Browsing by Author "Satyanarayana, L"
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Item 11. Statistical relationships and the concept of multiple regression.(2001-01-15) Indrayan, A; Satyanarayana, LItem 12. Multiple measurements and their simultaneous consideration.(2001-07-21) Indrayan, A; Satyanarayana, LItem Basic philosophy of statistical tests, confidence intervals and sample size determination.(2000-07-25) Indrayan, A; Satyanarayana, LItem Childhood Cancer Incidence in India: A Review of Population-Based Cancer Registries.(2014-03) Satyanarayana, L; Asthana, Smitha; Labani, S PreetiObjectives: To summarize and provide an overview of the childhood cancer incidence reported in 25 population-based cancer registries of India. Methods: Secondary data on age-adjusted rates of cancer incidence for children (0-14 years) were collected from the report of the National Cancer Registry Programme in the year 2013. range of age-adjusted-rates per million children were tabulated for six regions of the country. Results: Age-adjusted cancer incidence rates ranged from 18.6 per million to 159.6 per million for boys and 11.3 to 112.4 for girls. The highest incidence was observed for males (159.6) in Southern region of the country and the lowest in North-east in both boys (18.6) and girls (11.3). Leukemia and lymphoma were the commonest malignancies in boys whereas leukemia and brain tumors were commonest in girls. Conclusion: Childhood cancer indicidence appears to be increasing in India.Item Childhood cancer risk trends in India (1982-2000).(2007-12-08) Satyanarayana, L; Asthana, SmitaItem Clinical predictors of hospitalization in an acute attack of bronchial asthma.(1994-04-01) Sethi, G R; Kapoor, S; Sachdev, H P; Satyanarayana, LThe present study was undertaken to identify the clinical predictors of hospitalization in an acute attack of bronchial asthma in subjects aged 2-12 years. Seventy five children with an acute attack of bronchial asthma were evaluated. A detailed clinical history and examination was recorded and baseline investigations sent before starting therapy. All subjects were treated with injection adrenaline (two doses) and those who did not respond were hospitalized. Twenty subjects who were hospitalized were compared with 32 cases who were discharged and did not have a relapse on follow up. After multivariate analysis, the factors independently predictive of hospitalization were, pulsus paradoxus (> 10 mm Hg; OR = 1.02), younger age (below 5 years, OR = 0.98) and severe accessory muscle use (OR = 89.6). Presence of any 2 of these 3 clinical predictors has a high sensitivity (90%) and specificity (96%). The investigative variables significant after multivariate analysis were low pH (OR = 0.00) and polymorphonuclear leucocytosis (> 70%) on peripheral smear (OR = 1.12). The sensitivity of this model was similar (90%) but specificity was lower (90.6%). The addition of investigative variables to clinical model did not improve the predictability. It is concluded that it is possible to identify at presentation, children with acute bronchial asthma who require hospitalization and clinical variables are sufficient for this purpose.Item A comparative study of cervical cancer screening methods in a rural community setting of North India.(2014-04) Satyanarayana, L; Asthana, S; Bhambani, S; Sodhani, P; Gupta, SCONTEXT: Pap smear testing as a conventional cervical screening approach has limitations for implementation and aided visual cervical testing has varying results in different regions. AIMS: The aim of this study is to demonstrate the performance of aided visual cervical screening tests as against conventional Pap smear testing in a rural community setting of North India. SETTINGS AND DESIGN: This was a rural community based cross‑sectional study. MATERIALS AND METHODS: All 7603 ever married women of age 30‑59 years surveyed in a pocket of Dadri Tehsil, Uttar Pradesh, India were targeted for screening by Pap, visual inspection of cervix using acetic acid (VIA) and visual inspection of cervix using Lugol’s iodine (VILI) methods. Screen positives were referred to colposcopy and confirmation by histology. STATISTICAL ANALYSIS USED: Detection of histological cervical intraepithelial neoplasia (CIN) II + and CIN III + assessed separately by sensitivity, specificity and likelihood ratio’s and predictive values. Analysis of data was performed by using IBM SPSS statstics software version 16.0. RESULTS: A total of 65.6%(4988/7604) eligible women of 30‑59 years age group in the target population were screened. Out of 4988, further analysis was performed on 4148 after excluding those who did not complete all screenings, who lost to follow‑up and had missing histology results. Screen positivity rates by Pap (ASCUS and above), VIA and VILI were 2.6%, 9.7% and 13.5% respectively. Sensitivity and specificity of detecting the CIN III+ lesions were 87.5 and 98.8% for Pap, 50.0% and 96.7% for VIA and 50.0% and 95.7% for VILI respectively. CONCLUSIONS: VIA screening demonstrated as a feasible primary screening test for detecting high grade CIN and as to perform better when the Pap test is not feasible.Item A comprehensive index for longitudinal monitoring of child health status.