Shinjini Bhatnagar

Translational Health Science and Technology Institute

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Nitya Wadhwa

Translational Health Science and Technology Institute

Ramachandran Thiruvengadam

Translational Health Science and Technology Institute

Pallavi Kshetrapal

Translational Health Science and Technology Institute

Uma Chandra Mouli Natchu

Society for Applied Studies

Bapu Koundinya Desiraju

Translational Health Science and Technology Institute

Rakesh Lodha

All India Institute of Medical Sciences

Pramod Kumar Garg

All India Institute of Medical Sciences

Shailaja Sopory

Translational Health Science and Technology Institute

Anil Kumar Pandey

Post Graduate Institute of Medical Education and Research

Mudita Gosain

Translational Health Science and Technology Institute

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Translational Health Science and Technology Institute

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All India Institute of Medical Sciences Raipur

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All India Institute of Medical Sciences Bhopal

Post Graduate Institute of Medical Education and Research

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Johns Hopkins University

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Association of maternal prenatal copper concentration with gestational duration and preterm birth: a multi-country meta-analysis

medRxiv (Cold Spring Harbor Laboratory) (2022)

Nagendra Monangi Huan Xu Yue‐Mei Fan Rasheda Khanam Waqasuddin Khan

ABSTRACT Background Copper (Cu), an essential trace mineral regulating multiple actions of inflammation and oxidative stress, has been implicated in risk for preterm birth (PTB). We aimed to determine the association of maternal plasma/serum Cu concentrations during pregnancy with PTB risk and gestational duration in a large multi-cohort study including diverse populations. Methods Gestational duration data and maternal plasma or serum samples of 10,449 singleton live births were obtained from 18 geographically diverse study cohorts. Maternal plasma or serum Cu concentrations were determined by inductively coupled plasma mass spectrometry (ICP-MS) analysis. The associations of maternal Cu with PTB and gestational duration were analyzed using logistic and linear regressions for each cohort. The estimates were then combined using meta-analysis. Associations between maternal Cu and acute phase reactants (APRs), malaria, and HIV infection were analyzed in 1239 samples from the Malawi cohort. Findings The maternal prenatal Cu concentration in our study samples followed a normal distribution with a mean of 1.92 μg/ml and a standard deviation of 0.43 μg/ml, and Cu concentrations increased with gestational age up to 20 weeks. The random effect meta-analysis across the 18 cohorts revealed that 1 μg/ml increase in maternal Cu concentration before the third trimester was associated with a higher risk of PTB with an OR of 1.30 (95% CI: 1.08 to 1.57) and shorter gestational duration of 1.64 days (95% CI: 0.56 to 2.73). The estimated effects were generally consistent across all sites. In the Malawi cohort, higher maternal Cu concentration, concentrations of multiple APRs and infections (malaria and HIV) were correlated and associated with greater risk of PTB and shorter gestational duration. Interpretation Our study supports a robust negative association between maternal mid-gestation Cu concentration and gestational duration and a positive association with risk for preterm birth. Cu concentration was strongly correlated with APRs and infection status suggesting its potential role in inflammation, a pathway implicated in the mechanisms of PTB. Therefore, maternal Cu could be used as a potential marker of the integrated inflammatory pathways during pregnancy and risk for preterm birth.

10.1101/2022.08.27.22278198

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Acute Abdomen

Jaypee Brothers Medical Publishers (P) Ltd. eBooks (2011)

Shinjini Bhatnagar Veereshwar Bhatnagar Vidyut Bhatia

Acute abdomen

10.5005/jp/books/11182_63

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Rotavirus Nonstructural Protein NSP4 Induces Heterotypic Antibody Responses during Natural Infection in Children

The Journal of Infectious Diseases (2003)

