devendra mehta | Rajasthan Technical University (original) (raw)

Papers by devendra mehta

The Indian Journal of Pediatrics, 1996

He!icobacterpylori is responsible for one of the most frequently encountered infectious diseases ... more He!icobacterpylori is responsible for one of the most frequently encountered infectious diseases worldwide. Helicobacter pylori infection can lead to the development of gastritis and peptic ulcer disease. The presence of Helicobacterpylori in the human stomach also represents an increased risk of gastric cancer and gastric lymphoma. Epidemiological data obtained in adults suggest that the actual colonization with Helicobacter pylori is in fact determined by childhood factors. Therefore, the pediatric age group represents the ideal target population for studies.

The Indian Journal of Pediatrics, 1998

Moaified food Starches were developed as a stabilizer, providing desirable consistency, texture, ... more Moaified food Starches were developed as a stabilizer, providing desirable consistency, texture, and storage ability. They are used primarily in strained and junior foods and, to a minor extent, in infant formulas. However, despite the fact that there is an increasing tendency to introduce solid foods to infants at a very early age, there is few long-term studies to delineate the effect of starch feeding on the growth of young infants.

Current Problems in Pediatrics, 1994

Journal of pediatric gastroenterology and nutrition, 2005

To examine psychosocial differences in diagnostic subgroups of children with recurrent abdominal ... more To examine psychosocial differences in diagnostic subgroups of children with recurrent abdominal pain (RAP). Children meeting Apley's 1975 definition of RAP were divided according to physician ratings into three subgroups, based on the Rome II diagnostic criteria of functional gastrointestinal disorders: functional dyspepsia (n=17), irritable bowel syndrome (n=18), and functional abdominal pain (n=27). Groups were compared using measures of (a) child psychopathology, (b) parent psychopathology, and (c) child pain, somatization, and functional disability. Multivariate results from a discriminant function analysis demonstrated that children classified according to these criteria could not be differentiated with respect to parent reported child psychopathology or child pain, somatization, and functional disability. There were significant univariate differences, however, between groups on parental psychopathology (F=4.39, P=0.02); parents of children with functional dyspepsia reported greater parental psychopathology symptoms than the other two groups. This study provides a preliminary comparison of pain, somatization, functional impact, and psychopathology ratings in the Rome II diagnostic subclassifications of children with RAP. Further investigation utilizing larger sample sizes, pain measures specifying pain location, and parental modeling of somatic behavior is indicated to better understand potential similarities and differences between these subgroups.

Current allergy and asthma reports, 2008

Gastroesophageal refl ux and extraesophageal refl ux have been postulated to be involved in the p... more Gastroesophageal refl ux and extraesophageal refl ux have been postulated to be involved in the pathogenesis of otitis media. This is supported by recent studies revealing the presence of gastric pepsin in the middle ear space of children with otitis media but not in control patients without otitis media. Refl ux's role in otitis media appears to be most pronounced in younger children and those with purulent effusions.

Southern Medical Journal, 1998

The hemolytic-uremic syndrome (HUS) comprises hemolytic anemia, acute renal failure, and thromboc... more The hemolytic-uremic syndrome (HUS) comprises hemolytic anemia, acute renal failure, and thrombocytopenia. It is the most frequent cause of acute renal failure in children. This review is based on an extensive overview of the literature dealing with the HUS in children. HUS is the most common cause of acute renal failure in infants and young children and follows a diarrheal prodrome approximately 90% of the time. Nearly all postdiarrheal cases are caused by enterohemorrhagic E coli infections, in particular serotype O157:H7. Mortality is around 5%, and approximately 50% of survivors manifest some types of sequelae. Surveillance and contact investigation are important to control outbreaks, as well as early and aggressive treatment of symptomatic subjects to prevent mortality and severe complications, such as chronic renal disease.

