Praveen Sobti - Academia.edu (original) (raw)

Papers by Praveen Sobti

Journal of Forensic Medicine, 2003

Children are exposed to physical, chemical, biological and social environment. Child survival hin... more Children are exposed to physical, chemical, biological and social environment. Child survival hinges on basic needs to support life, among these, a safe and healthy environment. The lack of water supply and sanitation are the primary reasons why diseases transmitted via feces are so common in developing countries. The most common of the diseases are diarrhea and intestinal worm infestation. Chemical pollution of diverse nature derived from industrial and agricultural wastes are increasingly finding their way into the environment. The impact on the health includes abnormal growth and development, endocrine/hormone disruption, cancers, including leukemia, sarcoma, lymphoma and compromised immune system. Prevention is the only sustainable solution for a healthy future of the children. Parents are increasingly interested in the impact of environment on their children. As our patients' advocates, we must work toward reversing the current deterioration of the environment in the world.

Pediatric Hematology Oncology Journal, Mar 1, 2018

Jaypee Brothers Medical Publishers (P) Ltd. eBooks, 2005

Indian Journal of Otology, 2016

Context and Aims: A limited number of studies have been conducted for the assessment of hearing l... more Context and Aims: A limited number of studies have been conducted for the assessment of hearing loss in thalassemic patients on regular chelation therapy and even fewer studies were conducted using otoacoustic emissions (OAEs). The present study was conducted to assess the prevalence of ototoxicity in multiple transfused thalassemic patients on regular iron chelation therapy (with desferrioxamine [DFO] and deferasirox), to compare the efficacy of OAEs (distortion-product OAEs [DPOAEs]) with that of pure tone audiometry (PTA) for hearing assessment and to correlate ototoxicity with age, mean hemoglobin (Hb), serum ferritin levels, dose and duration of chelation therapy, and therapeutic index Settings and Design: This was a prospective, observational study conducted in a tertiary care hospital. Subjects and Methods: Thirty thalassemic patients undergoing regular iron chelation therapy with DFO and deferasirox were included in this prospective study. Hearing assessment was done using otoscopy, tympanometry, PTA, and DPOAEs between January 1, 2010, and June 30, 2010. Follow-up studies were conducted after 12 months of chelation therapy using the same tests. Patients with and without ototoxicity were compared with respect to age, mean Hb, serum ferritin levels, dose and duration of chelation therapy, and therapeutic index. Statistical Analysis Used: Statistical analysis was carried out using the Student's t-test for normally distributed data and Pearson Chi-square test for categorical data. For nonparametric variables, Mann–Whitney and Wilcoxon tests were applied. Results: Using DPOAEs, 36% of patients were detected having a hearing deficit at the start of the study which increased to 46% at the end of study, whereas using PTA, the detection of hearing loss was 10% and 23%, respectively. DPOAE analysis showed a statistically significant decrease in the signal to noise ratio after 1 year of therapy at 4000 Hz, 5714 Hz, and 8000 Hz with maximum number of patients showing abnormality at 5714 Hz. The analysis revealed no significant difference between the affected and unaffected groups with respect to age, sex, height, weight, serum ferritin level, mean Hb, cumulative dose, mean daily dose and duration of chelation, or therapeutic index. Conclusions: Despite DFO doses usually felt to be low risk for ototoxicity (<40 mg/kg/day), we found a high rate of ototoxicity in our patients using DPOAEs (46%). No variables were identified that reliably predict ototoxicity. We impress on the need for regular audiological screening using DPOAEs for early detection of ototoxicity.

β thalassemia major is a hereditary hemolytic disorder treated with multiple blood transfusions. ... more β thalassemia major is a hereditary hemolytic disorder treated with multiple blood transfusions. The main complication of this treatment is iron overload initially in the reticuloendothelial system, joints and then in all parenchyma, especially the heart, liver, and endocrine glands. Increased iron deposition has a cytotoxic effect, leading to cell death and organ dysfunction. Measures of plasma ferritin levels and hepatic iron level are used for assessing body iron overload. Direct assessment of iron deposition in different organs necessitates tissue biopsy, which is not always possible. Magnetic Resonance Imaging (MRI) is a reliable & non-invasive tool for assessing tissue siderosis. With the advent of increasing options for iron chelation therapy, MRI can guide clinicians to more appropriately tailor chelation therapy to individual patient needs, producing greater efficacy with less toxicity. Future research in MRI monitoring aims at improved prevention of endocrine toxicities, p...

