, surveillance, and monitoring. Suitability criteria for developmental screening tools in LMICs have been established, but few tools meet all the benchmarks. Based on these, the authors identified two tools that may be considered suitable in the Indian context; the International guide for monitoring child development and the Monitoring child development in the integrated management of childhood illnesses context. However, implementing and sustaining a universal developmental screening program using these is not feasible in the present circumstances. There is emerging evidence that parent intervention programs have significant impact on outcomes related to early childhood development (ECD). The nurturing care framework encompasses five strategies known to enhance ECD in young children even in the presence of adversities; good health, adequate nutrition, responsive caregiving, opportunities for early learning and safety and security. This article discusses the paradigm shift to incorporation of nurturing care-based preventive, supportive and promotive health care services in office practice with active parental involvement. This may prove to be a better option with a more positive, long lasting and quicker impact on ECD.
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Affiliation(s)
- Sharmila Banerjee Mukherjee
- Department of Pediatrics, Lady Hardinge Medical College, New Delhi Correspondence to: Dr Sharmila B Mukherjee, Department of Pediatrics, Lady Hardinge Medical College, New Delhi.
| | - Satinder Aneja
- Department of Pediatrics, Lady Hardinge Medical College, New Delhi
| | - Suvasini Sharma
- Department of Pediatrics, Lady Hardinge Medical College, New Delhi
| | - Dipti Kapoor
- Department of Pediatrics, Lady Hardinge Medical College, New Delhi
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Chattopadhyay N, Aneja S. The Status of Early Childhood Development in India: Will We Reach the Countdown to 2030 Targets? Indian Pediatr 2021; 58 Suppl 1:S4-S10. [PMID: 34687181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Early childhood development (ECD) provides building blocks for future educational achievement, emotional and moral development; the early years of life provide a critical window of opportunity for intervention. Experts across the world are emphasizing on promotion of ECD through the 5-pronged Nurturing Care Framework (NCF). The Sustainable Development Goals have focussed on optimum development for all children by 2030. For India, with 164.5 million population of children between 0-6 years, the magnitude of the problem is huge. We have been focusing on ECD since the launching of the Integrated Child Development Scheme (ICDS) in 1976. Many national policies and programs have evolved since then to promote ECD. Inspite of all efforts, the overall picture of early childhood development in India is still not optimal, due to multiple factors. All five components of nurturing care framework have not been included comprehensively in the services offered. If India focuses on these areas and comes up with a convergent ECD delivery system through a single portal that can be provided with equity at the grassroot level, coupled with proper documentation, we may proceed towards our goals at a better pace. Multiple stakeholders (the government, public and private health care providers, non-government organizations, professional bodies) need to work in synergy to enable us to reach the 2030 goals.
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Affiliation(s)
- Nandita Chattopadhyay
- Department of Pediatrics, MGM Medical College, Kishanganj, Bihar. Correspondence to: Dr Nandita Chattopadhyay, 22M Srinath Mukherjee Lane, Kolkata 700 030.
| | - Satinder Aneja
- Department of Pediatrics, School of Medical Sciences and Research, Sharda University, Greater Noida, Uttar Pradesh
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Rees CA, Hooli S, King C, McCollum ED, Colbourn T, Lufesi N, Mwansambo C, Lazzerini M, Madhi SA, Cutland C, Nunes M, Gessner BD, Basnet S, Kartasasmita CB, Mathew JL, Zaman SMAU, Paranhos-Baccala G, Bhatnagar S, Wadhwa N, Lodha R, Aneja S, Santosham M, Picot VS, Sylla M, Awasthi S, Bavdekar A, Pape JW, Rouzier V, Chou M, Rakoto-Andrianarivelo M, Wang J, Nymadawa P, Vanhems P, Russomando G, Asghar R, Banajeh S, Iqbal I, MacLeod W, Maulen-Radovan I, Mino G, Saha S, Singhi S, Thea DM, Clara AW, Campbell H, Nair H, Falconer J, Williams LJ, Horne M, Strand T, Qazi SA, Nisar YB, Neuman MI. External validation of the RISC, RISC-Malawi, and PERCH clinical prediction rules to identify risk of death in children hospitalized with pneumonia. J Glob Health 2021; 11:04062. [PMID: 34737862 PMCID: PMC8542381 DOI: 10.7189/jogh.11.04062] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Existing scores to identify children at risk of hospitalized pneumonia-related mortality lack broad external validation. Our objective was to externally validate three such risk scores. METHODS We applied the Respiratory Index of Severity in Children (RISC) for HIV-negative children, the RISC-Malawi, and the Pneumonia Etiology Research for Child Health (PERCH) scores to hospitalized children in the Pneumonia REsearch Partnerships to Assess WHO REcommendations (PREPARE) data set. The PREPARE data set includes pooled data from 41 studies on pediatric pneumonia from across the world. We calculated test characteristics and the area under the curve (AUC) for each of these clinical prediction rules. RESULTS The RISC score for HIV-negative children was applied to 3574 children 0-24 months and demonstrated poor discriminatory ability (AUC = 0.66, 95% confidence interval (CI) = 0.58-0.73) in the identification of children at risk of hospitalized pneumonia-related mortality. The RISC-Malawi score had fair discriminatory value (AUC = 0.75, 95% CI = 0.74-0.77) among 17 864 children 2-59 months. The PERCH score was applied to 732 children 1-59 months and also demonstrated poor discriminatory value (AUC = 0.55, 95% CI = 0.37-0.73). CONCLUSIONS In a large external application of the RISC, RISC-Malawi, and PERCH scores, a substantial number of children were misclassified for their risk of hospitalized pneumonia-related mortality. Although pneumonia risk scores have performed well among the cohorts in which they were derived, their performance diminished when externally applied. A generalizable risk assessment tool with higher sensitivity and specificity to identify children at risk of hospitalized pneumonia-related mortality may be needed. Such a generalizable risk assessment tool would need context-specific validation prior to implementation in that setting.
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Affiliation(s)
- Chris A Rees
- Division of Pediatric Emergency Medicine, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Shubhada Hooli
- Section of Pediatric Emergency Medicine, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA
| | - Carina King
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden and Institute for Global Health, University College London, London, UK
| | - Eric D McCollum
- Global Program in Respiratory Sciences, Eudowood Division of Pediatric Respiratory Sciences, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, USA and Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Tim Colbourn
- Institute for Global Health, University College London, London, UK
| | | | | | - Marzia Lazzerini
- WHO Collaborating Centre for Maternal and Child Health, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy
| | - Shabir Ahmed Madhi
- South African Medical Research Council: Vaccines and Infectious Diseases Analytics Research Unit, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - Clare Cutland
- South African Medical Research Council: Vaccines and Infectious Diseases Analytics Research Unit, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - Marta Nunes
- South African Medical Research Council: Vaccines and Infectious Diseases Analytics Research Unit, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases Unit, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Sudha Basnet
- Center for Intervention Science in Maternal and Child Health, University of Bergen, Norway
| | - Cissy B Kartasasmita
- Department of Child Health, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - Joseph L Mathew
- Pediatric Pulmonology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | | | | | | - Nitya Wadhwa
- Translational Health Science and Technology Institute, Faridabad, India
| | - Rakesh Lodha
- All India Institute of Medical Sciences, New Delhi, India
| | - Satinder Aneja
- School of Medical Sciences & Research, Sharda University, Greater Noida, India
| | - Mathuram Santosham
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | | | - Mariam Sylla
- Gabriel Touré Hospital, Department of Pediatrics, Bamako, Mali
| | - Shally Awasthi
- King George's Medical University, UP, Department of Pediatrics, Lucknow, India
| | | | | | | | - Monidarin Chou
- University of Health Sciences Faculty of Medicine, Rodolph Mérieux Laboratory, Phom Phen, Cambodia
| | | | - Jianwei Wang
- Chinese Academy of Medical Sciences & Peking Union, Medical College Institute of Pathogen Biology, MOH Key Laboratory of Systems Biology of Pathogens and Dr Christophe Mérieux Laboratory, Beijing, China
| | - Pagbajabyn Nymadawa
- Mongolian Academy of Sciences, Academy of Medical Sciences, Ulaanbaatar, Mongolia
| | - Philippe Vanhems
- Hospices Civils de Lyon, Infection Control Unit; CIRI, Centre International de Recherche en Infectiologie, (Team PHE3ID), Université Claude Bernard Lyon, Lyon, France
| | - Graciela Russomando
- Universidad Nacional de Asuncion, Instituto de Investigaciones en Ciencias de la Salud, San Lorenzo, Paraguay
| | - Rai Asghar
- Rawalpindi Medical College, Rawalpindi, Pakistan
| | | | | | - William MacLeod
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Irene Maulen-Radovan
- Instituto Nactional de Pediatria Division de Investigacion Insurgentes, Mexico City, Mexico
| | - Greta Mino
- Children's Hospital Dr Francisco de Ycaza Bustamante, Head of Department, Infectious diseases, Guayaquil, Ecuador
| | - Samir Saha
- Dhaka Shishu Hospital, Dhaka, Bangladesh
| | | | - Donald M Thea
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Alexey W Clara
- US Centers for Disease Control, Central American Region, Guatemala City, Guatemala
| | - Harry Campbell
- Centre for Global Health, Usher Institute, The University of Edinburgh, Edinburgh, Scotland
| | - Harish Nair
- Centre for Global Health, Usher Institute, The University of Edinburgh, Edinburgh, Scotland
| | - Jennifer Falconer
- Institute for Global Health and Development, Queen Margaret University, Edinburgh, Scotland
| | - Linda J Williams
- Centre for Global Health, Usher Institute, The University of Edinburgh, Edinburgh, Scotland
| | - Margaret Horne
- Centre for Global Health, Usher Institute, The University of Edinburgh, Edinburgh, Scotland
| | - Tor Strand
- Research Department, Innlandet Hospital Trust, Lillehammer, Norway
| | - Shamim A Qazi
- Department of Maternal, Newborn, Child and Adolescent Health (Retired), World Health Organization, Geneva, Switzerland
| | - Yasir B Nisar
- Department of Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland
| | - Mark I Neuman
- Division of Emergency Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Aneja S, Sharma S. Hypoxic ischaemic encephalopathy in low resource settings-time to stop cooling? Lancet Glob Health 2021; 9:e1187-e1188. [PMID: 34358490 DOI: 10.1016/s2214-109x(21)00343-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 07/15/2021] [Indexed: 01/23/2023]
Affiliation(s)
- Satinder Aneja
- Department of Paediatrics, School of Medical Sciences & Research, Sharda University, Greater Noida, India.
