Browsing by Author "Awasthi, Shally"
Now showing 1 - 20 of 36
Results Per Page
Sort Options
Item Anemia and undernutrition among preschool children in Uttar Pradesh, India.(2003-10-29) Awasthi, Shally; Das, Rohini; Verma, Tuhina; Vir, SheilaThis study was conducted to assess the prevalence of anemia among preschool children (3-5 years) and its association with malnutrition in rural Barabanki district of Uttar Pradesh, India. Three out of 18 sub-centers in Nindura block, Barabanki, each with six villages, were randomly selected for this survey and 654 boys and 546 girls were included. Mean hemoglobin level in g/dL among boys and girls was 10.1 (SD: 1.66) and 9.9 (SD: 1.67) (P <0.06) respectively. The proportion of anemic children (Hb <11 g/dL) was 70%. Boys were heavier and taller as compared to girls. Among the 67.3% underweight children the mean hemoglobin level was 9.85 (SD: 1.67) as compared to 10.39 (SD: 1.62) in those without malnutrition (P <0.0001). Likewise, stunted children (87.6%) had statistically significantly lower mean hemoglobin levels than those not stunted. The odds ratio of an underweight and stunted child having moderate to severe anemia was 1.66. While more than half caretakers knew about the term "anemia " and associated physical weakness with it, only very few (2.5%) knew that iron intake will improve it. They relied on "doctors" (86.7%) for anemia prevention.Item Assessment of Asthma Knowledge of Parents of Children with Bronchial Asthma(Wolters Kluwer – Medknow, 2024-01) Verma, Shalini; Awasthi, Shally; Gupta, SarikaIntroduction: Understanding bronchial asthma plays a crucial role in the management and control of this chronic disease. While good asthma knowledge of the parents helps in better control of the disease in their children, it remains variable among the parents. Materials and Methods: This cross?sectional observational study was conducted in the outpatient asthma clinic of a tertiary center. New Castle Asthma Knowledge Questionnaire (NAKQ) were filled out by the caregivers of children (between 7 and 15 years, diagnosed as per global initiative for asthma guidelines) with bronchial asthma, after obtaining the proper consent. The validated Hindi version of the NAKQ questionnaire had a total of 31 questions regarding knowledge, acute asthma attacks, maintenance management, and misconceptions. Results: Eighty?five parents responded to the NAKQ questionnaire during this 1?year duration. 58 (68.24%) were fathers, and 27 (31.76%) were mothers, filling out the questionnaires. The knowledge score of the respondents enrolled in the study ranged from 10 to 18, the median knowledge score was 14, and the mean knowledge score of respondents was 14.02 ± 1.93. Conclusion: The mean knowledge score of the parents of bronchial asthma patients was found to be low in our setting as compared to other studies where a similar questionnaire was used.Item Association of CFTR gene mutation with bronchial asthma.(2012-04) Maurya, Nutan; Awasthi, Shally; Dixit, PratibhaMutation on both the copies of cystic fibrosis transmembrane conductance regulator (CFTR) gene results in cystic fibrosis (CF), which is a recessively transmitted genetic disorder. It is hypothesized that individuals heterozygous for CFTR gene mutation may develop obstructive pulmonary diseases like asthma. There is great heterogeneity in the phenotypic presentation and severity of CF lung disease. This could be due to genetic or environmental factors. Several modifier genes have been identified which may directly or indirectly interact with CFTR pathway and affect the severity of disease. This review article discusses the information related to the association of CFTR gene mutation with asthma. Association between CFTR gene mutation and asthma is still unclear. Report ranges from studies showing positive or protective association to those showing no association. Therefore, studies with sufficiently large sample size and detailed phenotype are required to define the potential contribution of CFTR in the pathogenesis of asthma.Item Association of Specific Dietary Fatty Acids with Asthma in Urban School Children