Sushil Kumar Kabra

All India Institute of Medical Sciences | AIIMS · Department of Paediatrics

Objectives To evaluate the performance of the empiric tool by Gupta et al. in predicting neurological outcomes in children admitted to the pediatric intensive care unit (PICU) and to evaluate the association of biomarkers S100B and NSE with neurological outcomes. Methods This prospective observational study was conducted in 163 critically ill child...

Environmental pollution has harmful effects on human health, particularly the respiratory system. We aimed to study the impact of daily ambient air pollution on daily emergency room visits for acute respiratory symptoms. This study was conducted in two tertiary respiratory care centres in Delhi, India. Daily counts of emergency room visits were col...

Background: Eczema (atopic dermatitis) is a major global public health issue with high prevalence and morbidity. Our goal was to evaluate eczema prevalence over time, using standardized methodology. Methods: The Global Asthma Network (GAN) Phase I study is an international collaborative study arising from the International Study of Asthma and Aller...

Background: It has been more than 17 years since the introduction of free ART in India. At this point, it would be prudent to look at the factors associated with the survival of persons living with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) (PLHA) who are already enrolled in the ART program. Methods: PLHAs enrol...

Objective: Our objective was to compare norepinephrine plus dobutamine versus epinephrine as the first-line agent in children with fluid refractory cold septic shock. Design: Open-label randomized controlled study. Setting: A single-center PICU from North India. Patients: Children 2 months to less than 18 years old with fluid refractory cold...

Dengue is an important public health problem with a wide clinical spectrum. The World Health Organization classifies dengue into probable dengue, dengue with warning signs, and severe dengue. Severe dengue, characterized by plasma leakage, severe bleeding, or organ impairment, entails significant morbidity and mortality if not treated timely. There...

Introduction: Data are scarce on hs-CRP as a biomarker for airway inflammation in pediatric asthma. We aimed to examine correlation between hs-CRP and asthma control levels. Methods: Children with physician- diagnosed asthma, ages 6 to 15 years, were enrolled. GINA-2016 criteria were used to assess the level of asthma control. The relationships bet...

Objectives: To describe prevalence of various imaging findings in chronic granulomatous disease (CGD) patients; and find imaging biomarkers for differentiating chest infections caused by different micro-organisms. Methods: A retrospective study was conducted on 15 patients (49 scans) with proven CGD. Scans which had a correlative microbiological...

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Introduction The high burden of respiratory syncytial virus (RSV) infection in young children disproportionately occurs in low- and middle-income countries (LMICs). The PROUD (Preventing RespiratOry syncytial virUs in unDerdeveloped countries) Taskforce of 24 RSV worldwide experts assessed key needs for RSV prevention in LMICs, including vaccine an...

Objectives: To determine the discriminatory value of various impulse oscillometry (IOS) parameters, and to find the cut-off value of the appropriate parameter for identifying exercise-induced bronchoconstriction (EIB) in children with asthma. Methods: This cross-sectional study was conducted in India from October 2016 to March 2018 in children w...

Background: Suboptimal exposure to antituberculosis drugs has been associated with unfavourable treatment outcomes. We aimed to investigate estimates and determinants of first-line antituberculosis drug pharmacokinetics in children and adolescents at a global level. Methods: We systematically searched MEDLINE, Embase, and Web of Science (1990-20...

Background: Oxygen delivery devices with positive end-expiratory pressure (PEEP) valves have been described, but high inspiratory flows may lead to poor tolerance in tachypneic patients. Positive expiratory pressure oxygen therapy (PEP-OT) using an occlusive face mask, oxygen reservoir, and PEEP valve has not been evaluated in clinical settings....

Objective The objectives of this study were to determine the prevalence of insulin resistance (IR), dyslipidemia and metabolic syndrome (MS) in children with asthma, aged 10 to 15 years and to determine if these metabolic abnormalities showed an association with asthma symptom control and lung function. Methods We conducted a cross-sectional study...

Poster session 2, September 22, 2022, 12:30 PM - 1:30 PM Objectives To present details of a case series of fungal osteomyelitis initially misdiagnosed as disseminated tuberculosis, in pediatric patients with chronic granulomatous disease. Method Informed consent was obtained from the parents of three children (known cases of chronic granulomatous...

Poster session 2, September 22, 2022, 12:30 PM - 1:30 PM Objectives Cryptococcus spp. is usually opportunistic pathogens affecting immunocompromised individuals causing meningitis primarily. Non-CNS presentations are a rare entity and we hereby present a series of 3 cases in the past 1 year (2021-2022). Methods Case records of the three patients...

