National Institute of Medical Statistics

Lal Bahadur Nagar, India

National Institute of Medical Statistics

Lal Bahadur Nagar, India
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Sinha S.,Sitaram Bhartia Institute of Science and Research | Sinha S.,Guru Gobind Singh Indraprastha University | Aggarwal A.R.,National Institute of Medical Statistics | Osmond C.,Sunder Lal Jain Hospital | And 3 more authors.
Indian Pediatrics | Year: 2017

Objective: To evaluate intergenerational change in anthropometric indices of children and their predictors. Design: Prospective cohort. Participants: New Delhi Birth Cohort participants (F1), born between 1969 and 1972, were followed-up for anthropometry at birth and 6-monthly intervals until 21 years. Their children (F2) below 10 years were evaluated anthropometrically. Outcome measure: Intergenerational change (F2-F1) in height, weight and body mass index (BMI) of children in comparison to their parents at corresponding ages. Results: 432 F2-F1 pairs were analyzed in age-groups of 0-5 (26.9%) and 5-10 (73.1%) years. Children were considerably taller (0-5 years 0.99 SD; 5-10 years 1.17 SD) and heavier (0-5 years 0.77 SD; 5-10 years 1.52 SD) while only those aged 5-10 years were broader (had a higher BMI; 1.03 SD), than their parents. These increases for 0-5 and 5-10 years, respectively corresponded to 3.9 and 6.4 cm for height, 1.3 and 5.4 kg for weight and 0.2 and 1.9 kg/m2 for BMI. Lower parents’ anthropometric indices and poor water supply and sanitation facilities; higher age of parents at child birth and of children when measured (for height and weight); and more parental education (for weight and BMI), were associated with greater intergenerational gains in children. Conclusion: Over one generation in an urban middle-class population, whose general living conditions had improved, underfive children have become considerably taller and heavier, and 5- 10 year old children have additionally become broader, than their parents at corresponding ages. Child populations probably ‘grow up’ before ‘growing out’. © 2017, Indian Academy of Pediatrics.


Rai R.K.,Society for Health and Demographic Surveillance | Singh L.,National Institute of Medical Statistics | Singh P.K.,TERI University
Nutrition | Year: 2017

Objective Children born to mothers with abnormal body mass index (BMI) have increased risk for mortality. The aim of this study was to investigate whether maternal BMI is a risk factor for neonatal death in select Asian countries, including the nature of association between maternal BMI and the discrete timing of neonatal death. Methods Nationally representative, the standard Demographic and Health Survey data from nine Asian countries were used. In all, 55 629 mothers reported their index birth; 840 reported neonatal mortality. Descriptive statistics and multivariate logistic regression analyses were applied to attain the study objective. Results Overweight mothers had higher odds of neonatal mortality than mothers with optimum weight. No significant association was registered for obese mothers, possibly due to insufficient power. During the first 7 d (0–1 and 2–6 d) of birth, children born to overweight mothers had higher odds of dying, whereas for the remaining period (7–27 d), maternal underweight was the risk factor for neonatal mortality. Conclusion Interventions should target high-risk pregnancies to reduce the rate of neonatal mortality. With the help of community health workers or physicians, preconception counseling of prospective mothers with abnormal BMI should be devised. If conceived, underweight or overweight or obese women should be marked as high-risk pregnancy during their antenatal care visits, and they must be encouraged for delivery at an institution equipped with an emergency obstetric and neonatal care unit. © 2017 Elsevier Inc.


Mandal N.,Desert Medicine Research Center | Anand P.K.,Desert Medicine Research Center | Gautam S.,National Institute of Medical Statistics | Das S.,Regional Medical Research Center | Hussain T.,Regional Medical Research Center
Critical Reviews in Microbiology | Year: 2017