and Adolescents: Inferences from a Cross-Sectional Multicentric Study From India(Indian Academy of Pediatrics, 2025-01) Awasthi, Shally; Kumar, Divas; Pandey, Anuj Kumar; Agarwal, Girdhar G; Anish, Thekkumkara Surendran; Bharti, Bhavneet; Mahanta, B N; Singh, CM; Khera, Daisy; Shekhawat, Dolat Singh; Mathew, Joseph L; Singh, Kuldeep; Bhat, Mushtaq A; A R, Somashekar; Kar, Sonali; Nair, SumaOBJECTIVE To assess the association of dietary fa?y acids with asthma in Indian school children. METHODS Children aged 6-16 years were enrolled from randomly selected urban schools in 10 ci?es. The Interna?onal Study on Asthma and Allergies in Childhood Phase III Ques?onnaire was used to assess the prevalence of asthma. Three-day dietary intake data was obtained using 24-hr dietary recall method. Intake of saturated fa?y acids (SFA), monounsaturated fa?y acids (MUFA), polyunsaturated fa?y acids (PUFA) and trans fa?y acids (TFA) was calculated using DIETSOFT so?ware. RESULTS Between April 2019 and February 2020, 2428 par?cipants were recruited (49.8% males) from 60 schools. The prevalence of asthma was 2.4% (95 % CI 1.8, 3.1). The mean (SD) intake of various FA (g per kg) were 0.19 (0.22) for SFA,18 (0.22) for MUFA, 0.17 (0.18) for PUFA and 0.003 (0.005) for TFA. SFA intake in those with asthma was 0.35 (0.34) as compared to 0.18 (0.21) without asthma (P value < 0.001). On uncondi?onal logis?c regression, dietary intake of TFA was associated with asthma in children [OR 2.16 (95% CI 1.27, 3.68)]. CONCLUSION Dietary intake of SFA and TFA is associated with asthma in children.Item Association of TLR4 and TNF-a Gene Polymorphisms and TLR4 mRNA Levels in Preterm Birth in a Northern Indian Population(Indian Academy of Pediatrics, 2019-03) Awasthi, Shally; Pandey, MonikaObjective: To assess the association of TLR4 (rs4986790 and rs4986791) and TNF-α(rs1800629) genes polymorphisms and TLR4mRNA levels with preterm birth. Methods:Hospital-based case-control study on women of Caucasoid morphological subtype ethnicityin Northern India. Inclusion criteria for cases: women aged between 18-40 years with pretermbirth (<37 weeks gestation), and for controls: women who delivered a term neonateconsecutive to an enrolled case. Three polymorphisms TLR4 (Asp299 Gly, Thr399 Ill) andTNF-á (-308G/A) and TLR4 mRNA levels were compared between cases and controls.Results: From 2012-2015, 559 cases and 559 controls were recruited. TLR4 mRNA levelswere found to be higher (P<0.001) in cases [(0.7 (0.04)] than in controls [(0.5 (0.04)]. Noassociation was found between TLR4 Asp299 Gly, TLR4 Thr399 Ill and TNF-α (-308G/A)with preterm birth. Conclusion: Increased TLR4 mRNA levels seem to be associated withpreterm birth, and can be investigated further as a potential biomarker for identifying womenat riskItem Blood zinc levels in children hospitalized with severe pneumonia: a case control study.(2004-05-08) Kumar, Saket; Awasthi, Shally; Jain, Amita; Srivastava, R CA case control study was conducted in a referral and teaching hospital in North India on children aged 2 months to 5 years, to compare blood zinc levels in 50 cases of severe pneumonia and 50 age,sex and nutritional status matched controls. Mean blood Zinc levels in cases and controls was 376.1 ug/dL + 225.73 and 538.52 microg/dL +/- 228.0 respectively ( P value 0.0003). In logistic regression model severe pneumonia was associated with lower blood zinc level, use of biomass fuel and isolation of H. Influenzae from nasopharyngeal swab. Cotrimoxazole resistant S. pneumoniae were isolated from 95% of cases and 41.2 % of controls (P = 0. 0004). Therefore, the role of zinc in treatment of severe pneumonia should be investigated.Item Can Impulse Oscillometry be Used to Monitor Asthmatic Children?(Indian Academy of Pediatrics, 2020-02) Awasthi, ShallyItem Childhood Pneumonia: What’s Unchanged, and What’s New?