MBBS, Lady Hardinge Medical College, University of Delhi
Diplomate National Board (MD Pediatrics), All India Institute of Medical Sciences, New Delhi
Ph.D. (Pediatrics), All India Institute of Medical Sciences, New Delhi
As a Senior Research Scientist and Pediatric Gastroenterologist at the Centre for Diarrheal Diseases and Nutrition Research, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, we conducted hypothesis driven studies that evaluated interventions directed at host responses in morbidity related to infections. Our research was primarily to facilitate evidence based recommendations in child health for global and national policy; algorithm for treatment of persistent diarrhea, low osmolarity oral rehydration salts solution and zinc in treatment of diarrhea. We participated in developing the clinical and research discipline of Pediatric Gastroenterology at AIIMS.
Current Research Interest
The predominant direction of our research is to conduct hypothesis driven and hypothesis generating studies that will facilitate development of knowledge based interventions and public health tools for child health. The broad focus is in the domain of molecular mechanistic causality of neonatal and infant infections particularly with reference to host responses and the potential interventions. Components of the immune system may be permanently programmed by events in fetal and early peri-or neonatal life which would have post-natal consequences. In order to study this hypothesis further we are doing immunological characterization of cord blood and early infancy, in full-term appropriate- and small-for-gestational age neonates, to examine the status of immune system maturation in a situation of intrauterine growth retardation; we are also evaluating other potential modifiers of the immune system maturation and development. Our other immediate objective is to understand if micronutrient supplementation or modification of the host gut flora can affect the host immune response to vaccines in early post natal life; an important public health issue in our country and other low and middle income settings where the efficacy of oral vaccines is poor.
In India, more than a quarter of the one million neonatal deaths are attributed to serious bacterial infections that include pneumonia, sepsis and meningitis. These severe infections are also a major cause of hospitalization in young infants. The outcomes of these infections in early infancy are poor. Interventions that can immediately improve the efficacy of existing standard therapy of serious bacterial infection in low resource settings are a high priority. We propose to study the biology of serious bacterial infections and evaluate interventions that can influence host responses to infections. As an immediate objective we propose to study the possible effects of micronutrients on host responses in infections amongst young infants.
Poor responses to vaccines in developing countries have impeded attempts at disease eradication or control. An initial program in this domain is to evaluate if micronutrients supplementation or factors that alter intestinal flora influence host immune responses to vaccines given at birth.
Another research focus is to develop diagnostics and low cost health products for childhood diseases. As an initial step in that direction we are developing a rapid in-house point of care test for diagnosis of celiac disease (CD) in partnership with International Centre for Genetic Engineering & Biotechnology, All India Institute of Medical Sciences and an industry.
Member National Academy of Sciences
Member National Academy of Medical Sciences
Fellow National Academy of Sciences
WHO Temporary Advisor for research in childhood diarrheal diseases
Recognition for research in Pediatric Gastroenterology at 2nd World Congress of Pediatric Gastroenterology, Hepatology & Nutrition
Hotam Tomar Gold Medal in recognition of excellent scientific contribution and services in Paediatric Gastroenterology and Nutrition
Dr. ST Achar Gold Medal Award for Research in Child Health
Bhatnagar S, Wadhwa N,Aneja S, Lodha R, Kabra SK, Natchu UCM, Sommerfelt H, Dutta AK, Chandra J, Rath B, Sharma M, Sharma VK, Kumari M and Strand TA. Zinc as adjunct treatment in infants aged between 7 and 120 days with probable serious bacterial infection: a randomised, double-blind, placebo-controlled trial. Lancet 2012;379:2072-8.
Wadhwa N, UCM Natchu, Sommerfelt H, Strand TA, Kapoor V, Saini S, Kainth UPS, Bhatnagar S (corresponding author). Oral rehydration solution containing zinc does not reduce during or stool volume of acute diarrhea in hospitalized children: A randomized controlled study. J Pediatr Gastroenterol Nutr. 2011 Aug; 53(2):161-7.