Objective: To develop diagnostic algorithm for cystic fibrosis (CF) in setting of unavailability of sweat chloride, based on clinical features and basic laboratory investigations. Methods: In a prospective observational study, we enrolled children with recurrent/persistent pneumonia with either malabsorption or poor growth, undergoing sweat chlo...

Allergic bronchopulmonary aspergillosis (ABPA) is an IgE-mediated hypersensitivity reaction predominantly occurring in patients of asthma and cystic fibrosis. The typical radiological findings in ABPA include central bronchiectasis and fleeting opacities. In this retrospective study, the aim was to describe cases of ABPA in children who had a mass-...

Monkeypox is caused by a pox virus closely related to smallpox virus and spreads from animals to humans, and humans to humans following close contact. Prior smallpox vaccination gives partial protection against monkeypox. The steady increase in monkeypox cases in Africa over the past few decades were ignored by the global scientific community till...

Introduction : For the diagnosis of airway anomalies, bronchoscopy is the gold standard. Infant pulmonary function testing is an emerging modality to assess airways and its utility in diagnosis and monitoring is unexplored in clinical studies. Objectives : To evaluate infant Pulmonary Function Test [Tidal Breathing Flow Volume Loop (TBFVL)] in chil...

Objective: To measure changes in muscle thickness and echogenicity, reflecting muscle bulk and quality, respectively, of quadriceps femoris (QF), in critically ill children. Methods: This study was done on 58 children aged 1-18 y requiring mechanical ventilation, admitted in a pediatric intensive care unit (PICU) of a tertiary care hospital from...

M. pneumoniae (Mp) is a significant pathogen causing atypical pneumonia but by far these infections are underreported clinical entities in India. In the present study, we report the prevalence of Mp and describe the demographic and baseline clinical data of Mp-positive cases in an Indian tertiary care hospital.

Background: A bronchoscopy is an essential tool in pediatric pulmonology. However, the practices involved in the procedure are variable. Objective: To evaluate prevalent practices and variations in pediatric flexible bronchoscopy in India. Methods: An online survey was conducted via Google forms between September 2018 and March 2019. We circul...

Objectives: Evaluation of immunological factors responsible for discordant virological responses postcombination antiretroviral therapy (cART) in human immunodeficiency virus (HIV)-positive children aged <5 years. Materials and methods: Immunological profiling of enrolled 30 HIV-positive children was done at enrollment, 6 and 12 months. Flow cyt...

Objective: To determine the outcomes in children with MIS-C receiving different immunomodulatory treatment. Methods: In this multicentric, retrospective cohort study, data regarding treatment and outcomes of children meeting the WHO case definition for MIS-C, were collected. The primary composite outcome was the requirement of vasoactive/inotrop...

Objective: Obesity and asthma are related conditions, however, the underlying mechanism between the two is not understood. This study aims to determine the correlations between fractional exhaled nitric oxide (FeNO) and spirometry parameters in obese asthmatic children. Design and method: In this study, 47 overweight/ obese asthmatic children (p...

Objective: Obesity is a major risk factor for asthma in children. Obese children have an increased risk of asthma; have more frequent and severe exacerbations, decreased lung function, and poor quality of life. However, the relationship between obesity, lung function, and asthma control remains unclear in obese asthmatic Indian children. Therefore...

Objectives: To evaluate if the use of a quality improvement (QI) initiative improves initiation and acceptability of noninvasive ventilation (NIV) in critically ill children with respiratory distress. Methods: The study was carried out in 3 phases over a period of 6 mo in the pediatric intensive care unit of a tertiary care hospital in children ag...

A patient, an adolescent male, presented to us with complaints of recurrent respiratory tract infections since childhood. Differentials considered were cystic fibrosis (CF), bronchial asthma with allergic bronchopulmonary aspergillosis (ABPA), primary ciliary dyskinesia (PCD) and primary immunodeficiency disorders. Sweat chloride test, total IgE an...

Rapid, cost-effective, and sensitive diagnostic assays are essential for global tuberculosis (TB) control, especially in high TB burden, resource-limited settings. The current study was designed to evaluate diagnostic accuracy of Truenat MTB-Rif Dx (MolBio) in children less than 18 years of age, with symptoms suggestive of TB. Gastric Aspirate, Ind...

Monocytes are known to play a critical role in dengue pathophysiology. However, which monocyte subset expresses what inflammatory mediator(s) and what transcriptional features distinguish each of the monocyte subset in vivo remain poorly understood. In this study we provide a detailed transcriptional analysis of the three human monocyte subsets in...

Purpose The choice of Esophageal replacement (ER) depends on surgeons’ preference and patients’ anatomical condition. A cross-sectional study was done to compare the long-term outcomes of two methods of ER, Gastric transposition (GT) and Colonic interposition (CI). Methods Children who had undergone ER from January 1997 to December 2017 with a min...

