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Faculty
Department of Respiratory Allergy & Applied Immunology
and
National Centre of Respiratory Allergy, Asthma & Immunology (NCRAAI)
1. Dr. Raj Kumar
Professor and Head
Phone: (O): 011-27667102/441/667182, Extn: 144, Fax (O): 011-27666549
Mobile : 098101-46835
Email : rajkumarvpci@gmail.com; rajkumar_27563@yahoo.co.in
Website : www.drrajkumar.com
Professor Raj Kumar did his M.B.B.S. in 1984 from Maulana Azad Medical College & Assoc. LNJP, GB Pant Hospital, New Delhi and MD (Tuberculosis & Respiratory Diseases) in 1995 from VP Chest Institute, University of Delhi, Delhi.
Dr. Raj Kumar, presently heading the Department of Respiratory Allergy & Applied Immunology, and Head, National Centre of Respiratory Allergy, Asthma & Immunology (NCRAAI), VP Chest Institute, a premier government research institute of University of Delhi, Delhi. His unique Department and Centre pioneered acclaimed research in India including systematic comprehensive studies on the etiologic significance of pollen, insects, fungi, algae and animal dander etc. in respiratory allergic disorders which involved the development of various modern in-vitro techniques to study their allergenic and antigenic properties.
Dr Raj Kumar has research interests in clinical allergy with special reference to food allergy in bronchial asthma, rhinitis, fungal allergy and other respiratory diseases. He has over 20 years of experience with diagnostic & therapeutic modalities in management of respiratory diseases. He has special interest in diagnostic Bronchoscopy. Actively involved in teaching MD/DTCD (Pulmonary Medicine)/ & Ph.D. courses. He has to his credit over 205 publications; 7 books; 85 original papers; 42 articles, and 71 abstract. He has been principal investigator of many government funded research projects on indoor air pollution, food allergy and bronchial asthma and allergy rhinitis, Sleep, Smoking Cessation funded by govt. agencies viz. ICMR, UGC, DST, Ministry of Environment & Forests and the World Health Organisation (WHO) and Ministry of Health & Family Welfare, India. He is the Secretary, Society of Tobacco Control (STC) and Member, executive council of Indian College Allergy, Asthma & Applied Immunology and National College of Chest Physicians. He is the Treasurer of the South Asia Association of Allergy, Asthma & Immunology (SAAAACI). He is member of National Science Academy and Member of National Academy of Medical Sciences. He has organized the 13th Joint National Conference of the Indian Chest Society (ICS) and the National College of Chest Physicians (NCCP) NAPCON - 2011” at India Habitat Centre, New Delhi, 27th - 30th November 2011 and also first International Conference of South Asia Association of Allergy, Asthma & Immunology (SAAAACI) during Feb 12-13, 2011. He has organized 80 conferences, attended 202 conferences and presented abstracts 71 at conferences.
Some specific areas of study undertaken by Dr. Raj Kumar include Allergic Bronchopulmonary Aspergillosis, Food Allergy in Bronchial Asthma, Bronchial Asthma, Rhinitis, Allergy /Allergy testing, Indoor Air Pollution and Respiratory Allergy, Smoking Cessation, Bronchoscopy, and food allergy in detail starting from prevalence, diagnosis, protein characterization, role of IgE, allergenic cross-reactivity etc.
To mention a few awards and honours received by Dr. Raj Kumar - “Delhi Gaurav” in 1997, “Outstanding performance, remarkable contribution and distinguished service to the IMA-East Delhi Branch” in 1997, Rashtriya Gaurav Saman” by Delhi Govt. in 1998, “Senior Scientist Award” by NCCP(I) in 1999, “David A and Julie A Steven Scholar Award for contribution on ABPA” in 2006 in Greece. Many fellowships and scholarships, Travel grants to visit in different countries for academic work such as Singapore, Korea, France, Thailand, Greece, Sweden, Italy, USA etc. He has been member of editorial boards of national and international journals, Supervisor and examiner for MD and DTCD exams, Reviewer of different national and international journals. Dr. Raj Kumar has been in charge of a “Tobacco Cessation Clinic (TCC)” funded by WHO since 2002, providing free counseling and other educational programmes. He has also conducted many workshops to train the physicians, counselors, volunteers and other stake holders involved in smoking cessation. He has been involved in training Bronchoscopy to the physician from Srilanka and Bangladesh.
(2) Research Areas
· Allergic Bronchopulmonary Aspergillosis: An epidemiological study on ABPA has been done for the first time in India and the prevalence of ABPA was 16% in asthmatic patients (Asian Pacific Journal of Allergy and Immunology-2000; Clin Pul Med-2004). For the first time, a clinico-serological evaluation of ABPA has been done staging ABPA as mild, moderate and severe form of ABPA. (Journal of Asthma-2002, Chest-2003). The ABPA patients were categorized as ABPA-S, ABPA-CB and ABPA-CB-ORF for the first time. This study was awarded for David A and Julie A Stevens Scholar award in 2006 at Greece. ABPA with Aspergilloma mimicking pulmonary tuberculosis has been seen and many cases of ABPA was evaluated, 30% of ABPA were misdiagnosed as tuberculosis and given treatment (Ind J Tub; 47:103-105, Ind J Tub 2000, Ind J Allergy Asthma Immunol 2003, Indian J. of Allergy, Asthma and Immunology, 2010, Annals of Allergy, Asthma & Immunology 2011). A clinical, serological and radiological characteristic of patterns of ABPA was evaluated (Annals of Allergy, Asthma & Immunology 2011). The role of Itraconazole in ABPA has also been examined (Saudi Medical Journal-2003). Subsequently, the study of ABPA has been reviewed extensively and published in different journals.
· Food Allergy in Bronchial Asthma: Role of food allergy in bronchial asthma has been studied in detail including epidemiology, type of common food products causing allergy and clinical and serological aspects in the diagnosis of food allergy in bronchial asthma (Clin. Pulm Med-2005). Black gram allergy in patients of asthma and rhinitis; Prevalence of food allergy in respiratory diseases (Allergy-2005); Relevance of IgE estimation in allergic bronchial asthma with special reference to food allergy (Asia Pac All Immunol 2006); Sensitization of blackgram allergy in patients of asthma and rhinitis. Clinical evaluation and characterization of allergens (Allergy 2006); Rice allergy in rhinitis and asthma (Immunology 2007) has been studied extensively. Prevalence of food allergy by identification of IgE mediated food allergy and allergens in older children’s and adults with asthma and rhinitis was evaluated and found out to be 4% (India J Chest Dis Allied Sc 2010).
· Bronchial Asthma: Specific detailed studies undertaken covered topics such as Prevalence of asthma in school girls; Evaluation of market spacer in bronchial asthma: Study on different drugs (Ipratropium Bromide, Tiopropium) used in bronchial asthma; Role of inhaled Frusemide in asthma; Pulmonary function test of parents of asthmatic children; Exhaled carbon monoxide level as marker of clinical severity and control of asthma; Pulmonary rehabilitation in asthma and COPD; Inhaled magnesium sulphate in severe asthma; Time of recovery of acute exacerbation in asthma, IgE level in asthmatic patients and their families has been studies. Affect of Indoor Air Pollutants and Bronchial Asthma in Children has been evaluated extensively.
· Rhinitis: Airway obstruction in rhinitis is an important area studied in detail besides other aspects of rhinitis. Different drugs (Budesonide, Beclomethasone) used have been studied for their efficacies. Pulmonary function test in patients of Rhinitis and Prevalence of Allergic Rhinitis in Children has been evaluated. Indore Air pollutant level such as RSPM, SO2, NO2, and rhinitis has been studied in children’s.
· Allergy/Allergy testing: A study of skin sensitivity to various allergens by Intradermal test in patients (341) with respiratory allergy, bronchial asthma and allergenic rhinitis in India has been studied and published (Intern med J Thai 2003). Three hundred and forty one patients have undergone allergy testing with 20,119 Intradermal tests done. Identification of cross-reactive patients amongst different curvularia species (Int Arch Allerr & Immu 2002), allergic cross-reactivity of curvularia lunata with other airborne fungal species (Allergy 2002) have been studies.
· Indoor Air Pollution and respiratory allergy: Role of indoor air pollution on respiratory system of children in different parts of Delhi has been studies. The correlation between clinical symptoms, Spirometry, passive smoking and Indoor air pollutants like NO2, SO2 and SPM have been evaluated in homes of different parts of Delhi. Indoor air pollution and history of asthma, rhinitis, URI have been extensively studies. (Archives of Environmental & Occupational Health 2007: 62 (2); 75-80, Asia Pacific Journal of Public Health. 2008 Vol (20) No.1, 36‑48). Impact of domestic air pollution from cooking fuel on respiratory allergy in children in India has been studied (Asian Pacific Journal of Allergy and Applied Immunology (2008) 26: 213-222). Other studies conducted were – Effect pf air pollution on respiratory systems of auto-rickshaw drivers in Delhi; Bronchial asthma in petrol pump workers(Ind J Occ and Env Medicine 2000; 4(4): 168- 171, Indian Journal of Occupational and Environmental Medicine 2003; 7(3): 13-16).
