Prof. Dr. SHAHID H SHEIKH | Doetsk Christian University (original) (raw)

Papers by Prof. Dr. SHAHID H SHEIKH

Research paper thumbnail of Breakthrough Treatment of Irritable Bowel Syndrome in the Light of Nucleopathy

Advanced Research in Gastroenterology & Hepatology, 2018

Irritable Bowel Syndrome is a chronic disease in almost in every community across the planet with... more Irritable Bowel Syndrome is a chronic disease in almost in every community across the planet with no cure. Patients suffering from this ailment live a very disturbed and painful quality of life. Weight loss, and other prominent derogatory health conditions prevail swiftly that carry a social and financial burden on the family. Conventional allopathy has no solution but the symptomatic transitory relief. Interestingly, many physicians cater the remedial cocktail to IBS Patients focusing on the central and peripheral nervous system to calm down its gastro-intestinal excitatory response. Therefore, to decrease the frequency and inconvenience of the symptomatology. It is very logical lead to start tracing the involvement of the nervous system right from the effected tissues involved in this ailment and track the possible neo-pathogenesis of the IBS. Indeed it's the branch of vagus nerve that distribute the supply of Neuro network to the gastro-intestinal tract linking the end tissues with the controlling neurons. The pathophysiology of the controlling neurons is never taken into an account for a possible involvement in the systems malfunctioning. Long behold, as we tracked this novel phenomenon and found a new revelation. The controlling neurons nuclei overwhelmed with the Neuro-invasive viral genomic proliferation in turn, incapacitating the neuronal homeostasis. Therefore, instigation of the gastrointestinal tract malfunctioning comes into play causing Irritable Bowel Syndrome; IBS.

Research paper thumbnail of Benefits of pulmonary rehabilitation in pediatric asthma

Pediatric pulmonology, Jan 7, 2018

There are limited studies evaluating the role of pulmonary rehabilitation (PR) in pediatric asthm... more There are limited studies evaluating the role of pulmonary rehabilitation (PR) in pediatric asthma. A retrospective chart review was performed of all pediatric patients with a diagnosis of asthma enrolled in PR. Demographics, medications, and clinical records were reviewed. In addition, PFTs, 6-min walk test (6MWT), and patient/parent symptom and quality of life surveys before and after PR were evaluated. A total of 38 patients were enrolled in PR; 18 (47%) female and 20 (53%) male. Mean participant age was 11.33 ± 3.37 (range 4-19) years. Twenty-two (58%) were Caucasian and nine (24%) African American. Chart review was limited by incomplete data sets for many participants. Following PR, significant improvement was noted in mean 6MWT distance (1541 vs 1616 feet, P = 0.05) and FEV1 (89.9% of predicted versus 96.4%, P = 0.04). Survey instruments demonstrated improvement in several clinical factors, however, there was no significant change in weight following PR despite scheduled cardi...

Research paper thumbnail of Erratum to: Racial differences in pet ownership in families of children with asthma

World Journal of Pediatrics, 2017

Research paper thumbnail of Novel CT Scoring System for Sinus Disease in Adults With Cystic Fibrosis

Chest, 2016

There is no easy-to-use scoring system for CT Scans of the sinuses that is specific to cystic fib... more There is no easy-to-use scoring system for CT Scans of the sinuses that is specific to cystic fibrosis (CF). We propose a simple and easily implemented scoring system to quantify severity of sinus disease in adults with CF. METHODS: After IRB approval, we validated a scoring system in 69 adults with CF and 50 age-matched controls. CT scans were interpreted by three physicians (pulmonologist, ENT surgeon and a neuro radiologist) on two separate sittings. Parameters include maxillary opacification and nasal obstruction scored in a graded fashion (0 to 3) with 0 ¼ normal, 1 ¼ mild (<33%), 2 ¼ moderate (33-66%) and 3¼severe (>66%), while lateral nasal wall displacement, uncinate process absence/demineralization, and mucocele were scored as 1¼present, 0¼absent. Intra-rater and inter-rater reliability were measured by intraclass correlations (ICC). RESULTS: CF patients aged 21-30 years (mean¼24.7 AE SD 2.49). Intra-Rater Reliability: in CF cohort (n¼69), reliability for the 10 CT categories ranged from .70 to 1.00. Twenty six (87%) were in the excellent range, and remaining 4 (13%) were evaluated as good. In the non-CF cohort (n¼50), reliabilities ranged from .44 to 1.00. Twenty seven (90%) were in the excellent range. Inter-Rater Reliability: in CF cohort, 10 CT categories across the three raters ranged from .35 to 1.00. Excellent reliability was achieved in 15 (50%) of the observations. In the non-CF cohort, reliabilities ranged from .44 to 1.00. CONCLUSIONS: A novel and easy-to-use CT scoring system for CF sinus disease in adults was validated with acceptable interand intra-rater reliability. CLINICAL IMPLICATIONS: This new CF sinus disease specific scoring system can quantify disease severity and can be used with acceptable reliabilities by clinicians, surgeons and radiologists.

