Dr. Arnab Nandy
@aiims.edu
PhD student, Department of Pediatrics
All India Institute of Medical Sciences, New Delhi
MBBS, MD (Pediatrics)
Scopus Publications
Scopus Publications
Rashmi Yadav, Sushil Kumar Kabra, Raj Kumar Yadav, Arnab Nandy, Ashish Datt Upadhyay, Kana Ram Jat, and Rakesh Lodha
Informa UK Limited
OBJECTIVES
To explore the efficacy of combination of bhramari pranayama and om chanting as an adjunct to standard pharmacological treatment on asthma control, quality of life, pulmonary function and airway inflammation in asthmatic children.
METHODS
Children (n = 110; 8-15 years) with uncontrolled or partly controlled asthma were recruited from the Pediatric Chest Clinic of All India Institute of Medical Sciences, New Delhi. Eligible participants were randomized to either home-based online bhramari pranayama and om chanting plus standard treatment (YI + ST) group, or standard treatment (ST) alone group. Primary outcome measures were 12 week change in level of asthma symptom control; asthma control questionnaire (ACQ) score, spirometry indices, impulse oscillometry parameters and pediatric asthma quality of life questionnaire (PAQLQ) score. Secondary outcome was change in fractional exhaled nitric oxide (FeNO) levels at 12 weeks. Beginning from the enrolment, every participant was evaluated at 0, 2, 6 and 12 weeks. Results: After 12 weeks of intervention, higher proportion (68.2%) of children were found to have controlled asthma symptoms in the YI + ST group as compared to ST group (38.5%) according to per protocol analysis (p = 0.03). When compared to ST group, children in YI + ST group showed significantly lower ACQ score, higher PAQLQ score and reduced FeNO levels. No significant changes were observed for the lung function parameters.
CONCLUSION
Children practicing bhramari pranayama and om chanting for 12 weeks have better asthma symptom control, quality of life and reduced airway inflammation than those taking standard pharmacotherapy alone.
Madhumita Nandi, Md Abu Sayeed Mullick, Arnab Nandy, Moumita Samanta, Sumantra Sarkar, and Tapas Kumar Sabui
Oxford University Press (OUP)
ABSTRACT Objective To observe the association between serum vitamin D level and disease activity in juvenile idiopathic arthritis (JIA). Methods The observational study was conducted at a tertiary care hospital during 2017-2019. Patients suffered from JIA were recruited through purposive sampling which was stratified by the disease activity based on the Juvenile Arthritis Disease Activity Score 27 (JADAS27) criteria. Serum vitamin D was estimated alongside other laboratory parameters. The numerical and categorical variables were analysed with appropriate statistical tests. Results 40 subjects were studied where inactive disease was observed in nine subjects (22.5%), five subjects (12.5%) were found to be in low disease activity and moderate disease activity groups each, and twenty-one subjects (52.5%) had high disease activity. Considering the total sample size of the study, the mean (SD) JADAS27 score and serum vitamin D level were observed to be 12.02 (11.31) and 23.10 (5.93) respectively. A negative correlation was found between the JADAS27 score and serum vitamin D (r= -0.67). The corrected Chi-square test had revealed significant association between the status of serum vitamin-D and disease activity groups (=16.28; p < .001). Conclusions In JIA, higher grade of disease activity was found to be significantly associated with lower serum vitamin D.
Rakesh Mondal, Arnab Nandy, Debadyuti Datta, Rahul Majumdar, Avijit Hazra, and Sankar Kumar Das
Informa UK Limited
INTRODUCTION
We aimed to evaluate joint mechanics in newborn by goniometric assessment of major joints in healthy babies born at different gestational ages (GAs).
MATERIALS AND METHODS
An institution based observational study was carried out on healthy newborn babies within two days of birth. Study subjects were born at 28-41 completed weeks of gestation. The major joints of upper and lower limbs were assessed with manual goniometer for joint angles in relation to specific passive movements and range of motion (ROM) calculated where applicable. All measurements were made by a single observer with careful consideration of plane of movement and axes involved. Strength of association between joint angles and GA was quantified by Pearson's r coefficient.
RESULTS
Six major joints (shoulder, elbow, wrist, hip, knee, and ankle) were evaluated on either side in 433 babies. No significant differences were found between male and female babies and left or right side of the body. For most joints, a secular declining trend of joint angle or ROM was noted with good to strong inverse correlation with GA. The strongest associations were for flexion-extension ROM and adduction-abduction ROM at shoulder, palmar flexion at wrist and dorsiflexion at ankle joint with r values of -0.76, -0.75, -0.75, and -0.75, respectively.
CONCLUSIONS
The reading of a specific joint angle in the newborn infants was found to be dependent on GA. Precise calibration of gestation appropriate joint angles had laid down the foundation for functional assessment of multimodal joint mechanics.HighlightsEvaluation of newborn joint angles require stringent attention toward the plane and axis of the particular joint movement being assessed.Major joint angles and range of motion in newborn infants were observed to follow a secular declining trend according to the gestational age.Precise estimation of gestation appropriate joint angle will be helpful to understand the mechanics of musculoskeletal medicine in newborn.