(1995-04-01) Satyanarayana, L; Indrayan, A; Sachdev, H P; Gupta, S MThe aim of this study was to develop a single comprehensive index of child mortality for longitudinal assessment of health status of children. The need for such a comprehensive index arose from conflicting trends in different child mortality indicators. The data for the study was taken from the Sample Registration System (SRS) reports of the Registrar General of India. SRS is known to provide reliable estimates of births and deaths at the State and the National level. The study included five child mortality indicators, namely, under five mortality rate (U5MR), infant mortality rate, neonatal mortality rate, perinatal mortality rate and still birth rate. These were available for fifteen states of India over the years 1972-1988. To develop this index we modified an earlier method based on factor analysis. Factor analysis of data on various indicators of child mortality revealed two factors which together explained 78% to 93% of the total variation in different years. The first factor was identified as representing mortality after birth and the second as before and during birth. The comprehensive index was obtained as a linear combination of these two factors. The resultant index thus fairly represented all five mortality indicators and provided a comprehensive and reasonably correct picture of child mortality. The lower the magnitude of this index, the better was the child health status. Trends in the index showed that the highest decline in the magnitude was in the state of Kerala followed by Punjab, Andhra Pradesh, Gujarat and Maharashtra in that order. This indicates steady improvement of the child health status over years in these states. In the State of Jammu and Kashmir, the index remained more or less constant over the years though the magnitude was low in the cross-sectional comparison with other states. Thus the comprehensive index developed by using factor analysis of the various mortality indicators can be used for the longitudinal monitoring of child health status in the states of India.Item Designs of medical studies.(1999-07-31) Indrayan, A; Satyanarayana, LItem Evaluation of risk factors for fatal neonatal sepsis.(1996-10-01) Mathur, N B; Singh, A; Sharma, V K; Satyanarayana, LOBJECTIVE: To evaluate risk factors for fatal neonatal sepsis. DESIGN: Prospective study. SETTING: Referral neonatal unit of a teaching hospital. SUBJECTS: 171 neonates admitted with sepsis. METHODS: Clinical examination and investigations on the day of admission were recorded and the neonates followed up to determine the final outcome. RESULTS: The overall fatality was 48.5%. In the univariate analysis, the factors significantly associated with death were weight, gestational age, age at onset of sepsis, hypothermia, requirement of IPPV, presence of refractory septic shock, neutropenia, metabolic acidosis and raised prothrombin time. However, in the multivariate analysis, only neutropenia, metabolic acidosis, increased prothrombin time and refractory septic shock retained their significance. The adjusted odd's ratio (95% confidence interval) were 0.095 (0.04 = 0.22), 1.14 (1.04-1.25), 1.04 (1.002-1.08) and 11.82 (5.47-69.40), respectively. CONCLUSION: Even in a setting with high fatality rates, high risk of mortality in neonatal sepsis can be identified and targeted for intensive intervention.Item Graphical methods to summarize data.(2000-01-04) Indrayan, A; Satyanarayana, LItem Growth and sexual maturation of low birth weight children: a 14 year follow up.