Research paper thumbnail of Racial differences in pet ownership in families of children with asthma

World Journal of Pediatrics, 2016

Background: Exposure to household domestic animals such as cats and dogs in early life may have s... more Background: Exposure to household domestic animals such as cats and dogs in early life may have some role in pathogenesis of asthma. Racial differences exist in the prevalence of asthma. We hypothesized that there may also be racial differences in pet ownership in families with asthma. Methods: A cross sectional study was conducted from June 2011 to December 2014 on 823 of 850 (97%) families of children with asthma for pet ownership. Comparisons among racial groups were done using chi square analysis and one-way analysis of variance. Results: The mean age of the cohort was 6.9±4.4 years. A total of 540 (65.62%) patients were Caucasian, 195 (23.7%) African American, 42 (5.1%) hispanics, and 26 (3.2%) biracial with one Caucasian parent. Pets in the home were reported by 470 (58.5%) households. Signifi cantly fewer African American and hispanic families had pets in the home (26.9% and 44.7%) than biracial and Caucasian families (72% and 69.9%, P<0.001). Likewise, significantly more biracial and Caucasian families were noted to have dogs (52% and 54.4%) or cats (25.4% and 40%) or both cats and dogs (28% and 18%) than African Americans families (20.3%, P<0.001; 7.1%, P<0.001) and (4.6%, P<0.001), respectively. Conclusion: Among families with asthmatic children, pet ownership is significantly more likely in Caucasian families compared with African-American and Hispanic families, thus there is a racial diversity in pet ownership among families of children with asthma.

Research paper thumbnail of Changes in pulmonary function tests following antibiotics in infants with pulmonary exacerbation of cystic fibrosis

European Respiratory Journal, Sep 1, 2013

Body: Progressive lung disease plays an important role in CF morbidity. In older patients, improv... more Body: Progressive lung disease plays an important role in CF morbidity. In older patients, improvement in PFT during CF exacerbation reflect clinical improvement but similar effectiveness of PFT in infants is not well known. Methods: After local IRB approval, charts of all patients with CF who underwent infant PFT (under sedation with raised volume thoraco-abdominal technique) before and after 2 weeks of I/V antibiotic therapy for CF exacerbation between 2000-2012 at Nationwide Children's Hospital, Columbus, OH, were reviewed and included in this study. Results: Forty-one studies were completed in 28 patients, mean age 20.8 ±48 weeks. IV antibiotic therapy was received in the home by 15 (56%) and in the hospital by 13 (43%) patients. Length of hospital stay averaged 7.7 ±6.8 days. The mean number of antibiotic days was 17.8 ±4.9.

Research paper thumbnail of Ethnic diversity in having pets at home in families with asthma

European Respiratory Journal, Sep 1, 2013

Research paper thumbnail of Screening for asthma-like symptoms and acute care utilization can be used to identify children in the community who may be at risk for undiagnosed asthma

European Respiratory Journal, Sep 1, 2013

Research paper thumbnail of Safety and efficacy of omalizumab in children with allergic asthma

European Respiratory Journal, Sep 1, 2011

Background: Omalizumab (Xolair) is a humanized monoclonal antibody used in the treatment of adult... more Background: Omalizumab (Xolair) is a humanized monoclonal antibody used in the treatment of adults and children over 12 years with moderate to severe allergic asthma. Pediatric studies are few. Objective: A retrospective chart review of pediatric patients who received omalizumab in the past 10 years for asthma at Nationwide Children's Hospital, Columbus, Ohio. Results: We had 13 patients, M:F 7:6, median age 13 years (range 9-17), median duration of therapy 36 months (range 1 to 59 months), 9 African American and 4 Caucasian, duration of asthma 15 years (8 to 16). Eight are still on therapy. All patients had severe persistent asthma. Twelve patients were receiving combination therapy (ICS and LABA). Only 4 patients claimed compliance with their asthma controller therapy. Five had family history of asthma, 6 had smoking exposure. Median IgE before starting omalizumab was 249 (range 78 to 2600). Mean BMI was 25.7 and 46% of the patients were above the 100 percentile for BMI. Comparing between one year before and during omalizumab, mean hospital admission/patient/year decreased from 1.7±2.4 to 0.58±1.4 (p<0.05). There was also a trend towards improvement in ED visits from 2.3±3.2 to 1.7±3. Mean FEV1 during one year before omalizumab therapy, at initiation of therapy and during therapy was 91±18, 94±17, and 93±11 and was not statistically different. Two of 13 patients were taken off omalizumab because of serious side effects, one with anaphylaxis and second with dilated cardiomyopathy. Anaphylaxis was noted on first dose and cardiomyopathy was diagnosed in 5th year on therapy. Conclusion: Omalizumab is add-on therapy for some patients with allergic asthma. Adverse reactions in children are limiting factor.