Arnab Nandy, Tanushree Mondal, Debadyuti Datta, Somosri Ray, Nitis Kumar, M. Divyoshanu Ivan, Avijit Hazra, and Rakesh Mondal
Springer Science and Business Media LLC
To explore association between serum ferritin and severity of sepsis among children, and relate levels to the final outcome. This observational study was conducted in a tertiary care hospital between I February and 30 July, 2019. Serum ferritin level was estimated in children (age 6 months to 12 years) suffering from sepsis, irrespective of the probable etiology. Children with hemoglobinopathies, autoimmune diseases, previous blood transfusion, severe acute malnutrition, hemophagocytic lymphohistiocytosis and chronic hepatitis were excluded. The ferritin level was measured sequentially at pre-defined stages of illness viz., sepsis, severe sepsis, septic shock and multiorgan dysfunction syndrome (MODS). Association between serum ferritin and severity of sepsis was analyzed, and ferritin level was related to the final outcome of death or recovery by receiver operating characteristic (ROC) curve analysis. The study group included 47 children with sepsis who progressed to a state of MODS; 32 recovered from MODS. Significant differences in serum ferritin level were observed with severity of sepsis. There was clear demarcation of ferritin levels between sepsis severity stages. The proportion of death among the 47 MODS cases was 31.9% (95% CI 18.6–45.2%). ROC analysis in the MODS group indicated that serum ferritin >1994.3 ng/mL predicts mortality (AUC 0.73 [95% CI 0.58–0.85]) with sensitivity 66.7% [95% CI 38.4–88%] and specificity 100.0% [95% CI 89.1–100%]. There is clear demarcation of serum ferritin levels that can help differentiation of sepsis severity stages in children with sepsis. There is no such demarcation between survivors and non-survivors in MODS cases.
Debadyuti Datta, Tanushree Mondal, Mihir Sarkar, Soumita Chel, Sankar Kumar Das, Arnab Nandy, Divyoshanu M Ivan, and Rakesh Mondal
Oxford University Press (OUP)
Abstract Objectives To determine the burden and etiological factors of leave against medical advice (LAMA) in Indian children. Methodology In this prospective study, legal guardians of 528 patients who took the decision of LAMA were interviewed (using structured question answers based multi-option) and data were captured over a period of 16 months. The resultant database was analyzed using standard statistical methods. Results About 6.12% of childhood LAMA cases were dealt out of total pediatric admission including newborns. Neonatal preponderance noted in cases of LAMA from intensive care unit (ICU; 57.14%, p < 0.05). The overall male (n = 293) to female (n = 235) ratio in this study was 1.25:1. Number of LAMA patients was higher from rural area (83.33%), mostly admitted in ICU (93.65%, Pearson’s chi-squared test, p < 0.05). Higher proportion (29.47%) of patients with infection availed LAMA from neonatal age group but overall LAMA patients fall under category of respiratory disorders (22.35%). Interest of the domestics issues other than suffering child was considered primary during LAMA for those admitted in ward as compared with ICU patients [odds ratio (OR): 1.73, CI: 1.02–2.94, p < 0.05]. ICU patients were reportedly to be taken to private health care facility (OR: 1.93, CI: 1.06–3.49, p < 0.05). Duration of stay before taking LAMA from ward was <7 days (85.59%, OR: 0.19, CI: 0.11–0.35, p < 0.05). Upper-lower socio-economic class attributed financial constraint as the main reason for LAMA (Pearson’s chi-squared test, Chi-square value: 152.23, p < 0.05). Conclusions This study tried to elucidate the determinants of childhood LAMA in rural Indian setting.
Arnab Nandy, Aritra Guha, Debadyuti Datta, and Rakesh Mondal
Informa UK Limited
Abstract In the routine practice of neonatology, differentiating preterm premature new-born from small-for-date (SFD) new-born infant is an essential aspect to anticipate different clinical scenarios and monitor accordingly. Clinical assessment of new-born maturity is an invincible tool in resource poor areas for the purpose, without any prior investment. Over the past decades, clinical method for new-born infant maturity assessment has evolved intricately. From defining prematures with a mere statement of birth weight to clinical assessment of new-born as per gestational age with a comprehensive scheme based on neural and physical maturity characteristics of a new-born, clinical method for new-born maturity assessment has evolved substantially to the present where we stand. A complete review on the evolutionary history of clinical method for new-born infant maturity assessment will enable researchers in this field to get acquainted with the trend of past research work in accordance to the recent advancement all over the world. In the process, the lacunae still present in this area of study can be spotted which will invite new research proposals. Looking into the recent context, clinical method for assessing new-born infant maturity is making further forward shift with an attempt to quantify neuromuscular maturity criteria with further precision and incorporation of additional criteria. “What is known – What is New” (Authors’ summary) What is known Neuro-muscular and external physical characteristic assessment together has greater significance for evaluating new-born infant’s maturity as per gestational age over using individual one of them. Evaluation of brain maturity through passive muscle tone assessment of new-born infants with different maneuvers has the imperative role in determining new-born infant maturity. What is new Clinical method for determining new-born infant maturity as per gestational age is being made explicit with the incorporation of criteria like feeding behavior of the new-born and objective assessment of anthropometric parameters, beside neuro-muscular and external physical characteristics evaluation. Neuro-muscular maturity can be quantified further with absolute values or closer range of values of different maneuvers and signs used in the clinical method for evaluating new-born infant maturity as per gestational age with more precision.