Abstract Background The role of serum Procalcitonin (PCT) in adults in diagnosis of Community acquired pneumonia (CAP) is well established, however, role in pediatric CAP remains controversial. Objectives The objective of this study was to investigate the utility of serum procalcitonin in differentiating bacterial community-acquired lower respirato...

Background: The diagnosis of CPA relies on the detection of the IgG Aspergillus antibody, which is not freely available, especially in resource-poor settings. Point-of-care tests like LDBio Aspergillus ICT lateral flow assay, evaluated in only a few studies, have shown promising results for the diagnosis of CPA. However, no study has compared the...

Background Acute respiratory infections (ARI) are the leading cause of morbidity and mortality in children below 5 years of age. Methods This multisite prospective observational study was carried out in the Pediatrics’ out-patient departments of 5 medical colleges across India with an objective to assess the feasibility of establishing Acute Respi...

Background: Childhood cancer survivors are 8.8 times more likely to die of pulmonary causes when compared to general population: an aspect of concern. Pulmonary dysfunction is the third leading cause of non recurrence related cause of death among Hodgkin lymphoma survivors. Methods: A cross section study on Hodgkin lymphoma survivors in complete re...

Background & objectives: To eliminate tuberculosis (TB), the National TB Elimination Programme (NTEP) has given an algorithm for diagnosis and treatment of TB in children. This study was carried out to assess the prevailing practices to identify TB in severely malnourished children admitted to various nutrition rehabilitation centres (NRCs). Method...

Persons living with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) (PLHA) enrolled from antiretroviral therapy (ART) centers located in three different cities in India – Delhi, Pune and Kolkata, and were followed up at six monthly intervals monitoring the WHO stage, CD4 counts, complete blood counts and liver and kidne...

Cystic fibrosis (CF), an autosomal recessive monogenic disorder, leads to abnormal exocrine gland secretions. The complex treatment regi- men is time-consuming, burdensome, and costly. Poor treatment adherence may result in increased morbidity and mortality, increased healthcare costs, and hospitalizations, resulting in school absenteeism, decr...

Background The diagnosis of CPA relies on the detection of IgG Aspergillus antibody which is not freely available, especially in resource-poor settings. Point-of-care tests like LDBio Aspergillus ICT lateral flow assay, evaluated in only a few studies, have shown promising results for diagnosis of CPA. However no study has compared the diagnostic p...

To study the clinical, laboratory characteristics and outcomes of multisystem inflammatory syndrome in children (MIS-C) temporally related to coronavirus disease 2019 (COVID-19) in a resource-limited setting. All children meeting the World Health Organization case definition of MIS-C were prospectively enrolled. Baseline clinical and laboratory par...

Objectives Clostridioides difficile is an important pathogen responsible for antibiotic-associated diarrhoea (AAD). This study was aimed to perform multi-locus sequence typing (MLST) of C. difficile isolates from AAD cases using and to understand the clonal relationship between these C. difficile strains. Methods Thirty five strains and a standard...

Background The Global Asthma Network (GAN) Phase-I study in India aimed to study the prevalence, time trends and associated risk factors of allergic rhinitis and eczema among 6-7-year-old, and 13-14-year-old school children and their parents. Methods Cross-sectional, multicenter study using self and parent administered questionnaire among randomly...

Objectives: To evaluate the outcomes of children with congenital heart disease (CHD) awaiting surgery admitted to a pediatric intensive care unit (PICU) with acute illness. Methods: In this retrospective study from a single center, the outcomes of children up to 18 y of age with unoperated CHD admitted to PICU with acute illness and factors affe...

Objective The objective of the sub-analysis of data from centers across urban areas in India of the Global Asthma Network (GAN) was to study the 1) prevalence of symptoms of asthma in children and adults, 2) change in prevalence of asthma and its trigger factors since the International Study of Asthma and Allergies in Childhood (ISAAC), and, 3) cur...

Objective: To determine high resolution CT (HRCT) patterns of pulmonary fibrosis (PF) in children; and their etiological correlates. Methods: This was a retrospective study involving 149 children with diffuse lung disease (DLD). Patterns of involvement were classified based on dominant lung finding as ground glass opacity (GGO) dominant, nodule...

Background: Pediatric bronchoscopy is an important tool in pediatric pulmonology. However, the practices involved in the procedure are variable. Objective: To evaluate prevalent practice and variations in pediatric flexible bronchoscopy in India. Methods: An online survey conducted between September 2018 to March 2019 via Google forms. The survey w...