· Smoking Cessation: Tobacco consumption among college students of University of Delhi has been done and total 25% students use tobacco in one of the form (Ind. J. of Prev. Social Medicine – 2010). The Role of Pharmacotherapy and counseling in Tobacco Cessation was evaluated and the quit rate at one year as found to be 26% (Lung India 2010, Ind. J. Chest Allied Sci-2007). Tobacco Cessation in India was review (Ind. J. Chest Dis. Allied Sci.-2005). Effect of smoking on atopic predisposition and sensitization to allergens were studies (Indian J. Chest Allied Sci.-2008). A comparative study was done between bidi and cigarette smokers and Breath CO level was found to be significantly more in bidi smokers compared to cigarette smokers. (Ind. J. Chest Dis All. Sci.-2010). Breath CO level in passive smokers mainly the worker in hotel restaurants, bar were studies and found to be significantly high compared to non smokers (Ind. J. Chest Dis. Allied Sci. 2011). Rhinitis was found to be more in bidi smokers comparison to cigarette smokers (Ind. J. Allergy, Asthma, Immunol 2011). Contributed to develop Tobacco Dependence guideline for national tobacco control programe, Govt. of India (Tobacco Dependence Treatment Guideline Govt. of India-2011). The smoking Cessation program and other preventing strategies for COPD was evaluation. (JAPI-2012).
(3) Ongoing and Completed Research Projects
Ongoing Research project
1. Effect of Indoor Air Pollution on respiratory function children (7‑15 years).
2. To study the prevalence of Obstructive Sleep Apnoea amongst middle aged Chronic Obstructive Airway Disease (COPD & persistent asthma) patients by a home based sleep study and atopy.
3. Effects of Steroids on Peripheral Skin Thickness Assessed by Ultrasound in Patients of Interstitial Lung Disease (ILD) and Other Respiratory Diseases.
4. Genetic Association study of Polymorphisms related to chronic obstructive Pulmonary Disease and its measures in north Indian population: COPD Genetics Consortium.
Completed Research project
1. Studies on foods as sensitizing and inducing factors of allergy disorders with special reference to bronchial asthma.
2. Molecular Genetic Asthma in Indian population.
3. Delhi college students Tobacco survey, Antismoking Campaign and Anti-smoking intervention – with the objectives to study the profile of smokers (College students ) and their perception towards its use, to conduct antismoking educational programme, to provide support to quit smoking, to provide assistance to visit to antismoking.
4. To study the prevalence of Obstructive Sleep Apnea amongst middle aged Chronic Obstructive Airway patients by a home based sleep study and its relation to atopy.
5. To undertake information for measuring Carbon Monoxide level of passive smokers working in Delhi hotel & restaurants.
(4) List of Publications
(a) International Journal:
1. Raj Kumar, Gaur SN. Prevalence of allergic bronchopulmonary aspergillosis in patients with bronchial asthma. Asian Pacific Journal of Allergy and Immunology 2000, 18:18- 185.
2. Raj Kumar, SK Chhabra, SN Gaur. A comparative clinicophysiological study of Beclomethasone Dipropionate and Disodium Cromoglycate in patients with bronchial asthma. Chest 2000; 118: 4: 187 (S).
3. Raj Kumar. Allergic Bronchopulmonary Aspergillosis in bronchial asthma: a review of 29 cases. Allergy & Clinical Immunology International 2000: 102 (S).
4. Raj Kumar, Tajender Vasu. Paradoxical response to chemotherapy in Tuberculous pleural effusion. Saudi Medical Journal 2001; 22(9): 812 – 813.
5. Vandana Bisht, BP Singh, Raj Kumar, Naveen Arora, Susheela Sridhara. Culture filtrate antigens and allergens of Epicoccum nigrum cultivated in modified semi-synthetic medium. Medical Microbiology and Immunology 2002; 191: 11-15.
6. Ratna Gupta, BP Singh, Susheela Sridhara, SN Gaur, Raj Kumar, Vijay K Chaudhary, Naveen Arora. Identification of Cross-reactive proteins amongst different Curvularia species. International Archieves of Allergy & Immuno 2002; 127: 38 46.
7. Raj Kumar, Deepti Chopra, HK Vatsa, Neelima Raj, Sanjay Rajpal. Evaluation of Pulmonary Function Test in parents of asthmatic children. Inter Med J Thai 2002; 18: 151 – 154.
8. Ratna Gupta, BP Singh, S Sridhara, SN Gaur, R Kumar, VK Chaudhary, N Arora. Allergenic cross-reactivity of Curvularia lunata with other airborne fungal species. Allergy 2002; 57: 636 – 640.
9. Raj Kumar, Deepti Chopra. Evaluation of Allergic bronchopulmonary Aspergillosis in patients with and without central bronchiectasis. J of Asthma 2002; 39(6): 473- 477
10. R Nagarkatti, C B Rao, J P Rishi, R Chetiwal, V Shandilya, VK Vijayan, Raj Kumar, HK Pemde, SK Sharma, Sweety Sharma, AB Singh, SV Gangal, Balaram Ghosh. Association of IFNG gene polymorphism with asthma in the Indian population. J Allergy Clin Immunol 2002; 110(3): 410-412.
11. Raj Kumar, Rajan Arora, SN Gaur. Effect of Itraconazole therapy in Allergic Bronchopulmonary Aspergillosis. Saudi Medical Journal 2003; 24(5): 546-547.
12. Raj Kumar, Mild, moderate and severe form of allergic bronchopulmonary aspergillosis – a clinical and serological evaluation. Chest 2003; 124: 890-892.
13. Pankaj Singhal, Raj Kumar. A Study of Skin Sensitivity to Various Allergens by Intradermal Test in Patients with Respiratory Allergy (Bronchial Asthma and Allergic Rhinitis) in India. Intern Med J Thai 2003; 19(3): 202‑206.
14. Raj Kumar, Pranav Singh. Epidemiological Aspects of Allergic Bronchopulomonary Aspergillosis. Clin Pul Med 2004; 11: 65-70.
15. Raj Kumar, HK Vatsa, Govind Prasad. Airway Obstruction in Rhinitis. Intern Med J Thai 2004; 20: 95-98.
16. Rana Nagarkatti, Raj Kumar, Surendra K. Sharma, Balaram Ghosh. Association of IL4 Gene Polymorphisms with Asthma in North Indians. International Archives of Allergy and Immunology 2004; 134: 206-212.
17. Raj Kumar. Food Allergy in Bronchial Asthma. Clin Pulm Med 2005; 12: 139-145.
18. Dolly Kumari, Raj Kumar, S. Sridhara, Naveen Arora, S N Gaur, B P Singh. Sensitization blackgram allergy in patients of asthma and rhinitis: Clinical evaluation and Characterization of allergens. Allergy 2006; 61(1): 104-110.
19. Raj Kumar, Bhanu P. Singh, Prakriti Srivastava, Susheela Sridhara, Naveen Arora and Shailendra N Gaur. Relevance of serum IgE estimation in allergic bronchial asthma with special reference to food allergy. Asia Pacific Journal of Allergy and Immunology 2006; 24: 191-199.
20. Raj Kumar, Prakiriti Srivastava, S. Sridhara, Naveen Arora, SN Gaur, BP Singh. Rice (Oryza Sativa) allergy in rhinitis and asthma patients. A clinico-immunologic study. Immunology; 2007, 212: 141-147.
21. Raj Kumar, Jitendra K Nagar, Harsh Kumar, Alka S Kushwah, Mahesh Meena, Pawan Kumar, Neelima Raj, MK Singhal, SN Gaur. Association of indoor and outdoor air pollutant level with respiratory problems among children in an industrial area of Delhi, India. Archives of Environmental & Occupational Health 2007: 62 (2); 75-80.
22. K Raj, K Dolly, S Prakriti, F Heena, A Naveen, GSN, SBP. Rrevalence of food allergy and its impact on bronchial asthma & rhinitis patients. Allergy:2007,62(83S) 347.
23. Priyanka Aggarwal, Raj Kumar. Diagnostic yield of induced sputum and fibreoptic bronchoscopy in sputum smear negative pulmonary tuberculosis. Respirology 2007: 12 (S 4), A240.
24. Raj Kumar, Jitendra K. Nagar, Alka Singh Kushwah, Neelima Raj, Mahesh Meena, SN Gaur. Indoor air pollution and respiratory function of children in Ashok Vihar in Delhi; an exposure – response study. Asia Pacific Journal of Public Health. 2008 Vol (20) No.1, 36‑48.
25. Ravneet Singh Grover, Raj Kumar. Exhaled carbon monoxide levels: As a marker of clinical severity and control of asthma. Journal of Asthma 2008; 45: 8; 677-680.
26. Raj Kumar, Jitender K Nagar, Neelima Raj, Pawan Kumar, Alka S Kushwah, Mahesh Meena, SN Gaur. Impact of domestic air pollution from cooking fuel on respiratory allergies in children in India, Asian Pacific Journal of Allergy and Applied Immunology (2008) 26: 213-222.
