7 results on '"Chellani, Harish"'
Search Results
2. Effect of weekly vitamin D supplements on mortality, morbidity, and growth of low birthweight term infants in India up to age 6 months: randomised controlled trial
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Kumar, Geeta Trilok, Sachdev, Harshpal Singh, Chellani, Harish, Rehman, Andrea M, Singh, Vini, Arora, Harsh, and Filteau, Suzanne
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- 2011
3. Growth Faltering Among Discharged Babies from Inpatient Newborn Care Facilities: Learnings from Two Districts of Himachal Pradesh.
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Joseph, Jessy, Jalal, Ruchita, Nagrath, Monal, Dasgupta, Rajib, Chellani, Harish, Pandey, R. M., Sood, Mangla, Goyal, Rajat, and Ramji, Siddarth
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NEWBORN infants ,PREMATURE infants ,INFANTS ,INPATIENT care ,INFANT care - Abstract
Objective: To determine the burden of early growth faltering and understand the care practices for small and sick babies discharged from newborn units in the district. Study design: Observational and follow-up study. Participants: 512 babies discharged from two Special Newborn Care Units (SNCUs) and four Newborn Stabilization Units (NBSUs) in two districts of Himachal Pradesh. Methods: Anthropometric assessments, interview of mothers and Accredited Social Health Activists (ASHAs) conducted between August, 2018 and March, 2019. Change in weight-for-age z-score (ΔWAZ) of <−0.67SD between birth and assessment was used to define growth faltering. Outcomes: Proportion of growth faltering (or catch-down growth) in small and sick babies discharged from SNCUs and NBSUs, and infant care practices. Results: Growth faltering was observed in a significant proportion of both term (30%) and preterm (52.6%) babies between 1 to 4 months of age. Among babies with growth faltering (n=180), 73.9% received a home visit by ASHA, and only 36.7% received a follow-up visit at a facility. There were 71.3% mothers counselled at discharge (mostly informed about breast feeding). Most (96.7%) mothers did not perceive inadequate weight gain in their babies post-discharge. During home visits, ASHAs weighed 61.6% of the infants with growth faltering. Amongst infants who had growth faltering, only 49.6% of mothers had been provided information about their infant's growth and 57.1% mothers had received breastfeeding counselling. Conclusion: Small and sick newborn infants (both term and preterm babies) discharged from special care newborn units are at increased risk of early growth faltering. Follow-up care provided to these infants is inadequate. There is a need to strengthen both facility-based and home-based follow up of small and sick newborn infants discharged from newborn care facilities. [ABSTRACT FROM AUTHOR]
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- 2022
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4. Lessons from implementation research on community management of Possible Serious Bacterial Infection (PSBI) in young infants (0-59 days), when the referral is not feasible in Palwal district of Haryana, India.
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Mukhopadhyay, Rupak, Arora, Narendra Kumar, Sharma, Pradeep Kumar, Dalpath, Suresh, Limbu, Priya, Kataria, Geetanjali, Singh, Rakesh Kumar, Poluru, Ramesh, Malik, Yogesh, Khera, Ajay, Prabhakar, P. K., Kumar, Saket, Gupta, Rakesh, Chellani, Harish, Aggarwal, Kailash Chander, Gupta, Ratan, Arya, Sugandha, Aboubaker, Samira, Bahl, Rajiv, and Nisar, Yasir Bin
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BACTERIAL diseases ,NEONATAL sepsis ,SCIENTIFIC community ,MEDICAL personnel ,RESEARCH implementation ,INFANTS ,PREMATURE infants - Abstract
Background: Neonatal sepsis is a major cause of death in India, which needs hospital management but many families cannot access hospitals. The World Health Organization and the Government of India developed a guideline to manage possible serious bacterial infection (PSBI) when a referral is not feasible. We implemented this guideline to achieve high coverage of treatment of PSBI with low mortality. Methodology: The implementation research study was conducted in over 50 villages of Palwal district, Haryana during August 2017-March 2019 and covered a population of 199143. Policy dialogue with central, state and district health authorities was held before initiation of the study. A baseline assessment of the barriers in the implementation of the PSBI intervention was conducted. The intervention was implemented in the program setting. The research team collected data throughout and also co-participated in the implementation of the intervention for the first six months to identify bottlenecks in the health system and at the community level. RE-AIM framework was utilized to document implementation strategies of PSBI management guideline. Implementation strategies by the district technical support unit (TSU) included: (i) empower mothers and families through social mobilization to improve care-seeking of sick young infants 0–59 days of age, (ii) build capacity through training and build confidence through technical support of health staff at primary health centers (PHC), community health centers (CHC) and sub-centers to manage young infants with PSBI signs and (iii) improve performance of accredited social health activists (ASHAs). Findings: A total of 370 young infants with signs of PSBI were identified and managed in 5270 live births. Treatment coverage was 70% assuming that 10% of live births would have PSBI within the first two months of life. Mothers identified 87.6% (324/370) of PSBI cases. PHCs and CHCs became functional and managed 150 (40%) sick young infants with PSBI. Twenty four young infants (7-59days) who had only fast breathing were treated with oral amoxicillin without a referral. Referral to a hospital was refused by 126 (84%); 119 had clinical severe infection (CSI), one 0–6 days old had fast breathing and six had critical illness (CI). Of 119 CSI cases managed on outpatient injection gentamicin and oral amoxicillin, 116 (96.7%) recovered, 55 (45.8%) received all seven gentamicin injections and only one died. All 7–59 day old infants with fast breathing recovered, 23 on outpatient oral amoxicillin treatment; and 19 (79%) received all doses. Of 65 infants managed at either district or tertiary hospital, two (3.1%) died, rest recovered. Private providers managed 155 (41.9%) PSBI cases, all except one recovered, but sub-classification and treatment were unknown. Sub-centers could not be activated to manage PSBI. Conclusion: The study demonstrated resolution of implementation bottlenecks with existing resources, activated PHCs and CHCs to manage CSI and fast breathers (7–59 day old) on an outpatient basis with low mortality when a referral was not feasible. TSU was instrumental in these achievements. We established the effectiveness of oral amoxicillin alone in 7–59 days old fast breathers and recommend a review of the current national policy. [ABSTRACT FROM AUTHOR]
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- 2021
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5. Differences in multiple immune parameters between Indian and U.S. infants.