(Dr. K C Chaudhuri Foundation, 2023-07) Yadav, Krishna Kumar; Awasthi, ShallyChildhood pneumonia is still a significant clinical and public health problem. India contributes the highest number of deaths due to pneumonia, accounts for about 20% of global mortality among under five children. Various etiologic agents including bacteria, viruses and atypical organism are responsible for childhood pneumonia. Recent studies suggest that viruses are one of the major causes of childhood pneumonia. Among viruses, respiratory syncytial virus has got great attention and several recent studies are reporting it as an important organism for pneumonia. Lack of exclusive breast feeding during first six months, improper timing of start and content of complimentary feeding, anemia, undernutrition, indoor pollution due to tobacco smoking and use of coal and wood for cooking food and lack of vaccinations are important risk factors. X-ray chest is not routinely performed to diagnose pneumonia while use of lung ultrasound is increasing to detect consolidation, pleural effusion, pneumothorax and pulmonary edema (interstitial syndrome). Role of C-reactive protein (CRP) and procalcitonin is similar, to differentiate between viral and bacterial pneumonia, however duration of antibiotics is better guided by procalcitonin. Newer biomarkers like IL-6, presepsin and triggering receptor expressed on myeloid cells 1 are needed to be evaluated for their use in children. Hypoxia is significantly associated with childhood pneumonia. Therefore, use of pulse oximetry should be encouraged for early detection and prompt treatment of hypoxia to prevent adverse outcomes. Among the available tools for risk of mortality assessment in children due to pneumonia, PREPARE score is the best but external validation will be needed.Item Client satisfaction with immunization services in urban slums of Lucknow District.(2009-05) Nath, Bhola; Singh, Jai V; Awasthi, Shally; Bhushan, Vidya; Singh, Shivendra K; Kumar, VishwajeetObjective. To assess the satisfaction of parents with the immunization services and its association with their sociodemographic characteristics. Methods. The study was a part of the coverage evaluation survey conducted using the WHO 30 cluster sampling methodology in the Urban slums of Lucknow district, north India. Analysis for a total of 388 respondents of completely or partially immunized children, was done to assess the level of satisfaction and its determinants. Results.The overall satisfaction was more than 90% in the respondents of both the categories of the children, however the difference between the satisfaction rates was found to be significant. Also the satisfaction with accessibility (p<0.04) and information given by the health worker (p<0.00) differed significantly between completely and partially immunized. Most of the sociodemographic factors were not found to have a significant association with the satisfaction related to different parameters of the immunization services. Conclusion. The dissatisfaction regarding the various aspects of immunization services emphasizes the imperative need to intervene, for the achieving the goal of universal immunization.Item Determinants of childhood mortality and morbidity in urban slums in India.(2003-12-15) Awasthi, Shally; Agarwal, SiddharthThe large and continuous increase in India's urban population and the concomitant growth of the population residing in slums has resulted in overstraining of infrastructure and deterioration in public health. The link between urbanization, a degraded environment, inaccessibility to healthcare and a deteriorating quality of life is significant and particularly evident in the sharp inequities in IMR if one looks at urban specific studies. It is hence, germane to address the appalling inequalities in the distribution and access to basic amenities and health services with a focus on enhanced service coverage, improved sanitation and water supplies and mobilization of community action for effectively mitigating the childhood death and disease burden in urban slums.Item Does cytokine gene polymorphism affect steroid responses in idiopathic nephrotic syndrome?