27. Singh AK, Gaur S, Kumar R. A randomized controlled trial of intravenous mangnesium sulphate as an adjunct to standard therapy in acute severe asthma. Iran J Allergy Asthma Immunol, 2008 Dec; 7(4): 221-9.
28. Anupam K Singh, SN Gaur, Raj Kumar. Clinical predictors associated with PEFR in severe exacerbation of asthma. Chest 2008, 134: 8003 S.
29. Shailendra N. Gaur, Anupam Singh, Raj Kumar. Evaluating role of inhaled magnesium sulphate as an adjunct to salbutamol and ipratropium in severe acute asthma. Chest 2008; 134: 92001 S.
30. Nurul Haque, Rajkumar, VK Vijayan. Effect of glycomic control on outcome of acute exacerbation of COPD. Respirology 2008; 13(5): A120 S.
31. Caroli R, Goel N. Kalra H, Shah A, Menon B, Kumar R, Chhabra SK, Vijayan VK. Impact of respiratory intensive care unit (ICU) on survival of patients of interstitial lung diseases (ILD). Respirology 2008; 13(5): A 113 S.
32. Raj Kumar, Jitendra K Nagar, Pawan Kumar, Alka S Kushwah, Mahesh Meena, JP Srivastava. Impact of environmental tobacco smoke and indoor air pollution on respiratory allergy on children in Delhi. Respirology 2008; 13(5): A117 S.
33. Raj Kumar. Association of family history of allergy in patients of Asthma-Do parents centre more rise of asthma trend grandparents? Respire. 2010;2:72-75.
34. Raj Kumar. Clinical, Serological and radiological characteristics of parents with allergic Bronchopulmonary Aspergillosis (ABPA). Annals of Allergy, Asthma and Immunology. 2011(107) 5 (S-I) A35.
35. Dolly Kumari, Naveen Arora, Ramkrishan Kasera, S. Sridhara, Raj Kumar, Bhanu Pratap Singh. Isolation and charactertaion of a 28KDa major allergen from black gram (Phaseolus Mungo). Immunobiology 2012 (Accepted).
(b) National Journal:
36. Anil K. Aggarwal, Boby Bhalhotra, Raj Kumar, Ashok Shah. Intrathoracic Goiter in a 26 year old male. Indian J. Chest Dis Allied Sci. 1995; 37(4): 239-242.
37. Raj Kumar, Vatsa HK, Gaur SN. Role of nebulized ipratropium bromide in acute exacerbation of early chronic obstructive airway disease. JAPI 1998; 46: 1024-1026.
38. Raj Kumar, Vatsa HK, Gaur SN. Comparative study of Nebulised Salbutamol and Ipratropium Bromide in acute exacerbation of bronchial asthma. Indian J Allergy Appl Immunol 1998; 12(2): 93-95.
39. Raj Kumar, Vatsa HK, Gaur SN. Serial Measurements of lung volumes after inhaled salbutamol and salmeterol in bronchial asthma. Indian J Allergy Appl Immunol 1998; 12(2): 97-100.
40. Raj Kumar, Gaur SN. Malignant pleural mesothelioma without asbestos exposure. Indian J Chest Dis Allied Sci 1999; 41: 61-64.
41. Ratna Gupta, BP Singh, Susheela Sridhara, Raj Kumar, VK Chaudhary, Naveen Arora. Antigenic /allergenic proteins of curvularia lunata in natural media. Indian J Allergy & Appl Immunol 1999; 13(2): 45‑50.
42. Raj Kumar, Gaur SN. A comparative study of budesonide and beclomethasone dipropionate aqueous nasal spray in perennial rhinitis. Indian J Allergy & Appl Immunol, 1999; 13(2): 41-43.
43. Raj Kumar. Effect of air pollution on respiratory system of autorickshaw Drivers in Delhi. Ind J Occ and Env Medicine 1999; 3(4): 171-173.
44. Raj Kumar. Allergic Bronchopulmonary Aspergillosis with Aspergilloma mimicking pulmonary tuberculosis. Ind J Tub 2000; 47: 103-105.
45. Raj Kumar. Allergic Bronchopulmonary Aspergillosis – Review of 29 cases. Ind J Tub 2000, 47; 237 239.
46. Raj Kumar, Vatsa HK. Comparative study of inhaled salbutamol, Ipratropium Bromide in chronic bronchitis. The Ind. Pract. 2000, 53(11): 737 ‑ 739.
47. Raj Kumar, Susheela Sridhara, Jyotsna Verma, Naveen Arora, BP Singh. Clinico-immunologic study on allergy to pulses – a case report. Indian J Allergy & Applied Immunol 2000; 14(1): 15 – 20.
48. Sanjay Rajpal, Raj Kumar, Dhingra VK, Kabir Sheikh. Isoniazid induced psychosis – a case report. Indian J Allergy & Applied Immunol 2000; 14(1): 25 – 27.
49. Raj Kumar. A study of respiratory symptoms and lung function of welders in Delhi. Ind J Occ and Env Medicine 2000; 4(4): 168 – 171.
50. Dhingra VK, Sanjay Raj Pal, Raj Kumar. Concomitant presentation of pulmonary tuberculosis and Pulmonary Hydatid Disease in a TB health worker. Indian J Allergy & Applied Immunol 2001 15(1); 49 – 52.
51. Raj Kumar, HK Vatsa, Govind Prasad. Therapeutic response of cumulative and non-cumulative doses of inhaled salbutamol in Bronchial asthma. Ind J Allergy & Appl Immunol 2001; 15(2): 103 – 105.
52. Dhingra VK, Sanjay Raj Pal, Raj Kumar. Epituberculosis responding without change of treatment regimen: A case report. Indian J Allergy & Applied Immunol 2001; 15(2): 111 – 116.
53. Raj Kumar, SN Gaur. Comparative evaluation of market spacer and home made (Bislery bottle) spacer in the management of Bronchial Asthma. Journal of the Association of Physicians of India 2002; 50: 397 – 399.
54. Sanjay Raj Pal, VK Dhingra, M Malik, Raj Kumar. Tuberculous epididymo-orchitis trated with intermittent therapy – a case report. Ind J Allergy Asthma Immunol 2002; 16(1): 51 – 54.
55. Raj Kumar, Clinical and radiological profile of 91 sputum positive (AFB) patients of pulmonary tuberculosis. “The Antiseptic” Vol 99; 12:447-448.
56. VK Dhingra, KK Chopra, Sanjay Rajpal, M Malik, Raj Kumar. Radiological and bacteriological profile of Pulmonary Tuberculosis in Diabetes. IJAAI 2002; 16(2): 103-106.
57. Raj Kumar, Vallish K Bhardwaj. Allergic Bronchopulmonary Aspergillosis in India Chest (Indian edition) 2003; 4(2): 67-68.
58. Raj Kumar. The role of inhaled frumeside in management of bronchial asthma. Indian Journal of Allergy, Asthma and Immunology 2003: 17(1): 5-8.
59. Dolly Kumari, Raj Kumar, S Sridhara, Naveen Arora, S N Gaur, B P Singh. Prevalence of food allergies in patients with respiratory allergy, asthma and allergic rhinitis. Indian J Allergy Asthma Immunol (Abstract) 2003; 17(1): 37.
60. Raj Kumar, Tarun Chugh, SN Gaur. Allergic Bronchopulmonary Aspergillosis – A Review. Ind J Allergy Asthma Immunol 2003; 17(2): 55-66.
61. S N Gaur, Raj Kumar, R Sinha. Prevalence of bronchial asthma in petrol pump workers of Delhi. Indian Journal of Occupational and Environmental Medicine 2003; 7(3): 13-16.
62. Susheel Kumar Bindroo, Raj Kumar, S N Gaur. Effect of Home-based Pulmonary Rehabilitation Program on Disability in Patients with Persistent Bronchial Asthma. IJAAI, 2004; 18(2): 63-71.
63. V K Vijayan, Raj Kumar. Tobacco Cessation in India. Indian J Chest Dis Allied Sci 2005; 47: 5-8.
64. Aman Pandey, Pankaj Singhal, Raj Kumar, S N Gaur. Effect of Home-based Pulmonary Rehabilitation Program on Disability in Patients with Chronic Obstructive Pulmonary Disease. Indian J Chest Allied Sci 2005; 47: 217‑219.
65.Tanmaya Talukdar, Pankaj Singhal, Ankit Jain, Raj Kumar, S N Gaur. Inhaled Magnesium Sulfate in the treatment of severe asthma. Indian J Allergy Asthma Immunol 2005; 19: 29-35.
66. Raj Kumar, Jitendra K Nagar, SN Gaur. Indoor air pollution and respiratory morbidity – A review. Indian J Allergy Immunol 2005; 19(1): 1-9.
67. Pankaj Singhal, Raj Kumar, S.N.Gaur. “Assessment of time course for recovery of patients with acute exacerbation of chronic pulmonary obstructive pulmonary disease and bronchial asthma. Indian J Allergy Asthma Immunol 2006; 20(1): 29-36.