The Indian Journal of Pediatrics, 1999

Inflammation of the gastric and duodenal mucosa is the end result of an imbalance between mucosal... more Inflammation of the gastric and duodenal mucosa is the end result of an imbalance between mucosal defensive and aggressive factors. The degree of inflammation and imbalance between defensive and aggressive factors can then result in varying degrees of gastritis and/or mucosal ulceration. Gastritis and ulcers of the duodenum or stomach can be classified as primary or secondary. The majority of children with chronic gastritis and ulcers in the stomach or duodenum have secondary inflammation or mucosal ulceration. These secondary ulcers generally occur due to a systemic condition like head trauma or overwhelming sepsis, or as sequelae to drug ingestion (i.e. non-steroidal anti-inflammatory agents), but secondary gastroduodenal ulcers can also occur in specific disease conditions such as Zollinger-Ellison syndrome or Crohn's disease.

The Indian Journal of Pediatrics, 1996

... Re-cently, glucoamylase deficiency has been noted to be perhaps more common than su-crase-iso... more ... Re-cently, glucoamylase deficiency has been noted to be perhaps more common than su-crase-isomaltase deficiency, and an impor-tant potential cause of postprandial symp-toms from starch maldigestion. Page 9. 1096; Vol. 63. No. ...

The Indian Journal of Pediatrics, 2000

Celiac disease and dermatitis herpetiformis are caused by the alcohol soluble fractions of wheat,... more Celiac disease and dermatitis herpetiformis are caused by the alcohol soluble fractions of wheat, barley, and rye. Reliable serological tests are available for both mass and risk group screening and recent epidemiological studies on celiac disease suggest that the prevalence varies between 1:100-300 in different continents. The clinical manifestations of the disease has changed in the West and the classical symptomatic cases represent only approximately 1/7th of all diagnosed cases. Symptoms such as, anemia, short stature, dental enamel defect or osteoporosis can be the only manifestations of the atypical disease. There is an increased prevalence of celiac disease in patients with autoimmune diseases. Recent data suggest that there is a correlation between the prevalence of autoimmune diseases and the number of years that an individual consumes gluten-containing foods. Genetic studies revealed a high prevalence of certain HLA antigens in celiac patients, however, there is likelihood that non-HIA genes are also important in the pathomechanism. An interesting new development is the recognition of tissue transglutaminase (tTG), an enzyme that probably forms an autoantigen with gluten. It is generally accepted that antibodies to tTG are identical to the previously described antiendomysium antibodies. Whether or not tTG is responsible for the initiation of an immunoreaction against prolamines or just exacerbates the immune response is a subject of further investigations.

The Laryngoscope, 2008

Objectives/Hypothesis: Gastroesophageal reflux disease (GERD) is common in children, and extraeso... more Objectives/Hypothesis: Gastroesophageal reflux disease (GERD) is common in children, and extraesophageal reflux disease (EORD) has been implicated in the pathophysiology of otitis media (OM). We sought to 1) determine the incidence of pepsin/pepsinogen presence in the middle ear cleft of a large sample of pediatric patients undergoing myringotomy with tube placement for OM; 2) compare this with a control population of pediatric patients undergoing middle ear surgery (cochlear implantation) with no documented history of OM; 3) analyze potential risk factors for OM in children with EORD demonstrated by the presence of pepsin in the middle ear cleft; and 4) determine if pepsin positivity at the time of myringotomy with tube placement predisposes to posttympanostomy tube otorrhea.

Pediatrics, 2014

ImproveCareNow (ICN) is the largest pediatric learning health system in the nation and started as... more ImproveCareNow (ICN) is the largest pediatric learning health system in the nation and started as a quality improvement collaborative. To test the feasibility and validity of using ICN data for clinical research, we evaluated the effectiveness of anti-tumor necrosis factor-α (anti-TNFα) agents in the management of pediatric Crohn disease (CD). Data were collected in 35 pediatric gastroenterology practices (April 2007 to March 2012) and analyzed as a sequence of nonrandomized trials. Patients who had moderate to severe CD were classified as initiators or non-initiators of anti-TNFα therapy. Among 4130 patients who had pediatric CD, 603 were new users and 1211 were receiving anti-TNFα therapy on entry into ICN. During a 26-week follow-up period, rate ratios obtained from Cox proportional hazards models, adjusting for patient and disease characteristics and concurrent medications, were 1.53 (95% confidence interval [CI], 1.20-1.96) for clinical remission and 1.74 (95% CI, 1.33-2.29) for corticosteroid-free remission. The rate ratio for corticosteroid-free remission was comparable to the estimate produced by the adult SONIC study, which was a randomized controlled trial on the efficacy of anti-TNFα therapy. The number needed to treat was 5.2 (95% CI, 3.4-11.1) for clinical remission and 5.0 (95% CI, 3.4-10.0) for corticosteroid-free remission. In routine pediatric gastroenterology practice settings, anti-TNFα therapy was effective at achieving clinical and corticosteroid-free remission for patients who had Crohn disease. Using data from the ICN learning health system for the purpose of observational research is feasible and produces valuable new knowledge.