(2008-10-15) Tripathi, Gaurav; Jafar, Tabrez; Mandal, Kaushik; Mahdi, Abbas A; Awasthi, Shally; Sharma, Raj K; Kumar, Alok; Gulati, Sanjeev; Agrawal, SurakshaBackground: Immunological responses may be possibly involved in the pathogenesis of idiopathic nephrotic syndrome (INS). Cytokines act as a potent immunomodulator. Pathogenesis of INS is associated with Th1 and Th2 cytokines imbalance. Aims, Settings and Design: We have investigated the association of IL-4, IL-6, and TNF-alpha gene polymorphisms and analyzed the data to evaluate the effect of these polymorphisms on the pathogenesis and clinical course of INS. Materials and Methods: One hundred fifty children with INS were selected. Children were analyzed for IL-4, IL-6, and TNF-alpha gene polymorphisms by using polymerase chain reaction and restriction fragment length polymorphism. Statistical Analysis Used: Chi-square test was used for different comparisons. The synergistic effects of IL-4, IL-6, and TNF-alpha gene polymorphisms were evaluated by using logistic regression analysis. Results and Conclusions: We compared the steroid-resistant (SR) and steroid-responsive (SS) groups. Our results showed strong association of IL-6 -G174C, and IL-4 -C590T at genotypic level (P = 0.0121, OR = 14.71, 95% CI = 1.59-136.46; and P = 0.0386, OR = 7.29, 95% CI = 1.26-41.69). TNF-alpha revealed a strong association at genotypic level (P = 0.0121, OR = 14.71, 95% CI = 1.59-136.46), as well as at allelic level (P = 0.0433, OR = 2.251, 95% CI = 1.09-4.66), demonstrating that it may be considered one of the genetic risk factors affecting the steroid response in INS patients. The GG genotype of IL-6 -G174C, TT genotype of IL-4 -C590T, and AA genotype of TNF-alpha -G308A cytokine gene polymorphisms may be causative factors for nonresponsiveness towards steroid therapy among INS children.Item Effect of Different Doses of Inhaled Corticosteroids on the Isolation of Nasopharyngeal Flora in Children with Asthma(Indian Academy of Pediatrics, 2019-11) Nirmal, Garima; Awasthi, Shally; Gupta, Sarika; Aggarwal, JyotsnaObjectives: To find the effects of inhaled corticosteroids and the impact of different doses ofinhaled corticosteroids on the isolation of nasopharyngeal flora in asthmatic children aged 1-15 years. Methods: The study included 75 children with asthma and 25 age-matchedcontrols. Nasopharyngeal swabs were obtained. Bacteria were identified by standardtechniques. Results: Pathogenic organisms were isolated from 36% of asthmatic childrenand 20% of controls, the difference was not significant statistically (OR=2.25, 95% CI=0.75-6.67, P=0.13). There was no statistically significant association of using a high dose ofinhaled corticosteroids with the isolation of pathogenic organisms. Usage of biomass fuel forcooking in the household of asthmatic children increases the risk of colonization (OR=3.4,95% CI= 1.26-9.10, P=0.03). Conclusion: Inhaled corticosteroids are safe in the treatmentof asthma and there is no association between different doses of Inhaled corticosteroids andisolation of the pathogenic organism.Item Energy and Protein Intake During Pregnancy in Relation to Preterm Birth: A Case Control Study.(2015-06) Awasthi, Shally; Chauhan, M; Pandey, M; Singh, S; Singh, UObjective: To find the association of maternal energy and protein intake with preterm birth. Design: Case-control study. Setting: Two hospitals at Lucknow in Northern India. Participants: Cases (n=350) were defined as mothers (age 18-40 y) of singleton live preterm (<37 wks) neonates. Controls (n=350) were mothers who delivered a singleton neonate, consecutive to enrolled case, after completing 37 weeks of gestation. Results: There was a statistically significant lower mean (SD) energy intake [cases 1624 (249) Kcal vs. controls 1911 (341) Kcal; P<0.001] and protein intake [cases 32.1 (6.1) vs. controls 37.2 (7.0); P<0.001] among women who delivered preterm neonates. Maternal energy and protein intake had significant positive correlation with neonatal weight, length, foot length, head circumference and chest circumference. Conclusion: Lower energy and protein intake during pregnancy is possibly associated with preterm birth.Item Evidence-based research in pediatric nutrition.(2015-09) Awasthi, ShallyItem Gender differences in perception and care-seeking for illness of newborns in rural Uttar Pradesh, India.