68. SN Gaur, ZU Khan, Raj Kumar. Youngest patient of ABPA in Indian subcontinent – a case report. Indian J Allergy Asthma Immunol 2006; 20(1): 37-40.
69. Om Prakash, Raj Kumar, M Rahman, SN Gaur. The clinico-physiological effect of inhaled Tiotropium Bromide and inhaled Ipratropium Bromide in severe chronic obstructive pulmonary disease. Indian J Allergy Asthma Immunol 2006; 20(2): 105.111.
70. Jitender K Nagar, JP Shrivastava, Raj Kumar, Umesh Chandra, Brijesh Rathi, SVS Rana, Kafeel Ahmad. Urban Air Pollution : a global health problem – A review. Bull Env Sci 2007, XXV(3); 201-223.
71. Krishna Gupta, Raj Kumar, SN Gaur. Effect of domicillary pulmonary rehabilitation programme on disability in patients with Interstitial Lung Disease. Indian J Chest Dis Allied Sci 2007; 49: 213-217.
72. Raj Kumar, Alka S Kushwah, Gopal C Mahakud, Suraj Prakash and VK Vijayan. Smoking cessation interventionals and continuous abstinence rate at one year. Indian J Chest Allied Sci 2007: 49 (4), 201‑208.
73. Raj Kumar, Ritu Kulshrestha. Transbronchial lung biopsy in diffuse pulmonary cystic disease – a diagnostic dilemma. Indian J Pathol Microbiol 2007, 50(1), 241.
74. Nitin Goel, BP Singh, Naveen Arora, Raj Kumar. Effect of smoking on atopic predisposition and sensitization to allergens. Indian J Chest Allied Sci 2008: 50 (4), 329-33.
75. Raj Kumar, Pankaj Singhal, Ankit Jain, Neelima Raj. Prevalence of bronchial asthma and allergic rhinitis in school girls in Delhi. Indian J Allergy, Asthma and Immunology 2008: 22(2): 99-104.
76. Raj Kumar, Suraj Prakash, AK Kushwah, VK Vijayan. Breath carbon monoxide concentration in cigarette and bidi smokers in India. Indian J Chest Dis All Sci 2010; 52: 19-24.
77. Pranav Singh, Raj Kumar. Assessment of the effectiveness of sustained release bupropion and intensive physician advice in smoking cessation, Lung India , 2010; 27: 11-18.
78. Raj Kumar, R.Anandha Kumar: Allergic Bronchpulmonary Aspergillosis: Clinical spectrum of 101 cases. Indian J. of Allergy Asthma & Immunology, 2010 (241)55.
79. Raj Kumar, Dolly Kumari, Prakriti Srivastava, Vishal Khare, Hena Fakhr, Naveen Arora, S.N. Gaur, B.P. Singh. Identification of IgE mediated tool allergy and allergens in older children and adults with asthma and allergic Rhinitis. Indian J. Chest Dis. Allied Sci. 2010; 52; 217-224.
80. Raj Kumar, Alka S, Khushrah, Suraj Prakash, V. K. Vijayan. A study of Tobacco Consumption among college students of University of Delhi, Delhi, India. Indian Journal of Preventive and Social Medicine 2010 (41, 3-4): 198-202
81. Raj Kumar, Gopal C. Mahakud, Jitendra K Nagar, SP Singh, N. Raj, K. Gopal, VK Vijayan. Breathe Carbon Monoxide level of non-smokers exposed to environmental tobacco smoke. Indian J Chest Dis Allied Sci., 2011:53:215-219.
82. Raj Kumar, Gopal C. Mahakud, Jitendra K Nagar, Tabassum and Nitin Goel. Rhinitis and Tobacco Consumption : A brief study. Indian J Allergy Asthma Immunol 2011:25(1):15-20.
83. SN Gaur, Raj Kumar, Amit Kumar Lohia, Kshitij Agarwal. Sensitivity to common aeroallergens in allergic rhinitis as a predictor of bronchial hyperreactivity and development of asthma. Indian J Allergy Asthma Immunol 2011:25(2):61-66.
84. Ritu Kulshrestha, BK Menon, Raj Kumar, VK Vijayan. Role of a pattern based approach in interpretation of transbronchoscopic lung biopsy and its clinical implications. Indian J Chest Dis Allied Sci., 2012;54:9-17.
85. Raj Kumar, VK Vijayan. Smoking cessation programs and other preventive strategies for chronic obstructive pulmonary disease. JAPI, 2012:58;53-56.
86. Raj Kumar, Nitin Goel and SN Gaur. Sarcodosis in North Indian Population: Retrospective Study. Indian J Chest Dis Allied Sci., 2012 (Accepted).
87. Raj Kumar. Asthma in children. Health Care Bulletin, 1996; 4: 1-2.
88. Raj Kumar. The role of peak flow meter in Asthma care. Health Care Bulletin 1996; 1: 2-3.
89. Raj Kumar. Occupational asthma. Respiratory Diseases and air pollution disorders (IMA Publication) 1997; 78-83.
90. Raj Kumar. Haemoptysis. Respiratory Diseases and air pollution disorders (IMA Publication) 1997; 54‑60.
91. Raj Kumar. Acute severe asthma in children. Issues in pediatric practice. Jan-Mar 1999; 13-16.
92. Raj Kumar. Parent Education Programme – Issues in pediatric practice. April-June, 1999; 6-9.
93. Raj Kumar, M Singhal, Gaur SN. Role of clarithromycin in lower respiratory tact infections. Medicine update 1999; 927-928.
94. Raj Kumar. Inhalation therapy in bronchial asthma. Medicine update 1999; 8: 1075-1077.
95. Raj Kumar and Rahul Handa, Current Management of asthma – a review. Medicine update 1999 (Nov.), 1299 – 1303.
96. Raj Kumar and Rajan Arora. Bronchial Asthma in Children. Issues in Pediatric Practice 2000, July-Sept.: 7-11.
97. Puneet, Raj Kumar and Gaur SN. Pulmonary Tuberculosis in children. Issues in paediatric practice, 2000.
98.Yogesh, Raj Kumar. Allergic rhinitis in childhood. ENT update 2000, V-1, No.3, 4-7.
99. Raj Kumar. Inhalation Devices used in Bronchial Asthma, Course-cum-Workshop on Allergy & Asthma November 8-13 booklet 2000.
100. Puneet Tyagi, Raj Kumar. Bronchitis in children. Issues in Pediatric Practice 2000, Jan – Mar, 11 – 13.
101. Raj Kumar, Ajay Gupta. Difficult asthma. Refresher (CME) Course in Respiratory Diseases (Course book) V.P. Chest Institute. 2001, April – May, 35 – 37.
102. Raj Kumar, Inhalation therapy in Br. Asthma. Refresher (CME) Course in Respiratory Diseases (Course book) V.P. Chest Institute. 2001, April – May, 38 – 44.
103. Puneet Tyagi, S.N.Gaur, Raj Kumar. Childhood Tuberculosis. Refresher (CME) Course in Respiratory Diseases (Course book)) V.P. Chest Institute. 2001, April – May, 73 – 80.
104. Raj Kumar, Deepti Chopra. Pneumonia in childhood. Issues in Paediatric Practice 2001; V3 (1): 12 – 15.
105. Raj Kumar, Pranav Singh. Inhalation therapy in Bronchial Asthma. Continuing Medical Education (CME) in Respiratory Diseases. VP Chest Institute, April 2002, 15 – 19.
106. Ajay Gupta, Pankaj Singhal, Raj Kumar. Allergic Bronchopulmonary Aspergillosis (ABPA). Continuing Medical Education (CME) in Respiratory Diseases. VP Chest Institute, April 2002, 75 – 79.
107. Vallish Kr Bhardwaj, Raj Kumar. COPD: Recent advances in management. Medicine Update, 2002; 10 (4): 40-42.
108. Raj Kumar. Inhalation devices used in bronchial asthma. World health review, 2002 (1): 10-13.
109. Raj Kumar. Smoking Cessation. 3rd CME in respiratory disease, 3rd & 4th May 2003, book: 110-114.
110. Sushil Bindroo, Raj Kumar. Long term oxygen therapy. Respiratory care practice, 2003 (1): 8-10.
111. Sushil Bindroo, Raj Kumar. New insights in asthma, management options and current practice for use of oral methylxanthin in retard form. Medicine Update, 2004 (12, 3): 1-3.
112. Raj Kumar. Antimicrobial selection in community-acquired pneumonia. Co-sultaxime Update, 2004: 1(6): 1-4.
113. Raj Kumar, Harsh Kumar. Chapter on – Smoking Cessation. A practical approach to respiratory diseases, 2005: 435-441.
114. Raj Kumar, Suraj Prakash, Alka Singh Kushwah, Harsh Kumar. Smoking Cessation – Control Measures. Lung India, 2005; 22: 66-71.