Research paper thumbnail of Use of New Knowledge and Knowledge Management to Gain Competitive Advantage

New knowledge may perhaps be the only remaining and one of the most critical sources of competiti... more New knowledge may perhaps be the only remaining and one of the most critical sources of competitive advantage available to an organization in the 21 st century. This is true; more so, as previously available traditional resources may no longer offer any significant competitive advantage. To remain competitive, organizations must create and use new knowledge. However, the current practices in knowledge acquisition, utilization, and management are mostly limited to capturing, recycling, and deploying the existing information, and making it available on a technology platform. This is done with the hope that individuals will not only use the information made available to them, but will also voluntarily contribute to the growth of the organization's knowledge pool. Most organizations are also woefully reluctant to realize that knowledge obsolescence is inevitable, and that the knowledge based on organizational consensus or common wisdom based on collective experiences can be wrong. To create new knowledge and attain competitive advantage, organizations need to locate and gather information and business intelligence about their internal and external consumers of knowledge and convert them into new knowledge.

Research paper thumbnail of Changes in Infant Pulmonary Function Tests and Stop Ventilation HRCT Scans of Chest After Antibiotic Therapy in Infants with Acute Pulmonary Exacerbation of Cystic Fibrosis

Research paper thumbnail of Mortality Risk and Pulmonary Function in Adults With Cystic Fibrosis at Time of Wait Listing for Lung Transplantation

The Annals of thoracic surgery, Jan 30, 2015

Lung transplantation (LTx) benefit for survival in cystic fibrosis (CF) patients placed on the wa... more Lung transplantation (LTx) benefit for survival in cystic fibrosis (CF) patients placed on the wait list is not well studied. To predict the relationship between initial forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) and the hazard ratio (HR) associated with LTx in CF patients, the United Network for Organ Sharing database was queried from 2005 to 2006 for adult patients with CF. Survival was assessed from wait list entry time until death on wait list, death after LTx, or censoring. Multivariate Cox proportional hazards models were used to assess the effect of LTx. The first model estimated the HR of LTx with adjustment for FEV1 or FVC and other covariates, and the second model estimated the HR of LTx conditional on FEV1 or FVC at listing. Two hundred seventy-eight patients with CF were included in the cohort, and 277 were used for survival analysis. Lung transplantation reduced the risk for death controlling for FEV1 (HR, 0.601; 95% confidence interval,...

Research paper thumbnail of Demographics, clinical course and outcome of children with status asthmaticus treated in a pediatric critical care unit: 8 year review

Background: This retrospective study was done to understand demographics and clinical course in c... more Background: This retrospective study was done to understand demographics and clinical course in children with status asthmaticus treated in a tertiary care pediatric intensive care unit (PICU).Methods: The medical charts of all patients above 5 years of age admitted to the PICU with status asthmaticus, at Nationwide Children's hospital, Columbus, OH, between 2000-2007 were reviewed. Two hundred and forty seven (247) children were admitted on 281 occasions. Patients with significant co-morbidities were excluded. Final analysis was done using 222 encounters in 183 patients.Results: The mean age was 11 years (range, 5-20 years). The mean PICU stay was 2.1 days (range, 1-15 days) and mean hospital stay was 3.6 days. Male: Female 109:74. Eighty nine (49%) were on no asthma controller medications. Adherence to therapy was noted in 124 of whom only 41 (33%) claimed compliance. 191 were known asthmatics. Asthma severity noted in 75 patients revealed 22 (29%) had mild intermittent, mild ...