(2009-02-03) Willis, Jeffrey R; Kumar, Vishwajeet; Mohanty, Saroj; Singh, Pramod; Singh, Vivek; Baqui, Abdullah H; Awasthi, Shally; Singh, J V; Santosham, Mathuram; Darmstadt, Gary LAlthough gender-based health disparities are prevalent in India, very little data are available on care-seeking patterns for newborns. In total, 255 mothers were prospectively interviewed about their perceptions and action surrounding the health of their newborns in rural Uttar Pradesh, India. Perception of illness was significantly lower in incidence (adjusted odds ratio=0.56, 95% confidence interval 0.33-0.94) among households with female versus male newborns. While the overall use of healthcare providers was similar across gender, the average expenditure for healthcare during the neonatal period was nearly four-fold higher in households with males (Rs 243.3 +/- 537.2) compared to females (Rs 65.7 +/- 100.7) (p=0.07). Households with female newborns used cheaper public care providers whereas those with males preferred to use private unqualified providers perceived to deliver more satisfactory care. These results suggest that, during the neonatal period, care-seeking for girls is neglected compared to boys, laying a foundation for programmes and further research to address gender differences in neonatal health in India.Item Health related quality of life among children with cancer in Hyderabad, India.(2010-07) Awasthi, Shally; Agnihotri, KasturiItem IMCI approach in tertiary hospitals, India.(2009-07) Jain, Ritu; Awasthi, Shally; Awasthi, AvivarObjective. This study was conducted to compare physicians’ diagnosis with Integrated Management of Childhood Illness (IMCI) algorithm generated diagnosis in hospitalized children aged 2 – 59 months. Methods. Recruited were patients aged 2-59 months admitted with one or more IMCI danger signs. IMCI and physician's diagnosis were noted and compared. Results. In 222 included subjects, mean duration of illness was 9.4 (SD: 16.5) days. Among those with cough or difficult breathing, 44 (19.8%) and 66 (29.7%) were diagnosed as either severe pneumonia or mild to moderate pneumonia by physicians and IMCI algorithm, respectively (p= 0.015). Among 146 presenting as fever, 140 (95.9%) were diagnosed as very severe febrile disease by the IMCI algorithm, whereas physicians diagnosed these as either malaria in 10/146 (6.7%), pyogenic meningitis in 47/146 (32.2%), sepsis in 31/146 (21.3%), tuberculous meningitis in 17/146 (11.6%), encephalitis in 5/146 (3.4%), measles in 3/146 (2.1%) or others in 24/146 (16.4%). Conclusion. As there was a low concordance between physician and IMCI algorithmic diagnosis of pneumonia (Kappa value= 0.74, 95% CI: (0.64 – 0.84)) and since very severe febrile disease is not a diagnosis made by the physicians, the IMCI algorithms have to be refined for appropriate management of these conditions.Item Increased expression of ADAM33 protein in asthmatic patients as compared to non-asthmatic controls.(2013-03) Tripathi, Priya; Awasthi, Shally; Husain, Nuzhat; Prasad, Rajendra; Mishra, VikasBackground & objectives: ADAM33 is a member of a family of genes that encode membrane-anchored proteins with a disintegrin and a metalloprotease domain, primarily expressed in lung fibroblasts and bronchial smooth muscle cells. ADAM33 has been identified as a risk factor for asthma and is known as a gene associated with airway remodelling. The present study was conducted with the aims to investigate the expression of ADAM33 protein in patients of asthma and non-asthmatic controls, and to assess if the expression of ADAM33 protein relates with severity of asthma. Methods: A total of 35 subjects, including 27 patients with asthma and eight non-asthmatic controls were included using Global Initiative for Asthma guidelines 2005. Bronchial biopsy tissues were collected and paraffin sections were made to store all study samples. Immunohistochemistry was performed using standardized protocol. Results: An increase in expression of ADAM33 protein was observed in the epithelium, smooth muscle and mesenchymal cells of asthma cases when compared to controls but there was no relationship with severity of asthma. Interpretation & conclusions: A higher expression of ADAM 33 protein was seen in asthma patients compared to controls. Large prospective studies need to be done with adequate study design to confirm these preliminary finding.Item Intra-class correlation estimates for assessment of vitamin A intake in children.