115. Sushil Bindroo, Nitin Goel, Raj Kumar. Long term oxygen therapy 2004; 12(3): 23-25.
116. Raj Kumar. FDC’s in the management of tuberculosis : Radiological efficacy and the current WHO recommendations. Medicine Update, February 2005, 7-11.
117. Raj Kumar. Antimicrobial selection in community acquired pneumonia. Medicine Update, February 2005, 9-11.
118. Raj Kumar, Nitin Goel. Clinical case study – lower respiratory tract infection. Clinical case studies. August 2005, 1-5.
119. Raj Kumar, Pranav Singh. Smoking cessation measures: current concepts. Book released at Chest Summit 2006. organized by Foundation for Chest Critical Care & Sleep Medicine at India Habitat Centre, Delhi on Oct. 12-15,2006.
120. Singh P, Kumar R. Inhalation therapy in bronchial asthma. Indian Practitioner 2006: 59; 5:302-306.
121. Raj Kumar. Respiratory impact of food allergy. 1st International Conference on Lung health PULMOCON‑2008, 20-22 Feb 2008.
122. Raj kumar.Book Review – Text book of Pulmonary Medicine by D. Behra. JP Brothers – 2010, Indian J. Chest Dis. 2010-170
123. Raj Kumar, Nitin Goel. Magnitude of the problem of smoking in south-east Asia. Manual on Tuberculosis HIV and Lung Diseases – A practical Approach (Editor VK Arora, published by Jaypee) : 2010,Chapter 29, 379-388.
124. Raj Kumar. Indoor air pollution from cooking fuel and lung health, occupational and environmental health, Vidyanilyam Prakashan 2010(6) Page 57-70
125. Raj Kumar. Smoking and Lung Diseases : NCCP text book of Respiratory Medicine : Jaypee Brothers Medical Publisher(P.) Ltd. 2011:27:247-751.
126. Raj Kumar. Air Pollution and Respiratory Diseases. NCCP Text Book of Respiratory Medicine: Jaypee Brothers P. Ltd. 2011(28):752-755.
127. Raj Kumar Chapter in Book – Allergic Rhinitis and Sinusitis - by PS Shankar, Agam Vora and Salil Bendre. “Immunology in clinical practice”, Mumbai; 2011. 25-29.
128. Raj Kumar. Book review Textbook of Pulmonary and Critical Care Medicine: Jaypee Brothers P. Ltd. Indian J Chest Dis Allied Sci. 2011;53:191.
D. Written Books (Author of Books & Booklets)
1. An atlas of Common Allergens (2011)
Authors: Raj Kumar and VK Vijayan
Publisher: Vidyaniyam Prakashan 2011, Pages 96
A 96 page hardbound volume provides for easy identification of a variety of common allergens with their brief descriptions, habitat etc with color photographs.
2. Guidelines for smoking cessation – A manual for physicians (2003)
3. Smoking! Do you want to quit? Simple guidelines. (Released on 31.5.2002, ‘World No Tobacco Day’)
Authors: Raj Kumar and VK Vijayan
An 8 page booklet, this document briefly explains the best ways for the smokers to quit as well as new treatments to help. It also tells about ways to avoid relapses and talks about concerns smokers may have about quitting.
4. Smoking! Do you want to quit? A quit book ((Released on 31.5.2002, ‘World No Tobacco Day’)
Authors: VK Vijayanand Raj Kumar
A 40 page booklet aimed at educating the general public in detail on the harmful effects of environmental tobacco exposure and how tobaccosis is responsible for considerable avoidable morbidity and mortality. The book goes on aiming at helping smokers quit tobacco consumption in a step-by-step manner. The book is written in easy style for the common public to follow.
5. Textbook of Respiratory Medicine
Author : S.N.Gaur and Raj Kumar - 2001
Publisher : MBD Publication
Tuberculosis has generated a lot of interest in its study after the advent of AIDS. Similarly, respiratory diseases became more important after the understanding of the effect of environmental pollution on lung. Both these ailments literally constitute the maximum number of cases encountered in medical practice. Infectious diseases (Pneumonia), TPE, ABPA, Parasitic diseases which are less seen in developed countries are still prevalent in developing countries.
The book has 26 chapters covering major lung diseases in compact and concise manner. Each chapter contains figures, tables and sufficient X-ray photographs to provide the better picture of the disease. Chapters on Clinical assessment, Physical examination, Radiology, Specific diagnostic procedures, pulmonary function test have been incorporated to provide the practical aspects. Clinical aspects of very disease have been provided in the respective chapters supported by X-ray photographs. Recent concepts in the management of Tuberculosis as per WHO guidelines have been included in the chapter on Tuberculosis. Rare topics like Sleep apnoea syndrome. Air pollution, Drug-induced lung diseases have been included in the book.
It is a useful textbook for undergraduates, internists in respiratory diseases and clinicians.
1. Damma (A booklet in Hindi – 1997)
Authors: Dr. Raj Kumar and Dr. Neelima Raj.
20 pages booklet, answering all patient’s questions, devices used, their correct technique and details about disease, for the patients have been dealt here. The main emphasis is given on the patients’ education regarding disease and the social stigma attached. This book is in simple Hindi so that our common people can understand it.
2. Asthma – A Guide to Patients and Medical Practitioners
A 61 page book 1st Edition – 1997
Author – Dr. Raj Kumar
Publishers : Dhriti Publications
This book is written mainly for the patients and medical practitioners to provide them a clear understanding about the disease in simple language. All relevant questions which come in patient’s mind are answered. Various aspects of disease, management, devices used, prevention, role of immunotherapy is dealt. The pictorial diagrams have been given a place for clear understanding.
National Centre of Respiratory Allergy, Asthma and Immunology (NCRAAI)
The “National Centre of Respiratory Allergy, Asthma and Immunology (NCRAAI)” is a state-of- the-art Professional, Academic and National Centre for representing the specialty of respiratory allergy at all levels. The “National Centre for Respiratory Allergy, Asthma and Immunology” was inaugurated by Prof. P.N. Tandon, President of the National Brain Research Centre Society and Chairman, Governing Body to the Institute on 12th February 2011, during the inauguration of “1st Conference of the South Asia Association of Allergy, Asthma and Clinical Immunology (SAAAACI-2011)” is an important landmark as Vallabhbhai Patel Chest Institute is well known globally for its contributions in the field of respiratory allergy. We have started the research activities of the Centre with focus on community based research in allergy and asthma.
The Centre is under the supervision of Prof. Raj Kumar. The Centre fulfills the national need for providing relief to large number of patients in the community suffering from Respiratory allergy. It has eminently discharged its role and has earned a unique place in the field of Respiratory Allergy. The main objective is to improve allergy care – through research, education, and training. The Centre is fully equipped with latest technology in the field of research, Allergy testing and helpful for a large number of patients in proper diagnosis & efficient management of respiratory allergy diseases.
Achievements
1. For the first time in India, systematic comprehensive studies on the etiologic significance of pollen, insects, fungi, algae and animal dander, etc., in respiratory allergic disorders have been undertaken which involved the development of various modern in vitro techniques to study their allergenic and antigenic properties. These techniques include Radio-allergosorbent test (RAST), Rocket immunoelectrophoresis, Crossed immunoelectrophoresis (CIE), Crossed-line immunoelectrophoresis (CLIE), Sodium dodecyl sulphate -Polyacrylamide gel electrophoresis (SDS-PAGE), Thin layer isoelectric-focussing (TLIEF), etc. In addition, the immunochemical quantitation of airborne insect-derived allergen particles has been carried out for the first time in our country.
2. Development of an easy method of inhalation provocation test to detect the cause of allergic asthma which has been referred to, in standard text book of Respiratory Medicine by Crofton.
3. Establishment of monoclonal antibody staining techniques for the study of immunology of tuberculosis and leprosy.
4. Some of the studies have helped in understanding the alterations of immune system (i) in diseases like tuberculosis, leprosy and breast cancer and (ii) on treatment with drugs.
5. Study on phylogeny of immune response revealed that as one goes higher in the evolutionary tree, the classical complement pathway becomes more active as compared to alternative complement pathway.
6. Prevalence of food allergy in Bronchial asthma has been studied. The percentage of Food-related symptoms is common among respiratory allergy patients. Self-reports prevalence of food allergy was 69% could be confirmed in 4.4%, resulting in an overall estimated prevalence of 1.1% ([0.7101.75] at 95% Cl) in respiratory allergy patients. The common offending foods are rice, citrus fruits, blackgram and banana. Indoor air pollution and respiratory allergy.
7. Effect of Indoor air pollution on respiratory allergy has been studied extinguisley. Impact of air pollution like NO2, SO and RSPM has been studied.
8. An epidemiological study on ABPA has been done for the first time in India and the prevalence of ABPA was 16% in asthmatic patients.
9. For the first time, a clinico-serological evaluation of ABPA has been done staging ABPA as mild, moderate and severe form of ABPA. The ABPA patients were categorized as ABPA-S, ABPA-CB and ABPA-CB-ORF for the first time. This study was awarded for David A and Julie A Stevens Scholar award in 2006 at Greece.
