DSIR recognized | FWA approved-FWA00012971

Association of umbilical cord blood lead with neonatal behavior at varying levels of exposure

3 July, 2014 Publications


Download Paper
Download Supplement

Background: In the light of the ongoing debate about lowering the cut-off for acceptable blood lead level to <5 μg/dL from the currently recommended level of <10 μg/dL, we considered whether prenatal exposure to varying levels of lead is associated with similar or disparate effects on neonatal behavior. Methods: Using Brazeltons Neonatal Behavioral Assessment Scale (NBAS), an epidemiological approach and robust statistical techniques like multivariate linear regression, logistic regression, Poisson regression and structural equations modeling analyses we estimated the simultaneous indirect effects of umbilical cord blood lead (CBL) levels and other neonatal covariates on the NBAS clusters. Results: We observed that when analyzed in all study subjects, the CBL levels independently and strongly influenced autonomic stability and abnormal reflexes clusters. However, when the analysis was restricted to neonates with CBL <10 μg/dL, CBL levels strongly influenced the range of state, motor and autonomic stability clusters. Abnormal walking reflex was consistently associated with an increased CBL level irrespective of the cut-off for CBL, however, only at the lower cut-offs were the predominantly behavioral effects of CBL discernible. Conclusion: Our results further endorse the need to be cognizant of the detrimental effects of blood lead on neonates even at a low-dose prenatal exposure.
Behav Brain Funct. 2006;2:22.


By: Patel AB, Mamtani MR, Thankre TP, Kulkarni H

Loss of lag-response curvilinearity of indices of heart rate variability in congestive heart failure

3 July, 2014 Publications


Download Paper

Background: Heart rate variability (HRV) is known to be impaired in patients with congestive heart failure (CHF). Time-domain analysis of ECG signals traditionally relies heavily on linear indices of an essentially non-linear phenomenon. Poincaré plots are commonly used to study non-linear behavior of physiologic signals. Lagged Poincaré plots incorporate autocovariance information and analysis of Poincaré plots for various lags can provide interesting insights into the autonomic control of the heart. Methods: Using Poincaré plot analysis, we assessed whether the relation of the lag between heart beats and HRV is altered in CHF. We studied the influence of lag on estimates of Poincaré plot indices for various lengths of beat sequence in a public domain data set (PhysioNet) of 29 subjects with CHF and 54 subjects with normal sinus rhythm. Results: A curvilinear association was observed between lag and Poincaré plot indices (SD1, SD2,SDLD and SD1/SD2 ratio) in normal subjects even for a small sequence of 50 beats (p value for quadratic term 3 × 10-5, 0.002, 3.5 × 10-5 and 0.0003, respectively). This curvilinearity was lost in patients with CHF even after exploring sequences up to 50,000 beats (p values for quadratic term > 0.5). Conclusion: Since lagged Poincaré plots incorporate autocovariance information, these analyses provide insights into the autonomic control of heart rate that is influenced by the non-linearity of the signal. The differences in lag-response in CHF patients and normal subjects exist even in the face of the treatment received by the CHF patients.
BMC Cardiovasc Disord. 2006;6:27.


By: Thakre TP, Smith ML

Bias-corrected diagnostic performance of the naked eye single tube red cell osmotic fragility test (NESTROFT): An effective screening tool for ß-thalassemia