| | - Suvasini Sharma
- Department of Paediatrics, Lady Hardinge Medical College, New Delhi, India
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Chang E, Joel M, Chang H, Du J, Yu J, An Y, Hansen J, Omuro A, Chiang V, Aneja S. Deep Learning Survival Analysis for Brain Metastases Treated with Stereotactic Radiosurgery. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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22
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Choi R, An Y, Aneja S, Bindra R, Bond J, Chiang V, Hansen J, Hebert R, Matouk C, Yu J. Stereotactic Radiosurgery for Pediatric Arteriovenous Malformations: A Case Series Reflecting One Institution’s Experience With Treatment. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Greenberger B, Chang E, Mistro M, Taylor J, Harrison A, Decker R, Werner-Wasik M, Dicker A, Aneja S. A Multi-Institutional External Validation of a Deep-Learning Based Platform for Prediction of Outcomes following SBRT Treatment for Early-Stage Non-Small Cell Lung Cancer. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Aneja S, Kumar P, Choudhary TS, Srivastava A, Chowdhury R, Taneja S, Bhandari N, Daniel A, Menon P, Chellani H, Bahl R, Bhan MK. Growth faltering in early infancy: highlights from a two-day scientific consultation. BMC Proc 2020; 14:12. [PMID: 32944069 PMCID: PMC7490870 DOI: 10.1186/s12919-020-00195-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2020] [Indexed: 11/10/2022] Open
Abstract
Faltering of growth in early life has been recognized as a public health challenge among Indian babies. A two-day consultation on growth faltering in early infancy was organized to examine the data and evidence on identification and management of early growth failure and to identify knowledge gaps and future areas of research. The consultation was supported by the Biotechnology Industry Research Assistance Council (BIRAC), the Indian Academy of Pediatrics (Nutrition Chapter), Vardhman Mahavir Medical College and Safdarjung Hospital, and the Society for Applied Studies. It brought together researchers, clinicians, policy makers and program managers.
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Affiliation(s)
- Satinder Aneja
- School of Medical Sciences and Research, Sharda University, Greater Noida, India
| | - Praveen Kumar
- Department of Pediatrics, Lady Hardinge Medical College and Associated Kalawati Saran Children’s Hospital, New Delhi, India
| | - Tarun Shankar Choudhary
- Knowledge Integration and Translational Platform (KnIT) at the Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | - Akanksha Srivastava
- Knowledge Integration and Translational Platform (KnIT) at the Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | - Ranadip Chowdhury
- Knowledge Integration and Translational Platform (KnIT) at the Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | - Sunita Taneja
- Knowledge Integration and Translational Platform (KnIT) at the Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | - Nita Bhandari
- Knowledge Integration and Translational Platform (KnIT) at the Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | - Abner Daniel
- Nutrition Section, UNICEF India Country Office, New Delhi, India
| | - Purnima Menon
- Poverty, Health, and Nutrition Division, International Food Policy Research Institute, New Delhi, India
| | - Harish Chellani
- Department of Pediatrics, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Rajiv Bahl
- Department of Maternal, Newborn, Child and Adolescent Health, World Health Organisation, Geneva, Switzerland
| | - Maharaj Kishan Bhan
- National Science Professor, Indian Institute of Technology, New Delhi, India
- Knowledge Integration and Translational Platform (KnIT), Biotechnology Industry Research Assistance Council (BIRAC), New Delhi, India
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Sharma S, Anand A, Garg D, Batra S, Mukherjee SB, Patra B, Aneja S. Use of the International League Against Epilepsy (ILAE) 1989, 2010, and 2017 Classification of Epilepsy in children in a low-resource setting: A hospital-based cross-sectional study. Epilepsia Open 2020; 5:397-405. [PMID: 32913948 PMCID: PMC7469804 DOI: 10.1002/epi4.12401] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 04/18/2020] [Accepted: 05/10/2020] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVES This cross-sectional study was designed to test the applicability of the 1989, 2010, and 2017 International League Against Epilepsy (ILAE) classification of epilepsy in children from a resource-limited setting in India. METHODS Classification of seizure types and syndromes was done through parental interviews and review of medical records in children with epilepsy aged one month to 18 years. Available investigations including EEG, MRI, and metabolic/genetic tests were used in classifying patients as per the 1989, 2010, and 2017 ILAE (level II-epilepsy type) classification. We compared the proportion of children remaining unclassified by each scheme. RESULTS Seven hundred and twenty-six children (436 males, mean age 6.4 ± 4.6 years) were enrolled. Using the 1989 ILAE classification, we were able to classify 95.7%, and 82.6% children by the 2010 scheme. The 2017 ILAE classification could classify all 726 children at level I (seizure type), 664 (91.0%) children at level II (epilepsy type), and an electroclinical syndrome could be identified in 409 (56.1%) of the children. An etiology could be identified in 75%, perinatal brain injury being the most frequent. West syndrome was the most common electroclinical syndrome, identified in 22.7% patients. The 1989 ILAE classification system was superior to the 2010 system (P = .01) in epilepsy classification. There was no difference between the 1989 and 2017 schemes (P = .31) or the 2010 and 2017 schemes (P = .10). SIGNIFICANCE The 2017 ILAE classification, being multidimensional, allowed classification of children who could not undergo extensive evaluation due to economic constraints and also provided room for overlapping etiologies.
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Affiliation(s)
- Suvasini Sharma
- Department of PediatricsLady Hardinge Medical College and associated Kalawati Saran Children’s HospitalNew DelhiIndia
| | - Aakanksha Anand
- Department of PediatricsLady Hardinge Medical College and associated Kalawati Saran Children’s HospitalNew DelhiIndia
| | - Divyani Garg
- Department of NeurologyLady Hardinge Medical College and associated Smt. Sucheta Kriplani HospitalNew DelhiIndia
| | - Sakshi Batra
- Department of PediatricsLady Hardinge Medical College and associated Kalawati Saran Children’s HospitalNew DelhiIndia
| | - Sharmila B. Mukherjee
- Department of PediatricsLady Hardinge Medical College and associated Kalawati Saran Children’s HospitalNew DelhiIndia
| | - Bijoy Patra
- Department of PediatricsLady Hardinge Medical College and associated Kalawati Saran Children’s HospitalNew DelhiIndia
| | - Satinder Aneja
- Department of PediatricsLady Hardinge Medical College and associated Kalawati Saran Children’s HospitalNew DelhiIndia
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Kaushik JS, Aneja S. Duchenne Muscular Dystrophy: Journey from Histochemistry to Molecular Diagnosis. Indian Pediatr 2020; 57:741-743. [PMID: 32844760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Jaya Shankar Kaushik
- Department of Pediatrics, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India.
| | - Satinder Aneja
- Department of Pediatrics, School of Medical Sciences and Research, Sharda University, Greater Noida, Uttar Pradesh, India
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Aneja S, Joshi J. Presumptive Treatment of Acute Febrile Illness for Preventing Acute Encephalitis Syndrome: Does It Work? Indian Pediatr 2020; 57:607-608. [PMID: 32727934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Satinder Aneja
- Department of Pediatrics, School of Medical Science and Research, Sharda University, Greater Noida, Uttar Pradesh, India.
| | - Jyoti Joshi
- Center for Disease Dynamics, Economics and Policy, New Delhi, India
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28
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Carol Liu YC, Ibekwe T, Kelso JM, Klein NP, Shehu N, Steuerwald W, Aneja S, Dudley MZ, Garry R, Munoz FM. Sensorineural hearing loss (SNHL) as an adverse event following immunization (AEFI): Case definition & guidelines for data collection, analysis, and presentation of immunization safety data. Vaccine 2020; 38:4717-4731. [PMID: 32418788 DOI: 10.1016/j.vaccine.2020.05.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 05/06/2020] [Indexed: 01/22/2023]
Abstract
This is a Brighton Collaboration case definition of the term "Sensorineural Hearing Loss" to be utilized in the evaluation of adverse events following immunization. The case definition was developed by a group of experts convened by the Coalition for Epidemic Preparedness Innovations (CEPI) in the context of active development of vaccines for Lassa Fever and other emerging pathogens. The case definition format of the Brighton Collaboration was followed to develop a consensus definition and define levels of diagnostic certainty, after an exhaustive review of the literature and expert consultation. The document underwent peer review by the Brighton Collaboration Network.