10.Tobacco consumption among college students of University of Delhi has been done and total 25% students use tobacco in one of the form and the Role of Pharmacotherapy and counseling in Tobacco Cessation was evaluated and the quit rate at one year as found to be 26%.
11. A comparative study was done between bidi and cigarette smokers. The Breath CO level was found to be significantly more in bidi smokers compared to cigarette smokers. The Breath CO level in passive smokers mainly the worker in hotel restaurants, bar were studies and found to be significantly high compared to non smokers.
Transfer of Technology
Identification of local allergens lead to proper diagnosis and treatment of the patients with respiratory allergy. The results of immunotherapy with specific local allergens were encouraging. This created an exceedingly heavy demand on the Department for supply of these allergens from all over the country. Until 1969, the Department tried to cope with the ever increasing demand but the patients had to wait for several months for investigations and treatment. The Department at that time transferred the technology of allergen preparation to the CSIR, Institute of Genomics & Integrative Biology, a Govt. of India Undertaking to make them available on commercial scale for the use on patients.
Teaching/Training Programmes
Workshops on allergy, allergens and immune response
In 1975, the Department started conducting biannual Workshops on Allergy, Allergens and Immunotherapy in order to impart training, in clinical and laboratory aspects of diagnosis and management of allergic respiratory diseases to medical practitioners and faculty members of hospitals/research institutions working in various parts of India. From 1981 onwards, the Institute has been conducting these workshops in collaboration with the Institute of Genomics & Integrative Biology (CSIR). Faculty members and scientists from the VP Chest Institute, the Institute of Genomics & Integrative Biology (IGIB) and other medical institutions from Delhi and other parts of India participate in the teaching programme. About 25-50 medical postgraduates are trained annually in these workshops. The latest workshop in this series on "Respiratory Allergy: Diagnosis and Management" which was the 37th workshop held on April 2-6, 2012.
Patient’s Care
The Department has been the pioneer centre for research and teaching in the identification of local allergens and management of respiratory allergic disorders by administering immunotherapy. The skin test facility provided by the Department for a large number of patients has been helpful in proper diagnosis and efficient management of respiratory allergy diseases. In selected patient the Immunotherapy is given for therapeutic use. The department involved in the following activities:
1. Out Patient Department (OPD)
The Department conducts the OPD in the Vishwanathan Chest Hospital of the Vallabhbhai Patel Chest Institute on 5 days a week and to provide state-of-the- art facilities for diagnosis and therapeutic management of patients suffering from chest diseases.
2. Tobacco Cessation Clinic (TCC)
A Tobacco Cessation Clinic has been running on every Monday and Wednesday from 2:30 to 4:30 P.M. It is a World Health Organization (WHO) funded programme. The aims of helping people to stop smoking, preventing people from beginning to smoke and protecting non-smokers from the exposure to tobacco smoke.
3. Laboratory Testing
The Department is specialized and fully equipped with latest technology in the field of Allergy testing and doing different types of Allergy tests depend on allergic symptoms, history or the conditions of the skin.
(A) Skin Prick Test / Intradermal Test
The Department is doing the following types of allergy testing by Skin Prick test/ Intradermal tests:
i). Skin Prick Test : Common Aeroallergens (60 Allergens)
ii). Skin Prick Test : Food Allergy (67 Allergens)
iii). Skin Prick Test : Aspergillus Species (04 Allergens)
iv). Skin Prick Test : Fungal Allergy (12 Allergens)
(B) Specific IgE Allergy Screening Tests (MMUNOBLOT ASSAY TEST).
The Department is doing following types of SERUM BASED SPECIFIC IgE Allergy screen panel
Tests:
i). Indian Respiratory Panel Allergy (20 Allergens)
ii). Indian Food Panel Allergy (20 Allergens)
iii). Pediatric Panel Allergy (20 Allergens)
iv). Indian Mixed Panel Allergy (80 Allergens)
(C) Specific IgE Mediated Test (IMMUNOCAP - RAST)
(D) Specific IgG Test (Food Intolerance).
The Department is doing more than 200 different foods, which is commonly consumed by people as a daily needs. This food intolerance is base on microarray technology and available only for research purpose and not for patents.
(E) Total IgE Test.
The Department is doing Quantitative analysis of Immunoglobulin E (Total IgE) concentration in Human serum.
(F) Protein estimation. The Department is doing the estimation of different part of proteins from the human serum, are:
1). Albumin; 2). α1 – antitrypsin; 3). α2 – globulin ; and 4). β - globulin
Research
1. Studies on pollen allergy in Delhi metropolitan area
Systematic and comprehensive studies on the identification of clinically important pollen aeroallergens were undertaken. These studies involved, (i) Field surveys of Delhi and adjoining areas. (ii) Aerobiological surveys to identify and enumerate common airborne pollen types to study their seasonal prevalence. (iii) Collection and processing of common pollen types. (iv) Preparation and storage of pollen extracts, and (v) Clinico- immunologic studies to evaluate their allergenic significance. A large number of pollen types were identified 'and quantified in the air and their seasonal patterns were recorded. More than 150 different pollen extracts were prepared and were evaluated for their allergenic significance in patients with allergic respiratory disorders. About 50 of them were. found to be clinically significant. Besides these common anemophillous pollen allergens, allergy to pollen of an entomophillous plant (papaya tree) was also reported.
2. Studies on the allergenic significance of plants parts Parthenium and its relationship to pollen allergens Allergenic -potential of pollen and various parts of Parthenium hysterophorous was also studied: Pollen extract was found to be allergenic in 28% patients followed by flower (8%) and leaf extracts (6%) in that order. These studies suggested close relationship among pollen, leaf and flower extracts.
3. Atopic relationship amongst some species of chenopodiaceae and amarant- haceae
Antigens from pollen of the four species of chenopodiaceae (viz. Chenopodium album, C. murale, C. ambrosioides and a tetraploid of C. album) and two species of Amaranthaceae (viz. Amaranthus spinosus and A. hybridus) were skin tested on about 100 patients of nasobronchial allergy. The results indicated that positivity proneness of the patients varied from species to species; probably due to species in chenopodiaceae specific allergenic factors in this family.
4. Studies on allergenic fungi of Delhi metropolitan area A comprehensive, systematic study of aerial fungal spores in Delhi area was undertaken. In early sixties the fungal spores were enumerated using gravimetric methods by simultaneous exposure of slides and petri-plates. Two peak periods of fungal spore concentration were reported, one from September to November and the other from February to April. A comparison of results of the two gravinetric techniques with those obtained with a volumetric sampler was made in late 1980's. Of the 150 fungal types encountered in Delhi air, 20 were show:1 to be allergenic and aetiologically related to respiratory allergic disorders. Several new fungal allergens including 12 species of Aspergillus have also been identified.
5. Identification of new fungal allergens
Volumetric aeromycological survey of Delhi was undertaken to identify and quantify yet unknown airborne allergenic fungi of Delhi area. With a view to evaluating their significance as inhalant allergens, intradermal tests with a number of new fungal extracts were performed on the patients with respiratory diseases. Results showed that Penicillium nigricans, P. chrysogenum, P. funiculosam, Aspergillus clavatus, Fusarium chamydosporium, Nigrospora sp., Syncephalastrum sp., Gliocladium sp., and Trichoderma viridae were allergenically significant. Inclusion of these yet unknown fungal allergens in the skin test kit will increase the scope of identification of causative allergens in the patients of allergic respiratory disorders.
6. Presence of shared as well as unique allergenic and antigenic components in different fungal species Systematic studies were undertaken on the presence of shared or specific allergens or antigenic components among various genera, species and varieties of airborne fungi. .The results revealed that the allergenic and antigenic components among different fungal genera were largely specific and only a few of them were cross-reacting. Among various species of Aspergillus, a number of both shared as well as species specific components were observed. However, most of the allergenic and antigenic components among different varieties of P. funiculosum were found to be cross-reacting and only a few of them were variety specific.
7. Studies on insects Aetiologic significance of about 35 insects, prevalent in Delhi atmosphere was evaluated and all of them were found to be important inhalant allergens. Elevated levels of insect allergen specific IgE antibodies in the sera of respiratory allergy patients by radioimmunoassay were found.
8. lmmunochemical quantification of airborne insects and other allergens The etiologic significance of insects as producers of inhalant allergens causing type I respiratory allergic diseases was demonstrated by immunochemical quantification of airborne insect allergens for the first time in India, The insects studied were butterfly, moth, mosquito and housefly. These results have established conclusively that insects play an important role in type I hypersensitivity disorders of respiratory system.
On immunochemical quantification, seasonal varieties were noted in the amounts of airborne horse and dog dander allergens. Horse dander allergen varied from 0-16.5 ug/m3 of air, its peak periods being January to April and September to October. Airborne dog dander allergen ranged from 0-4.7 ug/m3 of air and was maximum during the months of January to March and September to December.
