Publications by authors named "Pooja Dewan"

Objectives: To compare the levels of organochlorine pesticide (OCP) residues in sera and bone marrow of children with malignant and non-malignant hematological disorders (HDs) with those in healthy controls.

Methods: This case-control study was conducted among children aged ≤ 12 years with malignant and non-malignant HDs and non-anemic healthy controls. Children with gross congenital malformations, neurodevelopmental disorders, and chronic systemic diseases were excluded.

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Background: The collection of race and ethnicity data in clinical trials using standardized categories is recommended by the US Food and Drug Administration, although this is primarily for domestic reasons. The applicability and understanding of the categories in multinational trials are uncertain.

Methods: We analyzed patient-level data from 13 major heart failure trials, examining race and ethnicity data recorded by country, as recommended by the Food and Drug Administration: "American Indian or Alaska Native," "Asian," "Black or African American," "Native Hawaiian or Other Pacific Islander," and "White" for race and "Hispanic or Latino" as a minimum for ethnicity (with an expanded list of ethnicities available).

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Objectives: To assess the total antioxidant capacity (TAC) in children living with HIV (CLHIV) and to evaluate the effect of antiretroviral therapy (ART) and vitamin E supplementation on TAC.

Methods: The study included CLHIV on ART ≥ 2 years, ART-naïve CLHIV and healthy controls. CLHIV on ART ≥ 2 years received vitamin E supplements in addition to combination ART for three months duration.

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Introduction: Failure to thrive (FTT) refers to failure of expected weight gain, striking lack of well-being and inadequate physical growth in children. The causes vary with geographical and socio-economic factors. In developed countries, FTT is usually a symptom of an underlying disease, often a gastrointestinal or neurological disorder.

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Objective: To develop evidence-based guidelines for the prevention, identification, and management of growth failure in infants under 6 months (U6M), ensuring early detection and intervention to improve health outcomes.

Justification: Growth failure in the first 6 months of life significantly increases the risk of acute malnutrition and stunting in later childhood. Unlike older children, management in this age group prioritizes establishing exclusive breastfeeding and addressing feeding challenges.

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Objective: To assess the efficacy of glutamine mouthwash versus standard oral hygiene protocol (SOHP) in reducing the overall incidence, duration and severity of oral mucositis in children with acute lymphoblastic leukemia (ALL) receiving High Dose Methotrexate (HDMTX).

Methods: In this cross-over trial, children with ALL due to receive four courses of HDMTX (2 g/m/dose) (on days 8, 22, 36, and 50 of consolidation) were randomized to receive two consecutive courses of HDMTX with glutamine mouthwash plus SOHP, followed by two HDMTX courses with SOHP only; or vice-versa. Glutamine suspension was administered twice daily by swish and swallow technique, starting one day before the course of HDMTX and continued upto 7 days or till mucositis persisted.

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Background: How different combinations of comorbidities influence risk at the patient level and population level in patients with heart failure with mildly reduced ejection fraction/heart failure with preserved ejection fraction is unknown. We aimed to investigate the prevalence of different combinations of cardiovascular and noncardiovascular comorbidities (ie, multimorbidity) and associated risk of death at the patient level and population level.

Methods: Using patient-level data from the TOPCAT trial (Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist) and PARAGON-HF trial (Prospective Comparison of ARNI With ARB Global Outcomes in HF With Preserved Ejection Fraction), we investigated the 5 most common cardiovascular and noncardiovascular comorbidities and the resultant 45 comorbidity pairs.

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Unlabelled: Iron deficiency anaemia (IDA) makes an individual prone to bacterial infections. The antimicrobial defence mechanism of neutrophils is orchestrated by Nicotinamide Adenine Dinucleotide Phosphate Hydrogen (NADPH) oxidative burst which is iron-dependent. The few previous studies documenting a decrease in neutrophil oxidative burst in iron-deficient children have been based mainly on the Nitro blue tetrazolium test (NBT).

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Background B-cell acute lymphoblastic leukemia (B-ALL) is one of the most common childhood malignancies and comprises almost the majority of acute leukemias in children. At the end of induction, minimal residual disease (MRD) is one of the most important prognostic indicators. MRD is commonly detected by multiparametric flow cytometry.

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Background: Cognitive impairment is common in patients with heart failure and preserved ejection fraction but its clinical correlates and prognostic associations are poorly understood.

Methods: We analyzed cognitive function, using the Mini-Mental State Examination (MMSE), in patients with heart failure and preserved ejection fraction enrolled in a prespecified substudy of the PARAGON-HF trial (Prospective Comparison of Angiotensin Receptor Neprilysin Inhibitor With Angiotensin Receptor Blocker Global Outcomes in Heart Failure With Preserved Ejection Fraction). Logistic regression analyses were performed to determine the variables associated with lower MMSE scores at baseline and postbaseline decline in MMSE scores at 48 weeks.