Tuberculosis (TB) is a major public health problem, invading all age groups world-wide. It is an opportunistic infection affecting the individuals alone or with co-infections. Childhood TB is a neglected aspect and a significant health problem in epidemic areas. It constitutes more than 20% of TB incidence. Pediatric TB exists in the shadow of adult TB. The clinicians concentrate on pulmonary manifestation of TB, whereas it is a major problem in both pulmonary and extra-pulmonary infections. The rate of infection with this disease is mostly associated with poverty, social disruption and human immunodeficiency virus (HIV) infection. The diagnosis of extra-pulmonary TB (EPTB) is more difficult than pulmonary TB (PTB). Delayed diagnosis and executive treatment contribute to increase in the mortality rate in endemic areas. This article provides the evidence-based simple and safe screening method, indicating rapid, highly sensitive and specific diagnostic tests for pulmonary and EPTB in children. The most important aspect of treatment is the correct course of anti-tubercular drugs. This review serves the purpose of quick reference for microbiologists, epidemiologists, academicians, students and researchers. It provides guidance regarding early diagnosis and treatment accuracy of pediatric TB. © 2017 Informa UK Limited, trading as Taylor & Francis Group.


Chaturvedi H.K.,National Institute of Medical Statistics | Mahanta J.,Regional Medical Research Center | Bajpai R.C.,National Institute of Medical Statistics | Pandey A.,National Institute of Medical Statistics
BMC Public Health | Year: 2013

Background: Household survey data of Changlang district, Arunachal Pradesh, were used in the present study to assess the prevalence of opium use among different tribes, and to examine the association between sociodemographic factors and opium use. Methods. A sample of 3421 individuals (1795 men and 1626 women) aged 15 years and older was analyzed using a multivariate logistic regression model to determine factors associated with opium use. Sociodemographic information such as age, education, occupation, religion, ethnicity and marital status were included in the analysis. Results: The prevalence of opium use was significantly higher (10.6%) among men than among women (2.1%). It varied according to age, educational level, occupation, marital status and religion of the respondents. In both sexes, opium use was significantly higher among Singpho and Khamti tribes compared with other tribes. Multivariate logistic regression indicated that opium use was significantly associated with age, occupation, ethnicity, religion and marital status of the respondents of both sexes. Multivariate rate ratios (MRR) for opium use were significantly higher (4-6 times) among older age groups (≥35 years) and male respondents. In males, the MRR was also significantly higher in respondents of Buddhist and Indigenous religion, while in females, the MRR was significantly higher in Buddhists. Most of the female opium users had taken opium for more than 5 years and were introduced to it by their husbands after marriage. Use of other substances among opium users comprised mainly tobacco (76%) and alcohol (44%). Conclusions: The study reveals the sociodemographic factors, such as age, sex, ethnicity, religion and occupation, which are associated with opium use. Such information is useful for institution of intervention measures to reduce opium use. © 2013 Chaturvedi et al.; licensee BioMed Central Ltd.


Juneja A.,National Institute of Medical Statistics | Sharma S.,Institute of Cytology and Preventive Oncology
Journal of Cancer Research and Therapeutics | Year: 2015

Sample size is one of the basics issues, which medical researcher including oncologist faces with any research program. The current communication attempts to discuss the computation of sample size when sensitivity and specificity are being evaluated. The article intends to present the situation that the researcher could easily visualize for appropriate use of sample size techniques for sensitivity and specificity when any screening method for early detection of cancer is in question. Moreover, the researcher would be in a position to efficiently communicate with a statistician for sample size computation and most importantly applicability of the results under the conditions of the negotiated precision.


Pandey A.,National Institute of Medical Statistics | Aggarwal A.,National Institute of Medical Statistics | Maulik M.,National Institute of Medical Statistics | Gupta J.,National Institute of Medical Statistics | Juneja A.,National Institute of Medical Statistics
Pharmaceutical Medicine | Year: 2013

The Clinical Trials Registry - India (CTRI), an online system (www.ctri.nic.in) for the registration of clinical trials being conducted in India, has its secretariat at the National Institute of Medical Statistics of the Indian Council of Medical Research in New Delhi. The primary objective of the CTRI is to ensure that all clinical trials conducted in India are registered in order to bring transparency, accountability and access to clinical trials. Since its launch on 20 July 2007, the CTRI has gone from strength to strength and, as of January 2013, more than 3,300 trials had been registered. Although initiated as a voluntary exercise, registration of trials requiring approval by the drug regulatory authority in India has been made mandatory. Editors from 11 major biomedical journals in India require submission of the clinical trial registration number as a prerequisite for publication. In addition, several ethics committees also insist upon trial registration. The CTRI is a primary registry of the WHO's International Clinical Trials Registry Platform. This article discusses the challenges encountered during the setting up of the CTRI and the strategies adopted, and also explains the steps to trial registration in the CTRI. © 2013 Springer International Publishing Switzerland.