Journal of Forensic Medicine and Toxicology, 2003

Georgian medical news, 2013

This review paper provides a summary of the current state of knowledge regarding GHD provides rec... more This review paper provides a summary of the current state of knowledge regarding GHD provides recommendations for the diagnosis and treatment of GHD in adult patients with thalassaemia major (TM). The reported prevalence of adult GHD and /or IGF-I deficiency in TM patients varies from 8% to 44 % in different centers. Because GH treatment requires analysis of many factors, including the effect of treatment on cardiac functions, metabolic parameters and psychosocial functioning, along with safety, ethical considerations, financial cost and other burdens of therapy, stringent diagnostic criteria are needed. The authors report the diagnostic recommendations of the International Study Group of Endocrine Complications in Thalassemia (I-CET) for adult TM patients.The pros and cons of GH treatment must be discussed with each patient, after which GH doses should be individualized and titrated to maximum efficacy with minimal side effects. Prospective studies to monitor potential benefits ver...

Indian pediatrics, 2008

The objective was to study the prevalence of obesity among adolescents in public schools of Ludhi... more The objective was to study the prevalence of obesity among adolescents in public schools of Ludhiana, catering to the affluent segment of population. We selected 1000 students from these schools by random, purposive sampling. Their anthropometry was taken. Students also filled-up a prevalidated questionnaire regarding dietary habits and lifestyle. Overweight/Obesity was defined using age and sex specific Body mass index (BMI) cut off points. Incidence of obesity was 3.4% and overweight was 12.7%. A significantly greater number of boys (15%) were overweight as compared to girls (10%).

PEDIATRICS, 2008

with negative physical and psychosocial consequences have emerged. OBJECTIVE: The researchers' go... more with negative physical and psychosocial consequences have emerged. OBJECTIVE: The researchers' goal was to study Internet use and abuse by Greek adolescents and to identify the psychological profile and lifestyle of users. Intervention attempts will also be designed and discussed. METHODS: An Athens adolescent population representative sample of 315 (164 boys, 151 girls) high school students (mean age: 15 years) were included in the study. For Internet-addiction diagnosis, an international tool (Young's Internet Addiction Test questionnaire) was used. ⌻he Strengths and Difficulties Questionnaire was applied to screen for emotional and behavioral problems. Physical activity and physical fitness were also assessed with appropriate questions. Correlation and 2 statistics were performed by using SPSS (SPSS Inc, Chicago, IL). RESULTS: According to the results, 167 (53.4%) of 315 adolescents were using the Internet for Ͼ1 year, 82 (26%) of 315 reported daily use, and 25 (8%) of 315 reported Ͼ20 hours' use weekly. Boys were spending significantly more time using the Internet than girls (P Ͻ .05). According to Young's Questionnaire scoring, no youngster in our sample was addicted. However, in 28 (9.4%) of 315 adolescents, Young's Questionnaire scoring was suggestive of occasional or frequent problems of Internet overuse. The most frequent reason for using the Internet was games (P Ͻ .05), and 18 (5.8%) of 315 children in our sample were cyberbullying victims. There was a positive correlation of Internet use and hyperactivity according to the Strengths and Difficulties Questionnaire results (P Ͻ .05). Positive correlations were also noted for Internet use and delinquency (P Ͻ .001) as well as dysfunctional peer relationships (P Ͻ .001). CONCLUSIONS: Use of the Internet is popular among Greek youth, and it can be related to psychosocial problems if overused.

Indian Journal of Clinical Biochemistry, 2000

Serum total and ionised calcium levels were measured at birth and at 48 hours in 25 term neonates... more Serum total and ionised calcium levels were measured at birth and at 48 hours in 25 term neonates with birth asphyxia (one minute APGAR score of 6 or less) and in 25 normal term neonates (one minute APGAR score of 7 or more). Infants were categorised into two groups TAGA (term appropriate for gestational age) and TSGA (term small for gsstational age). Asphyxiated infants had significantly lower serum total and ionised calcium values at birth as well as at 48 hours. Abnormal clinical features were observed in 48% of asphyxiated infants. Low ionised calcium was detected in symptomatic babies, who had otherwise normal total calcium values. Due to hyocalcemia especially ionised calcium in asphyxiated infants and high frequency of functional derangement associated with this hypocalcemioa, serial monitoring of serum isonised calcium levels is necessary.