(2005-03-12) Agarwal, Girdhar G; Awasthi, Shally; Walter, Stephen DIn many community-based surveys, multi-level sampling is inherent in the design. In the design of these studies, especially to calculate the appropriate sample size, investigators need good estimates of intra-class correlation coefficient (ICC), along with the cluster size, to adjust for variation inflation due to clustering at each level. The present study used data on the assessment of clinical vitamin A deficiency and intake of vitamin A-rich food in children in a district in India. For the survey, 16 households were sampled from 200 villages nested within eight randomly-selected blocks of the district. ICCs and components of variances were estimated from a three-level hierarchical random effects analysis of variance model. Estimates of ICCs and variance components were obtained at village and block levels. Between-cluster variation was evident at each level of clustering. In these estimates, ICCs were inversely related to cluster size, but the design effect could be substantial for large clusters. At the block level, most ICC estimates were below 0.07. At the village level, many ICC estimates ranged from 0.014 to 0.45. These estimates may provide useful information for the design of epidemiological studies in which the sampled (or allocated) units range in size from households to large administrative zones.Item Intravenous device associated blood stream staphylococcal infection in paediatric patients.(2011-08) Jain, Amita; Agarwal, Astha; Verma, Raj Kumar; Awasthi, Shally; Singh, K PBackground & objectives: Intravenous device (IVD) associated nosocomial blood stream infections due to staphylococci are major cause of morbidity and mortality. The present study was carried out to assess the frequency of staphylococcal IVD associated infections in a paediatric ward of a tertiary case hospital. Prevalence of resistance to commonly used antimicrobials in hospital acquired staphylococcal isolates was also tested. Methods: Children admitted in paediatric wards with IVD for more than 48 h were enrolled. Blood, IVD tip at the time of removal, skin swab at the site of insertion of IVD and nasal swab were collected and cultured by standard protocol. All staphylococcal isolates from any source were analyzed for antimicrobial susceptibility by disk diffusion method. Genotyping matching of those staphylococcal isolates was done which were isolated from different sites of the same patient, but were phonotypically similar. Genotype of blood isolate was compared with genotype of isolate from nose/IVD/skin. Results: Staphylococcus aureus was the most frequent blood isolate (8.7%) followed by Candida (2.9%), coagulase negative staphylococci (CoNS 2.6%), Pseudomonas spp. (0.4%), Klebsiella spp. (0.3%) and Escherichia coli (0.1%). Isolation of microorganisms from blood was significantly higher in patients whose skin, IVD and nose were colonized by same microorganism (P<0.001). None of the staphylococcal isolate was found to be resistant to glycopeptides (vancomycin and teicoplanin). High penicillin and oxacillin resistance was present in both S. aureus (penicillin resistance; 76.8%, oxacillin resistance; 66.7%) and CoNS (penicillin resistance; 73.3%, oxacillin resistance; 60.0%). Among CoNS biotypes, S. haemolyticus was commonest blood isolate while S. epidermidis was commonest isolate from Skin/nose. Only 33.3 per cent of S. aureus blood stream infections and most of S. epidermidis and S. haemolyticus blood infections were IVD associated. Interpretation & conclusions: Staphylococci were the major causative agent of nosocomial blood stream infections. All episodes of septicaemia due to S. epidermidis and S. haemolyticus were IVD associated while only 1/3 of S. aureus septicaemia was IVD associated.