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Rathore, Deepak K., Holmes, Tyson H., Nadeau, Kari C., Mittal, Pratima, Batra, Achla, Rosenberg-Hasson, Yael, Sopory, Shailaja, Gupta, Rohit, Chellani, Harish K., Aggarwal, Kailash C., Bal, Vineeta, Natchu, Uma Chandra Mouli, Bhatnagar, Shinjini, Tavassoli, Morvarid, Lyell, Deirdre J., Rath, Satyajit, Wadhwa, Nitya, and Maecker, Holden T.
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PHENOTYPES ,IMMUNOGENETICS ,INFANTS ,ETHNIC differences ,CORD blood ,FLOW cytometry - Abstract
To compare immune phenotypes across two geographic and ethnic communities, we examined umbilical cord blood by flow cytometry and Luminex in parallel cohorts of 53 newborns from New Delhi, India, and 46 newborns from Stanford, California. We found that frequencies of a B cell subset suggested to be B-1-like, and serum IgM concentration were both significantly higher in the Stanford cohort, independent of differences in maternal age. While serum IgA levels were also significantly higher in the Stanford cohort, IgG1, IgG2, and IgG4 were significantly higher in the New Delhi samples. We found that neutrophils, plasmacytoid dendritic cells, CD8+ T cells, and total T cells were higher in the U.S. cohort, while dendritic cells, patrolling monocytes (CD14dimCD16+), natural killer cells, CD4+ T cells, and naïve B cells were higher in the India cohort. Within the India cohort, we also identified cell types whose frequency was positively or negatively predictive of occurrence of infection(s) in the first six months of life. Monocytes, total T cells, and memory CD4+ T cells were most prominent in having an inverse relationship with infection. We suggest that these data provide impetus for follow-up studies linking phenotypic differences to environmental versus genetic factors, and to infection outcomes. [ABSTRACT FROM AUTHOR]
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- 2018
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6. Zinc as an adjunct treatment for reducing case fatality due to clinical severe infection in young infants: study protocol for a randomized controlled trial.
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Wadhwa, Nitya, Basnet, Sudha, Uma Chandra Mouli Natchu, Shrestha, Laxman P., Bhatnagar, Shinjini, Sommerfelt, Halvor, Strand, Tor A., Ramji, Siddarth, Aggarwal, K. C., Chellani, Harish, Govil, Anuradha, Jajoo, Mamta, Mathur, N. B., Bhatt, Meenakshi, Mohta, Anup, Ansari, Imran, Basnet, Srijana, Chapagain, Ram H., Shah, Ganesh P., and Shrestha, Binod M.
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THERAPEUTIC use of zinc ,SEPSIS ,INFANT mortality ,INFECTION ,ANTIBIOTICS ,PREVENTION - Abstract
Background: An estimated 2.7 of the 5.9 million deaths in children under 5 years of age occur in the neonatal period. Severe infections contribute to almost a quarter of these deaths. Mortality due to severe infections in developing country settings is substantial despite antibiotic therapy. Effective interventions that can be added to standard therapy for severe infections are required to reduce case fatality. Methods/Design: This is a double-blind randomized placebo-controlled parallel group superiority trial to investigate the effect of zinc administered orally as an adjunct to standard therapy to infants aged 3 days up to 2 months (59 days) hospitalized with clinical severe infection, that will be undertaken in seven hospitals in Delhi, India and Kathmandu, Nepal. In a 1:1 ratio, we will randomly assign young infants to receive 10 mg of elemental zinc or placebo orally in addition to the standard therapy for a total of 14 days. The primary outcomes hospital case fatality, which is death due to any cause and at any time after enrolment while hospitalized for the illness episode, and extended case fatality, which encompasses the period until 12 weeks after enrolment. Discussion: A previous study showed a beneficial effect of zinc in reducing the risk of treatment failure, as well as a non-significant effect on case fatality. This study was not powered to detect an effect on case fatality, which this current study is. If the results are consistent with this earlier trial, we would have provided strong evidence for recommending zinc as an adjunct to standard therapy for clinical severe infection in young infants. Trial registration: Universal Trial Number: U1111-1187-6479, Clinical Trials Registry - India: CTRI/2017/02/007966: Registered on February 27, 2017. [ABSTRACT FROM AUTHOR]
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- 2017
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7. Growth faltering in early infancy: highlights from a two-day scientific consultation.
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Aneja, Satinder, Kumar, Praveen, Choudhary, Tarun Shankar, Srivastava, Akanksha, Chowdhury, Ranadip, Taneja, Sunita, Bhandari, Nita, Daniel, Abner, Menon, Purnima, Chellani, Harish, Bahl, Rajiv, and Bhan, Maharaj Kishan
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INFANTS ,KNOWLEDGE gap theory ,BIOTECHNOLOGY industries ,GROWTH ,MEDICAL schools - Abstract
Background: 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. [ABSTRACT FROM AUTHOR]
- Published
- 2020
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