Khadija Irshad - Academia.edu (original) (raw)
Papers by Khadija Irshad
Pakistan Journal of Medical and Health Sciences
Introduction: The onset and rise of COVID-19 and its sudden progression to a worldwide pandemic l... more Introduction: The onset and rise of COVID-19 and its sudden progression to a worldwide pandemic lead medical and dental institutes to change their way of teaching and conducting assessments to distance learning as compared to the previously applied conventional approaches. Teaching and assessment during this era have changed vastly, earlier it was solely traditional/live Objective Structured Clinical Examination (OSCE) but due to the current circumstances electronic/online OSCE (E-OSCE) method was introduced. In Pakistan also, Pakistan Medical Council (PMC) and the College of Physicians and Surgeons of Pakistan (CPSP) conducted online exams so that the scheduled exams do not get delayed. Aim: The main objective of this paper is to measure the reliability of an E-OSCE and to compare it with the traditional OSCE. Methodology: This was a cross-sectional study which got conducted at the Rawal Institute of Health Sciences, Islamabad. Traditional OSCEs and E-OSCEs were conducted with 71 p...
Frontiers in Plant Science
Abiotic stress is one of the major constraints which restrain plant growth and productivity by di... more Abiotic stress is one of the major constraints which restrain plant growth and productivity by disrupting physiological processes and stifling defense mechanisms. Hence, the present work aimed to evaluate the sustainability of bio-priming salt tolerant endophytes for improving plant salt tolerance. Paecilomyces lilacinus KUCC-244 and Trichoderma hamatum Th-16 were obtained and cultured on PDA medium containing different concentrations of NaCl. The highest salt (500 mM) tolerant fungal colonies were selected and purified. Paecilomyces at 61.3 × 10-6 conidia/ml and Trichoderma at about 64.9 × 10-3 conidia/ml of colony forming unit (CFU) were used for priming wheat and mung bean seeds. Twenty- days-old primed and unprimed seedlings of wheat and mung bean were subjected to NaCl treatments at 100 and 200 mM. Results indicate that both endophytes sustain salt resistance in crops, however T. hamatum significantly increased the growth (141 to 209%) and chlorophyll content (81 to 189%), over...
Pakistan Journal of Medical and Health Sciences
Objective: The purpose of this study is to determine the perception and knowledge regarding denta... more Objective: The purpose of this study is to determine the perception and knowledge regarding dental implants among patients admitted to hospital. Study Design: Cross-sectional/ Descriptive study Place and Duration: Islamic International Dental Hospital, Islamabad and Rawal Institute of Health Sciences, Islamabad for the duration of six months from September 2021 to February 2022. Methods: There were 160 patients of both genders were included in this survey. Presented patients had age between 18-70 years. After obtaining informed written consent, detailed demographics of each patient were recorded. Standardized self-explanatory questionnaires were given to patients during regular dental visits to assess their knowledge, source of information, and attitude about dental implants. SPSS 22.0 was used to analyze all data. Results: Among 160 cases, majority of the cases 90 (56.3%) were females and 70 (43.7%) were males. 27 (16.9%) were aged between 18-28 years, 25 (15.6%) had 29-38 years, 4...