Pediatric Research, 1998

Glucagon is reported to relieve esophageal food impaction in 37-75% of cases, presumably due to i... more Glucagon is reported to relieve esophageal food impaction in 37-75% of cases, presumably due to immediate esophageal smooth muscle relaxation. We report our experience on the use of glucagon for esophageal coin dislodgement in children with recent (< 12 hour) ...

The Journal of Pediatrics, 2000

The Journal of Pediatrics, 2010

Objectives To assess the prevalence of small intestinal bacterial overgrowth (SIBO) and methane p... more Objectives To assess the prevalence of small intestinal bacterial overgrowth (SIBO) and methane production in children with encopresis.

The Journal of Pediatrics, 2011

Journal of Pediatrics, 2000

Journal of Pediatric Gastroenterology and Nutrition, 1994

Journal of Pediatric Gastroenterology and Nutrition, 1994

Journal of Pediatric Gastroenterology and Nutrition, 2006

Journal of Pediatric Gastroenterology and Nutrition, 2005

Primary diagnosis included chronic cough, cystic fibrosis, asthma, bronchopulmonary dysplasia, re... more Primary diagnosis included chronic cough, cystic fibrosis, asthma, bronchopulmonary dysplasia, recurrent pneumonia. 10 males and 12 females. Ages ranged from 3 months to 15years. Pepsin levels ranged from 0 ng/ml to 367 ng/ml (with a cut off value of >6.5 ng/ml ...

The Indian Journal of Pediatrics, 1996

He!icobacterpylori is responsible for one of the most frequently encountered infectious diseases ... more He!icobacterpylori is responsible for one of the most frequently encountered infectious diseases worldwide. Helicobacter pylori infection can lead to the development of gastritis and peptic ulcer disease. The presence of Helicobacterpylori in the human stomach also represents an increased risk of gastric cancer and gastric lymphoma. Epidemiological data obtained in adults suggest that the actual colonization with Helicobacter pylori is in fact determined by childhood factors. Therefore, the pediatric age group represents the ideal target population for studies.

The Indian Journal of Pediatrics, 1998

Moaified food Starches were developed as a stabilizer, providing desirable consistency, texture, ... more Moaified food Starches were developed as a stabilizer, providing desirable consistency, texture, and storage ability. They are used primarily in strained and junior foods and, to a minor extent, in infant formulas. However, despite the fact that there is an increasing tendency to introduce solid foods to infants at a very early age, there is few long-term studies to delineate the effect of starch feeding on the growth of young infants.

Current Problems in Pediatrics, 1994

Journal of pediatric gastroenterology and nutrition, 2005

To examine psychosocial differences in diagnostic subgroups of children with recurrent abdominal ... more To examine psychosocial differences in diagnostic subgroups of children with recurrent abdominal pain (RAP). Children meeting Apley&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s 1975 definition of RAP were divided according to physician ratings into three subgroups, based on the Rome II diagnostic criteria of functional gastrointestinal disorders: functional dyspepsia (n=17), irritable bowel syndrome (n=18), and functional abdominal pain (n=27). Groups were compared using measures of (a) child psychopathology, (b) parent psychopathology, and (c) child pain, somatization, and functional disability. Multivariate results from a discriminant function analysis demonstrated that children classified according to these criteria could not be differentiated with respect to parent reported child psychopathology or child pain, somatization, and functional disability. There were significant univariate differences, however, between groups on parental psychopathology (F=4.39, P=0.02); parents of children with functional dyspepsia reported greater parental psychopathology symptoms than the other two groups. This study provides a preliminary comparison of pain, somatization, functional impact, and psychopathology ratings in the Rome II diagnostic subclassifications of children with RAP. Further investigation utilizing larger sample sizes, pain measures specifying pain location, and parental modeling of somatic behavior is indicated to better understand potential similarities and differences between these subgroups.