3 July, 2014 Publications


Download Paper

Background: It is being increasingly recognized that a majority of the countries in the thalassemia-belt need a cost-effective screening program as the first step towards control of thalassemia. Although the naked eye single tube red cell osmotic fragility test (NESTROFT) has been considered to be a very effective screening tool for b-thalassemia trait, assessment of its diagnostic performance has been affected with the reference test- and verification-bias. Here, we set out to provide estimates of sensitivity and specificity of NESTROFT corrected for these potential biases.We conducted a cross-sectional diagnostic test evaluation study using data from 1563 subjects from Central India with a high prevalence of b-thalassemia. We used latent class modelling after ensuring its validity to account for the reference test bias and global sensitivity analysis to control the verification bias. We also compared the results of latent class modelling with those of five discriminant indexes. We observed that across a range of cut-offs for the mean corpuscular volume (MCV) and the hemoglobin A2 (HbA2) concentration the average sensitivity and specificity of NESTROFT obtained from latent class modelling was 99.8 and 83.7%, respectively. These estimates were comparable to those characterizing the diagnostic performance of HbA2, which is considered by many as the reference test to detect b-thalassemia. After correction for the verification bias these estimates were 93.4 and 97.2%, respectively. Combined with the inexpensive and quick disposition of NESTROFT, these results strongly support its candidature as a screening tool—especially in the resource-poor and high-prevalence settings.
Hematology. 2006;11:277-86.


By: Mamtani M, Jawahirani A, Das K, Rughwani V, Kulkarni H[/tippy]

Value of Mean Corpuscular Volume and Mean Corpuscular Hemoglobin in Screening for ß -Thalassaemia Trait

3 July, 2014 Publications


Download Paper

Background: No Abstract available.

Acta Haematol. 2006; 116: 223-5.


By: Mamtani M, Jawahirani A, Das K, Rughwani V, Kulkarni H[/tippy]

Predictive Performance of Anthropometric Indexes of Central Obesity for the Risk of Type 2 Diabetes

3 July, 2014 Publications


Download Paper

Background: In spite of several available anthropometric indexes, the relative merit of these indexes for the prediction of type 2 diabetes remains unknown. Considering that obesity and diabetes commonly coexist as co-morbidities, our objective was to directly compare the performance of measures of central and general obesity to predict the risk of type 2 diabetes. Methods. We conducted a case-control study of type 2 diabetes on 150 cases and 150 age- and gender-matched controls. We directly compared the predictive performance of five anthropometric indexes: four related to central obesity—waist circumference (WC), waist/hip ratio (WHR), abdominal volume index (AVI) and conicity index (CI); and one related to general obesity—body mass index (BMI).We used various statistical approaches like area under (AUC) receiver-operating characteristic (ROC) curves, likelihood ratios, logistic regression and Shannon’s entropy to compare the performance of the indexes in the study sample as well as bootstrapped samples. Results. WC had the highest overall predictive accuracy that was gender insensitive (AUC 0.77 in males and 0.74 in females); a comparable information content as that of AVI (Shannon’s entropy  1.81 for WC and 1.84 for AVI) and was a better predictor of the risk of type 2 diabetes than all the remaining indexes. WC also correlated strongly with the biochemical markers of diabetes like blood sugar and lipid profile. Conclusions. WC is a simple, non-invasive and accurate predictor of the risk of type 2 diabetes that can potentially be used in screening programs in developing countries.
Arch Med Res. 2005; 36: 581-9.


By: Mamtani MR, Kulkarni HR

Platelet distribution width (PDW) is increased in vaso-occlusive crisis in sickle cell disease.

3 July, 2014 Publications


Download Paper

Background: Considering the multigenic and multifactorial nature of the disease, we argue that a generalized bone marrow hyperplasia—and not merely erythroid hyperplasia—will occur in sickle cell disease. Consequently, we expect the hematological parameters to depict erythroid, myeloid as well as megakaryocyte hyperplasia. In the light of this expectation, we hypothesized that platelet distribution width (PDW) will increase in sickle cell disease. Here, we report the results from a cross-sectional study of 216 children admitted with complaints suggestive of vaso-occlusive crisis. We observed a strong association between PDW and sickle cell disease as compared to children who had HbAA genotype. Our findings bridge previous inconsistencies relating to the role of platelets in sickle cell disease. Implications of this finding are discussed. Ann Hematol. 2004;83:331-5.


By: Amin MA, Amin AP, Kulkarni HR

Study Area

1 July, 2014 Uncategorized
Study Area

LMRF is working since 5 years in 20 PHCs stated as 10 control and 10 Intervention Clusters in four districts of Maharashtra i.e.

