Asif Doja | University of Ottawa | Université d'Ottawa (original) (raw)

Papers by Asif Doja

The purpose of this study was to assess YouTube videos for their efficacy as a patient resource f... more The purpose of this study was to assess YouTube videos for their efficacy as a patient resource for infantile spasms. Videos were searched using the terms infantile spasm, spasm, epileptic spasm, and West syndrome. The top 25 videos under each term were selected according to set criteria. Technical quality, diagnosis of infantile spasms, and suitability as a teaching resource were assessed by 2 neurologists using the Medical Video Rating Scale. There were 5858 videos found. Of the 100 top videos, 46 % did not meet selection criteria. Mean rating for technical quality was 4.0 of 5 for rater 1 and 3.9 of 5 for rater 2. Raters found 60 % and 64 % of videos to accurately portray infantile spasms, respectively, with significant agreement (Cohen k coefficient 0.75, P <.001). Ten videos were considered excellent examples (grading of 5 of 5) by at least 1 rater. YouTube may be used as an excellent patient resource for infantile spasms if guided search practices are followed.

Journal of Child Neurology, 2022

Objectives To examine the clinical features, course, and management of children at age <2 year... more Objectives To examine the clinical features, course, and management of children at age <2 years with tremor. Methods:Retrospective chart review of all patients aged <2 years presenting to a tertiary care neurology clinic between 2005 and 2019. Descriptive and inferential statistics were used. Results: We identified 29 children with tremor presenting at age <2 years. The mean age at onset, diagnosis and follow-up was 3.22 months (SD 3.63), 6.97 months (SD 5.44), and 10.83 months (SD 5.29), respectively. Tremor was more noticeable surrounding eating, sleep, or extreme emotions. The tremor did not interfere with development or require pharmacologic treatment in any patient. At follow-up, 31% had complete resolution of their tremor with the rest being stable or improved. Patients with resolved tremor were statistically more likely to have a younger age of diagnosis ( F = 3.895, P = .033), no medical history ( P = .029, χ2 = 7.112), and leg tremor ( P = .028, χ2 = 7.143). Conclu...

Canadian Medical Education Journal, 2020

Background: Researchers have shown that clinical educators feel insufficiently informed about how... more Background: Researchers have shown that clinical educators feel insufficiently informed about how to teach and assess the CanMEDS roles. Thus, our objective was to examine the extent to which program directors utilize evidence-based tools and the medical education literature in teaching and assessing the CanMEDS roles. Methods: In 2016, the authors utilized an online questionnaire to survey 747 Canadian residency program directors (PD’s) of Royal College of Physicians and Surgeons of Canada (RCPSC) accredited programs. Results: Overall, 186 PD’s participated (24.9%). 36.6% did not know whether the teaching strategies they used were evidence-based and another third (31.9%) believed they were “not at all” or “to a small extent” evidence-based. Similarly, 31.8% did not know whether the assessment tools they used were evidence-based and another third (39.7%) believed they were “not at all” or “to a small extent” evidence-based. PD’s were aware of research on teaching strategies (62.4%) ...

Paediatrics & Child Health, 2021

Disruptive behaviour disorders (DBDs)—which can include or be comorbid with disorders such as att... more Disruptive behaviour disorders (DBDs)—which can include or be comorbid with disorders such as attention-deficit hyperactivity disorder, oppositional defiant disorder, conduct disorder and disruptive mood dysregulation disorder—are commonly seen in paediatric practice. Given increases in the prescribing of atypical antipsychotics for children and youth, it is imperative that paediatric trainees in Canada receive adequate education on the optimal treatment of DBDs. We describe the development, dissemination, and evaluation of a novel paediatric resident curriculum for the assessment and treatment of DBDs in children and adolescents. Pre–post-evaluation of the curriculum showed improved knowledge in participants.

Perspectives on Medical Education, 2020

Introduction The informal curriculum—an essential complement to the formal curriculum—is delivere... more Introduction The informal curriculum—an essential complement to the formal curriculum—is delivered to medical trainees through learning outside the classroom. We sought to explore nurse-mediated aspects of trainee education in the informal curriculum in obstetrics and gynecology (OBGYN), as well as nursing perceptions of their role in medical trainee education. Methods Naturalistic, non-participant observations (40 h) were performed on a tertiary care birthing unit (BU) to document teaching and learning interactions. Insights gleaned from observations informed subsequent semi-structured interviews with BU nurses (n = 10) and focus group discussions with third-year medical students who had completed an OBGYN rotation (n = 10). Thematic analysis was conducted across data sets. Results Conceptions of nurse-mediated education differed considerably between nurses and trainees. Nurses were widely acknowledged as gatekeepers and patient advocates by both groups, although this role was some...