Turkish Online Journal of Qualitative Inquiry, Aug 4, 2021
OBJECTIVE: To describe characteristics of patients presenting with moyamoya syndrome (MMS) to a t... more OBJECTIVE: To describe characteristics of patients presenting with moyamoya syndrome (MMS) to a tertiary center in an ethnically diverse urban cohort. METHODS: Retrospective analysis of patients presenting to our institution from 1995 to 2016 was performed. ICD9 and 10 codes for moyamoya disease and MMS were confirmed through chart review. We reviewed 252 patients, 181 were excluded due to diagnosis of aneurysm, stroke, or other conditions. Chart review was conducted on 71 patients with angiographically confirmed MMS. SAS version 9.4 was used. The AA and Caucasian patients were reviewed using chi-squared tests for the categorical variables and two-sample test for age. Results: 71 cases were confirmed to have MMS. Of these, 28 were AA, 30 Caucasian, 1 Asian, 11 had race coded as unknown and 1 missing race. Most were female, (68% AA and 73% Caucasians). Mean age of onset was about the same for both races, 34.1 and 35.6 years with most patients (26%) in the age group 30-39. The most common symptom was unilateral weakness (23%). AA\u27s had a significantly lower rate of transient ischemic attacks (TIA) compared to Caucasian patients (7% vs 27%, p=0.049). AA patients were also noted to have higher rates of weakness (32% vs 13%, p=0.086). Most common risk factor was hypertension which was higher in AA (56% vs 38%). Hyperlipidemia (41% vs 31%) was also higher in AA. Smoking (52% vs 44%), diabetes (24% vs 15%) and CAD (10% vs 7%) were higher in Caucasians. Treatments were medical management only (41%) and surgical intervention (31%). AA\u27s had significantly higher rates of receiving medical treatment compared to Caucasians (86% vs 60%, p=0.029). They had a slightly lower rate of receiving surgical treatment, but this difference was not significant (32% vs 43%, p=0.38)
Objective: To review characteristics of patients presenting with moyamoya disease (MMD) to an urb... more Objective: To review characteristics of patients presenting with moyamoya disease (MMD) to an urban tertiary center in North America. Background: The etiology, demographic variables and patterns of disease in African Americans (AA) compared to Caucasians (CA) is still not fully understood. Design/Methods: Retrospective analysis of patients presenting to our institution from 1995 to 2016 was performed. ICD9/10 codes for MMD were confirmed. We reviewed 252 patients, 181 were excluded due to other diagnosis. Chart review was conducted on 71 patients with angiographically confirmed MMD. SAS version 9.4 was used. AA and CA patients were reviewed using chi-squared tests for categorical variables and two-sample test for age. Results: Of 71 MMD cases, 29 were AA, 30 CA, 1 Asian, 11 had race coded as unknown. Most were female (68% AA and 73% CA). Mean age of onset was about the same, 34.1 and 35.6 years. The most common symptom was unilateral weakness (23%). AA\u27s had a significantly lower rate of transient ischemic attacks (TIA) compared to CA (7% vs 27%, p=0.049). AA\u27s were noted to have higher rates of weakness (32% vs 13%, p=0.086). 6 patients had intracerebral hemorrhage of which, 5 were AA. Most common risk factor was hypertension which was higher in AA (56% vs 38%). Hyperlipidemia (41% vs 31%) was also higher in AA. Smoking (52% vs 44%), diabetes (24% vs 15%) and coronary artery disease (10% vs 7%) were higher in CA. AA\u27s had significantly higher rates of receiving medical treatment compared to CA\u27s (86% vs 60%, p=0.029) and a lower rate of receiving surgery, which was not significant (32% vs 43%, p=0.38). Conclusions: Our study revealed a lower rate of TIAs and a higher rate of receiving medical therapy in AA which could be due to different socioeconomic factors. Studies are needed to understand MMD in different races
Neurology, 2015
Background Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis has been described with a well... more Background Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis has been described with a well defined set of clinical features. The associated syndrome has been characterized, frequently young women with teratomas of the ovary who develop changes of mood, behavior, and personality. The clinical picture usually progresses to include seizures, decreased level of consciousness, dyskinesias and autonomic instability. We report a case of refractory hyperkinetic movements and dyskinesias associated with NMDAR encephalitis. Case presentation A 17 year old female who initially presented with new-onset of seizure. Two days following her admission and her return to baseline, patient developed acute psychosis in the setting of rapidly progressive encephalopathy. Her clinical course was further complicated by a multitude of extrapyramidal findings including orofascial dyskienisa, diffuse chroeathetoid and dystonic movements. Patient had extensive work up including brain imaging, serology te...
Cureus, Jan 23, 2017
We present a systemic review of available literature on the complications of deep venous thrombos... more We present a systemic review of available literature on the complications of deep venous thrombosis that develops in patients presenting with acute stroke. There are several pharmacological and physical treatment options available and used. We aim to summarize the management plans currently used at different centers. In conclusion, low-dose anticoagulant therapy for ischemic stroke is recommended. In the case of intracerebral hemorrhage, pneumatic sequential compression devices should be placed initially, followed by the administration of ultra-fractioned heparin on the next day, and then oral anticoagulant therapy to replace the heparin after a week in high-risk patients. Similar prophylactic treatment recommendations are used for subarachnoid hemorrhage.