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Affiliation(s)
- Yi-Chun Carol Liu
- Department of Otorhinolaryngology, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
| | - Titus Ibekwe
- Department of Otorhinolaryngology, University of Abuja, Nigeria
| | - John M Kelso
- Division of Allergy, Asthma and Immunology, Scripps Clinic, San Diego, CA, USA
| | - Nicola P Klein
- Kaiser Permanente Vaccine Study Center, Oakland, CA, USA
| | - Nathan Shehu
- Department of Pediatric Infectious Diseases, Jos University, Nigeria
| | - Wendy Steuerwald
- Department of Audiology, Phoenix Children's Hospital, Phoenix, AZ, USA
| | - Satinder Aneja
- Department of Pediatrics, School of Medical Sciences and Research, Sharda University, Gr Noida, India
| | - Matthew Z Dudley
- Department of International Health, and Institute for Vaccine Safety, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Flor M Munoz
- Department of Pediatrics, Section of Infectious Diseases, and Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, USA.
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29
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Chetan C, Sharma S, Mathur SB, Jain P, Aneja S. Clinical Profile and Short-term Outcome of Pediatric Status Epilepticus at a Tertiary-care Center in Northern India. Indian Pediatr 2020. [DOI: 10.1007/s13312-020-1753-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Chetan C, Sharma S, Mathur SB, Jain P, Aneja S. Clinical Profile and Short-term Outcome of Pediatric Status Epilepticus at a Tertiary-care Center in Northern India. Indian Pediatr 2020; 57:213-217. [PMID: 32198859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To assess clinical profile and short term treatment outcomes of pediatric status epilepticus (SE) at a tertiary-care center in northern India. METHODS Prospective cohort study enrolled children aged 1 month to 18 years presenting with SE to the emergency department. Enrolled children (109) were treated as per hospital protocols. Clinical features during hospitalization were noted. Pediatric overall performance category (POPC) scale was used for classification of outcome at the time of discharge. RESULTS Acute symptomatic etiology was identified in 66 (60.6%) cases (CNS infections were predominant). Previous diagnosis of epilepsy was found in 32 (29.4%) children; and benzodiazepine responsive SE were seen in 65 (59.6%) children. Predictors of unfavorable outcome were acute symptomatic etiology (adjusted OR 4.50; 95% CI 1.49, 13.62) and no treatment administered prior to hospital (adjusted OR 3.97; 95% CI 1.06, 14.81). CONCLUSIONS Acute symptomatic etiology, mainly acute CNS infections, is the leading cause of SE in this region. Early and pre-hospital management with benzodiazepines may improve SE outcome.
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Affiliation(s)
- Chinmay Chetan
- Division of Pediatric Neurology, Department of Pediatrics, Lady Hardinge Medical College and associated Kalawati Saran Children Hospital, New Delhi, India
| | - Suvasini Sharma
- Division of Pediatric Neurology, Department of Pediatrics, Lady Hardinge Medical College and associated Kalawati Saran Children Hospital, New Delhi, India. Correspondence to: Dr Suvasini Sharma, Division of Pediatric Neurology, Department of Pediatrics, Lady Hardinge Medical College and associated Kalawati Saran Children Hospital, New Delhi 110 001, India.
| | - Surendra B Mathur
- Division of Pediatric Neurology, Department of Pediatrics, Lady Hardinge Medical College and associated Kalawati Saran Children Hospital, New Delhi, India
| | - Puneet Jain
- Division of Pediatric Neurology, Department of Pediatrics, Lady Hardinge Medical College and associated Kalawati Saran Children Hospital, New Delhi, India
| | - Satinder Aneja
- Division of Pediatric Neurology, Department of Pediatrics, Lady Hardinge Medical College and associated Kalawati Saran Children Hospital, New Delhi, India
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Gupta J, Sharma S, Mukherjee SB, Jain P, Aneja S. Neuro-Developmental and Epilepsy Outcomes of Children with West Syndrome: A Cross-Sectional Study from North India. Ann Indian Acad Neurol 2020; 23:177-181. [PMID: 32189858 PMCID: PMC7061506 DOI: 10.4103/aian.aian_503_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 02/12/2019] [Accepted: 03/04/2019] [Indexed: 11/05/2022] Open
Abstract
Objectives: To assess the neurodevelopmental outcome of West syndrome (WS) in Indian children, who differ in their clinical profile from the western population. Materials and Methods: This cross-sectional study enrolled children aged 2--5 years with prior diagnosis of WS between November 2013 and March 2015. They were assessed for epilepsy outcome and developmental outcome using developmental profile 3 (DP3) and vineland adaptive behavioral scale II (VABS II). Results: Sixty-one children were enrolled. Perinatal asphyxia (40.9%), neonatal hypoglycemia (14.8%), and neonatal meningitis (9.8%) were predominant causes among the children with known etiology. Favorable epilepsy outcome (seizure freedom for >6 months) was observed in 29/61 patients (47.5%). Moderate to severe developmental delay was observed in 55/61 children (91.8%). Favorable developmental outcome (GDS by DP3 >70) was observed in just 5/61 (8%) patients. Conclusions: This study highlights the high prevalence of developmental delay in this population of children with WS, with adverse perinatal events being the most common etiology.
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Affiliation(s)
- Juhi Gupta
- Department of Pediatrics, Lady Harding Medical College and Associated Kalawati Saran Children's Hospital, New Delhi, India
| | - Suvasini Sharma
- Department of Pediatric Neurology, Lady Harding Medical College and Associated Kalawati Saran Children's Hospital, New Delhi, India
| | - Sharmila B Mukherjee
- Department of Pediatric Neurology, Lady Harding Medical College and Associated Kalawati Saran Children's Hospital, New Delhi, India
| | - Puneet Jain
- Department of Pediatric Neurology, Lady Harding Medical College and Associated Kalawati Saran Children's Hospital, New Delhi, India.,Division of Neurology, Department of Pediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Satinder Aneja
- Department of Pediatric Neurology, Lady Harding Medical College and Associated Kalawati Saran Children's Hospital, New Delhi, India
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Yadav S, Jain P, Sharma S, Kumar V, Aneja S. Guillain-Barre syndrome in North Indian children: Clinical and serial electrophysiological features. Neurol India 2020; 67:724-727. [PMID: 31347543 DOI: 10.4103/0028-3886.263191] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Guillain-Barre syndrome (GBS) is a common acquired polyneuropathy in children. Aim To describe the clinical and serial electrophysiological features along with short-term outcomes of children with GBS in north India. Setting and Design This was a prospective study conducted at a tertiary care pediatric hospital in north India. Materials and Methods Consecutive children, aged 2 to 18 years, with GBS, presenting within 4-weeks of onset of weakness, diagnosed on clinical and/or electrophysiological grounds, were enrolled. The enrolled children underwent a detailed clinical-assessment followed by nerve conduction studies. Repeat nerve conduction studies were performed after 2-weeks of the first study to determine changes in the electrophysiological subtype. The patients were followed up for 3 months. Results Thirty-six children were studied. The mean age at presentation was 5.1 years [standard deviation (SD): 2.1]. The mean medical research council (MRC)-sum-score at admission was 24.1 (SD: 10.4). Thirty-three children (91%) had loss of ambulation, 24 (66%) had cranial nerve involvement, and 6 (16.6%) required ventilation. At presentation, 20 had acute motor axonal neuropathy (AMAN), 13 had acute inflammatory demyelinating polyneuropathy (AIDP), 2 had in-excitable nerves, and 1 had normal findings. Four children, initially diagnosed as AIDP, had AMAN with reversible conduction failure on the repeat study. The final classification was AMAN in 25 (69.4%; 95% confidence interval (CI), 51.9-83.7%) and AIDP in 9 children (25%; 95% CI, 12.1-42.2%). Only one patient was nonambulatory at a 3-month follow-up (n = 32). The Erasmus GBS outcome score was 2 in 2 (5.6%), 3 in 5 (13.9%), 4 in 26 (72.2%), and 5 in 3 (8.3%) patients. Conclusions The serial electrophysiological studies were helpful in establishing the final correct diagnosis.