International Journal of Contemporary Pediatrics, 2020

Background: Drug induced hearing impairment is likely in subjects undergoing multiple blood trans... more Background: Drug induced hearing impairment is likely in subjects undergoing multiple blood transfusions which necessitates timely detection and rehabilitation, especially in the pediatric age group.Methods: A total 30 thalassemic patients undergoing regular iron chelation therapy with Desferrioxamine and Deferasirox were included in this prospective study. Follow up studies were conducted after 12 months of chelation therapy i.e. after 1 year thus spanning a total duration of 1 years.Results: The most common age group was 4-8 years (46%) followed by 8-12 years (20%). Male patients outnumbered female patients in the ratio of 2.75:1 constituting 73% of study population oral Deferasirox (80%) followed Desferrioxamine (13.3%) and a combination therapy (6.6%). The distribution shows shift of pure tone average in higher thresholds with continuation of therapy.Conclusion: Despite Desferrioxamine doses usually felt to be low risk for ototoxicity (less than 40 mg/kg/day), found a high rate ...

Recent Advances in Pediatrics—15, 2005

Acta Bio Medica : Atenei Parmensis, 2019

In adult thalassemia major (TM) patients, a number of occult and emerging endocrine complications... more In adult thalassemia major (TM) patients, a number of occult and emerging endocrine complications, such as: central hypothyroidism (CH), thyroid cancer, latent hypocortisolism, and growth hormone deficiency (GHD) have emerged and been reported. As the early detection of these complications is essential for appropriate treatment and follow-up, the International Network of Clinicians for Endocrinopathies in Thalassemia and Adolescent Medicine (ICET-A) promoted a survey on these complications in adult TM patients, among physicians (pediatricians, hematologists and endocrinologists) caring for TM patients in different countries. The data reported by 15 countries are presented. The commonest endocrine complications registered in 3.114 TM adults are CH and GHD (4.6 % and 3.0 %, respectively), followed by latent hypocortisolism (1.2%). In 13 patients (0.41%) a cytological papillary or follicular thyroid carcinoma was diagnosed in 11 and 2 patients, respectively, and a lobectomy or thyroide...

The first case of COVID 19 in India was reported on 30th January 2020 and it has affected approxi... more The first case of COVID 19 in India was reported on 30th January 2020 and it has affected approximately 82,29,313 people of which nearly 1,22,607 patients have succumbed to the illness and the count is only increasing (as per data accessed on 3/11/2020 from mygov.in). The Government of India announced a total lockdown on 25th March 2020 to prevent the spread of the infection. Many health care facilities in the government sector were converted to COVID 19 dedicated hospitals, shutting their doors to patients with non-COVID illnesses. The decision although necessary had a dire impact on patients with chronic diseases such as hemoglobin disorders in particular thalassemia as continued timely care is essential. Difficulties in getting drugs, transportations, and blood supply have been reported in the literature during the COVID-19 pandemic. Furthermore, many clinicians and patients with chronic diseases have highlighted the problem of access to and utilization of services1,2. A survey b...

International Journal of Hematology-Oncology and Stem Cell Research, 2021

Background: Thalassemia is a chronic disease requiring lifelong treatment. The adherence to regul... more Background: Thalassemia is a chronic disease requiring lifelong treatment. The adherence to regular iron chelation therapy is important to ensure complication-free survival and good quality of life. The study aim to assess the adherence to iron chelation therapy (ICT) in patients with transfusion-dependent thalassemia (TDT), evaluate various causes of non-adherence and study the impact of non-adherence on the prevalence of complications secondary to iron overload. Materials and Methods: Patients with TDT on ICT for > 6 months were enrolled in the study. Hospital records were reviewed for demographic details, iron overload status, treatment details, and the prevalence of complications. A study questionnaire was used to collect information on adherence to ICT, knowledge of patients, and the possible reasons for non-adherence. Results: A total of 215 patients with a mean age of 15.07+7.68 years and an M: F ratio of 2.2:1 were included in the study. Non-adherence to ICT was found in ...

Pediatric Hematology Oncology Journal, 2018