Dhamija M.,Rajiv Gandhi Cancer Institute | Kapoor G.,National Institute of Medical Statistics | Juneja A.,National Institute of Medical Statistics
Journal of Pediatric Hematology/Oncology | Year: 2014

Background: Drug administration is a multiprofessional process. The high toxicity and low therapeutic index of chemotherapy drugs make medication errors a significant problem, resulting in excessive patient morbidity and cost. Objective: An audit of the delivery of infusional chemotherapy among pediatric inpatients was planned, with the objective of improving practice and minimizing errors.Method: An observational study was conducted between January and August 2012. Patients were followed up from their premedication until the completion of postchemotherapy hydration and/or rescue drugs. Errors were recorded and classified by error type, cause, severity, unit location, medication involved, and harm caused.Results: A total of 205 observations were made and 23(13.6%) errors recorded, of which 6 were intercepted. No life-threatening adverse drug event was recorded. The most important risk factor predisposing to errors was admission to nonpediatric ward (P=0.004). Documentation errors and incorrect infusion time were the 2 most common errors, whereas the most frequent error node was administration error. Appropriate steps were taken to prevent their reoccurrence.Conclusions: This study helped provide important information about the rate and epidemiology of medication errors, emphasizing on the role of audit in enabling development of appropriate errorreducing strategies, particularly in the context of quality assurance in hospitals. Copyright © 2013 by Lippincott Williams & Wilkins.


Rastogi M.,SASTRA University | Ojha R.P.,SASTRA University | Devi B.P.,SASTRA University | Aggarwal A.,National Institute of Medical Statistics | And 2 more authors.
Neurochemical Research | Year: 2012

Bacopa monnieri (L.) is a revered medicinal plant of traditional Indian system of medicine effective against cognitive impairment in ageing and SDAT. In our previous study, long term administration of bacosides was found to exhibit remarkable anti ageing effect, ameliorate age associated neurochemical and neurobehavioral deficits and prevent hippocampal neuronal degeneration in middle aged and aged rat brain cortex. In continuation to the previous study, the present study aims to investigate the neuroprotective effect of bacosides against age related chronic neuroinflammation in Wistar rat brain on 3 months treatment. Recently, neuroinflammation has gained considerable interest in age associated neurodegeneration and pathologies like SDAT due to its slow onset and chronic nature. The results of the present study demonstrated the significant attenuation of age dependant elevation of pro inflammatory cytokines, iNOS protein expression, total nitrite and lipofuscin content in middle aged and aged rat brain cortex on long term oral administration of bacosides. Thus, the present results suggest that bacosides possess immense potential to act as a neuroprotective agent due to its pleiotropic action for the prevention of ageing complications and SDAT progression. © Springer Science+Business Media, LLC 2011.


News Article | November 16, 2016
Site: www.rdmag.com

A controversial experiment to revive brain-dead accident victims has been scrapped. The Indian Council of Medical Research’s (ICMR) National Institute of Medical Statistics officially removed the “ReAnima” trial from India’s clinical trial registry on Nov. 11. The experiment began in May when Himanshu Bansal, an orthopedic surgeon at Anupam Hospital in the north Indian state of Uttarakhand, announced plans to give approximately 20 brain-dead people a mix of interventions including injections of mesenchymal stem cells, peptides, transcranial laser stimulation and median nerve stimulation. Transcranial laser stimulation is a process that involves shinning pulses of near-infrared light in the brain, while median nerve stimulation is the electrical stimulation of a major nerve that runs from the neck to the arm. Both techniques have been proven to improve cognition in patients with traumatic brain injury. The ICMR identified several regulatory lapses in the trial that led to the decision, including a failure to seek permission to proceed from the Drug Controller General of India, a requirement for all clinical trials in India. Bansal previously described his aim as bringing brain-dead individuals back to a minimally conscious state where patients show flickers of consciousness like moving their eyes to track objects. While there is little evidence to show that brain-dead people can recover with function, Bansal has maintained that there is a significant number of cases of people who have recovered full consciousness from a minimally conscious state. However, other researchers have doubted the project, claiming that situations where brain-dead individuals on life support who return to a fully functional state is hard to interpret and often lack evidence of brain death such as the apnea test, a measure of whether the person’s brain stem is making an effort to breathe. Other concerns raised by scientists and physicians include whether the trial is ethically justified and that the mix of interventions has not been tested in animal models. In a press statement, Bansal defended the proposal, saying there is no good animal models for human brain death.