Research paper thumbnail of Changes in Pulmonary Function and Controlled Ventilation-High Resolution CT of Chest After Antibiotic Therapy in Infants and Young Children with Cystic Fibrosis

Lung, Jan 12, 2015

Infants with cystic fibrosis (CF) develop early progressive lung disease which may be asymptomati... more Infants with cystic fibrosis (CF) develop early progressive lung disease which may be asymptomatic. Infant pulmonary function tests (IPFT) and controlled ventilation-high resolution computed tomography (CV-HRCT) of chest can detect early asymptomatic lung disease. It is not well established that these objective measures can detect changes in lung disease after clinical interventions. The purpose of this study was to evaluate usefulness of IPFT and CV-HRCT to detect changes in lung disease after intravenous (IV) antibiotic therapy in infants with early CF-related lung disease. IPFTs and CV-HRCT done before and after 2 weeks of IV antibiotics in infants at our institution over the last 12 years were compared. CV-HRCTs were compared using the modified Brody scoring system. The sample included 21 infants, mean age 85.2 ± 47.6 weeks. Mean change in weight was 0.4 ± 0.38 kg (p = 0.001). Significant changes in IPFT included mean % predicted FEV0.5 (+13.5 %, p = 0.043), mean %FEF25-75 (+30....

Research paper thumbnail of Pulmonologist Versus Radiologist Interpretation of Cystic Fibrosis on CT Imaging

Research paper thumbnail of Cardiac fibroma, anomalous pulmonary venous course, and persistent pneumonia in a patient with gorlin syndrome

Pediatric Pulmonology, 2012

We report the unusual case of a child referred for persistent pneumonia and possible pulmonary no... more We report the unusual case of a child referred for persistent pneumonia and possible pulmonary nodules who was found to have a cardiac fibroma and diagnosed with Gorlin syndrome. Pulmonologists should be aware of the potential for vascular anomalies associated with this syndrome as well as the risk for pulmonary metastases from primary skin tumors. Pediatr Pulmonol. 2014; 49:E7–E9. © 2013 Wiley Periodicals, Inc.

Research paper thumbnail of Reduction in Growth Velocity in Children and Adolescents with Asthma Treated with Inhaled Fluticasone

Research paper thumbnail of The Authors Respond

Pediatric Pulmonology, 2000

Research paper thumbnail of Moderate hemoptysis of unknown etiology

Pediatric Pulmonology, 1999

The underlying cause and treatment of hemoptysis should be addressed promptly to avoid potentiall... more The underlying cause and treatment of hemoptysis should be addressed promptly to avoid potentially life-threatening complications. We report on a previously healthy 11-year-old white boy who presented with acute hemoptysis. On bronchoscopy, bleeding was noted from the right upper and lower lobes. Right bronchial arteriography revealed multiple regions of abnormal ''blushing'' throughout the right bronchial arterial distribution which was successfully controlled by right bronchial arterial embolization. In spite of an extensive work-up, we were not able to determine the cause of bleeding. The patient has been followed for 18 months without any recurrence and without evidence of any systemic disease. Our patient does not fit any diagnostic category of pulmonary bleeding and further case reports are needed to delineate this entity.

Research paper thumbnail of Assessing bronchodilator responsiveness in infants using partial expiratory flow-volume curves

Pediatric Pulmonology, 2003

Our objective was to compare the effectiveness of maximum forced expiratory flow measured at func... more Our objective was to compare the effectiveness of maximum forced expiratory flow measured at functional residual capacity (V&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;maxFRC) and the ratio of flow at 75% of the forced expiratory volume to peak forced expiratory flow (FEF(75)/FEF(peak)) for detecting bronchodilator-related changes in wheezy infants. In 55 infants (mean age, 7.8 +/- 3.1 months) with a history of recurrent wheezing, V&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;maxFRC and FEF(75)/FEF(peak) were measured at baseline and 15 min following nebulized albuterol. Mean results from 4 baseline and 4 postalbuterol partial expiratory flow-volume curves were compared at baseline and following bronchodilator challenge. The strength (relative effect size) of each measure for assessing change was quantified by dividing the mean of the pre- to postdifferences by the standard deviation of the differences. Mean percent predicted V&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;maxFRC was 41.3 +/- 34.3% at baseline and 44.4 +/- 34.0% following albuterol. Mean FEF(75)/FEF(peak) was 26.7 +/- 13.4% at baseline and 35.8 +/- 14.3% following albuterol. The mean percent change from baseline [(post-pre)/pre] in percent predicted V&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;maxFRC was 18.3 +/- 39.3, and for FEF(75)/FEF(peak), it was 44.1 +/- 36.8. The change in FEF(75)/FEF(peak) following albuterol was significantly greater than the change in V&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;maxFRC (P…

Research paper thumbnail of Breakthrough Treatment of Irritable Bowel Syndrome in the Light of Nucleopathy