JAMA Network Open, 2021

IMPORTANCE A significant portion of neurology literature is published in general medicine journal... more IMPORTANCE A significant portion of neurology literature is published in general medicine journals. Despite this, a detailed examination of publication patterns of neurology articles in these journals has not yet been carried out. OBJECTIVE To examine the publication patterns of neurology articles in general medicine journals during a 10-year period using a bibliometric approach. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional bibliometric analysis identified the top 5 general medicine journals using the 2017 Journal Citations Report. Four other medical subspecialties (ie, immunology, endocrinology, gastroenterology, and pulmonology) were selected for comparison of publication patterns with neurology. Using MEDLINE, the 5 journals were searched for articles published between 2009 and 2018 that were indexed with the following MeSH terms: nervous system diseases, immune system diseases, endocrine system diseases, gastrointestinal diseases, and respiratory tract diseases. Data analysis was conducted from February 2019 to December 2020. MAIN OUTCOMES AND MEASURES Publications were characterized by journal, specialty, and study design. These variables were used for comparison of publication numbers. RESULTS The general medicine journals with the 5 highest journal impact factors (JIF) were New

Applied Physiology, Nutrition, and Metabolism, 2021

To determine the physical literacy, defined as the capability for a physically active lifestyle, ... more To determine the physical literacy, defined as the capability for a physically active lifestyle, of children with medical conditions compared with healthy peers, this multicenter cross-sectional study recruited children with medical conditions from cardiology, neurology (including concussion), rheumatology, mental health, respirology, oncology, hematology, and rehabilitation (including cerebral palsy) clinics. Participants aged 8–12 years (N = 130; mean age: 10.0 ± 1.44 years; 44% female) were randomly matched to 3 healthy peers from a normative database, based on age, gender, and month of testing. Total physical literacy was assessed by the Canadian Assessment of Physical Literacy, a validated assessment of physical literacy measuring physical competence, daily behaviour, knowledge/understanding, and motivation/confidence. Total physical literacy mean scores (/100) did not differ (t(498) = –0.67; p = 0.44) between participants (61.0 ± 14.2) and matched healthy peers (62.0 ± 10.7). ...

JAMA Network Open, 2021

IMPORTANCE The recognition of magnetic resonance imaging (MRI) features associated with distinct ... more IMPORTANCE The recognition of magnetic resonance imaging (MRI) features associated with distinct causes of myelitis in children is essential to guide investigations and support diagnostic categorization. OBJECTIVE To determine the clinical and MRI features and outcomes associated with spinal cord involvement in pediatric myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD), multiple sclerosis (MS), and seronegative monophasic myelitis. DESIGN, SETTING, AND PARTICIPANTS In this cohort study, participants were recruited between 2004 and 2017 through the multicenter Canadian Pediatric Demyelinating Disease Study, which enrolled youth younger than 18 years presenting within 90 days of an acquired demyelinating syndrome. Of the 430 participants recruited, those with lesions on available spine MRI and anti-MOG testing performed on archived samples obtained close to clinical presentation were selected. Participants with poor-quality images and final diagnoses of nondemyelinating disease, antiaquaporin 4 antibody positivity, and relapsing seronegative myelitis were excluded. Data analysis was performed from December 2019 to November 2020. MAIN OUTCOMES AND MEASURES Spinal cord involvement was evaluated on 324 MRI sequences, with reviewers blinded to clinical, serological, and brain MRI findings. Associated clinical features and disability scores at 5 years of follow-up were retrieved. Results were compared between groups. RESULTS A total of 107 participants (median [IQR] age at onset, 11.14 [5.59-13.39] years; 55 girls [51%]) were included in the analyses; 40 children had MOGAD, 21 had MS, and 46 had seronegative myelitis. Longitudinally extensive lesions were very common among children with MOGAD (30 of 40 children [75%]), less common among those with seronegative myelitis (20 of 46 children [43%]), and rare in children with MS (1 of 21 children [5%]). Axial gray matter T2-hyperintensity (ie, the H-sign) was observed in 22 of 35 children (63%) with MOGAD, in 14 of 42 children (33%) with seronegative myelitis, and in none of those with MS. The presence of leptomeningeal enhancement was highly suggestive for MOGAD (22 of 32 children [69%] with MOGAD vs 10 of 38 children [26%] with seronegative myelitis and 1 of 15 children [7%] with MS). Children with MOGAD were more likely to have complete lesion resolution on serial images (14 of 21 children [67%]) compared with those with MS (0 of 13 children). CONCLUSIONS AND RELEVANCE These findings suggest that several features may help identify children at presentation who are more likely to have myelitis associated with MOGAD. Prominent involvement of gray matter and leptomeningeal enhancement are common in pediatric MOGAD, although the pathological underpinning of these observations requires further study.