News Article | November 14, 2016
Site: www.sciencemag.org

BENGALURU, INDIA—The Indian Council of Medical Research (ICMR) has derailed a controversial experiment that would seek to revive brain-dead accident victims. On 11 November, ICMR’s National Institute of Medical Statistics removed the “ReAnima” trial from India’s clinical trial registry. In May, Himanshu Bansal, an orthopedic surgeon at Anupam Hospital in the north Indian state of Uttarakhand, announced plans to give around 20 brain-dead people a mix of interventions including injections of mesenchymal stem cells and peptides, and transcranial laser stimulation and median nerve stimulation. Transcranial laser stimulation involves shining pulses of near-infrared light into the brain; median nerve stimulation is the electrical stimulation of a major nerve that runs from the neck to the arm. Both techniques have been shown to improve cognition in patients with traumatic brain injury. Bioquark, a biotech firm based in Philadelphia, Pennsylvania, had agreed to supply the trial with peptides that are said to help regenerate brain cells. In interviews with Indian media in the spring, Bansal described his aim as bringing brain-dead individuals back to a “minimally conscious state” in which patients show flickers of consciousness, such as moving their eyes to track objects. Although there is scant evidence that brain-dead people can recover such function, Bansal says the medical literature describes a significant number of cases of people who have recovered full consciousness from a minimally conscious state. Other researchers point out that it is improbable that the ReAnima trial—which hasn’t yet begun—would achieve its goals. “While there have been numerous demonstrations in recent years that the human brain and nervous system may not be as fixed and irreparable as is typically assumed, the idea that brain death could be easily reversed seems very far-fetched,” Dean Burnett, a neuroscientist at the United Kingdom’s Cardiff University, told .  Medical journals have on occasion carried reports of brain-dead individuals on life support returning to a fully functional state, but researchers have argued that such cases are hard to interpret and often lack evidence of brain death such as the apnea test, a measure of whether the person’s brain stem is making an effort to breathe. Scientists and physicians are also raising concerns about whether the ReAnima trial is ethically justified. One concern is that the mix of interventions has not been tested in animal models. On their own, the treatments the ReAnima trial would use have shown promise in people with traumatic brain injury, says Amar Jesani, editor of the in Mumbai. “But once brain stem death has taken place, and there is no cognition or consciousness, one cannot rely on a few disconnected studies. Why couldn’t they combine these interventions and do proper animal studies?” And even if the experiment were to succeed, he asserts, bringing a brain-dead person back to a minimally conscious state would traumatize family members. In a press statement, Bansal argued that there are no good animal models for human brain death. Asked in a June interview for what he planned to do if patients were brought back to a minimally conscious state but did not regain further function, Bansal responded that his team “had not planned for it” initially, but that he had since purchased an insurance policy to cover the costs of full-time care of such patients. Still, the ReAnima team has struggled to convince family members to allow brain-dead accident victims to be enrolled in the trial, says Ira Pastor, chief executive officer of Bioquark. ICMR identified several regulatory lapses in the trial, including a failure to seek permission to proceed from the Drug Controller General of India, a requirement for all clinical trials in India. Now that ICMR has deregistered ReAnima, the Drug Controller General of India G. N. Singh must stop the trial immediately, says ICMR Deputy Director General Geeta Jotwani in New Delhi. Bansal told that “ICMR has nothing to do with the trial,” and says the matter rests with the drug controller. Singh’s office did not respond to questions from . Bioquark’s Pastor says that the setback ultimately won’t stop the project, and if necessary the team would pursue the trial outside India. “We are in no major rush, in that it represents a ‘Google Moonshot’–style project,” he says. “Many road blocks, no doubt, will pop up. But the project will go on.”

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