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Affiliation(s)
- Sandeep Yadav
- Department of Pediatrics, Lady Hardinge Medical College and Associated Kalawati Saran Children's Hospital, New Delhi, India
| | - Puneet Jain
- Division of Neurology, Department of Pediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Suvasini Sharma
- Department of Pediatrics, Lady Hardinge Medical College and Associated Kalawati Saran Children's Hospital, New Delhi, India
| | - Virendra Kumar
- Department of Pediatrics, Lady Hardinge Medical College and Associated Kalawati Saran Children's Hospital, New Delhi, India
| | - Satinder Aneja
- Department of Pediatrics, Lady Hardinge Medical College and Associated Kalawati Saran Children's Hospital, New Delhi, India
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Pellegrin S, Munoz FM, Padula M, Heath PT, Meller L, Top K, Wilmshurst J, Wiznitzer M, Das MK, Hahn CD, Kucuku M, Oleske J, Vinayan KP, Yozawitz E, Aneja S, Bhat N, Boylan G, Sesay S, Shrestha A, Soul JS, Tagbo B, Joshi J, Soe A, Maltezou HC, Gidudu J, Kochhar S, Pressler RM. Neonatal seizures: Case definition & guidelines for data collection, analysis, and presentation of immunization safety data. Vaccine 2019; 37:7596-7609. [PMID: 31783981 PMCID: PMC6899436 DOI: 10.1016/j.vaccine.2019.05.031] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 05/09/2019] [Indexed: 01/29/2023]
Affiliation(s)
- Serena Pellegrin
- Clinical Neuroscience, UCL-Institute of Child Health, London, UK; Department of Child Neuropsychiatry, University of Verona, Verona, Italy
| | - Flor M Munoz
- Baylor College of Medicine, Department of Pediatrics, Houston, TX, USA
| | | | - Paul T Heath
- Vaccine Institute, St Georges University of London, London, UK
| | - Lee Meller
- Syneos Health, Safety & Pharmacovigilance, Raleigh, NC, USA
| | - Karina Top
- Department of Pediatrics, Dalhousie University, Halifax, NS, Canada
| | - Jo Wilmshurst
- Department of Paediatric Neurology, Red Cross War Memorial Children's Hospital, Neuroscience Institute, University of Cape Town, South Africa
| | - Max Wiznitzer
- Rainbow Babies & Children's Hospital, Cleveland, OH, USA
| | | | - Cecil D Hahn
- Division of Neurology, The Hospital for Sick Children and Department of Paediatrics, University of Toronto, Toronto, Canada
| | - Merita Kucuku
- National Agency for Medicines and Medical Devices, Tirana, Albania
| | - James Oleske
- Department of Pediatrics, Rutgers - New Jersey Medical School, Newark, NJ, USA
| | | | - Elissa Yozawitz
- Saul R. Korey Department of Neurology, Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Satinder Aneja
- Department of Pediatrics, School of Medical Sciences & Research, Sharda University, Gr Noida, India
| | - Niranjan Bhat
- Center for Vaccine Innovation and Access PATH, Seattle, WA, USA
| | | | - Sanie Sesay
- Clinical Sciences, Sanofi Pasteur, Marcy L'Etoile, France
| | | | - Janet S Soul
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Beckie Tagbo
- Institute of Child Health, University of Nigeria Teaching Hospital, Nigeria
| | - Jyoti Joshi
- Center for Disease Dynamics, Economics & Policy, New Delhi, India
| | - Aung Soe
- Medway NHS Foundation Trust, Kent, UK
| | - Helena C Maltezou
- Department for Interventions in Healthcare Facilities, Hellenic Center for Disease Control and Prevention, Athens, Greece
| | - Jane Gidudu
- Centers for Disease Control and Prevention, Global Immunization Division, Atlanta, USA
| | - Sonali Kochhar
- Global Healthcare Consulting, New Delhi, India; Department of Public Health, Erasmus MC, University Medical Center, Rotterdam, the Netherlands; Department of Global Health, University of Washington, Seattle, USA
| | - Ronit M Pressler
- Clinical Neuroscience, UCL-Institute of Child Health, London, UK; Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
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Mukherjee SB, Aneja S, Sharma S, Sharma M. Diagnostic Accuracy of Indian Scale for Assessment of Autism in Indian Children Aged 2-5 Years. Indian Pediatr 2019; 56:831-836. [PMID: 31724540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To determine the diagnostic accuracy of Indian Scale for Assessment of Autism (ISAA) in children aged between 2-5 years. Design: Setting:. STUDY DESIGN Study of diagnostic accuracy. PARTICIPANTS A consecutive sample of 500 children with suspected Autism (delay or regression of developmental milestones, delay or regression in speech, age-inappropriate understanding, behaviour, play and/or social interaction) was recruited. SETTING Tertiary level hospital, (November 2015 - November 2017). PROCEDURE Each child underwent an expert comprehensive assessment of Autism (reference tool) that included history, observation, examination, diagnostic criteria for Autism Spectrum Disorder (ASD) of the Diagnostic and Statistical Manual of Mental Disorders', 5th edition, Childhood Autism Rating Scale-2 (CARS2), developmental status and adaptive function. This was followed by the administration of ISAA (test tool) in Hindi language. Parameters of diagnostic accuracy and Receiver Operating Characteristic curves were computed. MAIN OUTCOME MEASURES ASD based on (i) expert assessment, (ii) CARS-2, and (iii) ISAA. RESULTS In children aged 2-3 years, sensitivity of ISAA was 100% (95% CI 98.2% -100%), specificity 28.9% (95% CI 17.7% to 43.4%), positive likelihood ratio 1.4 and negative likelihood ratio 0. In 3-5 year olds, sensitivity was 99.6% (95% CI 97.6% to 99.6%), specificity 33.3% (95% CI 15.1% to 58.3%), positive likelihood ration 1.5 and negative likelihood ratio 0.01. The degrees of autism based on the existing cut off values were inaccurate. CONCLUSIONS ISAA has sub-optimal performance in diagnosing and assessing severity in 2-5 year old children.
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Affiliation(s)
- Sharmila Banerjee Mukherjee
- Department of Pediatrics, Lady Hardinge Medical College and associated Kalawati Saran Children's Hospital, New Delhi, India. Correspondence to: Dr Sharmila B. Mukherjee, Professor, Department of Pediatrics, Lady Hardinge Medical College and associated Kalawati Saran Children's Hospital, New Delhi, India.
| | - Satinder Aneja
- Department of Pediatrics, Lady Hardinge Medical College and associated Kalawati Saran Children's Hospital, New Delhi, India
| | - Suvasini Sharma
- Department of Pediatrics, Lady Hardinge Medical College and associated Kalawati Saran Children's Hospital, New Delhi, India
| | - Meenakshi Sharma
- Department of Pediatrics, Lady Hardinge Medical College and associated Kalawati Saran Children's Hospital, New Delhi, India
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Kunnanayaka V, Jain P, Sharma S, Seth A, Aneja S. Addition of pyridoxine to prednisolone in the treatment of infantile spasms: A pilot, randomized controlled trial. Neurol India 2019; 66:385-390. [PMID: 29547159 DOI: 10.4103/0028-3886.227281] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background West syndrome is a catastrophic epilepsy syndrome characterized by infantile spasms, hypsarrhythmia, and developmental arrest or regression. Aim The aim of this study was to explore the role of pyridoxine in the management of infantile spasms. Setting and Design This was a pilot, randomized, open-label trial conducted at a tertiary level hospital from November 2012 to March 2014. Materials and Methods Children aged 3 months to 3 years presenting with infantile spasms in clusters (at least 1 cluster/day) with hypsarrhythmia or its variants on electroencephalogram (EEG) were enrolled. The study participants were randomized to receive either oral prednisolone (4 mg/kg/day) alone or 30 mg/kg/day of pyridoxine with oral prednisolone. The primary outcome measure was the proportion of children who achieved spasm freedom for 48 h on day-14 after treatment initiation, as per parental reports, in both the groups. The adverse effects were also monitored. The study was registered with clinicaltrials.gov (ClinicalTrials.gov Identifier: NCT01828437). Results Sixty-two children were randomized into the two groups with comparable baseline characteristics. The proportion of children with spasm cessation on day-14 was similar in the two groups (39 vs. 37%, P = 0.98). The adverse effects were comparable in both the groups. Conclusions The combination of pyridoxine with oral prednisolone was not found to be a beneficial therapy as compared to prednisolone alone in the treatment of infantile spasms in this pilot study. However, high dose pyridoxine may be safe in children with infantile spasms.