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Article Synopsis
  • - The study investigated whether the heart failure medication sacubitril/valsartan could lead to cognitive impairment, as it affects enzymes that degrade amyloid-β peptides, which are linked to Alzheimer's disease.
  • - Researchers used the Mini-Mental State Examination (MMSE) to assess cognitive function changes over 96 weeks in a subset of heart failure patients from the PARAGON-HF trial, comparing those on sacubitril/valsartan to those on valsartan alone.
  • - Results showed no significant difference in cognitive decline between the two groups, with both medications resulting in nearly identical changes in MMSE scores, suggesting sacubitril/valsartan does not have a negative effect on cognitive function in these patients. *
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Aims: Angiotensin receptor blockers have been shown to reduce heart failure hospitalization and cardiovascular mortality in men and women with heart failure with reduced ejection fraction (HFrEF). It is unknown whether there are differences between men and women in achieved dose and treatment discontinuation due to adverse events of candesartan.

Methods And Results: We conducted a post hoc analysis of the Candesartan in Heart failure: Assessment of Reduction in Mortality and morbidity (CHARM) programme.

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Background: The pediatric ICU (PICU) is a specialized area where critically sick children are managed. The mortality rates in PICUs are higher in developing countries as compared to developed nations. Many of these deaths could be prevented if very sick children were identified soon after they arrived at the health facility.

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Article Synopsis
  • - The study explores the use of peer support interventions for managing cardiometabolic diseases, like type 2 diabetes, in low- and middle-income countries, where the effectiveness is not well established.
  • - A scoping review analyzed 28 studies, with the majority from Asia, and found that while peer support is beneficial for emotional coping and disease management, definitions and implementations vary widely.
  • - The findings suggest a need for standardized definitions of peer support and continuous evaluation of programs to improve future research and effectiveness in managing these diseases in LMICs.
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  • - This study aimed to analyze the levels of T-regulatory cells (Tregs) in children with tuberculosis (TB) compared to healthy individuals, highlighting Tregs' role in managing immune responses related to TB.
  • - Researchers examined 40 TB patients (both severe and non-severe) and 20 healthy controls using flow cytometry to measure Treg percentages, finding significantly higher levels of both CD4CD25 high and CD4FoxP3 Tregs in TB patients.
  • - Although TB-infected children had more Tregs than the controls, the levels of Tregs did not significantly differ between those with severe and non-severe TB cases.
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Objective: To compare the long-term seroprotection (anti-HBs ≥10 IU/L) in children living with HIV (CLHIV) receiving a 3- or 4-dose double-strength (20 µg) recombinant Hepatitis B virus (rHBV) vaccination.

Methods: We present anti-retroviral therapy (ART) clinic based follow-up data collected from January, 2021 to August, 2022, from CLHIV who had received either 3-dose or 4-dose double-strength (20 µg) rHBV vaccination, after 36-42 months and assessed for anti-HBs titres, naïve and memory T-helper lymphocytes, CD4 counts and HIV viral load. Children found unprotected after primary immunization, were administered a single double-strength rHBV vaccine booster dose (20 µg) and seroprotection was reassessed after 4 and 12 weeks.

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Article Synopsis
  • The study investigates the impact of COVID-19 on patients with transfusion-dependent thalassemia (TDT) and compares their immune response to a control group without thalassemia.
  • Symptomatic cases were less common among thalassemia patients, and while initial antibody levels were similar, thalassemia patients exhibited lower IgG levels over time.
  • Severity of COVID-19 did not influence antibody titers, indicating that thalassemia patients generally experienced milder forms of the disease.
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Background: Recent guidelines proposed a classification for heart failure (HF) on the basis of left ventricular ejection fraction (LVEF), although it remains unclear whether the divisions chosen were biologically rational. Using patients spanning the full range of LVEF, we examined whether there was evidence of LVEF thresholds in patient characteristics or inflection points in clinical outcomes.

Methods: Using patient-level information, we created a merged dataset of 33 699 participants who had been enrolled in 6 randomized controlled HF trials including patients with reduced and preserved ejection fraction.

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  • The study aimed to assess the effectiveness and safety of sublingual methylcobalamin for treating vitamin B12 deficiency anemia in children aged 1-12 years.
  • A total of 37 children participated, showing significant improvements in serum cobalamin levels, reduced plasma homocysteine, and increased hemoglobin after 6 weeks of treatment, although 67.6% still experienced mild to moderate anemia.
  • The conclusion suggests that while sublingual methylcobalamin is effective, a longer treatment duration than six weeks may be necessary.
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Aims: Multimorbidity, the coexistence of two or more chronic conditions, is synonymous with heart failure (HF). How risk related to comorbidities compares at individual and population levels is unknown. The aim of this study is to examine the risk related to comorbidities, alone and in combination, both at individual and population levels.

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Introduction Plasma antioxidant capacity in children receiving chemotherapy decreases due to the effect of the disease and chemotherapy. Increased oxidative stress (OS) predisposes to an increased risk for chemotherapy-related toxicity and febrile neutropenic episodes. Materials and methods We conducted this case-control study in the hematology-oncology unit of the department of pediatrics of a tertiary hospital in Delhi, India, from November 2017 to March 2019 to compare OS between children with acute lymphoblastic leukemia (ALL) and healthy controls.

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