Efficacy of zinc supplements in reducing relapses in steroid-sensitive nephrotic syndrome. Arun S, Bhatnagar S, Menon S, Saini S, Hari P, Bagga A. Pediatr Nephrol 2009; 24(8): 1583-6.
Fontaine O, Kosek M, Bhatnagar S, Boschi-Pinto C, Chan KY, Duggan C, Martinez H, Ribeiro H, Rollins NC, Salam MA, Santosham M, Snyder JD, Tsai A, Vargas B, Rudan I. Setting Research Priorities to reduce Global Mortality from Childhood Diarrhoea by 2015. PLoS Med 2009;6:01-6.
Fasano A, M Araya, S Bhatnagar, D Cameron, C Catassi, M Dirks, ML Mearin, L Ortigosa, A Phillips. Federation of International Societies of Pediatric Gastroenterology, Hepatology, and Nutrition Consensus Report on Celiac Disease. Celiac Disease Working Group J Pediatr Gastroenterol Nutr 2008;47:214-219.
Bhatnagar S, Effects of zinc supplementation on child mortality. Lancet 2007;369:885-6.
Bhatnagar S, Aggarwal R. Lactose intolerance; should we worry about it? Brit Med J 2007;334:1331-2.
Kaur G, Rapthap CC, Kumar S, Bhatnagar S, Bhan MK, Mehra NK. Polymorphism in L-selectin, E-selectin and ICAM-1 genes inAsian Indian pediatric patients with celiac disease. Hum Immunol 2006;67(8):634-8. Epub
Ray P, Fenaux M, Sharma S, Malik J, Subodh S, Bhatnagar S, Greenberg H, Glass RI, Gentsch J, Bhan MK. Quantitative evaluation of rotaviral antigenemia in children with acute rotaviral diarrhea. J Infect Dis 2006 ;194(5):588-93.Epub.
Bhan MK, Bahl R, Bhatnagar S. Typhoid and paratyphoid fever. Lancet 2005;366:749-62.
Bhatnagar S, Gupta SD, Mathur M, Phillips AD, Kumar R, Knutton S, Unsworth J, Lock B, Natchu UC, Mukhopadhyaya S, Saini S, Bhan MK. Coeliac disease with mild to moderatehistological changes is a common cause of chronic diarrhea in indian children. J Pediatr Gastroenterol Nutr 2005;41:204-9.
Bhatnagar S, Bahl R, Sharma PK, Kumar GT, Saxena SK, Bhan MK. Zinc with oral rehydration therapy reduces stool output and duration of diarrhea in hospitalized children: a randomized controlled trial. J Pediatr Gastroenterol Nutr 2004;38(1):34-40.
Ray P, Malik J, Singh RK, Bhatnagar S, Bahl R, Kumar R, Bhan MK. Rotavirus Nonstructural Protein NSP4 induces heterotypic antibody response during natural infection in children. J Infect Dis 2003;187(11):1786-93.
Kaur G, Sarkar N, Bhatnagar S, Kumar S, Rapthap CC, Bhan MK, Mehra NK. Pediatric celiac disease in India is associated with multiple DR3-DQ2 haplotypes. Human Immunol 2002;63(8):677-82.
International Task Force. Effect of zinc supplementation on clinical course of acute diarrhea. J Health Population Nutr 2001;19:339-46.
Bhatnagar S (corresponding author), CHOICE Study Group. Multicenter, randomized, double-blind clinical trial to evaluate the efficacy and safety of a low osmolarity oral rehydration salts solution in children with acute watery diarrhea. Pediatrics 2001;107(4):613-8.
Alam NH, Majumdar RN, Fuchs GL & the CHOICE Study Group (Bhatnagar S: member of CHOICE Study Group). The efficacy and safety of a reduced osmolarity oral rehydration solution in adults with cholera: a randomized double blind clinical trial. Lancet 1999;354: 296-9.