Objective: To evaluate the common concerns and factors affecting planning a family during residen... more Objective: To evaluate the common concerns and factors affecting planning a family during residency and fellowship and to create required support services particular to those needs. Background: With the rise in burnout amongst physicians, family stress and parenthood during training may be an important factor in early career burnout. Studies have shown that childbearing and parenthood during residency and fellowship affects training and career satisfaction. With women in medicine comprising half the workforce and long training periods, it is a not uncommon for residents to start families during residency. Pregnancy, lactation, maternity/paternity leaves, post partum support affects resident education, training and often program completion time. Design/Methods: We conducted a detailed online survey of all residents and fellows at Henry Ford Hospital utilizing survey monkey. Questions were asked regarding knowledge of parental leave, policies pertaining to training and board examination, breast feeding policies, feasible childcare options and other parental resources. After the survey, parent support group was created which carried out meetings to address trainee\u27s needs. Results: Out of the total house officers surveyed, 78 responded to the survey. Among them 50% responded that due to their career plan, they put off planning a family while still in training. About 80% of them were not aware of the institution\u27s resources for new parents and 60% were unaware of lactation policies. Conclusions: Parent support group was created with the intent to address these issues and mitigate stress associated with childbirth during training. Monthly meetings with focus on specific issues such as lactation, work life integration and parenting as well as faculty panels and mentorship for interested residents are arranged as a part of this project. A more widespread initiative should be taken to provide parenthood support to residents and fellows
Neurology, 2015
OBJECTIVE: To identify predictors of mortality in bacterial meningitis who developed hydrocephalu... more OBJECTIVE: To identify predictors of mortality in bacterial meningitis who developed hydrocephalus. BACKGROUND: Hydrocephalus is a major complication of bacterial meningitis and can increase mortality. DESIGN/METHODS: Retrospective search of Nationwide Inpatient Sample (NIS) was done to identify patients with primary diagnosis of bacterial meningitis (ICD-9 code 320.x, 320.xx) who also had hydrocephalus (ICD-9 codes 331.3, 331.4). Patients with secondary diagnosis of intracranial hemorrhage, traumatic brain injury, brain tumor or brain metastasis were excluded in order to minimize nosocomial and iatrogenic bacterial meningitis cases from the sample. Complications were identified using their respective ICD-9 codes. Patients who underwent ventriculostomy were identified (ICD-9-CM procedure code 02.2). Multivariate logistic regression was used to identify predictors of mortality. RESULTS: Total 333 patients with bacterial meningitis who had hydrocephalus were found from year 2000 to 20...
Pakistan Journal of Medical and Health Sciences
Introduction: The onset and rise of COVID-19 and its sudden progression to a worldwide pandemic l... more Introduction: The onset and rise of COVID-19 and its sudden progression to a worldwide pandemic lead medical and dental institutes to change their way of teaching and conducting assessments to distance learning as compared to the previously applied conventional approaches. Teaching and assessment during this era have changed vastly, earlier it was solely traditional/live Objective Structured Clinical Examination (OSCE) but due to the current circumstances electronic/online OSCE (E-OSCE) method was introduced. In Pakistan also, Pakistan Medical Council (PMC) and the College of Physicians and Surgeons of Pakistan (CPSP) conducted online exams so that the scheduled exams do not get delayed. Aim: The main objective of this paper is to measure the reliability of an E-OSCE and to compare it with the traditional OSCE. Methodology: This was a cross-sectional study which got conducted at the Rawal Institute of Health Sciences, Islamabad. Traditional OSCEs and E-OSCEs were conducted with 71 p...
Frontiers in Plant Science
Abiotic stress is one of the major constraints which restrain plant growth and productivity by di... more Abiotic stress is one of the major constraints which restrain plant growth and productivity by disrupting physiological processes and stifling defense mechanisms. Hence, the present work aimed to evaluate the sustainability of bio-priming salt tolerant endophytes for improving plant salt tolerance. Paecilomyces lilacinus KUCC-244 and Trichoderma hamatum Th-16 were obtained and cultured on PDA medium containing different concentrations of NaCl. The highest salt (500 mM) tolerant fungal colonies were selected and purified. Paecilomyces at 61.3 × 10-6 conidia/ml and Trichoderma at about 64.9 × 10-3 conidia/ml of colony forming unit (CFU) were used for priming wheat and mung bean seeds. Twenty- days-old primed and unprimed seedlings of wheat and mung bean were subjected to NaCl treatments at 100 and 200 mM. Results indicate that both endophytes sustain salt resistance in crops, however T. hamatum significantly increased the growth (141 to 209%) and chlorophyll content (81 to 189%), over...
