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Personnel

• Dr Kamlesh Chopra
• Professor S K Sharma

WHY OUR CENTRE WAS CHOSEN

All India Institute of Medical Sciences (AIIMS), New Delhi (India) was established by an Act of Parliament in 1956 as an institution of national importance. Its main objectives were to develop patterns of teaching in undergraduate and postgraduate medical education in all its branches, so as to demonstrate a high standard of medical education to all medical colleges and other allied institutions in India; to bring together in one place educational facilities of the highest order for the training of personnel in all important branches of health activity; and to attain self-sufficiency in postgraduate medical education. AIIMS has state-of-art facilities for teaching, research and patient care. Medical and paramedical courses are taught at AIIMS. The institution awards its own undergraduate, postgraduate and doctorate degrees. Teaching and research are conducted in 50 disciplines. AIIMS plays a leading role in the field of medical research, having more than 1300 research publications by its faculty and researchers in a year. AIIMS also has a College of Nursing, which awards B.Sc (Hons) Nursing and B.Sc Nursing (Post-certificate) degrees. Twenty-five clinical departments, including six superspecialty centres, manage practically all types of disease conditions with support from preclinical and para-clinical departments. AIIMS also runs a 60-bedded hospital at the Comprehensive Rural Health Centre at Ballabgarh in Haryana and provides health cover to about 7.7 lakh people through the Centre for Community Medicine.

The institute has main hospital with total bed strength of 2424 beds along with state-of-art intensive care units. It has 6 centers for superspecialties including Cardiology, Cardio-Thoracic surgery, Cardioradiology, Neurology, Neurosurgery, Trauma centre, De-addiction center and state of- art intensive care monitoring facilities. It has Rotary Cancer Hospital with 200 beds. Each center has approximately 200 beds. AIIMS was the first one to do cardiac transplantation in the country. In addition, it has a cardiac transplantation. In addition it has very successful renal, bone marrow transplantation facilities.

Division of Pulmonary Medicine has a special place in the Department of Internal Medicine since inception of the Institute. Since beginning it has state-of-art facilities for measurement of pulmonary diffusing capacity with single breath and steady state techniques, estimation of lung volumes with body plethysmography, measurement of acid-base. Over a period of time, state-of-art intensive care unit and sleep laboratories were developed. Division of Pulmonary, Critical care and Sleep Medicine has contributed significantly by performing outstanding research. Special interest of the Division includes bronchial asthma, interstitial lung disease, sarcoidosis, tuberculosis, HIV/TB, obstructive sleep apnea and venous thrombo-embolism. Because of this the Division was chosen for performing ISAAC Phase Three study.

IMPACT OF ISAAC IN OUR CENTRE

ISAAC Phase Three Study data are known to faculty, residents and medical students at AIIMS, New Delhi. However, attention is being paid to increase their awareness of the findings in teaching ward rounds, outpatient department and chest clinic.

FINDINGS FOR OUR CENTRE

Publication from ISAAC Phase Three Data collected in New Delhi

Prevalence and risk factors for wheezing in children from rural areas of north India Surendra K. Sharma, M.D., Ph.D., and Amit Banga, M.D. (Allergy Asthma Proc 28:647–653, 2007; doi: 10.2500/aap2007.28.3059)

The purpose of this study was to document the prevalence of asthma-associated symptoms in children residing in rural areas and to determine risk factors for its development. We studied 8470 school children, aged 6–7 years and 13–14 years, from 10 villages on the outskirts of Delhi, India, over a 6-month period. The study was performed using the Hindi translated version of Phase III of the ISAAC questionnaires. All of the questionnaires were self-reported by children and/or parents. Frequent passage of trucks through the street near home (odds ratio [OR]: 95% CI, 1.7 [1.2–2.4]), maternal smoking (OR: 95% CI, 1.5, [1.1–2.1]), paternal smoking (OR: 95% CI, 1.3 [1.0 –1.8]), total number of cigarettes smoked by both parents of more than seven per day (OR: 95% CI, 1.9 [1.3–2.7]), paracetamol intake of more than once a month (OR: 95% CI, 1.9 [1.4 –2.6]), and current exposure to cats (OR: 95% CI, 1.5 [1.1–1.9]) were independently associated with occurrence of recent wheezing (in the last 12 months), whereas fruit intake of more than twice a week had a protective effect (OR: 95% CI, 0.7 [0.5– 0.9]). There is a significant burden of asthma-associated symptoms in children of rural areas of north India. Occurrence of wheezing among children from rural areas of Delhi is determined by a complex interplay of environmental agents that induce allergic sensitization and are proinflammatory and environmental agents that supplement the antioxidant stores.

Common ISAAC Phase Three Study Publications

1. Worldwide time trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in childhood: ISAAC Phases One and Three repeat multicountry cross-sectional surveys. Lancet 2006; 368:733–43 3. Worldwide trends in the prevalence of asthmasymptoms: phase III of the International Study of Asthma and Allergies in Childhood (ISAAC) Worldwide trends in the prevalence of asthma. Thorax 2007;62:757-65; originally published online 15 May 2007; doi:10.1136/thx.2006.070169
2. Association between paracetamol use in infancy and childhood, and risk of asthma, rhinoconjunctivitis, and eczema in children aged 6–7 years: analysis from Phase Three of the ISAAC programme. Lancet 2008;372:1039–48 Use of paracetamol in the first year of life and in later childhood, is associated with risk of asthma, rhinoconjunctivitis, and eczema at age 6 to 7 years. We suggest that exposure to paracetamol might be a risk factor for the development of asthma in childhood.
3. Worldwide time trends for symptoms of rhinitis and conjunctivitis: Phase III of the International study of asthma and allergies in childhood. Pediatr Allergy Immunol 2008; 19:110-24.
4. Is eczema really on the increase worldwide? J Allergy Clin Immunol 2008; 121:947-54.
5. Global map of the prevalence of symptoms rhinoconctivitis in children: the international study of asthma and allergies in childhood (ISAAC) phase three. Allergy 2009; 64:123-48.
6. Self Reported Truck Traffic on the Street of Residence and Symptoms of Asthma and Allergic Disease: A Global Relationship in ISAAC Phase Three. Environ Health Perspect 2009;117:1791-98.
7. Antibiotic use in infancy and risk of symptoms of asthma, hinoconjunctivitis and eczema in 6 to 7 year old children: ISAAC Phase Three. J Allergy Clin Immunol 2009;124:982-89.
8. Translation of questions: The International Study of Asthma and Allergies in Childhood (ISAAC) experience. Int J Tuberc Lung Dis. September 2009; 13: 1174-82
9. The impact of the method of consent on response rates in the ISAAC time trends study. Int J Tuberc Lung Dis 2010; 14:1059–65