Pratima Ray Jyoti Malik Ravi K. Singh Shinjini Bhatnagar Rajiv Bahl

Seroconversion of immunoglobulin A (IgA) and immunoglobulin G (IgG) (⩾4-fold rise) to rotavirus nonstructural protein 4 (NSP4) was determined, by use of enzyme-linked immunosorbent assay with fusion proteins glutathione S-transferase (GST)-NSP4 from strains SA11 (A), 116E (B), and RRV (C), in 40 children with acute rotavirus gastroenteritis and in 30 with the same disease due to other pathogens. The IgG seroconversion rates in the rotavirus group were 67.5%, 70%, and 60% when recombinant (r) NSP4A, -B, and -C, respectively, were used as antigen in the assay, and, for rotavirus-uninfected children, rates were 10%, 13%, and 7%. IgA seroconversion occurred in 57%, 70%, and 50%, respectively, of children with rotavirus gastroenteritis; in rotavirus-uninfected children, 1 child each seroconverted to the different rNSP4s. Among 9 children infected with strain NSP4A, 7, 6, and 5 children showed IgG seroconversion, and, among 18 infected with NSP4A, -B, and -C, 16, 17, and 15, respectively, showed IgG seroconversion. Between NSP4A-infected and NSP4B-infected children, IgA responses were similar to IgG responses. In conclusion, significant NSP4-specific antibody response occurs in natural rotavirus infection, and the antibody response appears to be broad and heterotypic in nature

Seroconversion

Immunoglobulin A

10.1086/375243

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Citations (43)

Severe Acute Malnutrition with Complications

Journal of the Epidemiology Foundation of India (2024)

Shally Awasthi Sushil K. Kabra Neelam Mohan Pushpa Kini Suvasini Sharma

Severe Acute Malnutrition

10.56450/jefi.2024.v2i1suppl.006

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Efficacy of Mung Bean (Lentil) and Pop Rice Based Rehydration Solutions in Comparison with the Standard Glucose Electrolyte Solution

Journal of Pediatric Gastroenterology and Nutrition (1987)

M. K. Bhan Ghai Op Vikram Khoshoo A Vasudev Shinjini Bhatnagar

Summary Children with acute diarrhea and moderate dehydration between 3 months and 5 years of age were randomly assigned to receive treatment with standard WHO oral rehydration solution (ORS) (n = 33) and two other solutions in which the 20 g/L glucose was substituted by 50 g/L of pop rice (n = 31) and 60 g/L of mung bean (lentil) powder (n = 29). Satisfactory oral rehydration, as assessed clinically and by changes in PCV and total serum solids (TSS), was achieved in 90.9% with WHO ORS, 96.8% with pop rice, and 96.6% in the mung bean ORS treated group (p > 0.05). The purging rates (ml/kg/h) until recovery were 2.49 ± 1.5 (pop rice); 2.91 ± 2.0 (WHO), and 3.41 ± 1.7 in the mung bean group (p > 0.05). The percentage of patients recovering from diarrhea within the 72 h study period was 58.0 (pop rice), 48.4 (WHO), and 44.8 for mung bean group (p > 0.05). Though differences in stool volumes and duration in the three groups were not statistically different, there was a trend toward improvement in efficacy with the pop rice ORS in several parameters: greater weight gain, higher percentage decline in TSS, higher urine output despite lower ORS intake, and lower purging rates. The intake of semisolids in the 24–72 h study period was also higher in the pop rice group as compared to the other two groups (p < 0.05). The number of breast feeds and intake of artificial milk was however similar in all groups (p > 0.05).

Mung bean

10.1002/j.1536-4801.1987.tb09315.x

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Additional file 2 of Comparison of first trimester dating methods for gestational age estimation and their implication on preterm birth classification in a North Indian cohort

Figshare (2021)

Ramya Vijayram Nikhita Damaraju Ashley Xavier Bapu Koundinya Desiraju Ramachandran Thiruvengadam

Additional file 2. Supplementary information tables.

Second trimester

10.6084/m9.figshare.14524684

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Celiac Disease in India

Journal of Pediatric Gastroenterology and Nutrition (2006)