Over the past 15 years, and despite many difficulties, significant progress has been made to advance child and adolescent tuberculosis (TB) care. Despite increasing availability of safe and effective treatment and prevention options, TB remains a global health priority as a major cause of child and adolescent morbidity and mortality—over one and a...

Background Azithromycin has immunomodulatory actions, and its beneficial effects have been demonstrated in asthmatic adults. There is limited data on children. Research question Does the addition of oral azithromycin (I) to standard therapy (C) in children with poorly controlled asthma (P) improve the asthma control (O) compared to standard treatm...

Children with cystic fibrosis (CF) constitute a high-risk group for COVID-19 with underlying chronic lung disease. COVID-19 severity varying from mild infection to need of intensive care has been described in children with CF. Two children with significant underlying pulmonary morbidity are described here, who developed severe disease following SAR...

Background SARS-CoV-2 infection in children frequently leads to only asymptomatic and mild infections. It has been suggested that frequent infections due to low-pathogenicity coronaviruses in children, impart immunity against SARS-CoV-2 in this age group. Methods From a prospective birth cohort study prior to the pandemic, we identified children w...

Background & objectives: Studies assessing the spatial and temporal association of ambient air pollution with emergency room visits of patients having acute respiratory symptoms in Delhi are lacking. Therefore, the present study explored the relationship between spatio-temporal variation of particulate matter (PM)2.5 concentrations and air quality...

Objective Early aggressive therapy using biologicals is increasingly being used in Juvenile Idiopathic Arthritis (JIA) for early disease remission. Pulse-steroids are used in induction regimes for rheumatic disorders such as systemic lupus erythematosus and systemic JIA; however, no controlled studies demonstrate their use in non-systemic JIA. The...

Objectives To elicit antibiotic prescribing patterns across Indian Pediatric Intensive Care Units (PICU) and assess attributes of the antibiotic stewardship programs.MethodsA link to a web-based questionnaire was sent by email to pediatric intensivists across India.ResultsResponses were received from 62 PICUs. Majority of respondents were from priv...

Background There is a lack of studies on cystic fibrosis (CF) outcomes in children from developing countries like India. Identifying risk factors for mortality may help identify the high-risk group and plan policy management of such patients. We aimed to determine the factors associated with mortality among Indian children with CF. Methods In this...

Asthma is a chronic airway inflammatory disease that results from a complex interplay of genetic, environmental, and lifestyle factors. There is no cure for asthma, and the management is usually as per published guidelines. As in many chronic diseases conditions, various alternative or complimentary therapies have been tried. Of these, yoga and pra...

Background: Cystic fibrosis (CF), an autosomal recessive monogenic chronic disorder affects the lungs, pancreas, and other exocrine glands, and manifests as recurrent respiratory infections, malabsorption, and a myriad of complications pertaining to other systems like hepatobiliary, endocrine and reproductive systems. Objectives were to assess the...

Aim To estimate acute gastrointestinal injury (AGI) in critically ill children and association of its severity with mortality. Methods In a prospective cohort study, critically ill children (1 month–18 years) were enrolled. Gastrointestinal symptoms over the first week of admission were classified into AGI grades 1 through 4, using a paediatric ad...

Asthma is common in children and exacerbations are usually triggered by respiratory viruses. There was considerable concern about the impact of COVID-19 on children with asthma. It was expected that children with asthma would fare poorly during the pandemic. However, the reported effect of the COVID-19 pandemic on pediatric asthma including acute a...

Background Current WHO algorithm has retained the signs and symptoms used in the older version for classifying severity of childhood pneumonia.Objective To study the role of clinical features (including that of current WHO criteria), and oxygen saturation (SpO2) in the diagnosis of childhood pneumonia.Study designMulticenter prospective cohort stud...

Objective To identify the risk factors for pneumonia and severe pneumonia in children.DesignProspective cohort study.SettingFive tertiary-care teaching hospitals in India.ParticipantsChildren 2 to 59 months of age suffering from acute respiratory infection (ARI).Main outcome measuresRisk factors for the development of WHO defined pneumonia and seve...

Objective To evaluate factors associated with risk of hospitalization in children with community-acquired pneumonia (CAP).DesignProspective cohort study.SettingMulti-site hospital based study.InterventionA separate acute respiratory tract infection (ARI) treatment unit (ATU) was established. The revised WHO case definition for ARI was used across a...

Vascular Endothelial Growth Factor has been demonstrated in squamous papillomas of Recurrent Respiratory Papillomatosis patients. This case series aimed at studying the feasibility and efficacy of systemic use of VEGF inhibitor Bevacizumab in advanced Juvenile Onset Recurrent Respiratory Papillomatosis (JORRP) patients. Three pediatric patients wit...