Current allergy and asthma reports, 2008

Gastroesophageal refl ux and extraesophageal refl ux have been postulated to be involved in the p... more Gastroesophageal refl ux and extraesophageal refl ux have been postulated to be involved in the pathogenesis of otitis media. This is supported by recent studies revealing the presence of gastric pepsin in the middle ear space of children with otitis media but not in control patients without otitis media. Refl ux's role in otitis media appears to be most pronounced in younger children and those with purulent effusions.

Southern Medical Journal, 1998

The hemolytic-uremic syndrome (HUS) comprises hemolytic anemia, acute renal failure, and thromboc... more The hemolytic-uremic syndrome (HUS) comprises hemolytic anemia, acute renal failure, and thrombocytopenia. It is the most frequent cause of acute renal failure in children. This review is based on an extensive overview of the literature dealing with the HUS in children. HUS is the most common cause of acute renal failure in infants and young children and follows a diarrheal prodrome approximately 90% of the time. Nearly all postdiarrheal cases are caused by enterohemorrhagic E coli infections, in particular serotype O157:H7. Mortality is around 5%, and approximately 50% of survivors manifest some types of sequelae. Surveillance and contact investigation are important to control outbreaks, as well as early and aggressive treatment of symptomatic subjects to prevent mortality and severe complications, such as chronic renal disease.

The Indian Journal of Pediatrics, 1999

Inflammation of the gastric and duodenal mucosa is the end result of an imbalance between mucosal... more Inflammation of the gastric and duodenal mucosa is the end result of an imbalance between mucosal defensive and aggressive factors. The degree of inflammation and imbalance between defensive and aggressive factors can then result in varying degrees of gastritis and/or mucosal ulceration. Gastritis and ulcers of the duodenum or stomach can be classified as primary or secondary. The majority of children with chronic gastritis and ulcers in the stomach or duodenum have secondary inflammation or mucosal ulceration. These secondary ulcers generally occur due to a systemic condition like head trauma or overwhelming sepsis, or as sequelae to drug ingestion (i.e. non-steroidal anti-inflammatory agents), but secondary gastroduodenal ulcers can also occur in specific disease conditions such as Zollinger-Ellison syndrome or Crohn's disease.

The Indian Journal of Pediatrics, 1996

... Re-cently, glucoamylase deficiency has been noted to be perhaps more common than su-crase-iso... more ... Re-cently, glucoamylase deficiency has been noted to be perhaps more common than su-crase-isomaltase deficiency, and an impor-tant potential cause of postprandial symp-toms from starch maldigestion. Page 9. 1096; Vol. 63. No. ...

The Indian Journal of Pediatrics, 2000

Celiac disease and dermatitis herpetiformis are caused by the alcohol soluble fractions of wheat,... more Celiac disease and dermatitis herpetiformis are caused by the alcohol soluble fractions of wheat, barley, and rye. Reliable serological tests are available for both mass and risk group screening and recent epidemiological studies on celiac disease suggest that the prevalence varies between 1:100-300 in different continents. The clinical manifestations of the disease has changed in the West and the classical symptomatic cases represent only approximately 1/7th of all diagnosed cases. Symptoms such as, anemia, short stature, dental enamel defect or osteoporosis can be the only manifestations of the atypical disease. There is an increased prevalence of celiac disease in patients with autoimmune diseases. Recent data suggest that there is a correlation between the prevalence of autoimmune diseases and the number of years that an individual consumes gluten-containing foods. Genetic studies revealed a high prevalence of certain HLA antigens in celiac patients, however, there is likelihood that non-HIA genes are also important in the pathomechanism. An interesting new development is the recognition of tissue transglutaminase (tTG), an enzyme that probably forms an autoantigen with gluten. It is generally accepted that antibodies to tTG are identical to the previously described antiendomysium antibodies. Whether or not tTG is responsible for the initiation of an immunoreaction against prolamines or just exacerbates the immune response is a subject of further investigations.