Annals of Clinical and Translational Neurology, 2020

Febrile‐infection related epilepsy syndrome (FIRES) is a devastating neurological condition chara... more Febrile‐infection related epilepsy syndrome (FIRES) is a devastating neurological condition characterized by a febrile illness preceding new onset refractory status epilepticus (NORSE). Increasing evidence suggests innate immune dysfunction as a potential pathological mechanism. We report an international retrospective cohort of 25 children treated with anakinra, a recombinant interleukin‐1 receptor antagonist, as an immunomodulator for FIRES. Anakinra was potentially safe with only one child discontinuing therapy due to infection. Earlier anakinra initiation was associated with shorter duration of mechanical ventilation, ICU and hospital length of stay. Our retrospective data lay the groundwork for prospective consensus‐driven cohort studies of anakinra in FIRES.

Brain, 2020

Heterozygous mutations in KMT2B are associated with an early-onset, progressive and often complex... more Heterozygous mutations in KMT2B are associated with an early-onset, progressive and often complex dystonia (DYT28). Key characteristics of typical disease include focal motor features at disease presentation, evolving through a caudocranial pattern into generalized dystonia, with prominent oromandibular, laryngeal and cervical involvement. Although KMT2B-related disease is emerging as one of the most common causes of early-onset genetic dystonia, much remains to be understood about the full spectrum of the disease. We describe a cohort of 53 patients with KMT2B mutations, with detailed delineation of their clinical phenotype and molecular genetic features. We report new disease presentations, including atypical patterns of dystonia evolution and a subgroup of patients with a non-dystonic neurodevelopmental phenotype. In addition to the previously reported systemic features, our study has identified co-morbidities, including the risk of status dystonicus, intrauterine growth retardat...

Child Neurology Open, 2020

Exposure to n-hexane or toluene-containing solvents such as glue or gasoline can produce clinical... more Exposure to n-hexane or toluene-containing solvents such as glue or gasoline can produce clinical symptoms and neurophysiological findings that can mimic chronic inflammatory demyelinating polyneuropathy. The authors present a case of a boy with severe sensorimotor polyneuropathy with demyelinating features. Cerebrospinal fluid testing and magnetic resonance imaging spine did not show findings typical of chronic inflammatory demyelinating polyneuropathy. His lack of response to immunosuppressive therapy prompted a nerve biopsy which was instrumental in confirming a diagnosis of chronic organic solvent exposure, subsequently confirmed on history. This case highlights the importance of additional testing to ensure diagnostic certainty which allows appropriate treatment and/or disease management to be tailored appropriately including in this instance, the involvement of mental health counseling and avoidance of immunosuppressant medication.

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques, 2019

ABSTRACT: Background: In 2013, a task force was developed to discuss the future of the Canadian p... more ABSTRACT: Background: In 2013, a task force was developed to discuss the future of the Canadian pediatric neurology workforce. The consensus was that there was no indication to reduce the number of training positions, but that the issue required continued surveillance. The current study provides a 5-year update on Canadian pediatric neurology workforce data. Methods: Names, practice types, number of weekly outpatient clinics, and dates of certification of all physicians currently practicing pediatric neurology in Canada were obtained. International data were used to compute comparisons between countries. National data sets were used to provide information about the number of residency positions available and the number of Canadian graduates per year. Models for future projections were developed based on published projected population data and trends from the past decade. Results: The number of pediatric neurologists practicing in Canada has increased 165% since 1994. During this per...