Advanced Research in Gastroenterology & Hepatology, 2018

Irritable Bowel Syndrome is a chronic disease in almost in every community across the planet with... more Irritable Bowel Syndrome is a chronic disease in almost in every community across the planet with no cure. Patients suffering from this ailment live a very disturbed and painful quality of life. Weight loss, and other prominent derogatory health conditions prevail swiftly that carry a social and financial burden on the family. Conventional allopathy has no solution but the symptomatic transitory relief. Interestingly, many physicians cater the remedial cocktail to IBS Patients focusing on the central and peripheral nervous system to calm down its gastro-intestinal excitatory response. Therefore, to decrease the frequency and inconvenience of the symptomatology. It is very logical lead to start tracing the involvement of the nervous system right from the effected tissues involved in this ailment and track the possible neo-pathogenesis of the IBS. Indeed it's the branch of vagus nerve that distribute the supply of Neuro network to the gastro-intestinal tract linking the end tissues with the controlling neurons. The pathophysiology of the controlling neurons is never taken into an account for a possible involvement in the systems malfunctioning. Long behold, as we tracked this novel phenomenon and found a new revelation. The controlling neurons nuclei overwhelmed with the Neuro-invasive viral genomic proliferation in turn, incapacitating the neuronal homeostasis. Therefore, instigation of the gastrointestinal tract malfunctioning comes into play causing Irritable Bowel Syndrome; IBS.

Research paper thumbnail of Benefits of pulmonary rehabilitation in pediatric asthma

Pediatric pulmonology, Jan 7, 2018

There are limited studies evaluating the role of pulmonary rehabilitation (PR) in pediatric asthm... more There are limited studies evaluating the role of pulmonary rehabilitation (PR) in pediatric asthma. A retrospective chart review was performed of all pediatric patients with a diagnosis of asthma enrolled in PR. Demographics, medications, and clinical records were reviewed. In addition, PFTs, 6-min walk test (6MWT), and patient/parent symptom and quality of life surveys before and after PR were evaluated. A total of 38 patients were enrolled in PR; 18 (47%) female and 20 (53%) male. Mean participant age was 11.33 ± 3.37 (range 4-19) years. Twenty-two (58%) were Caucasian and nine (24%) African American. Chart review was limited by incomplete data sets for many participants. Following PR, significant improvement was noted in mean 6MWT distance (1541 vs 1616 feet, P = 0.05) and FEV1 (89.9% of predicted versus 96.4%, P = 0.04). Survey instruments demonstrated improvement in several clinical factors, however, there was no significant change in weight following PR despite scheduled cardi...

Research paper thumbnail of Erratum to: Racial differences in pet ownership in families of children with asthma

World Journal of Pediatrics, 2017

Research paper thumbnail of Novel CT Scoring System for Sinus Disease in Adults With Cystic Fibrosis

Chest, 2016

There is no easy-to-use scoring system for CT Scans of the sinuses that is specific to cystic fib... more There is no easy-to-use scoring system for CT Scans of the sinuses that is specific to cystic fibrosis (CF). We propose a simple and easily implemented scoring system to quantify severity of sinus disease in adults with CF. METHODS: After IRB approval, we validated a scoring system in 69 adults with CF and 50 age-matched controls. CT scans were interpreted by three physicians (pulmonologist, ENT surgeon and a neuro radiologist) on two separate sittings. Parameters include maxillary opacification and nasal obstruction scored in a graded fashion (0 to 3) with 0 ¼ normal, 1 ¼ mild (<33%), 2 ¼ moderate (33-66%) and 3¼severe (>66%), while lateral nasal wall displacement, uncinate process absence/demineralization, and mucocele were scored as 1¼present, 0¼absent. Intra-rater and inter-rater reliability were measured by intraclass correlations (ICC). RESULTS: CF patients aged 21-30 years (mean¼24.7 AE SD 2.49). Intra-Rater Reliability: in CF cohort (n¼69), reliability for the 10 CT categories ranged from .70 to 1.00. Twenty six (87%) were in the excellent range, and remaining 4 (13%) were evaluated as good. In the non-CF cohort (n¼50), reliabilities ranged from .44 to 1.00. Twenty seven (90%) were in the excellent range. Inter-Rater Reliability: in CF cohort, 10 CT categories across the three raters ranged from .35 to 1.00. Excellent reliability was achieved in 15 (50%) of the observations. In the non-CF cohort, reliabilities ranged from .44 to 1.00. CONCLUSIONS: A novel and easy-to-use CT scoring system for CF sinus disease in adults was validated with acceptable interand intra-rater reliability. CLINICAL IMPLICATIONS: This new CF sinus disease specific scoring system can quantify disease severity and can be used with acceptable reliabilities by clinicians, surgeons and radiologists.