Pakistan Journal of Medical and Health Sciences
Objective: The purpose of this study is to determine the perception and knowledge regarding denta... more Objective: The purpose of this study is to determine the perception and knowledge regarding dental implants among patients admitted to hospital. Study Design: Cross-sectional/ Descriptive study Place and Duration: Islamic International Dental Hospital, Islamabad and Rawal Institute of Health Sciences, Islamabad for the duration of six months from September 2021 to February 2022. Methods: There were 160 patients of both genders were included in this survey. Presented patients had age between 18-70 years. After obtaining informed written consent, detailed demographics of each patient were recorded. Standardized self-explanatory questionnaires were given to patients during regular dental visits to assess their knowledge, source of information, and attitude about dental implants. SPSS 22.0 was used to analyze all data. Results: Among 160 cases, majority of the cases 90 (56.3%) were females and 70 (43.7%) were males. 27 (16.9%) were aged between 18-28 years, 25 (15.6%) had 29-38 years, 4...
Turkish Online Journal of Qualitative Inquiry, Aug 4, 2021
OBJECTIVE: To describe characteristics of patients presenting with moyamoya syndrome (MMS) to a t... more OBJECTIVE: To describe characteristics of patients presenting with moyamoya syndrome (MMS) to a tertiary center in an ethnically diverse urban cohort. METHODS: Retrospective analysis of patients presenting to our institution from 1995 to 2016 was performed. ICD9 and 10 codes for moyamoya disease and MMS were confirmed through chart review. We reviewed 252 patients, 181 were excluded due to diagnosis of aneurysm, stroke, or other conditions. Chart review was conducted on 71 patients with angiographically confirmed MMS. SAS version 9.4 was used. The AA and Caucasian patients were reviewed using chi-squared tests for the categorical variables and two-sample test for age. Results: 71 cases were confirmed to have MMS. Of these, 28 were AA, 30 Caucasian, 1 Asian, 11 had race coded as unknown and 1 missing race. Most were female, (68% AA and 73% Caucasians). Mean age of onset was about the same for both races, 34.1 and 35.6 years with most patients (26%) in the age group 30-39. The most common symptom was unilateral weakness (23%). AA\u27s had a significantly lower rate of transient ischemic attacks (TIA) compared to Caucasian patients (7% vs 27%, p=0.049). AA patients were also noted to have higher rates of weakness (32% vs 13%, p=0.086). Most common risk factor was hypertension which was higher in AA (56% vs 38%). Hyperlipidemia (41% vs 31%) was also higher in AA. Smoking (52% vs 44%), diabetes (24% vs 15%) and CAD (10% vs 7%) were higher in Caucasians. Treatments were medical management only (41%) and surgical intervention (31%). AA\u27s had significantly higher rates of receiving medical treatment compared to Caucasians (86% vs 60%, p=0.029). They had a slightly lower rate of receiving surgical treatment, but this difference was not significant (32% vs 43%, p=0.38)
Objective: To review characteristics of patients presenting with moyamoya disease (MMD) to an urb... more Objective: To review characteristics of patients presenting with moyamoya disease (MMD) to an urban tertiary center in North America. Background: The etiology, demographic variables and patterns of disease in African Americans (AA) compared to Caucasians (CA) is still not fully understood. Design/Methods: Retrospective analysis of patients presenting to our institution from 1995 to 2016 was performed. ICD9/10 codes for MMD were confirmed. We reviewed 252 patients, 181 were excluded due to other diagnosis. Chart review was conducted on 71 patients with angiographically confirmed MMD. SAS version 9.4 was used. AA and CA patients were reviewed using chi-squared tests for categorical variables and two-sample test for age. Results: Of 71 MMD cases, 29 were AA, 30 CA, 1 Asian, 11 had race coded as unknown. Most were female (68% AA and 73% CA). Mean age of onset was about the same, 34.1 and 35.6 years. The most common symptom was unilateral weakness (23%). AA\u27s had a significantly lower rate of transient ischemic attacks (TIA) compared to CA (7% vs 27%, p=0.049). AA\u27s were noted to have higher rates of weakness (32% vs 13%, p=0.086). 6 patients had intracerebral hemorrhage of which, 5 were AA. Most common risk factor was hypertension which was higher in AA (56% vs 38%). Hyperlipidemia (41% vs 31%) was also higher in AA. Smoking (52% vs 44%), diabetes (24% vs 15%) and coronary artery disease (10% vs 7%) were higher in CA. AA\u27s had significantly higher rates of receiving medical treatment compared to CA\u27s (86% vs 60%, p=0.029) and a lower rate of receiving surgery, which was not significant (32% vs 43%, p=0.38). Conclusions: Our study revealed a lower rate of TIAs and a higher rate of receiving medical therapy in AA which could be due to different socioeconomic factors. Studies are needed to understand MMD in different races
Neurology, 2015
Background Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis has been described with a well... more Background Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis has been described with a well defined set of clinical features. The associated syndrome has been characterized, frequently young women with teratomas of the ovary who develop changes of mood, behavior, and personality. The clinical picture usually progresses to include seizures, decreased level of consciousness, dyskinesias and autonomic instability. We report a case of refractory hyperkinetic movements and dyskinesias associated with NMDAR encephalitis. Case presentation A 17 year old female who initially presented with new-onset of seizure. Two days following her admission and her return to baseline, patient developed acute psychosis in the setting of rapidly progressive encephalopathy. Her clinical course was further complicated by a multitude of extrapyramidal findings including orofascial dyskienisa, diffuse chroeathetoid and dystonic movements. Patient had extensive work up including brain imaging, serology te...