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Affiliation(s)
- Vedavathi Kunnanayaka
- Department of Pediatrics, Lady Hardinge Medical College and associated Kalawati Saran Children's Hospital, New Delhi, India
| | - Puneet Jain
- Division of Pediatric Neurology, Department of Neonatal, Pediatric and Adolescent Medicine, BL Kapur (BLK) Super Speciality Hospital, New Delhi, India
| | - Suvasini Sharma
- Division of Pediatric Neurology, Department of Pediatrics, Lady Hardinge Medical College and associated Kalawati Saran Children's Hospital, New Delhi, India
| | - Anju Seth
- Department of Pediatrics, Lady Hardinge Medical College and associated Kalawati Saran Children's Hospital, New Delhi, India
| | - Satinder Aneja
- Division of Pediatric Neurology, Department of Pediatrics, Lady Hardinge Medical College and associated Kalawati Saran Children's Hospital, New Delhi, India
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Miccio J, Johnson S, Jairam V, Yu J, Hansen J, Aneja S, An Y, Decker R, Omay S, Chiang V, Park H. Upfront Stereotactic Radiosurgery in the Treatment of Brain Metastasis from Small Cell Lung Cancer. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.2348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Dudeja S, Gupta S, Sharma S, Jain A, Sharma S, Jain P, Aneja S, Chandra J. Incidence of vincristine induced neurotoxicity in children with acute lymphoblastic leukemia and its correlation with nutritional deficiencies. Pediatr Hematol Oncol 2019; 36:344-351. [PMID: 31514565 DOI: 10.1080/08880018.2019.1637981] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Injection vincristine is an important component of therapy for acute lymphoblastic leukemia (ALL). An important adverse effect of vincristine is neurotoxicity. The incidence of this adverse effect is well studied. The present was undertaken to determine the incidence of vincristine-induced neurotoxicity in children with ALL after the induction of remission phase of chemotherapy and to ascertain its correlation with undernutrition, vitamin B12, folate and iron deficiency. Thirty children (1-18 years) with ALL were enrolled at the commencement of chemotherapy. The electrophysiological evaluation was done at baseline and repeated after four doses of vincristine (1.5 mg/m2/dose). Clinical evaluation was done regularly. Anthropometry and serum B12, folate and ferritin levels were assessed at baseline. Twelve children over a 4-week period of observation had peripheral neuropathy clinically. The autonomic system was most commonly involved followed by motor and sensory system respectively. On electrophysiological testing, half of the patients had evidence of neuropathy. Micronutrient deficiencies were present in a significant number of patients-63.3% had a B12 deficiency, 20% were deficient in folate and 43.3% in iron. The incidence of vincristine-induced neuropathy in patients with/without these micro-nutrient deficiencies was not statistically significantly different. Vincristine-induced neuropathy is common in Indian children with ALL. The present study did not find any correlation between the occurrences of vincristine-induced neuropathy and nutritional deficiencies. Larger studies are warranted to evaluate the contribution of micronutrient deficiencies to the development of peripheral neuropathy in childhood ALL.
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Affiliation(s)
- Sankalp Dudeja
- Division of Neonatology, Department of Pediatrics, PGIMER , Chandigarh , India
| | - Shreya Gupta
- Department of Pediatrics, Lady Hardinge Medical College and Kalawati Saran Children's Hospital , New Delhi , India
| | - Sunita Sharma
- Department of Pathology, Lady Hardinge Medical College , New Delhi , India
| | - Anju Jain
- Department of Biochemistry, Lady Hardinge Medical College , New Delhi , India
| | - Suvasini Sharma
- Department of Pediatrics, Lady Hardinge Medical College and Kalawati Saran Children's Hospital , New Delhi , India
| | - Puneet Jain
- Division of Neurology, Department of Pediatrics, The Hospital for Sick Children , Toronto , Canada
| | - Satinder Aneja
- Department of Pediatrics, Lady Hardinge Medical College and Kalawati Saran Children's Hospital , New Delhi , India
| | - Jagdish Chandra
- Department of Pediatrics, Lady Hardinge Medical College and Kalawati Saran Children's Hospital , New Delhi , India
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Gao S, Kann B, Bindra R, Contessa J, Yu J, Aneja S. Deep Neural Networks for Radiographic Risk Stratification of Gliomas. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Kann B, Hicks D, Payabvash S, Mahajan A, Gupta V, Burtness B, Husain Z, Aneja S. External Validation and Radiologist Comparison of a Deep Learning Model (DLM) to Identify Extranodal Extension (ENE) in Head and Neck Squamous Cell Carcinoma (HNSCC) with Pretreatment Computed Tomography (CT) Imaging. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
Congenital disorders of glycosylation (CDG) are multisystemic inherited metabolic disorders with marked phenotypic variability. The most frequent described type is PMM2-CDG (earlier known as CDG Type Ia) which presents either with pure neurologic features or with combined neurologic and systemic features. The classical presentation is characterized by varied combinations of developmental delay, hypotonia, ataxia, dysmorphism, inverted nipples, and abnormal fat distribution. Strokelike episodes and seizures are known acute complications that usually occur on a background of developmental delay, ataxia, or dysmorphism. We report here a developmentally normal young girl who presented with isolated strokelike episodes and was diagnosed to have CDG Type Ia. This condition should be kept in the differentials of unexplained strokelike episodes in children. The diagnosis has important therapeutic and prognostic implications.
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Affiliation(s)
- Rajni Farmania
- 1 Division of Pediatric Neurology, Department of Pediatrics, BL Kapur (BLK) Super Speciality Hospital, Pusa Road, New Delhi, India
| | - Puneet Jain
- 1 Division of Pediatric Neurology, Department of Pediatrics, BL Kapur (BLK) Super Speciality Hospital, Pusa Road, New Delhi, India.,2 Division of Neurology, Department of Pediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Suvasini Sharma
- 3 Neurology Division, Department of Pediatrics, Lady Hardinge Medical College (LHMC) and associated Kalawati Saran Children Hospital, New Delhi, India
| | - Satinder Aneja
- 3 Neurology Division, Department of Pediatrics, Lady Hardinge Medical College (LHMC) and associated Kalawati Saran Children Hospital, New Delhi, India.,4 Department of Pediatrics, School of Medical Sciences & Research, Sharda University, Greater Noida, UP, India
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Kaushik S, Chopra D, Sharma S, Aneja S. Adverse Drug Reactions of Anti-Epileptic Drugs in Children with Epilepsy: A Cross-Sectional Study. Curr Drug Saf 2019; 14:217-224. [PMID: 30854975 PMCID: PMC6875869 DOI: 10.2174/1574886314666190311112710] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 02/22/2019] [Accepted: 02/28/2019] [Indexed: 11/29/2022]
Abstract
Background: Adverse drug reactions (ADRs) due to antiepileptic drugs (AEDs) in children contribute to poorer patient outcomes. However, reliable data ragarding such ADRs is not available. Objectives: Thus, the aim of the present study was to determine the incidence and patterns of ADRs of antiepileptic drugs in children aged 2-17 years presenting to a tertiary care teaching hospital. Methods: An observational study was conducted in the Department of Pediatrics, Kalawati Saran Children’s Hospital for a period of one year. Two hundred consecutive eligible patients (aged 2-17 yrs with epilepsy on AED) with consenting parents were enrolled. ADRs were noted using Paediatric Epilepsy Side Effect Questionnaire (PESQ) at clinic visits and any other ADRs reported by parents were also recorded. Causality, severity and avoidability assessments were done. Results: The mean age was 10.5 ± 3.6 years. A total of 139 ADRs occurred in 97 patients. One hundred and nine ADRs were reported by use of PESQ, in addition, 30 ADRs were reported by parents. Poor school result (33.8%) was the commonest ADR. Valproate (61.9%) was the main drug causing ADRs. Valproate, when used in polytherapy, was associated with more number of children experiencing ADRs (72.2%). The most common add on drug was clobazam (42.3%). Children with poorly controlled epilepsy were associated with more ADRs. Causality assessment revealed that 91.3% of the ADRs were probable. Most (94.9%) ADRs were of ‘mild’ category and 95.7% were probably preventable. Treatment was discontinued only in 6 patients of phenytoin toxicity. Conclusion: Cognitive and neurological problems were the most common ADRs seen in children with epilepsy. Polytherapy significantly increases the likelihood of ADRs in children.