Research paper thumbnail of Racial differences in pet ownership in families of children with asthma

World Journal of Pediatrics, 2016

Background: Exposure to household domestic animals such as cats and dogs in early life may have s... more Background: Exposure to household domestic animals such as cats and dogs in early life may have some role in pathogenesis of asthma. Racial differences exist in the prevalence of asthma. We hypothesized that there may also be racial differences in pet ownership in families with asthma. Methods: A cross sectional study was conducted from June 2011 to December 2014 on 823 of 850 (97%) families of children with asthma for pet ownership. Comparisons among racial groups were done using chi square analysis and one-way analysis of variance. Results: The mean age of the cohort was 6.9±4.4 years. A total of 540 (65.62%) patients were Caucasian, 195 (23.7%) African American, 42 (5.1%) hispanics, and 26 (3.2%) biracial with one Caucasian parent. Pets in the home were reported by 470 (58.5%) households. Signifi cantly fewer African American and hispanic families had pets in the home (26.9% and 44.7%) than biracial and Caucasian families (72% and 69.9%, P<0.001). Likewise, significantly more biracial and Caucasian families were noted to have dogs (52% and 54.4%) or cats (25.4% and 40%) or both cats and dogs (28% and 18%) than African Americans families (20.3%, P<0.001; 7.1%, P<0.001) and (4.6%, P<0.001), respectively. Conclusion: Among families with asthmatic children, pet ownership is significantly more likely in Caucasian families compared with African-American and Hispanic families, thus there is a racial diversity in pet ownership among families of children with asthma.

Research paper thumbnail of Changes in pulmonary function tests following antibiotics in infants with pulmonary exacerbation of cystic fibrosis

European Respiratory Journal, Sep 1, 2013

Body: Progressive lung disease plays an important role in CF morbidity. In older patients, improv... more Body: Progressive lung disease plays an important role in CF morbidity. In older patients, improvement in PFT during CF exacerbation reflect clinical improvement but similar effectiveness of PFT in infants is not well known. Methods: After local IRB approval, charts of all patients with CF who underwent infant PFT (under sedation with raised volume thoraco-abdominal technique) before and after 2 weeks of I/V antibiotic therapy for CF exacerbation between 2000-2012 at Nationwide Children's Hospital, Columbus, OH, were reviewed and included in this study. Results: Forty-one studies were completed in 28 patients, mean age 20.8 ±48 weeks. IV antibiotic therapy was received in the home by 15 (56%) and in the hospital by 13 (43%) patients. Length of hospital stay averaged 7.7 ±6.8 days. The mean number of antibiotic days was 17.8 ±4.9.

Research paper thumbnail of Ethnic diversity in having pets at home in families with asthma

European Respiratory Journal, Sep 1, 2013

Research paper thumbnail of Screening for asthma-like symptoms and acute care utilization can be used to identify children in the community who may be at risk for undiagnosed asthma

European Respiratory Journal, Sep 1, 2013

Research paper thumbnail of Safety and efficacy of omalizumab in children with allergic asthma

European Respiratory Journal, Sep 1, 2011

Background: Omalizumab (Xolair) is a humanized monoclonal antibody used in the treatment of adult... more Background: Omalizumab (Xolair) is a humanized monoclonal antibody used in the treatment of adults and children over 12 years with moderate to severe allergic asthma. Pediatric studies are few. Objective: A retrospective chart review of pediatric patients who received omalizumab in the past 10 years for asthma at Nationwide Children's Hospital, Columbus, Ohio. Results: We had 13 patients, M:F 7:6, median age 13 years (range 9-17), median duration of therapy 36 months (range 1 to 59 months), 9 African American and 4 Caucasian, duration of asthma 15 years (8 to 16). Eight are still on therapy. All patients had severe persistent asthma. Twelve patients were receiving combination therapy (ICS and LABA). Only 4 patients claimed compliance with their asthma controller therapy. Five had family history of asthma, 6 had smoking exposure. Median IgE before starting omalizumab was 249 (range 78 to 2600). Mean BMI was 25.7 and 46% of the patients were above the 100 percentile for BMI. Comparing between one year before and during omalizumab, mean hospital admission/patient/year decreased from 1.7±2.4 to 0.58±1.4 (p<0.05). There was also a trend towards improvement in ED visits from 2.3±3.2 to 1.7±3. Mean FEV1 during one year before omalizumab therapy, at initiation of therapy and during therapy was 91±18, 94±17, and 93±11 and was not statistically different. Two of 13 patients were taken off omalizumab because of serious side effects, one with anaphylaxis and second with dilated cardiomyopathy. Anaphylaxis was noted on first dose and cardiomyopathy was diagnosed in 5th year on therapy. Conclusion: Omalizumab is add-on therapy for some patients with allergic asthma. Adverse reactions in children are limiting factor.