Paediatrics and Child Health, 2011

S econd-generation antipsychotics (SGAs) may offer important benefits to children with mental hea... more S econd-generation antipsychotics (SGAs) may offer important benefits to children with mental health disorders. In recent years, the use of SGAs in children has expanded to a number of mental health disorders including disruptive and aggressive behaviour, irritability associated with autism-spectrum disorder and mood disorders. As with any medication, adverse effects can be significant, and the benefits and risks of therapy should be considered. The rising use of SGAs in Canada and internationally in children and youth has stimulated the creation of guidelines on monitoring their safety and effectiveness. The Canadian Alliance for Monitoring Effectiveness and Safety of Antipsychotics in Children (CAMESA) guideline group has developed evidence-based recommendations Guidelines

The Canadian Journal of Neurological Sciences, 2006

ABSTRACT:Because of a temporal correlation between the first notable signs and symptoms of autism... more ABSTRACT:Because of a temporal correlation between the first notable signs and symptoms of autism and the routine childhood vaccination schedule, many parents have become increasingly concerned regarding the possible etiologic role vaccines may play in the development of autism. In particular, some have suggested an association between the Measles-Mumps-Rubella vaccine and autism. Our literature review found very few studies supporting this theory, with the overwhelming majority showing no causal association between the Measles-Mumps-Rubella vaccine and autism. The vaccine preservative thimerosal has alternatively been hypothesized to have a possible causal role in autism. Again, no convincing evidence was found to support this claim, nor for the use of chelation therapy in autism. With decreasing uptake of immunizations in children and the inevitable occurrence of measles outbreaks, it is important that clinicians be aware of the literature concerning vaccinations and autism so tha...

Journal of Child Neurology, 2011

The purpose of this study was to assess YouTube videos for their efficacy as a patient resource f... more The purpose of this study was to assess YouTube videos for their efficacy as a patient resource for infantile spasms. Videos were searched using the terms infantile spasm, spasm, epileptic spasm, and West syndrome. The top 25 videos under each term were selected according to set criteria. Technical quality, diagnosis of infantile spasms, and suitability as a teaching resource were assessed by 2 neurologists using the Medical Video Rating Scale. There were 5858 videos found. Of the 100 top videos, 46% did not meet selection criteria. Mean rating for technical quality was 4.0 of 5 for rater 1 and 3.9 of 5 for rater 2. Raters found 60% and 64% of videos to accurately portray infantile spasms, respectively, with significant agreement (Cohen κ coefficient = 0.75, P < .001). Ten videos were considered excellent examples (grading of 5 of 5) by at least 1 rater. YouTube may be used as an excellent patient resource for infantile spasms if guided search practices are followed.

Autoimmunity Reviews, 2012

Anti-NMDAR encephalitis is a newly characterized syndrome with a progressive, predictable clinica... more Anti-NMDAR encephalitis is a newly characterized syndrome with a progressive, predictable clinical course and the possibility of effective treatment. Accurate and timely diagnosis is critical to selection and implementation of treatments, and optimal patient outcomes. Outcomes are improved with early diagnosis via indirect immunofluorescence or cell-based assays, and the rapid and appropriate administration of immunosuppressant and anti-psychotic therapies. Three possible scenarios accounting for the immunopathogenesis of anti-NMDAR encephalitis are presented, with the most probable one being that of paraneoplastic autoimmunity. Future efforts in this disorder should focus on elucidating the mechanisms that contribute to initiation of this antibody response, as well as exploring the role of tumors, infectious triggers and immune-reactivation. Finally, accessible tools need to be developed that allow for reliable identification of specific antibody markers against synaptic proteins.