9. Demonstration of shared as well as unique allergenic and antigenic components in different insects genera and species and male/female cockroaches Clinicoimmunologic and immunochemical analysis of the allergen extracts of male and female cockroaches (Periplaneta americana), different genera of cockroaches (P. americana and Blatella germanica) and mosquitoes (Anopheles stephensi, Culex quinquefasciatus and Aedes aegypti) revealed the presence of shared as well as specific allergenic and antigenic components in different sexes and genera of insects, These observations will have significant bearing on the immunotherapy of patients with respiratory allergy.
10. Etiologic significance of various dusts in respiratory allergy Of the four dusts investigated, house dust and rice dust were found to be important as inhalant allergens, while the other two (cotton and paper dusts) were almost of no allergenic significance. All the dust related arthropods (housefly, rice weevil, male and female cockroaches and house dust mite) were also found to be important sources of inhalant allergens. However, these arthropods were not found to contribute significantly to the allergenicity of house dust and rice dust allergens.
11.Purification and characterization of significant allergenic components of clinically important inhalant allergens Allergen extracts used for diagnosis and immunotherapy of patients with respiratory allergic disorders are crude, complex mixtures, each comprising a number of biochemical components of different shapes, sizes and properties. While some of them may be allergenic others are non-allergenic. A few of the allergenic components may be major while some others are minor contributors in the allergic activity of the crude extract. For efficient diagnosis and efficacious immunotherapy in patients, it is important that extracts of appropriate biological activity are used. However, techniques/ immunological reagents are not available for the quality control of various commercially available allergen extracts. The Department has been working on the purification, isolation and characterization of major allergenic components of different groups of allergens. Partial purification of the whole body extract of cockroach (male and female) suggested the presence of shared low molecular weight significant allergens and cockroach (male) specific high molecular weight minor allergens. In housefly, Fr. III (~66 ,KD) has been identified as one of the significant allergens.
12. Study on the time course of retention of allergenic activity of some important allergen extracts Usually an allergen extract, when stored at 4oC in aqueous form, is considered to retain its allergenic activity for a period of one year. However, loss of biological activity was observed in some extract within 9 months, while some other extracts showed retention of activity for 15 or more months, even when stored at room temperature. While extracts with reduced allergenic activity should not be used for diagnosis and therapy of patients, discarding the batches of latter extracts after one year storage, while they are still biologically active, will lead to financial loss. Thus, there is an urgent need of studying the shelf life of other clinically important extracts.
13. Comparison of biological activity in some clinically important, allergen extracts supplied by different manufacturers The diagnostic efficiency and therapeutic efficacy of various allergen extracts used for skin tests and immunotherapy in patients with IgE mediated bronchial asthma and/or allergic rhinitis depend on the biological activity in the allergens extracts used. No quality control methods/reagents are available for standardization of allergen extracts in India. For this purpose, the present study has been undertaken to compare the biological activity in commercially available allergen extracts prepared by different manufacturers in India. Biological activity varied from allergen to allergen. The results emphasize the need for developing immunologic reagents and procedures for quality control of clinically important allergen extracts in our country.
14. New methods for enumeration of airborne (i) total (viable + non-viable), (ii) only viable, (iii) immuno-cheniically quantified fungal allergens A new technique to quantify (i) total (viable + non viable) and (ii) (only viable) fungal species using the Burkard's Air Sampler was developed. Subsequently a new approach for simultaneous counting of air borne (i) total, (ii) only viable fungal spores and (iii) Immuno-chemically quantified fungal aeroallergens using membrane filtration technique was developed. The amount of allergen quantitated had a good correlation with the spore colony counts. House dust mites and their significance as aeroallergens. Mite fauna of house dust samples was studied. Various species of house dust mites (HDM) were identified and counted in the house dust samples of respiratory allergy patients in Delhi area. The results established that HDM is an important inhalant allergen in India.
15.Clinico-immunologic study on comparative evaluation of the sensitivity and specificity of common methods of diagnostic tests used in patients suffering with IgE mediated type I in allergic respiratory diseases The sensitivity and specificity of various diagnostic methods to identify the offending allergens in patients of respiratory allergy was compared employing skin tests, bronchial provocation tests (BPT), conjunctival tests and radio- allergosorbent tests (RAST). The results showed that the skin tests performed and graded as per the method and criteria developed in the Department give reliable information and the technique is very sensitive and specific. Results of skin tests showed a good co-relation with the BPT and RAST.
16. Development of a rapid method for preparation of allergen extracts A rapid method of preparation of allergen extracts was developed in which a mixture of chloroform and methanol was found to be a better defatting agent than conventionally used diethyl ether, and two hours period of extraction in the buffered saline was sufficient for optimal allergen recovery.
17. Studies on the causative allergens in patientsSeveral studies were undertaken to evaluate the etiologic significance of offending allergens in patients of bronchial asthma and allergic rhinitis using a number of allergens of different groups i.e. pollen, fungal, dust, animal dander and insect extracts. Results showed that all these groups played an important role in the etiology of allergic disorders in patients. The causative allergens varied from patient to patient and in different permutation and combination to various allergens of different groups.
18. Investigation on the role of immunotherapy in patients suffering with nasobronchial allergy Several studies on the therapeutic efficacy of immunotherapy in patients with nasobronchial allergy were undertaken. The best results were obtained in the patients suffering with seasonal nasobronchial allergy. It was observed that immunotherapy administered in properly selected patients gives encouraging results.
19. Studies on bronchial tolerance to histamine, methacholine chloride and specific antigen inhalation Increase in bronchial tolerance to histamine, methacholine chloride and specific allergens inhalation challenge was observed after treatment with Tylophora indica leaves, its alcoholic extract or its alkaloids. Similar therapeutic response was observed in patients after ingestion of whole plant powder of Solanum xaenthocarpum whole plant.
20. Effect of prior medication on intradermal test response in patients with respiratory allergies Our studies revealed that certain drugs used for symptomatic treatment of asthma, such as salbutamol, theophyline, adrenaline, etc., were found not to interfere with the results of intradermal tests in patients with type I respiratory allergy. Thus, skin testing of patients need not be postponed due to their inability to discontinue these drugs. However, use of long acting antihistamine-Astemizole resulted in abrogation of interdermal test response to allergens up to four weeks. Thus, it is recommended that prior to performance of skin tests such anti- histamines should be discontinued for a suitable period.
21. Studies on the role of animal danders in the etiology of respiratory allergic disorders Evaluation of seven animal danders as inhalant allergens was undertaken and relative allergenic significance was studied. The presence of shared and specific allergenic components in different animal dander was found.
22. Influenza virus infection and levels of total allergen specific and virus specific IgE in patients with respiratory allergic disorders The role of influenza virus in the etiology of type I respiratory allergic disorders was studied. The results suggested that respiratory viruses may precipitate symptoms of asthma either by inducing an increase in the total, or allergen-specific IgE (non-virus) and/or virus-specific IgE antibodies.
23. Role of food allergens in the etiology of nasobronchial allergy The role of 25 food allergen in etiology of respiratory allergy was studied. A sizable percentage of patients showed marked skin positivity to one or more food allergens suggesting their etiologic significance in the causation of nasobronchial allergy. Our results suggested that a markedly positive skin reaction to food allergens should not be ignored which may be confirmed by performing bronchial provocation test and/or RAST.
24. Heterogeneity of IgE mediated immune response to insects in patients with naso-bronchial allergic disorders A total number of 346 patients of bronchial asthma and/or allergic rhinitis were tested with 17 insect extracts. Sera of 200 of these patients were studied in various insect RASTs for the presence of allergen-specific IgE antibodies. The patients showed skin reactivity and RAST positivity to more than one of the 17 insect extract in various permutations and combinations. These results crossed- RAST -inhibition and absorption studies showed heterogeneity of immune response of patients to these insect allergens.
25. Comparative efficacy of 2 RHZE/4RH (4D) regime Vs 2 RHZ /4 RH (3D) regimen in Category I sputum positive pulmonary tuberculosis(R: Rifampicin; H: Isoniazid; Z: Pyrazinamide; E: Ethambutol).
26. Long term effects of beclomethasone inhalation (MDI) in bronchial asthma: Two year evaluation involving 100 patients was done.
27. Initial drug resistance in pulmonary tuberculosis and- efficacy of 6 months short course chemotherapy in such patients.
28. The incidence of sexually transmitted diseases (STD) as well as acquired immunodeficiency syndrome (AIDS) in patients of leprosy was studied. In spite of high prevalence of STD in leprosy patients, no case of AIDS could be detected.
29. Studies involving T cell homeostasis in tuberculosis patients at the start and following three months of chemotherapy revealed that there was a drastic alteration in T cell subsets in these patients which reverted to normal after three months of successful chemotherapy.
30. The T4/T8 homeostasis was also altered in patients with various stages of breast carcinoma and benign breast diseases.
31. Lymphocytes with HLA-DR II and IL-2 receptor markers were also reduced in patients with breast carcinoma. The blood levels of IL-2 of carcinoma pa1ients were comparable to that of normal controls although their blood levels of sIL-2R were increased.
32. The nutritional deficiency in leprosy patients was found to be poverty related and not disease related. The serum Zn, vitamin A and E levels were associated with disease.
