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Saluja T.,Shantha Biotechnics | Sharma S.D.,SMS Medical College | Gupta M.,Jawaharlal Institute of Postgraduate Medical Education & Research | Kundu R.,Institute of Child Health | And 14 more authors.
Vaccine | Year: 2014

Background: Rotavirus is the leading cause of severe, dehydrating diarrhea in children aged <5 years globally, with an estimated 25 million outpatient visits and 2 million hospitalizations attributable to rotavirus infections each year. The aim of this hospital-based surveillance was to summarize the local epidemiological and virological features of rotavirus and to estimate the disease burden in the population under surveillance in India. Methods: During the 16 months surveillance period from April 2011 through July 2012, a total of 4711 children under the age of 5 years were admitted with acute diarrhea at 12 medical centers attached to medical schools throughout India. Stool samples were randomly collected from 2051 (43.5%) subjects and were analyzed for rotavirus positivity using commercial enzyme immunoassay kit (Premier Rotaclone Qualitative Elisa) at the respective study centers. Rotavirus positive samples were genotyped for VP7 and VP4 by reverse-transcription polymerase chain reaction (RT-PCR) at a central laboratory. Results: During the study period, maximum number of rotavirus related hospitalizations were reported from December 2011 through February 2012. Out of the 2051 stool samples tested for rotavirus, overall 541 (26.4%) samples were positive for rotavirus VP6 antigen in stool. The highest positivity was observed in the month of December, 2011 (52.5%) and lowest in the month of May, 2011 (10.3%). We found that majority of the rotavirus positive cases (69.7%) were in children <24 months of age. The most common genotypes reported were G1 (38%), G2 (18%), G9 (18%), G12 (9%) and mixed strains (17%). Conclusions: The results of this study confirm the significant burden of acute rotavirus gastroenteritis as a cause of hospitalizations in under five children in India. © 2014. Source


Seth A.,Kalawati Saran Childrens Hospital | Sharma R.,Kalawati Saran Childrens Hospital
Indian Journal of Pediatrics | Year: 2013

Childhood obesity is an issue of serious medical and social concern. In developing countries including India, it is a phenomenon seen in higher socioeconomic strata due to the adoption of a western lifestyle. Consumption of high calorie food, lack of physical activity and increased screen time are major risk factors for childhood obesity apart from other genetic, prenatal factors and socio-cultural practices. Obese children and adolescents are at increased risk of medical and psychological complications. Insulin resistance is commonly present especially in those with central obesity and manifests as dyslipidemia, type 2 diabetes mellitus, impaired glucose tolerance, hypertension, polycystic ovarian syndrome and metabolic syndrome. Obese children and adolescents often present to general physicians for management. The latter play a key role in prevention and treatment of obesity as it involves lifestyle modification of the entire family. This article aims at discussing the approach to diagnosis and work-up, treatment and preventive strategies for childhood obesity from a general physician's perspective. © 2012 Dr. K C Chaudhuri Foundation. Source


Kanwal S.K.,Kalawati Saran Childrens Hospital | Kumar V.,Kalawati Saran Childrens Hospital
Indian Journal of Pediatrics | Year: 2011

An 11-month-old child presented with persistent seizures requiring ventilator support. The child had global developmental delay, was staying in the premises of battery manufacturing unit, had microcytic and hypochromic anemia with basophilic stripling on peripheral smear, lead line on radiograph of the long bones and BLL of 244 μg/dl. The CT scan of the brain revealed cerebral atrophy. The mother also had high BLL and lead line in the radiograph of the long bones. The child was managed with chelation therapy. Given the continuing lead exposure among occupational and general populations in India, this case study highlights the need for prompt environmental preventive actions as well as nutritional and preventive counseling for occupational populations. © 2011 Dr. K C Chaudhuri Foundation. Source


Mukherjee S.B.,Kalawati Saran Childrens Hospital | Malhotra M.K.,Kalawati Saran Childrens Hospital | Aneja S.,Kalawati Saran Childrens Hospital | Chakraborty S.,Pt. B.D. Sharma PGIMS | Deshpande S.,Dr. Ram Manohar Lohia Avadh University
Indian Pediatrics | Year: 2015

Objective: To determine the diagnostic accuracy of Indian Scale for Assessment of Autism (ISAA) in children aged 2–9 year at high risk of autism, and to ascertain the level of agreement with Childhood Autism Rating Scale (CARS). Design: Diagnostic Accuracy study Setting: Tertiary-level hospital. Participants: Children aged between 2 and 9 year and considered to be at a high risk for autism (delayed development, and age-inappropriate cognition, speech, social interaction, behavior or play) were recruited. Those with diagnosed Hearing impairment, Cerebral palsy, Attention deficit hyperactivity disorder or Pervasive developmental disorders (PDD) were excluded. Methods: Eligible children underwent a comprehensive assessment by an expert. The study group comprising of PDD, Global developmental delay (GDD) or Intellectual disability was administered ISAA by an investigator after one week. Both evaluators were blinded. ISAA results were compared to the Expert’s diagnosis and CARS scores. Results: Out of 102 eligible children, 90 formed the study group (63 males, mean age 4.5y). ISAA had a sensitivity 93.3, specificity of 97.4, positive and negative likelihood ratios 85.7 and 98.7 and positive and negative predictive values of 35.5 and 0.08, respectively. Reliability was good and validity sub-optimal (r low, in 4/6 domains). The optimal threshold point demarcating Autism from ‘No autism’ according to Receiver Operating Characteristic curve was ISAA score of 70. Level of agreement with CARS measured by Kappa coefficient was low (0.14). Conclusions: The role of ISAA in 3–9 year old children at high risk for Autism is limited to identifying and certifying Autism at ISAA score of 70. It requires re-examination in 2–3 year olds. © 2015, Indian Academy of Pediatrics. Source


Sharma R.,Kalawati Saran Childrens Hospital | Chandra J.,Kalawati Saran Childrens Hospital | Sharma S.,Lady Hardinge Medical College | Pemde H.,Kalawati Saran Childrens Hospital | Singh V.,Kalawati Saran Childrens Hospital
Journal of Pediatric Hematology/Oncology | Year: 2012

BACKGROUND:: Human leukocyte antigen-matched bone marrow transplant in the treatment of aplastic anemia is generally not feasible in developing countries due to lack of resources and expertise and immunosuppressive therapy (IST) has been used as an alternative. This study aims to report the long-term outcome of children with aplastic anemia treated with IST [antithymocyte globulin (ATG) and cyclosporine] in our hospital. PROCEDURE:: Case files of children with aplastic anemia who received IST from January 2001 to November 2009 were reviewed. RESULTS:: Thirty-five patients with aplastic anemia (14 very severe aplastic anemia; 21 severe aplastic anemia) were given IST. Seven patients expired within 3 months of therapy and were excluded. The analysis was done in 28 patients (24 male and 4 female; 12 very severe aplastic anemia and 16 severe aplastic anemia). The median age was 10 years (range, 5 to 12 y). Ten patients achieved partial response and 4 patients complete response at 1 year with overall response rate of 50%. Three nonresponders received a second course of ATG after 12 months out of which 2 responded. Hence, overall response including second course was 16 (57%). Three patients relapsed after a median interval of 23 months. The median duration of follow-up of 16 responders was 40 months (range, 15 to 119 mo). In the patients with long-term follow-up for >4 years (n=7), all were surviving and independent of transfusions. CONCLUSIONS:: In a developing country setting, IST with ATG and cyclosporine seems to be a good alternative treatment for aplastic anemia in children. Copyright © 2011 by Lippincott Williams & Wilkins. Source

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