Acta Anaesthesiologica Scandinavica, 2008

Alterations in electrolyte homeostasis associated with major surgery, intravenous fluid therapy, ... more Alterations in electrolyte homeostasis associated with major surgery, intravenous fluid therapy, malnutrition, and critical illness are common but usually non-specific. This case report describes the sudden onset of forceful rhythmic flexion movements in both lower limbs during scoliosis surgery in a 12-year-old paraplegic boy with spina bifida. These movements arose despite adequate depth of anaesthesia, complete neuromuscular blockade, and treatment of hypocalcaemia. They persisted postoperatively after reversal of neuromuscular blockade and emergence from anaesthesia. Hypomagnesaemia was identified and treated post-operatively which coincided with cessation of the movements. We deduce hypomagnesaemia to be the aetiology of this unusual clinical presentation. This report underscores the interdependency of Ca 21 and Mg 21 homeostasis in excitable tissues and emphasizes that abnormalities observed in each cation should not be considered independently. In the perioperative care of spinal fusion patients, hypocalcaemia is a well-recognised and understood complication.

Acta Anaesthesiologica Scandinavica, 2008

Academic Medicine, 2013

The Social Sciences and Humanities Research Council (SSHRC) asked Science-Metrix to identify curr... more The Social Sciences and Humanities Research Council (SSHRC) asked Science-Metrix to identify current practices in bibliometric evaluation of research in the social sciences and humanities (SSH). The resulting study involves a critical review of the literature in order to identify the specific characteristics of the SSH and their effects on the use of bibliometrics for evaluating and mapping research. In addition, this report presents an overview of methods of research benchmarking and mapping and identification of emerging SSH fields. This part of the report is particularly relevant because of the need to exercise considerable caution when using bibliometrics to evaluate and map SSH research. This report shows that bibliometrics must be used with care and caution in a number of SSH disciplines. Knowledge dissemination media in the SSH are different from those in the natural sciences and engineering (NSE), particularly because of the much greater role of books in the SSH. Articles account for 45% to 70% of research output in the social sciences and for 20% to 35% in the humanities, depending on the discipline. Bibliometric analyses that focus solely on research published in journals may not give an accurate representation of SSH research output. In addition, bibliometric analyses reflect the biases of the databases used. For example, the Social Science Citation Index (SSCI) and the Arts and Humanities Citation Index (AHCI) of Thomson ISI over-represent research output published in English. Original findings produced by this study show that the bias results in an estimated 20-25% over-representation of English material in the two databases. Findings from the scientific literature support those of Science-Metrix. Science-Metrix would like to thank the Observatoire des sciences et des technologies (OST) and, in particular, Vincent Larivière for his generous contribution in the analysis of citations made to journal papers among various fields of the social sciences and humanities. We would like to thank Yves Gingras of OST for his critical comments on a draft version of this report. We would also like to thank Malcolm Williams for the English translation of this report. Finally, we would like to thank SSHRC staff for their support during the course of this project. In particular, we would like to thank Christian Sylvain for his comments on a previous version of this report and we would like to thank Sylvie Paquette for her support, constructive comments and encouragement during this project. 6 Conclusions and recommendations..

Journal of Child Neurology, 2022

Canadian Medical Education Journal, 2020

Paediatrics & Child Health, 2021

Perspectives on Medical Education, 2020

JAMA Network Open, 2021

Applied Physiology, Nutrition, and Metabolism, 2021

JAMA Network Open, 2021

Annals of Clinical and Translational Neurology, 2020

Brain, 2020

Child Neurology Open, 2020

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques, 2019

Paediatrics and Child Health, 2011

The Canadian Journal of Neurological Sciences, 2006

Journal of Child Neurology, 2011

The purpose of this study was to assess YouTube videos for their efficacy as a patient resource f... more The purpose of this study was to assess YouTube videos for their efficacy as a patient resource for infantile spasms. Videos were searched using the terms infantile spasm, spasm, epileptic spasm, and West syndrome. The top 25 videos under each term were selected according to set criteria. Technical quality, diagnosis of infantile spasms, and suitability as a teaching resource were assessed by 2 neurologists using the Medical Video Rating Scale. There were 5858 videos found. Of the 100 top videos, 46% did not meet selection criteria. Mean rating for technical quality was 4.0 of 5 for rater 1 and 3.9 of 5 for rater 2. Raters found 60% and 64% of videos to accurately portray infantile spasms, respectively, with significant agreement (Cohen κ coefficient = 0.75, P < .001). Ten videos were considered excellent examples (grading of 5 of 5) by at least 1 rater. YouTube may be used as an excellent patient resource for infantile spasms if guided search practices are followed.

Autoimmunity Reviews, 2012

Acta Anaesthesiologica Scandinavica, 2008

Academic Medicine, 2013