33. Dapsone and Clofazimine, the important constituents of multi-drug therapy (MDT) were found to alter the early components of the complement pathway, in- vitro, only at a very high concentration.
34. Clofazimine alone enhanced O2 production of rat resident peritoneal macrophages in a dose-dependent manner. The drug lost. this property after exposure to light. Detailed physico-chemical properties (i.e. UV, IR, NMR and mass spectra) of light reacted Clofazimine were also studied.
35. Rats treated with MDT showed altered T cell homeostasis, while there was no effect on CH-50, C3, total T cells (W3/13), B cells (OX-4) or immunoglobulin levels.
36. The haemagglutinins isolated from Indian fresh water catfish were shown to be specific towards L-galactopyranose. This activity was radioresistant suggesting that the haemagglutinin could be a lectin.
37. The purified haemagglutinin from Indian fresh water catfish had native molecules of molecular weights of 187 KD and 55 KD. The ultrastructure of immune apparatus of this catfish was also studied.
38. Food Allergy in bronchial asthma.
The percentage of Food-related symptoms is common among respiratory allergy patients. Self-reports prevalence of food allergy was 69% could be confirmed in 4.4%, resulting in an overall estimated prevalence of 1.1% ([0.7101.75] at 95% Cl) in respiratory allergy patients. The common offending foods are rice, citrus fruits, blackgram and banana.
39. Isolation and characterization of a 28 kDa major allergen from blackgram (Phaseolus mungo)
Study was aimed to isolate and characterize a major allergenic protein from blackgram (Phaseolus mungo). Respiratory allergy patients with history of blackgram allergy were skin prick tested (SPT) and sera were collected from SPT positive patients. The purified protein separated at 28 kDa on 12% gel and showed IgE binding with 81% of blackgram hypersensitive patients’ sera on immunoblot indicating it to be a major allergen.
40.Clinical, serological and radiological characteristics of patients with allergic Bronchopulmonary aspergillosis (ABPA)
41. Sarcoidosis in North Indian population – a retrospective study
42. Assessment of peripheral skin thickness by ultrasound (Dermascan) in patients of interstitial lung disease (ILD).
The study was performed in patients of Interstitial Lung Disease (ILD) compared with normal. The skin thickness was measured in the volar aspect of the left forearm (mm, mean ± SEM) in the controland ILD patients was 1.425 ± 0.04824 and 1.146 ± 0.02632 respectively (p = 0.0001). The echogenic pixels determined by ultrasound (mean ± SEM) in Control and ILD patient was 6516 ± 383.9 and 4814 ± 415.4 respectively which was significantly less in ILD patents (p=0.0052).
43. Analysis of skin reactivity to various common aeroallergens by skin prick test in respiratory allergy patients [Bronchial Asthma (BA) & Allergic Rhinitis (AR)].
44. Impact of Indoor Respirable Particulate Matter on Respiratory Allergy in Children in India - An Exposure Response Study
The present study was took place at industrial, residential and urban village locations of Delhi, India with aim to identify the impact of indoor respirable particulate matter (PM5) on respiratory allergy in children (7-15 years).
45. A study of skin sensitivity to various food allergens in patients of bronchial and/or allergic rhinitis in India.
The study deals with the allergen patterns in sensitive patients with respiratory allergy (bronchial asthma and/or allergic rhinitis) in India. Patients diagnosed with bronchial asthma were 20.81%, allergic rhinitis were 33.22% and both bronchial asthma and allergic rhinitis were 45.97%. Significant skin positive reactions (2+ and above) were found in 71.57% subjects. The younger adults were the most commonly affected group with 21.46% significant skin positive patients. Insects 43.90% followed by various types of dust 22.33%, weeds 21.79%, trees 15.14%, fungal spores 11.98%, pollen 7.73%, kapok cotton 2.18%, silk 1.30% and wool 0.76% were the offending allergens.
47.Asthma Severity and Obstructive Sleep Apnea in Adults.
The study aim is to found any association of OSA with asthma symptoms and severity. In the study, the ESS was positive in 12% and BQ was positive in 18% of patients. While SPT was positive in 90% of patients. In the BQ positive asthma patients SPT was positive in 66%. Out of BQ positive patients, underwent home sleep study and were found to have OSA. Severe OSA was present but there was no correlation statistically in asthma severity and OSA severity.
48.Trace elements in indoor airborne particulate matter of Delhi and its effects on respiratory Allergy among children.
The present study was undertaken in Shahdara and Shahzada Bagh industrial locations of Delhi with the primary objective to determine the trace elements in indoor suspended particulate matter (SPM) and its effects on respiratory allergy in children. 3.8% children were exposed to environmental tobacco smoke (ETS). Diagnosis of asthma, rhinitis and upper respiratory tract infection (URTI) was made in 11.8%, 38.9% and 36.2% respectively.
49.Compositional study of domestic airborne particulate Matter in industrial locations of Delhi and its Relationship with asthma in children.
The present study was undertaken in Shahdara and Shahzada Bagh industrial areas of Delhi with the primary objective to determine the mineralogy and chemical composition of indoor suspended particulate matter (SPM) and its association with asthma in children. 11.8% children were diagnosed to have asthma of which 14.2% were in Shahdara and 9.6% in Shahzada Bagh. The level of indoor SPMwas high in the houses of Shahdara and Shahzada Bagh industrial areas of Delhi where children had asthma. Mineral groups such as quartz, carbonates (calcite and dolomite), mica (illite and muscovite), feldspar, talc-chlorite (talc and chlorite) were identified in the indoor SPM. High amount of quartz and mica minerals were associated with asthma in children. Major elements including Si, Al, Fe, Mg, Ca, Na, K, Mn and trace elements such as Cr, Co, Ni, Pb, Cu, Zn, Mo, Cd were also determined in the indoor SPM. The mean concentration level of Si, Cr, Ni, Pb, Zn and Cu was statistically significantly high in the houses where children had asthma.
50.Obstructive Sleep Apnea in Asthma and COPD Patients and its Relation to Atopy.
Patients with asthma and COPD were evaluated for OSA symptoms by Epworth Sleepiness Scale (ESS) and Berlin Questionnaire (BQ). Patients having high risk for OSA by ESS and BQ underwent home based sleep study. Skin prick test (SPT) against common allergens was done to diagnose atopy. ESS was positive in 12% of COPD patients and BQ was positive in 18% of COPD patients. In the BQ positive asthma patients SPT was positive in 66%, whereas in COPD it was positive in 71%. Out of BQ positive patients, underwent home sleep study and were found to have OSA. The Patients from home sleep study group underwent SPT, 69% were found to be atopic.
51.Relationship of Atopy and Exhaled Nitric Oxide in Patients of Allergic Rhinitis.
The aim of the study to investigate the relationship, between atopy and FeNO in patients of allergic rhinitis. FeNO levels were assessed in patients of both the sub-groups, the average value being 20.65 ± 13.10 ppb. The levels in atopic patients were 25.13 ± 12.79 ppb. On compared to levels in non-atopic patients 14.5 ± 11.14 ppb, the FeNO levels in atopic patients were significantly higher with statistical correlation (p = .009). However, no correlation was found between the number of SPT positives and levels of FeNO.
52.Breath carbon monoxide level of non-smokers exposed to environmental tobacco smoke.
The study was conducted with the help of a pre-designed questionnaire. The breath CO level was significantly higher in ETS exposed subjects who worked for more than nine hours a day in bars, restaurants and hotels (p = 0.018).
2. Dr. Balakrishnan Menon
Associate Professor
Age : 43 years
Present Position :
Associate Professor of Respiratory Allergy and Applied Immunology, and In-charge of Radiology services at Vallabhbhai Patel Chest Institute, University of Delhi
Educational Qualifications :
Professional Degrees :
MBBS from Maulana Azad Medical College, Delhi in 1991
DMRD (Radiology) from Maulana Azad Medical College, Delhi) in 1994
MD (Respiratory Medicine) from Patel Chest Institute, Delhi in 1998
Work Experience :
Heads independent unit of Respiratory Medicine at Vallabhbhai Patel Chest Institute where patients of Chest Diseases such as Asthma, TB, Cancer etc are treated
Manages Radiology services of Patel Chest Institute including Xray, CT Scans, Ultrasound and Interventional Radiology Procedures
Provides diagnostic laboratory services for allergy diagnosis etc
Developed India s first PACS system which is a system of electronically transmitting and storing patient X ray and CT images
Started latest 64 slice CT scanner at Patel Chest Institute
Nodal officer for Yoga services at Patel Chest Institute
Publications and Research:
45 research publications in national and international journals
4 chapters in books
Presented original research work in several national and international conferences
Principal Investigator and Co-Investigator in funded research projects
Teaching :
Supervisor for MD (Respiratory Medicine) and DTCD students
Examiner for MD (Respiratory Medicine), DNB and DTCD students
Conducted televised teaching for DNB students (Countrywide Classroom Programme) over Gyan Darshan Channel of Doordarshan and Gyan Vani of All India Radio
Invited as Expert Speaker for Programmes of Doordarshan and All India Radio