Bhatnagar S, Singh KD, Sazawal S, Saxena SK, Bhan MK. Efficacy of milk versus yogurt feeding in acute non-cholera diarrhea among malnourished children. J Pediatr 1998;132:999-1003.
Bhatnagar S, Bhan MK, Singh Kiran Deep, Srivastava R. Prognostic factors in hospitalized children with persistent diarrhoea; implications for diet therapy. J Ped Gastroenterol Nutr 1996;23:151-8.
Bhatnagar S, Bhan MK, Singh Kiran Deep, Saxena SK, Shariff M. Efficacy of milk based diets in persistent diarrhoea: a randomized controlled trial. Pediatrics 1996;98:1122-6.
Bhan MK, Bhatnagar S, Singh KD (Corporate authorship). International working group on persistent diarrhoea. Evaluation of the efficacy of an algorithm for the treatment of persistent diarrhoea: A multicentric study. Bull WHO 1996;74:479-89.
International Study Group, (Bhatnagar S: Corporate authorship) on reduced osmolarity ORS solutions. Multicentre evaluation of reduced-osmolarity oral rehydration salts solution. Lancet 1995;345:282-5.
Bhatnagar S, Bhan MK, George C, Gupta U, Kumar R, Bright DS, Saini S. Is small bowel bacterial overgrowth of pathogenic significance in persistent diarrhoea? Acta Paed 1992;81(S381):108S-13S.
Bhatnagar S, Bhan MK, Sazawal S, Gupta U, George C, Arora NK, Kashyap DK. Efficacy of massive dose oral gentamicin therapy in non bloody persistent diarrhoea with associated malnutrition. J Pediatr Gastroenterol Nutr 1992;12:117-24.
Sazawal S, Bhatnagar S, Bhan MK, Saxena SK, Arora NK, Aggarwal SK, Kashyap D. Alanine based oral rehydration solution. Assessment of efficacy in acute non-cholera diarrhoea among children. J Pediatr Gastroenterol Nutr 1991;12(4):461-8.
Bhan MK, Sazawal S, Bhatnagar S, Bhandari N, Guha DK, Aggarwal SK. Glycine, Glycyl-Glycine and Maltodextrin based oral rehydration solution: Assessment of efficacy and safety in comparison to standard ORS. Acta Pediatr Scand 1990;79:518-26.
Bhan MK, Ghai OP, Khoshoo V, Vasudev AS, Bhatnagar S, Arora NK, Rashmi, Stintzing Gudmund. Efficacy of lentil and pop rice based rehydration solution in comparison with standard glucose electrolyte solution. J Pediatr Gastroenterol Nutr 1987;6:392-9.
Bhatnagar S, Lodha R, Choudhury P, Sachdev HP, Shah N, Narayan S, Wadhwa N, Makhija P, Kunnekel K, Ugra D. Consensus statement of the IAP National Task Force: status report on management of acute diarrhea. Indian Pediatr 2007;44:380-9.
Bhatnagar S, Tandon N. Diagnosis of Celiac Disease. Indian J Pediatr 2006;73(8):703-9.
Chapters in standard text books
Bhatnagar S, Lodha R, Bhatia V, Wadhwa N, Agarwala A. Nutrition. Ghai Essential Pediatrics, 7th Edn. Pub: CBS & Distributors 2009;57-77.
Bhatnagar S, Aggarwal A, Kumar P. Nutritional management of Celiac disease in Basics of Clinical Nutrition. Ed: Joshi YK. 2007;302-16.
Bhatnagar S,Singh M, Medical Emergencies in Children, 4th edition Pub: Sagar 2007;334-51.
Bhatnagar S, Kunnekal K. Antimicrobial therapy in acute gastroenteritis. Rational Antimicrobial Practice in Pediatrics. Eds: Shah N, Singhal T. Pub: Indian Academy of Pediatrics 2006;125-33.
Bhatnagar S, Aggarwal A, Sharma P. Nutritional management of Celiac disease in Basics of Clinical Nutrition. Ed: Joshi YK. Pub: Jaypee 2003; 220-6.