Cureus, Jan 23, 2017
We present a systemic review of available literature on the complications of deep venous thrombos... more We present a systemic review of available literature on the complications of deep venous thrombosis that develops in patients presenting with acute stroke. There are several pharmacological and physical treatment options available and used. We aim to summarize the management plans currently used at different centers. In conclusion, low-dose anticoagulant therapy for ischemic stroke is recommended. In the case of intracerebral hemorrhage, pneumatic sequential compression devices should be placed initially, followed by the administration of ultra-fractioned heparin on the next day, and then oral anticoagulant therapy to replace the heparin after a week in high-risk patients. Similar prophylactic treatment recommendations are used for subarachnoid hemorrhage.
Objective: To evaluate the common concerns and factors affecting planning a family during residen... more Objective: To evaluate the common concerns and factors affecting planning a family during residency and fellowship and to create required support services particular to those needs. Background: With the rise in burnout amongst physicians, family stress and parenthood during training may be an important factor in early career burnout. Studies have shown that childbearing and parenthood during residency and fellowship affects training and career satisfaction. With women in medicine comprising half the workforce and long training periods, it is a not uncommon for residents to start families during residency. Pregnancy, lactation, maternity/paternity leaves, post partum support affects resident education, training and often program completion time. Design/Methods: We conducted a detailed online survey of all residents and fellows at Henry Ford Hospital utilizing survey monkey. Questions were asked regarding knowledge of parental leave, policies pertaining to training and board examination, breast feeding policies, feasible childcare options and other parental resources. After the survey, parent support group was created which carried out meetings to address trainee\u27s needs. Results: Out of the total house officers surveyed, 78 responded to the survey. Among them 50% responded that due to their career plan, they put off planning a family while still in training. About 80% of them were not aware of the institution\u27s resources for new parents and 60% were unaware of lactation policies. Conclusions: Parent support group was created with the intent to address these issues and mitigate stress associated with childbirth during training. Monthly meetings with focus on specific issues such as lactation, work life integration and parenting as well as faculty panels and mentorship for interested residents are arranged as a part of this project. A more widespread initiative should be taken to provide parenthood support to residents and fellows
Neurology, 2015
OBJECTIVE: To identify predictors of mortality in bacterial meningitis who developed hydrocephalu... more OBJECTIVE: To identify predictors of mortality in bacterial meningitis who developed hydrocephalus. BACKGROUND: Hydrocephalus is a major complication of bacterial meningitis and can increase mortality. DESIGN/METHODS: Retrospective search of Nationwide Inpatient Sample (NIS) was done to identify patients with primary diagnosis of bacterial meningitis (ICD-9 code 320.x, 320.xx) who also had hydrocephalus (ICD-9 codes 331.3, 331.4). Patients with secondary diagnosis of intracranial hemorrhage, traumatic brain injury, brain tumor or brain metastasis were excluded in order to minimize nosocomial and iatrogenic bacterial meningitis cases from the sample. Complications were identified using their respective ICD-9 codes. Patients who underwent ventriculostomy were identified (ICD-9-CM procedure code 02.2). Multivariate logistic regression was used to identify predictors of mortality. RESULTS: Total 333 patients with bacterial meningitis who had hydrocephalus were found from year 2000 to 20...