  • Nagpur
  • Bhandara
  • Wardha
  • Chandrapur

These Clusters were selected due to their low geographic area, higher number of Infant, Neonatal and Maternal Mortality ratio, poor facility services and delayed in seeking healthcare facilities and also due to lack of health Problem awareness.

Sr No. Districts PHCS Villages Population Sub- Centers
1 Nagpur Mansar 24 27377 7
Nagardhan 25 25349 5
Satak 19 17523 4
Kondhali 45 36364 9
Kanholibara 29 23636 5
Takalghat 34 32322 5
Salwa 31 19960 6
Badegaon 34 21997 6
Tishti 11 11831 3
Patansawangi 29 45499 7
Bela 36 21175 6
2 Wardha Sindhi- Rly 14 23689 6
Mandgao 59 35184 9
3 Bhandara Ekodi 31 30265 6
Kardi 25 30773 6
Pahela 38 32704 6
Pohara 29 29826 7
Dighori 14 16214 6
Bhuyar 31 17974 4
4 Chandrapur Shankarpur 28 25454 4


30 June, 2014 Uncategorized
Awards & Achievements by LMRF
  • Winner of 2009 Grant competition, South Asia Innovate for Nutrition, World Bank,  Bangladesh, 2009.
  • Chairman’s distinction for Manthan Award 2011.
  • Finalist at Vodafone ‘Mobiles for Good’ Grant Fund, 2011.
  • Selected for presentation of our work at mHealth Summit, Washington DC and World Breastfeeding Conference, New Delhi, 2012.
  • Audience vote prize at the South Asia Regional Development Marketplace – Knowledge Forum on nutrition presentations, Kathmandu, Nepal, June 2012.
  • CAMTech: As a result of our performance in Global Network studies, in collaboration with Massachusetts General Hospital, MGH CAMTech with MIT (Massachusetts Institute of Technology) invited us to participate in testing of low cost medical devices and this was published recently in New York Times.
Awards & Achievements by Dr.Archana Patel,SFI and the Program Director, LMRF
  • More than 100 publications to her credit and 51 since 2008 when the site was included as the GN site.
  • She has been invited to conduct workshops and deliver her presentations at a number of international forums such as :
    • International Food Policy Research Institute (IFPRI)
    • Partnerships and Opportunities to Strengthen and Harmonize Actions for Nutrition (POSHAN)
    • The Energy and Resource Institute (TERI)
    • ICMR
    • World Bank and South Asia Regional Development Market Place (SARDM)
    • Paediatric Emergency Triage, Geneva
    • Federation of Indian Chambers of Commerce and Industry (FICCI-HEAL)
    • Bill & Melinda Gates Foundation
    • WHO
    • Global Alliance to Eliminate Lead Paint
    • CAMTech
    • International Congress of Nutrition (ICN) symposium
    • University of Sydney
    • International Union of Nutrition Sciences (IUNS)
    • Pediatric Association Pediatric Academic Society (PAS)
    • Congress of the International Pediatric Association
    • SAIFRN, etc.
  • Vocational Excellence Award 2011-12 – Rotary Club of Nagpur
  • Lokmat Vidarbha Sakhi Gaurav Award 2012, for outstanding excellence and contribution to the field of medical services.
  • Indian Journal of Pediatrics Dr. I.C. Verma Excellence in Research Award 2013
  • Best Researcher Award: 7th Asian Society for Pediatric Research, Pediatric Academic Society, Denver, USA, May 2010
  • IndiaCLEN (Indian Clinical Epidemiology Network) Best Research Protocol – 2009


28 June, 2014 Uncategorized

The following is a list of downloadable publications by LMRF.


1.  Platelet distribution width (PDW) is increased in vaso-occlusive crisis in sickle cell disease.

2. Predictive Performance of Anthropometric Indexes of Central Obesity for the Risk of Type 2 Diabetes.

3. Value of Mean Corpuscular Volume and Mean Corpuscular Hemoglobin in Screening for ß -Thalassaemia Trait.

4. Bias-corrected diagnostic performance of the naked eye single tube red cell osmotic fragility test (NESTROFT): An effective screening tool for ß-thalassemia.