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Affiliation(s)
- Sundeep Kaushik
- Department of Pediatrics, Charak Palika Hospital, Moti Bagh NDMC, New Delhi-110021, India
| | - Deepti Chopra
- Department of Pharmacology, Government Institute of Medical Sciences, Kasna, Greater Noida, UP 201310, India
| | - Suvasini Sharma
- Neurology Division, Department of Pediatrics, Lady Hardinge Medical College and Associated Kalawati Saran Children's Hospital, New Delhi, India
| | - Satinder Aneja
- Department of Pediatrics, School of Medical Sciences & Research, Sharda University, Greater Noida, UP 201310, India
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Bhati P, Sharma S, Jain R, Rath B, Beri S, Gupta VK, Aneja S. Cerebral Palsy in North Indian Children: Clinico-etiological Profile and Comorbidities. J Pediatr Neurosci 2019; 14:30-35. [PMID: 31316640 PMCID: PMC6601115 DOI: 10.4103/jpn.jpn_46_18] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Aims and Objectives Cerebral palsy (CP) is a common motor disability in children. This study aimed at elaborating various comorbidities and etiologies and also at correlating motor disability with other disabilities. Material and Methods This hospital-based study was conducted in the outpatient department of a tertiary care hospital in Delhi on 160 children with CP in the age group 2-15 years. A detailed history taking and examination were conducted for each patient and appropriate investigations were performed. Results Most patients, that is 64.4%, were younger than 5 years of age and 72.5% were males. Most common etiology was birth asphyxia (41.9%). Maximum patients were of bilateral spastic (spastic quadriplegic) CP accounting 43.1%. Intellectual disability was the most common comorbidity across all subtypes of CP followed by epilepsy. Comorbidities such as epilepsy and all visual problems except optic atrophy were more common in spastic quadriplegic CP. Hearing, speech impairment, and optic atrophy were more common in dyskinetic CP. Chewing, swallowing, and drooling problems were more common in spastic quadriplegic CP. Conclusion Most common risk factor of CP is birth asphyxia; thus, by improving health care facilities, its incidence can be reduced. CP affects not only motor functions but also other important functions of body as well, and the more severe the motor disabilities, the more are other comorbidities and their intensity also increases with that of the intensity of brain insult.
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Affiliation(s)
- Parul Bhati
- Department of Pediatrics, Lady Hardinge Medical College and Kalawati Saran Children's Hospital, New Delhi, India
| | - Suvasini Sharma
- Department of Pediatrics, Lady Hardinge Medical College and Kalawati Saran Children's Hospital, New Delhi, India
| | - Ridhimaa Jain
- Department of Pediatrics, Lady Hardinge Medical College and Kalawati Saran Children's Hospital, New Delhi, India
| | - B Rath
- Department of Pediatrics, Lady Hardinge Medical College and Kalawati Saran Children's Hospital, New Delhi, India
| | - Sarita Beri
- Department of Ophthalmology, Lady Hardinge Medical College and SSK Hospital, New Delhi, India
| | - Vinod K Gupta
- Department of Physical Medicine and Rehabilitation, Lady Hardinge Medical College and Kalawati Saran Children's Hospital, New Delhi, India
| | - Satinder Aneja
- Department of Pediatrics, Lady Hardinge Medical College and Kalawati Saran Children's Hospital, New Delhi, India
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Kann B, Aneja S, Loganadane V G, Kelly J, Smith S, Decker R, Yarbrough W, Malhotra A, Burtness B, Husain Z. Successful Identification of Head and Neck Cancer (HNC) Nodal Metastasis (NM) and Extranodal Extension (ENE) Using Deep Learning Neural Networks. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.06.169] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abstract
There have been few case reports showing association of vitamin B12 deficiency with infantile spasms. We planned this study to see if there was an association of serum vitamin B12 deficiency in children with development of infantile spasms. Cases included children with infantile spasms of ages 6 months to 3 years. The controls were children in the same age group who had global developmental delay but no history of epileptic spasms. Mean serum vitamin B12, serum homocysteine, and urinary methylmalonic acid levels were measured in both groups and compared. Children with infantile spasms had lower mean serum vitamin B12 levels (354.1 pg/mL; standard deviation 234.1 pg/mL) as compared to children with global developmental delay without spasms (466.7 pg/mL; standard deviation 285.5 pg/mL) ( P value < .05). Mean serum homocysteine level (13.9 vs 7.8 μmol/L, P = .02) and mean urinary methylmalonic acid level (68.1 mmol/mol of creatinine vs 26.1 mmol/mol of creatinine, P = .03) were elevated in children with infantile spasms than in controls. Fourteen children (35.0%) with infantile spasms were vitamin B12 deficient compared with 3 (7.50%) controls ( P = .005). Thus, vitamin B12 deficiency may have an association with infantile spasms. More studies are needed before recommending routine measurement of serum B12 levels in children with infantile spasms.
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Affiliation(s)
- Mahender K Meena
- 1 Department of Pediatrics, Lady Hardinge Medical College, New Delhi, India
| | - Suvasini Sharma
- 2 Division of Pediatric Neurology, Department of Pediatrics, Lady Hardinge Medical College, New Delhi, India
| | - Himani Bhasin
- 1 Department of Pediatrics, Lady Hardinge Medical College, New Delhi, India
| | - Puneet Jain
- 2 Division of Pediatric Neurology, Department of Pediatrics, Lady Hardinge Medical College, New Delhi, India
| | - Seema Kapoor
- 3 Department of Pediatrics, Maulana Azad Medical College, New Delhi, India
| | - Anju Jain
- 4 Department of Biochemistry, Lady Hardinge Medical College, New Delhi, India
| | - Satinder Aneja
- 2 Division of Pediatric Neurology, Department of Pediatrics, Lady Hardinge Medical College, New Delhi, India
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Arora NK, Nair MKC, Gulati S, Deshmukh V, Mohapatra A, Mishra D, Patel V, Pandey RM, Das BC, Divan G, Murthy GVS, Sharma TD, Sapra S, Aneja S, Juneja M, Reddy SK, Suman P, Mukherjee SB, Dasgupta R, Tudu P, Das MK, Bhutani VK, Durkin MS, Pinto-Martin J, Silberberg DH, Sagar R, Ahmed F, Babu N, Bavdekar S, Chandra V, Chaudhuri Z, Dada T, Dass R, Gourie-Devi M, Remadevi S, Gupta JC, Handa KK, Kalra V, Karande S, Konanki R, Kulkarni M, Kumar R, Maria A, Masoodi MA, Mehta M, Mohanty SK, Nair H, Natarajan P, Niswade AK, Prasad A, Rai SK, Russell PSS, Saxena R, Sharma S, Singh AK, Singh GB, Sumaraj L, Suresh S, Thakar A, Parthasarathy S, Vyas B, Panigrahi A, Saroch MK, Shukla R, Rao KVR, Silveira MP, Singh S, Vajaratkar V. Neurodevelopmental disorders in children aged 2-9 years: Population-based burden estimates across five regions in India. PLoS Med 2018; 15:e1002615. [PMID: 30040859 PMCID: PMC6057634 DOI: 10.1371/journal.pmed.1002615] [Citation(s) in RCA: 108] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 06/15/2018] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Neurodevelopmental disorders (NDDs) compromise the development and attainment of full social and economic potential at individual, family, community, and country levels. Paucity of data on NDDs slows down policy and programmatic action in most developing countries despite perceived high burden. METHODS AND FINDINGS We assessed 3,964 children (with almost equal number of boys and girls distributed in 2-<6 and 6-9 year age categories) identified from five geographically diverse populations in India using cluster sampling technique (probability proportionate to population size). These were from the North-Central, i.e., Palwal (N = 998; all rural, 16.4% non-Hindu, 25.3% from scheduled caste/tribe [SC-ST] [these are considered underserved communities who are eligible for affirmative action]); North, i.e., Kangra (N = 997; 91.6% rural, 3.7% non-Hindu, 25.3% SC-ST); East, i.e., Dhenkanal (N = 981; 89.8% rural, 1.2% non-Hindu, 38.0% SC-ST); South, i.e., Hyderabad (N = 495; all urban, 25.7% non-Hindu, 27.3% SC-ST) and West, i.e., North Goa (N = 493; 68.0% rural, 11.4% non-Hindu, 18.5% SC-ST). All children were assessed for vision impairment (VI), epilepsy (Epi), neuromotor impairments including cerebral palsy (NMI-CP), hearing impairment (HI), speech and language disorders, autism spectrum disorders (ASDs), and intellectual disability (ID). Furthermore, 6-9-year-old children were also assessed for attention deficit hyperactivity disorder (ADHD) and learning disorders (LDs). We standardized sample characteristics as per Census of India 2011 to arrive at district level and all-sites-pooled estimates. Site-specific prevalence of any of seven NDDs in 2-<6 year olds ranged from 2.9% (95% CI 1.6-5.5) to 18.7% (95% CI 14.7-23.6), and for any of nine NDDs in the 6-9-year-old children, from 6.5% (95% CI 4.6-9.1) to 18.5% (95% CI 15.3-22.3). Two or more NDDs were present in 0.4% (95% CI 0.1-1.7) to 4.3% (95% CI 2.2-8.2) in the younger age category and 0.7% (95% CI 0.2-2.0) to 5.3% (95% CI 3.3-8.2) in the older age category. All-site-pooled estimates for NDDs were 9.2% (95% CI 7.5-11.2) and 13.6% (95% CI 11.3-16.2) in children of 2-<6 and 6-9 year age categories, respectively, without significant difference according to gender, rural/urban residence, or religion; almost one-fifth of these children had more than one NDD. The pooled estimates for prevalence increased by up to three percentage points when these were adjusted for national rates of stunting or low birth weight (LBW). HI, ID, speech and language disorders, Epi, and LDs were the common NDDs across sites. Upon risk modelling, noninstitutional delivery, history of perinatal asphyxia, neonatal illness, postnatal neurological/brain infections, stunting, LBW/prematurity, and older age category (6-9 year) were significantly associated with NDDs. The study sample was underrepresentative of stunting and LBW and had a 15.6% refusal. These factors could be contributing to underestimation of the true NDD burden in our population. CONCLUSIONS The study identifies NDDs in children aged 2-9 years as a significant public health burden for India. HI was higher than and ASD prevalence comparable to the published global literature. Most risk factors of NDDs were modifiable and amenable to public health interventions.