Research paper thumbnail of Use of New Knowledge and Knowledge Management to Gain Competitive Advantage

New knowledge may perhaps be the only remaining and one of the most critical sources of competiti... more New knowledge may perhaps be the only remaining and one of the most critical sources of competitive advantage available to an organization in the 21 st century. This is true; more so, as previously available traditional resources may no longer offer any significant competitive advantage. To remain competitive, organizations must create and use new knowledge. However, the current practices in knowledge acquisition, utilization, and management are mostly limited to capturing, recycling, and deploying the existing information, and making it available on a technology platform. This is done with the hope that individuals will not only use the information made available to them, but will also voluntarily contribute to the growth of the organization's knowledge pool. Most organizations are also woefully reluctant to realize that knowledge obsolescence is inevitable, and that the knowledge based on organizational consensus or common wisdom based on collective experiences can be wrong. To create new knowledge and attain competitive advantage, organizations need to locate and gather information and business intelligence about their internal and external consumers of knowledge and convert them into new knowledge.

Research paper thumbnail of Changes in Infant Pulmonary Function Tests and Stop Ventilation HRCT Scans of Chest After Antibiotic Therapy in Infants with Acute Pulmonary Exacerbation of Cystic Fibrosis

Research paper thumbnail of Mortality Risk and Pulmonary Function in Adults With Cystic Fibrosis at Time of Wait Listing for Lung Transplantation

The Annals of thoracic surgery, Jan 30, 2015

Lung transplantation (LTx) benefit for survival in cystic fibrosis (CF) patients placed on the wa... more Lung transplantation (LTx) benefit for survival in cystic fibrosis (CF) patients placed on the wait list is not well studied. To predict the relationship between initial forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) and the hazard ratio (HR) associated with LTx in CF patients, the United Network for Organ Sharing database was queried from 2005 to 2006 for adult patients with CF. Survival was assessed from wait list entry time until death on wait list, death after LTx, or censoring. Multivariate Cox proportional hazards models were used to assess the effect of LTx. The first model estimated the HR of LTx with adjustment for FEV1 or FVC and other covariates, and the second model estimated the HR of LTx conditional on FEV1 or FVC at listing. Two hundred seventy-eight patients with CF were included in the cohort, and 277 were used for survival analysis. Lung transplantation reduced the risk for death controlling for FEV1 (HR, 0.601; 95% confidence interval,...

Research paper thumbnail of Demographics, clinical course and outcome of children with status asthmaticus treated in a pediatric critical care unit: 8 year review

Background: This retrospective study was done to understand demographics and clinical course in c... more Background: This retrospective study was done to understand demographics and clinical course in children with status asthmaticus treated in a tertiary care pediatric intensive care unit (PICU).Methods: The medical charts of all patients above 5 years of age admitted to the PICU with status asthmaticus, at Nationwide Children's hospital, Columbus, OH, between 2000-2007 were reviewed. Two hundred and forty seven (247) children were admitted on 281 occasions. Patients with significant co-morbidities were excluded. Final analysis was done using 222 encounters in 183 patients.Results: The mean age was 11 years (range, 5-20 years). The mean PICU stay was 2.1 days (range, 1-15 days) and mean hospital stay was 3.6 days. Male: Female 109:74. Eighty nine (49%) were on no asthma controller medications. Adherence to therapy was noted in 124 of whom only 41 (33%) claimed compliance. 191 were known asthmatics. Asthma severity noted in 75 patients revealed 22 (29%) had mild intermittent, mild ...

Research paper thumbnail of Changes in Pulmonary Function and Controlled Ventilation-High Resolution CT of Chest After Antibiotic Therapy in Infants and Young Children with Cystic Fibrosis

Lung, Jan 12, 2015

Infants with cystic fibrosis (CF) develop early progressive lung disease which may be asymptomati... more Infants with cystic fibrosis (CF) develop early progressive lung disease which may be asymptomatic. Infant pulmonary function tests (IPFT) and controlled ventilation-high resolution computed tomography (CV-HRCT) of chest can detect early asymptomatic lung disease. It is not well established that these objective measures can detect changes in lung disease after clinical interventions. The purpose of this study was to evaluate usefulness of IPFT and CV-HRCT to detect changes in lung disease after intravenous (IV) antibiotic therapy in infants with early CF-related lung disease. IPFTs and CV-HRCT done before and after 2 weeks of IV antibiotics in infants at our institution over the last 12 years were compared. CV-HRCTs were compared using the modified Brody scoring system. The sample included 21 infants, mean age 85.2 ± 47.6 weeks. Mean change in weight was 0.4 ± 0.38 kg (p = 0.001). Significant changes in IPFT included mean % predicted FEV0.5 (+13.5 %, p = 0.043), mean %FEF25-75 (+30....