Shinjini Bhatnagar Alan D. Phillips M. K. Bhan

We have read the article of Bhatnagar et al. (1) with keen interest. The study is relevant in northern India; however, certain points need to be clarified. There is some misinterpretation of Marsh grading (2). In grade I, there is no change in villous architecture; there is only increased intraepithelial lymphocytes (IEL). In grade II, crypts are elongated and in grade III, there is various degree of villous atrophy starting from partial to total (grades IIIa, IIIb and IIIc) (2,3). The authors (1) have separated grade III into mild, moderate and severe mucosal changes. Data should have been interpreted as celiac disease (CD) was diagnosed on the basis of Marsh grade III changes, and depending on the severity of villous atrophy, they were further subclassified as mild, moderate and severe. Accordingly, 86% of their cases had either subtotal (44%) or total (42%) villous atrophy, and the other 14% had partial villous atrophy, and this figure matches perfectly with other studies published from India (subtotal/total villous atrophy in 70%-80% of cases) (4,5). Therefore, it would not be right to state that most Indian children with CD have mild to moderate histological changes (1). The number of CD patients diagnosed is 138 that constitute 53% (138/259) of chronic diarrhea rather than 40% mentioned in the article (1). In this study (1), cases were not from unselected group of children with chronic diarrhea alone as they had also associated abdominal distension and failure to thrive. It has been shown from north India that the prevalence of CD is just 17% in unselected group (5) and 50% in selected group of children with chronic diarrhea (4). The role of antiendomysial antibody (AEA) in the diagnosis of CD has been underplayed in this study (1). According to the authors, approximately 5% of the cases would have been missed if only AEA assay was used for diagnostic purpose. However, they have ignored those 20 of 57 cases with mild mucosal changes where AEA was positive, and 19 of them responded to gluten-free diet (GFD). Had the authors not done AEA, they would have missed the diagnosis in 19 cases. If histology was the sole criteria to decide about GFD trial, then what about the other 37 cases who were not put on GFD? In developing countries, serology plays an important role to distinguish villous atrophy caused by CD from other causes. This fact has been highlighted and emphasized from India (5,6). The above facts raised by us have direct implication on diagnosis of CD in developing countries. Shinjini Bhatnagar, PhD Alan D. Phillips, PhD Maharaj K. Bhan, MD Pediatric Gastroenterologist and Scientist Centre for Diarrhoeal Diseases Research and Nutrition, Department of Pediatrics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India

Villous atrophy

Abdominal distension

10.1097/01.mpg.0000229547.31585.b1

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Citations (11)

Probiotics in Pediatrics

The Indian Journal of Pediatrics (2015)

Meenakshi Bothra Shinjini Bhatnagar

10.1007/s12098-015-1719-1

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Quantitative Evaluation of Rotaviral Antigenemia in Children with Acute Rotaviral Diarrhea

The Journal of Infectious Diseases (2006)

Pratima Ray Martijn Fenaux Sumit Sharma Jyoti Malik Swati Subodh

Rotaviral antigen and RNA have recently been identified in the serum of patients with rotaviral gastroenteritis, but the roles they play in disease remains undetermined.Rotaviral antigen and RNA were quantified by enzyme-linked immunosorbant assay and by quantitative reverse-transcription polymerase chain reaction in stool and serum specimens from children with rotaviral diarrhea (n=102), children with nonrotaviral diarrhea (n=40), and nondiarrheal control children (n=30).Rotaviral antigenemia was detected in 64%, 3%, and 0% of the children with rotaviral diarrhea, the children with nonrotaviral diarrhea, and the nondiarrheal control children, respectively. The level of rotaviral antigen in serum was approximately 2x10(2) -fold lower than that in stool, and a moderate correlation was observed between the 2 levels. Rotaviral RNA was detected in 93% of the antigen-positive serum specimens. The median number of RNA copies in serum was approximately 1 x 10(5) -fold lower than that in stool, and no correlation was observed between the 2 levels. Serum levels of both antigen and RNA were inversely associated with baseline titers of rotaviral serum immunoglobulin G (P<.01). Antigenemia was also associated with G1 serotype.Rotaviral antigenemia and viremia were common in children with rotaviral diarrhea, but antigen and RNA levels in serum were substantially lower than those in stool. Antigenemia was associated with infection with G1 strains and with low baseline titers of rotaviral serum antibody.

Viremia

10.1086/505878

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Development and external validation of Indian population-specific Garbhini-GA2 model for estimating gestational age in second and third trimesters

The Lancet Regional Health - Southeast Asia (2024)

Veerendra P. Gadekar Nikhita Damaraju Ashley Xavier Shambo Basu Thakur Ramya Vijayram

A large proportion of pregnant women in lower and middle-income countries (LMIC) seek their first antenatal care after 14 weeks of gestation. While the last menstrual period (LMP) is still the most prevalent method of determining gestational age (GA), ultrasound-based foetal biometry is considered more accurate in the second and third trimesters. In LMIC settings, the Hadlock formula, originally developed using data from a small Caucasian population, is widely used for estimating GA and foetal weight worldwide as the pre-programmed formula in ultrasound machines. This approach can lead to inaccuracies when estimating GA in a diverse population. Therefore, this study aimed to develop a population-specific model for estimating GA in the late trimesters that was as accurate as the GA estimation in the first trimester, using data from GARBH-Ini, a pregnancy cohort in a North Indian district hospital, and subsequently validate the model in an independent cohort in South India.

Third trimester

10.1016/j.lansea.2024.100362

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