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Affiliation(s)
| | - M. K. C. Nair
- Kerala University of Health Sciences, Medical College PO, Thrissur, Kerala, India
| | - Sheffali Gulati
- Department of Paediatrics, All India Institute of Medical Sciences, New Delhi, India
| | | | | | - Devendra Mishra
- Department of Paediatrics, Maulana Azad Medical College, New Delhi, India
| | - Vikram Patel
- Sangath, Bardez, Goa, India
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Ravindra M. Pandey
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Bhagabati C. Das
- Department of Community Medicine, Kalinga Institute of Medical Sciences, Bhubaneshwar, Odisha, India
| | | | - G. V. S. Murthy
- Indian Institute of Public Health, Hyderabad, Telangana, India
| | - Thakur D. Sharma
- Himachal Foundation, Dharamshala, Kangra, Himachal Pradesh, India
| | - Savita Sapra
- Department of Paediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Satinder Aneja
- Department of Paediatrics, Lady Hardinge Medical College, New Delhi, India
| | - Monica Juneja
- Department of Paediatrics, Maulana Azad Medical College, New Delhi, India
| | - Sunanda K. Reddy
- Centre for Applied Research and Education on Neurodevelopmental Impairments and Disability related Health Initiatives (CARENIDHI), New Delhi, India
| | - Praveen Suman
- Department of Paediatrics, Sir Ganga Ram Hospital, New Delhi, India
| | | | - Rajib Dasgupta
- Department of Social Medicine and Community Health, Jawaharlal Nehru University, New Delhi, India
| | - Poma Tudu
- The INCLEN Trust International, New Delhi, India
| | | | - Vinod K. Bhutani
- Department of Paediatrics, Stanford University School of Medicine and Lucile Packard Children’s Hospital, California, United States of America
| | - Maureen S. Durkin
- Department of Population Health Sciences and Paediatrics, and Waisman Center, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States of America
| | - Jennifer Pinto-Martin
- University of Pennsylvania School of Nursing and School of Medicine, Philadelphia, United States of America
| | - Donald H. Silberberg
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America
| | - Rajesh Sagar
- Department of Psychiatry, All India Institute of Medical Science, New Delhi, India
| | - Faruqueuddin Ahmed
- Integral Institute of Medical Sciences & Research, Integral University, Lucknow, Uttar Pradesh, India
| | - Nandita Babu
- Department of Psychology, Delhi University, New Delhi, India
| | - Sandeep Bavdekar
- Department of Paediatrics, Seth GS Medical College & KEM Hospital, Mumbai, Maharashtra, India
| | - Vijay Chandra
- Department of Neurology, Paras Hospital, Gurugram, Haryana, India
| | - Zia Chaudhuri
- Department of Ophthalmology, Lady Hardinge Medical College, New Delhi, India
| | - Tanuj Dada
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Rashna Dass
- Department of Paediatric Disciplines, Health City Hospital, Guwahati, Assam, India
| | - M. Gourie-Devi
- Department of Neurology, Institute of Human Behaviour and Allied Sciences & Department of Neurophysiology, Sir Ganga Ram Hospital, New Delhi, India
| | - S. Remadevi
- School of Health Policy and Planning, Kerala University of Health Sciences, Thiruvananthapuram, Kerala, India
| | - Jagdish C. Gupta
- Ali Yavar Jung National Institute of Speech and Hearing Disabilities, Department of Empowerment of Persons with Disabilities, Kasturba Niketan, New Delhi, India
| | - Kumud K. Handa
- Department of ENT & Head Neck Surgery, Medanta Medicity, Gurugram, Haryana, India
| | - Veena Kalra
- Department of Paediatrics, Indraprastha Apollo Hospital, New Delhi, India
| | - Sunil Karande
- Department of Paediatrics, Seth GS Medical College & KEM Hospital, Mumbai, Maharashtra, India
| | - Ramesh Konanki
- Department of Paediatric Neurology, Rainbow Children’s Hospital, Hyderabad, Telengana, India
| | - Madhuri Kulkarni
- Department of Paediatrics, Mumbai Port Trust Hospital, Mumbai, Maharashtra, India
| | - Rashmi Kumar
- Department of Paediatrics, King George Medical University, Lucknow, Uttar Pradesh, India
| | - Arti Maria
- Department of Neonatology, Post Graduate Institute of Medical Education and Research and Dr. Ram Manohar Lohia Hospital, Delhi, India
| | - Muneer A. Masoodi
- Department of Community Medicine, Government Medical College, Srinagar, Kashmir, India
| | - Manju Mehta
- Department of Psychiatry, All India Institute of Medical Science, New Delhi, India
| | - Santosh Kumar Mohanty
- National Trust, Department of Empowerment of Persons with Disabilities, Ministry of Social Justice & Empowerment, Government of India, Delhi, India
| | - Harikumaran Nair
- Kerala University of Health Sciences, Medical College PO, Thrissur, Kerala, India
| | - Poonam Natarajan
- Vidya Sagar (formerly The Spastics Society of India), Chennai, Tamil Nadu, India
| | - A. K. Niswade
- Department of Paediatrics, Government Medical College, Nagpur, Maharashtra, India
| | - Atul Prasad
- Social Welfare Department, Government of Bihar, Patna, India
| | - Sanjay K. Rai
- Department of Community Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Paul S. S. Russell
- Department of Child & Adolescent Psychiatry and Facility for Children with Intellectual Disability, Christian Medical College, Vellore, Tamil Nadu, India
| | - Rohit Saxena
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Shobha Sharma
- Department of Paediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Arun K. Singh
- Rashtriya Bal Swasthya Karyakram, Ministry of Health and Family Welfare, Nirman Bhawan, New Delhi, India
| | - Gautam B. Singh
- Department of Otorhinolaryngology and Head and Neck Surgery (ENT), Lady Hardinge Medical College, New Delhi, India
| | - Leena Sumaraj
- Child Development Centre, Medical College Campus, Thiruvananthapuram, Kerala, India
| | | | - Alok Thakar
- Department of Otolaryngology & Head-Neck Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Sujatha Parthasarathy
- Department of Pediatric Neurology, The Hospital for Sick Children (SickKids), The Peter Gilgan Centre for Research and Learning, Toronto, Ontario, Canada
| | - Bhadresh Vyas
- Department of Paediatrics, M.P. Shah Government Medical College & G.G. Hospital, Jamnagar, Gujarat, India
| | - Ansuman Panigrahi
- Department of Community Medicine, Kalinga Institute of Medical Sciences, Bhubaneshwar, Odisha, India
| | - Munish K. Saroch
- Department of ENT, Dr. Rajender Prasad Government Medical College, Kangra, Himachal Pradesh, India
| | - Rajan Shukla
- Indian Institute of Public Health, Hyderabad, Telangana, India
| | - K. V. Raghava Rao
- RVM Institute of Medical Sciences and Research Center, Laxmakkapally, Telangana, India
| | - Maria P. Silveira
- Department of Paediatrics, Goa Medical College, Bambolim, Goa, India
| | - Samiksha Singh
- Indian Institute of Public Health, Hyderabad, Telangana, India
| | - Vivek Vajaratkar
- Sangath, Bardez, Goa, India
- Department of Orthopedic Surgery, Goa Medical College, Bambolim, Goa, India
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Singh AK, Wagner AL, Joshi J, Carlson BF, Aneja S, Boulton ML. Causality assessment of serious and severe adverse events following immunization in India: a 4-year practical experience. Expert Rev Vaccines 2018; 17:555-562. [PMID: 29865876 DOI: 10.1080/14760584.2018.1484285] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
BACKGROUND India has implemented the World Health Organization's revised Causality Assessment Protocol for adverse events following immunization (AEFI). We describe the number and types of serious/severe AEFIs, including deaths. RESEARCH DESIGN AND METHODS Analysis of causality classification of reported serious/severe AEFIs from 1 January 2012 to 7 January 2016 was done. Classification includes (A) consistent with causal association to immunization; (B) indeterminate; (C) coincidental association; or (D) unclassifiable. We present descriptive statistics across each category. RESULTS Analysis of causality assessment completed for 1037 reports of serious AEFIs: 499 (48%) were causally associated, 84 (8%) were indeterminate, 323 (31%) were coincidental, and 131 (13%) were unclassifiable. Of the 499 reports in the A category, the events were causally linked to vaccine product for 189 (18%), to immunization error for 135 (13%), and to immunization anxiety for 175 (17%). Among 279 reported deaths, more than half (55%; n = 153) were coincidental events and 37% were unclassifiable. CONCLUSIONS Causality assessment of AEFI cases is an important component of vaccination programs and post-marketing surveillance of vaccines. Field reporting and investigation of AEFIs can be improved for many severe or serious reports, most of which are not causally linked to the vaccination program.