The Laryngoscope, 2008

Objectives/Hypothesis: Gastroesophageal reflux disease (GERD) is common in children, and extraeso... more Objectives/Hypothesis: Gastroesophageal reflux disease (GERD) is common in children, and extraesophageal reflux disease (EORD) has been implicated in the pathophysiology of otitis media (OM). We sought to 1) determine the incidence of pepsin/pepsinogen presence in the middle ear cleft of a large sample of pediatric patients undergoing myringotomy with tube placement for OM; 2) compare this with a control population of pediatric patients undergoing middle ear surgery (cochlear implantation) with no documented history of OM; 3) analyze potential risk factors for OM in children with EORD demonstrated by the presence of pepsin in the middle ear cleft; and 4) determine if pepsin positivity at the time of myringotomy with tube placement predisposes to posttympanostomy tube otorrhea.

Pediatrics, 2014

ImproveCareNow (ICN) is the largest pediatric learning health system in the nation and started as... more ImproveCareNow (ICN) is the largest pediatric learning health system in the nation and started as a quality improvement collaborative. To test the feasibility and validity of using ICN data for clinical research, we evaluated the effectiveness of anti-tumor necrosis factor-α (anti-TNFα) agents in the management of pediatric Crohn disease (CD). Data were collected in 35 pediatric gastroenterology practices (April 2007 to March 2012) and analyzed as a sequence of nonrandomized trials. Patients who had moderate to severe CD were classified as initiators or non-initiators of anti-TNFα therapy. Among 4130 patients who had pediatric CD, 603 were new users and 1211 were receiving anti-TNFα therapy on entry into ICN. During a 26-week follow-up period, rate ratios obtained from Cox proportional hazards models, adjusting for patient and disease characteristics and concurrent medications, were 1.53 (95% confidence interval [CI], 1.20-1.96) for clinical remission and 1.74 (95% CI, 1.33-2.29) for corticosteroid-free remission. The rate ratio for corticosteroid-free remission was comparable to the estimate produced by the adult SONIC study, which was a randomized controlled trial on the efficacy of anti-TNFα therapy. The number needed to treat was 5.2 (95% CI, 3.4-11.1) for clinical remission and 5.0 (95% CI, 3.4-10.0) for corticosteroid-free remission. In routine pediatric gastroenterology practice settings, anti-TNFα therapy was effective at achieving clinical and corticosteroid-free remission for patients who had Crohn disease. Using data from the ICN learning health system for the purpose of observational research is feasible and produces valuable new knowledge.

Pediatric Research, 1998

Glucagon is reported to relieve esophageal food impaction in 37-75% of cases, presumably due to i... more Glucagon is reported to relieve esophageal food impaction in 37-75% of cases, presumably due to immediate esophageal smooth muscle relaxation. We report our experience on the use of glucagon for esophageal coin dislodgement in children with recent (< 12 hour) ...

The Journal of Pediatrics, 2000

The Journal of Pediatrics, 2010

Objectives To assess the prevalence of small intestinal bacterial overgrowth (SIBO) and methane p... more Objectives To assess the prevalence of small intestinal bacterial overgrowth (SIBO) and methane production in children with encopresis.

The Journal of Pediatrics, 2011

Journal of Pediatrics, 2000

Journal of Pediatric Gastroenterology and Nutrition, 1994

Journal of Pediatric Gastroenterology and Nutrition, 1994

Journal of Pediatric Gastroenterology and Nutrition, 2006

Journal of Pediatric Gastroenterology and Nutrition, 2005

Primary diagnosis included chronic cough, cystic fibrosis, asthma, bronchopulmonary dysplasia, re... more Primary diagnosis included chronic cough, cystic fibrosis, asthma, bronchopulmonary dysplasia, recurrent pneumonia. 10 males and 12 females. Ages ranged from 3 months to 15years. Pepsin levels ranged from 0 ng/ml to 367 ng/ml (with a cut off value of >6.5 ng/ml ...