Research paper thumbnail of Pulmonologist Versus Radiologist Interpretation of Cystic Fibrosis on CT Imaging

Research paper thumbnail of Cardiac fibroma, anomalous pulmonary venous course, and persistent pneumonia in a patient with gorlin syndrome

Pediatric Pulmonology, 2012

We report the unusual case of a child referred for persistent pneumonia and possible pulmonary no... more We report the unusual case of a child referred for persistent pneumonia and possible pulmonary nodules who was found to have a cardiac fibroma and diagnosed with Gorlin syndrome. Pulmonologists should be aware of the potential for vascular anomalies associated with this syndrome as well as the risk for pulmonary metastases from primary skin tumors. Pediatr Pulmonol. 2014; 49:E7–E9. © 2013 Wiley Periodicals, Inc.

Research paper thumbnail of Reduction in Growth Velocity in Children and Adolescents with Asthma Treated with Inhaled Fluticasone

Research paper thumbnail of The Authors Respond

Pediatric Pulmonology, 2000

Research paper thumbnail of Moderate hemoptysis of unknown etiology

Pediatric Pulmonology, 1999

The underlying cause and treatment of hemoptysis should be addressed promptly to avoid potentiall... more The underlying cause and treatment of hemoptysis should be addressed promptly to avoid potentially life-threatening complications. We report on a previously healthy 11-year-old white boy who presented with acute hemoptysis. On bronchoscopy, bleeding was noted from the right upper and lower lobes. Right bronchial arteriography revealed multiple regions of abnormal ''blushing'' throughout the right bronchial arterial distribution which was successfully controlled by right bronchial arterial embolization. In spite of an extensive work-up, we were not able to determine the cause of bleeding. The patient has been followed for 18 months without any recurrence and without evidence of any systemic disease. Our patient does not fit any diagnostic category of pulmonary bleeding and further case reports are needed to delineate this entity.

Research paper thumbnail of Assessing bronchodilator responsiveness in infants using partial expiratory flow-volume curves

Pediatric Pulmonology, 2003

Our objective was to compare the effectiveness of maximum forced expiratory flow measured at func... more Our objective was to compare the effectiveness of maximum forced expiratory flow measured at functional residual capacity (V&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;maxFRC) and the ratio of flow at 75% of the forced expiratory volume to peak forced expiratory flow (FEF(75)/FEF(peak)) for detecting bronchodilator-related changes in wheezy infants. In 55 infants (mean age, 7.8 +/- 3.1 months) with a history of recurrent wheezing, V&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;maxFRC and FEF(75)/FEF(peak) were measured at baseline and 15 min following nebulized albuterol. Mean results from 4 baseline and 4 postalbuterol partial expiratory flow-volume curves were compared at baseline and following bronchodilator challenge. The strength (relative effect size) of each measure for assessing change was quantified by dividing the mean of the pre- to postdifferences by the standard deviation of the differences. Mean percent predicted V&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;maxFRC was 41.3 +/- 34.3% at baseline and 44.4 +/- 34.0% following albuterol. Mean FEF(75)/FEF(peak) was 26.7 +/- 13.4% at baseline and 35.8 +/- 14.3% following albuterol. The mean percent change from baseline [(post-pre)/pre] in percent predicted V&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;maxFRC was 18.3 +/- 39.3, and for FEF(75)/FEF(peak), it was 44.1 +/- 36.8. The change in FEF(75)/FEF(peak) following albuterol was significantly greater than the change in V&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;maxFRC (P…

Research paper thumbnail of COVID-19

covid-19, 2020

HISTORICALLY, many epidemics prevailed over the period of time leaving a great devastation and hu... more HISTORICALLY, many epidemics prevailed over the period of time leaving a great devastation and human catastrophes. But yet left the man thinking to create something to defy it.

Having lost so many human lives, we must try to understand its modes aparande and best prepare our fool proof strategy to defy it and save the human life. AFM (Atomic Force Microscopy) has revealed by magnifying 1 billion times the genomic level
proliferation processes of a typical virus. That help us understand where to intervene.(Thanks to Alex Malkin, Alex McPhearson & Marco Plomp)1 they have opened the door for us to look at the detailed nano pathology of a virus.