5. Loss of lag-response curvilinearity of indices of heart rate variability in congestive heart failure.

6. Association of umbilical cord blood lead with neonatal behavior at varying levels of exposure.

7. A prospective cohort study of postoperative complications in the management of perforated peptic ulcer.

8. Insights into age- and sickle-cell-disease- interaction using principal components analysis.

9. Erythrophagocytosis in sickle cell anemia: Statistical evidence for a biological phenomenon.

10. Prevalence of b-thalassaemia in subcastes of Indian Sindhis: Results from a two-phase survey.

11. A simple method to combine multiple molecular biomarkers for dichotomous diagnostic classification.

12. A clinicopathological study of eyelid malignancies from central India.

13. A tool for rapid socioeconomic assessment.

14. Association of the pattern of transition between arousal states in neonates with the cord blood lead level.

15. Comparative study of four candidate strategies to detect cervical cancer in different health care settings.

16. Impact of training on observer variation in chest radio graphs of children with severe pneumonia.

17. Prognostic value of direct bilirubin in neonatal hyperbilirubinemia.

18. Is NESTROFT sufficient for mass screening for beta-thalassaemia trait?

19. Screening for HIV infection by health professionals in India.

20. A randomised controlled trial of high-dose isoniazid adjuvant therapy for multidrug-resistant tuberculosis.

21. Author Reply.

22. Influence of iron chelators on myocardial iron and cardiac function in transfusion-dependent thalassaemia: a systematic review and meta-analysis.

23. Author Reply.

24. Use of the QuantiFERON-TB Gold In-Tube test to monitor treatment efficacy in active pulmonary tuberculosis.

25. Value of chest radiography in predicting treatment response in children aged 3-59 months with severe pneumonia.

26. Breastfeeeding and infant feeding practices in India – A review of demographic and health surveys and national family health surveys.

27. Blood lead levels in children with encephalopathy.

28. A clinical tool to predict failed response to therapy in children with severe pneumonia.

29. Factors influencing the benefit of adjunctive devices during percutaneous coronary intervention in ST-segment elevation myocardial infarction: meta-analysis and meta-regression.

30. Value of early cardiac troponin I to predict long-term adverse events after coronary artery bypass graft surgery in patients presenting with acute coronary syndromes.

31. Bone recovery after zoledronate therapy in thalassemia-induced osteoporosis: a meta-analysis and systematic review.

32. Zinc and copper supplementation in acute diarrhea in children: a double-blind randomized controlled trial.

33. Survival benefit from early revascularization in elderly patients with cardiogenic shock after acute myocardial infarction: a cohort study.

34. Arbitrary units are a composite and useful measure of muscle sympathetic nerve activity.

35. Lack of Association of the Apoe 4 Allele with the Risk of Obstructive Sleep Apnea: Meta-Analysis and Meta-Regression.

36. Therapeutic Value of Zinc Supplementation in Acute and Persistent Diarrhea: A Systematic Review.

37. Influence of Zinc Supplementation in Acute Diarrhea Differs by the Isolated Organism.

38. Using wholre blood γ-interferon assay to improve diagnosis of tuberculous pleural effusion.

39. Hemoglobin F levels influence the results of NESTROFT: replication in two surveys.

40. Ultrafast papanicolaou stain modified for developing countries: efficacy and pitfalls.

41. Bayesian estimates of the prevalence of β-thalassemia trait in voluntary blood donors of central India: a survey.

42. Risk Factors for predicting diarrheal duration and morbidity in children with acute diarrhea.

43. What zinc supplementation does and does not achieve in diarrhea prevention: A systematic review and meta-analysis.



Click HERE for list of all publications.

Contact Us

28 June, 2014 Rest

Office Address:
Lata Medical Research Foundation,
Kinkini Kutir, Vasantnagar,
Nagpur – 440022

E-mail: [email protected]