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Affiliation(s)
- Awnish K Singh
- a National Technical Advisory Group on Immunization Secretariat , National Institute of Health and Family Welfare , New Delhi , India.,d Former Immunization Technical Support Unit , Public Health Foundation of India , New Delhi , India
| | - Abram L Wagner
- b Department of Epidemiology, School of Public Health , University of Michigan , Ann Arbor , MI , USA
| | - Jyoti Joshi
- c Center for Disease Dynamics Economics and Policy , New Delhi , India.,d Former Immunization Technical Support Unit , Public Health Foundation of India , New Delhi , India
| | - Bradley F Carlson
- b Department of Epidemiology, School of Public Health , University of Michigan , Ann Arbor , MI , USA
| | - Satinder Aneja
- f Kalawati Saran Children's Hospital , Lady Hardinge Medical College , New Delhi , India
| | - Matthew L Boulton
- b Department of Epidemiology, School of Public Health , University of Michigan , Ann Arbor , MI , USA.,e Department of Internal Medicine, Division of Infectious Diseases , University of Michigan Medical School , Ann Arbor , MI , USA
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Aneja S. Zika Virus Infection and Microcephaly in Infants: Is the Association Casual or Causal?: Public Health Viewpoint. Indian Pediatr 2018; 55:333-334. [PMID: 29726827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Satinder Aneja
- Department of Pediatrics, School of Medical Sciences and Research, Sharda University, India.
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48
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Mathew JL, Sharma S, Aneja S. Zika Virus Infection and Microcephaly in Infants: Is the Association Casual or Causal? Indian Pediatr 2018. [DOI: 10.1007/s13312-018-1264-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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49
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Bagri NK, Bagri N, Jana M, Gupta AK, Wadhwa N, Lodha R, Kabra SK, Chandran A, Aneja S, Chaturvedi MK, Sodhi J, Fitzwater SP, Chandra J, Rath B, Kainth US, Saini S, Black RE, Santosham M, Bhatnagar S. Efficacy of Oral Zinc Supplementation in Radiologically Confirmed Pneumonia: Secondary Analysis of a Randomized Controlled Trial. J Trop Pediatr 2018; 64:110-117. [PMID: 28575379 DOI: 10.1093/tropej/fmx036] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To evaluate the effect of zinc as an adjuvant therapy in radiologically confirmed pneumonia in children 2-24 months of age. PATIENTS AND METHODS We analyzed data of 212 children with pneumonia for whom chest X-ray films were available at enrollment and at least two radiologists agreed on the diagnosis of pneumonia. We compared the time to recovery in the two groups (n = 121, zinc group and n = 91, placebo group) using a Cox proportional hazards regression model. RESULTS Time to recovery was similar in both groups [median interquartile range: zinc, 84 h (64, 140 h); placebo, 85 h (65, 140 h)]. The absolute risk reduction for treatment failure was 5.2% (95% confidence interval: -4.8, 15.1) with zinc supplementation. CONCLUSION There was no significant beneficial effect of zinc on the duration of recovery or risk of treatment failure in children with radiologically confirmed pneumonia.
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Affiliation(s)
- Narendra Kumar Bagri
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Neha Bagri
- Mahajan Imaging, Defence Colony, New Delhi 110024, India
| | - Manisha Jana
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Arun Kumar Gupta
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Nitya Wadhwa
- Department of Pediatrics, All India Institute of Medical Sciences, Centre for Diarrheal Diseases and Nutrition Research, New Delhi 110029, India.,Pediatric Biology Centre, Translational Health Science and Technology Institute, Faridabad, Haryana 121001, India
| | - Rakesh Lodha
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Sushil Kumar Kabra
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Aruna Chandran
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21218, USA.,Department of Pediatrics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21218, USA
| | - Satinder Aneja
- Department of Pediatrics, Kalawati Saran Children's Hospital, Lady Hardinge Medical College, New Delhi 110001, India
| | - Mona K Chaturvedi
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Jitender Sodhi
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Sean Patrick Fitzwater
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21218, USA
| | - Jagdish Chandra
- Department of Pediatrics, Kalawati Saran Children's Hospital, Lady Hardinge Medical College, New Delhi 110001, India
| | - Bimbadhar Rath
- Department of Pediatrics, Kalawati Saran Children's Hospital, Lady Hardinge Medical College, New Delhi 110001, India
| | - Udaypal S Kainth
- Department of Pediatrics, Deen Dayal Upadhyay Hospital, New Delhi 110064, India
| | - Savita Saini
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Robert E Black
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21218, USA
| | - Mathuram Santosham
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21218, USA.,Department of Pediatrics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21218, USA.,Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21218, USA
| | - Shinjini Bhatnagar
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi 110029, India.,Department of Pediatrics, All India Institute of Medical Sciences, Centre for Diarrheal Diseases and Nutrition Research, New Delhi 110029, India
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Gupta S, Krishnan A, Sharma S, Kumar P, Aneja S, Ray P. Changing pattern of prevalence, genetic diversity, and mixed infections of viruses associated with acute gastroenteritis in pediatric patients in New Delhi, India. J Med Virol 2017; 90:469-476. [PMID: 29064572 DOI: 10.1002/jmv.24980] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 10/07/2017] [Indexed: 11/06/2022]
Abstract
There are very few studies that have assessed multiple viral agents causing Acute-Gastroenteritis (AGE) in India. The present study compared the changing pattern of prevalence and genetic diversity of five enteric viruses associated with acute-diarrhea in Delhi children within a gap of 5 years. Fecal samples were collected from diarrheal children (<4 years) during two winter seasons: year 2009-2010 (n = 59) and year 2014-2015 (n = 85). Samples were individually tested for rotavirus-A, norovirus, astrovirus, adenovirus, and sapovirus using EIA/RT-PCR and genetically characterized by phylogenetic analysis. Rotavirus was the most predominant (54.9%) virus followed by norovirus (25.7%), astrovirus (8.3%), and adenovirus (4.9%) with rare detection of sapovirus (0.7%). While detection rate increased for both rotavirus (49.2-58.8%) and astrovirus (5.1-10.6%), norovirus detection rate decreased (30.5-22.4%) from 2009 to 2015. During the same time period, adenovirus detection remained low (4.7-5.1%). Interestingly, mixed infections increased from 8.5% to 16.5% after 5 years. G1P[8] rotavirus strain was found most predominant (40%). Both type-1 and 8 astroviruses were detected. Single sapovirus detected was of genotype GII.1. Both GI (GI.5, GI.3) and GII (GII.1, GII.4, GII.7, GII.21, GII.13) genogroups of norovirus were detected. Of particular significance was the first detection of other NoV genotypes (besides GII.4 and GI.3) in Delhi. This is also the first report of NoV GI.5 from India. A change in prevalence pattern and increased diversity from 2009 to 2015 emphasizes the need for continued enteric virus surveillance to help measure the impact of new diarrhea vaccine(s) introduced in India.
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Affiliation(s)
- Shipra Gupta
- Department of Biotechnology, School of Chemical and Life Sciences, Jamia Hamdard University, New Delhi, India
| | - Anuja Krishnan
- Molecular Medicine, Jamia Hamdard University, New Delhi, India
| | - Sumit Sharma
- Department of Molecular Virology, Linkoping University, Linkoping, Sweden
| | - Praveen Kumar
- Department of Pediatrics, Kalawati Saran Children's Hospital, New Delhi, India
| | - Satinder Aneja
- Department of Pediatrics, Kalawati Saran Children's Hospital, New Delhi, India
| | - Pratima Ray
- Department of Biotechnology, School of Chemical and Life Sciences, Jamia Hamdard University, New Delhi, India
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