(1995-09-01) Bhargava, S K; Ramji, S; Srivastava, U; Sachdev, H P; Kapani, V; Datta, V; Satyanarayana, LOBJECTIVE: To evaluate the physical growth and sexual maturation of children born with low birth weight (< 2000 g). (LBW). DESIGN: Longitudinal follow up. SETTING: Hospital born urban cohort. METHODS: Weight, height, head circumference and pubertal changes were recorded till 14 years at specified intervals in 252 LBW and 176 control (term neonates with birth weights > or = 2500 g) children. Effect of prematurity and fetal growth retardation (SFD) was studied in 79 preterm appropriate for gestation and 45 term SFD children. RESULTS: LBW boys significantly lagged behind their controls for all physical growth parameters till 14 years, while the LBW girls had a physical growth comparable to controls after 11 years. Preterms had comparable weight, height and head circumference with their controls after 11 years. The SFDs, however, remained significantly handicapped in their overall physical growth even at 14 years. In comparison to controls, menarche occured 6 months earlier in preterms and 12 months earlier in SFD girls. However, there was no change in the sequence of pubertal changes in either preterms or SFDs. CONCLUSIONS: Fetal growth retardation has a lasting adverse effect on later physical growth, while most preterms catch up with their peers by adolescence.Item Hemoglobin estimation method.(2003-08-03) Satyanarayana, LItem Life time risk for development of ten major cancers in India and its trends over the years 1982 to 2000.(2008-02-06) Satyanarayana, L; Asthana, SmitaBackground : Understanding cancer magnitude, risk and trends will be of help in cancer control programs. Aim : To study trends in cumulative risk up to 64 years of age as lifetime risk of developing major cancers in India during the years 1982 to 2000. Design : Retrospective. Setting : Secondary sources of cancer-registration data. Materials and Methods : Data on age-specific cancer-incidence rates were collected for patients 0-64 years of age of either sex for 10 major cancer sites from the National Cancer Registry Program (NCRP) reports of India from Mumbai, Chennai, Bangalore, Bhopal and Delhi; and Barshi registries for the years 1982 or 1988 to 2000. Statistical Analysis : Cumulative risks computed for lifetime development of cancer. Linear trends were studied using simple linear regressions. Results : The lifetime risk among females for the10 cancer sites ranged from 0.02 to 3.3% and from 0.04 to 2.4% for the years 1982 and 2000 respectively; whereas among males, it ranged from 0.04 to 0.89% and from 0.05 to 0.95% respectively. Significant (P P P P Conclusion : Significant and higher rates of positive trends in lifetime cancer risks for breast cancer among females and for NHL among both sexes were observed.Item Measures of mortality and morbidity in children.(2000-05-23) Indrayan, A; Satyanarayana, LItem Medical Biostatistics(Indian Association of Preventive and Social Medicine, 2018-09) Asthana, S; Satyanarayana, LItem Methods of sampling and data collection.(1999-09-01) Indrayan, A; Satyanarayana, LItem Neonatal thigh circumference as an alternative indicator of low birth weight.(1986-06-01) Ramji, S; Marwah, J; Satyanarayana, L; Kapani, V; Mohan, M; Bhargava, S KItem Numerical methods to summarize data.(1999-11-04) Indrayan, A; Satyanarayana, LItem Predictors of mortality in subjects hospitalized with acute lower respiratory tract infections.(1997-03-01) Sehgal, V; Sethi, G R; Sachdev, H P; Satyanarayana, LOBJECTIVE: To identify the predictors of mortality due to acute lower respiratory tract infection (ALRI). DESIGN: Prospective cohort study. SETTING: Urban tertiary care teaching hospital. METHODS: 201 cases with ALRI between 2 weeks to 5 years of age were prospectively enrolled and followed up to determine outcome. Detailed history and clinical evaluation were recorded on a pretested proforma. Significant independent predictors of mortality were determined by comparison of dead subjects (n = 21) with surviving children (n = 180) in a multiple logistic analytic framework. RESULTS: The case fatality rate (CFR) was 10.45%. Significant independent predictors of mortality were (OR, 95% CI) age less than 1 year (23.1, 2.7-197.5), inability to feed (6.2, 1.3-30.7), associated loose stools (5.1,1.2-27.3), weight for age Z score < -3 (3.9,1.01-9.7), short duration of fever (1.2,1.0-1.5) and bandemia (1.1,1.05-1.2). The WHO guidelines identified 91% of children diagnosed as ALRI by clinical and investigative criteria. The CFR was related to severity of WHO classification ("pneumonia"-0%, "severe pneumonia"-8.7% and "very severe pneumonia"-47.0%). However, 2 of the 18 subjects with a diagnosis of "no pneumonia" expired (CFR 11.1% and 10% of total mortality). CONCLUSION: Even in settings of high case fatality, predictors of mortality can be identified in under five children suffering from ALRI. In this context, age below 1 year, inability to feed, presence of loose stools and severe malnutrition merit attention for interventional purposes.