Publications by authors named "Mohammed Naeem"

6 Publications

  • Page 1 of 1

Establishing an Antifungal Program to Reduce Invasive Fungal Infections in Patients With Acute Myeloid Leukemia Receiving Induction and Reinduction Chemotherapy.

J Oncol Pract 2018 Nov 15:JOP1800307. Epub 2018 Nov 15.

University of Virginia Health System, Charlottesville, VA; Atlanta Cancer Care, Atlanta, GA; and Medical University of South Carolina, Charleston, SC.

Purpose:: Twenty percent of patients with acute myeloid leukemia (AML) undergoing induction or reinduction chemotherapy at the University of Virginia Health System from May 2011 to August 2014 had a proven or probable invasive fungal infection (IFI). The purpose of our initiative was to reduce the percentage of proven or probable IFIs in patients with AML undergoing induction or reinduction chemotherapy at the University of Virginia Health System to 10% or less by June 2017, in concordance with national averages.

Methods:: A multidisciplinary team was formed to lead the comprehensive quality improvement (QI) initiative. The team generated both current process state and ideal process state workflow diagrams, a cause-and-effect diagram, and a Pareto diagram to determine the most relevant etiology for proven or probable IFIs in patients with AML undergoing induction or reinduction chemotherapy.

Results:: Analysis led to the creation of a program standardizing antifungal prophylaxis in this patient population, along with a suggested work-up for recalcitrant fevers. Through two tests of change (Plan-Do-Study-Act cycles 1 and 2), the QI initiative was able to effectively reduce the proven or probable IFI rate to 0% since program implementation in August 2016, thus surpassing both QI initiative goals and national rates of IFI. Mean length of stay (LOS) decreased by 3.4 days, and median intensive care unit LOS decreased by 2 days.

Conclusion:: Creation of a standardized antifungal prophylaxis program led to a marked decrease in LOS and the proven or probable IFI rate of patients with AML undergoing induction or reinduction chemotherapy.
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http://dx.doi.org/10.1200/JOP.18.00307DOI Listing
November 2018

Effect of N-Methyl-D-Aspartate Receptor Antagonist Dextromethorphan on Opioid Analgesia in Pediatric Intensive Care Unit.

Pain Res Manag 2016 27;2016:1658172. Epub 2016 Oct 27.

King Saud Bin Abdulaziz University-Health Sciences (KSAU-HS), Riyadh, Saudi Arabia; King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia; Department of Pharmacy, King Abdulaziz Medical City, Riyadh, Saudi Arabia.

. Pain control is an essential goal in the management of critical children. Narcotics are the mainstay for pain control. Patients frequently need escalating doses of narcotics. In such cases an adjunctive therapy may be beneficial. Dextromethorphan (DM) is NMDA receptor antagonist and may prevent tolerance to narcotics; however, its definitive role is still unclear. We sought whether dextromethorphan addition could decrease the requirements of fentanyl to control pain in critical children. . Double-blind, randomized control trial (RCT). . Pediatric multidisciplinary ICU in tertiary care center. . Thirty-six pediatric patients 2-14 years of age in a multidisciplinary PICU requiring analgesia were randomized into dextromethorphan and placebo. The subjects in both groups showed similarity in most of the characteristics. . Subjects while receiving fentanyl for pain control received dextromethorphan or placebo through nasogastric/orogastric tubes for 96 hours. Pain was assessed using FLACC and faces scales. . This study found no statistical significant difference in fentanyl requirements between subjects receiving dextromethorphan and those receiving placebo ( = 0.127). . Dextromethorphan has no effect on opioid requirement for control of acute pain in children admitted with acute critical care illness in PICU. The registration number for this trial is NCT01553435.
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http://dx.doi.org/10.1155/2016/1658172DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5102748PMC
March 2017

Characteristics of pediatric diabetic ketoacidosis patients in Saudi Arabia.

Saudi Med J 2015 Jan;36(1):20-5

Department of Pediatrics, King Abdulaziz Medical City, PO Box 22490, Riyadh 11426, Kingdom of Saudi Arabia. Tel. +966 (11) 8011111 Ext. 12841. Fax. +966 (11) 2520088 Ext. 11640. E-mail.

Objectives: To evaluate the clinical and biochemical characteristics of children with diabetic ketoacidosis (DKA).

Methods: In this retrospective study conducted between June 2012 and November 2013 at the King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia, we evaluated pediatric DKA admissions from 1995-2008 (Phase 1). From the case files, we obtained information related to patients' age, gender, weight, presenting complaints, serum biochemical profile, and management.

Results: This study included 373 DKA admissions with a median age of 11 years (interquartile range [IQR]: 8-13). The patients in the subgroup of age more than 10 years old had the highest proportion of admissions (n=250, 67%, p<0.000). The median duration of diagnosis of diabetes mellitus (DM) was 3 years (IQR: 2-6). New-onset DM was 47%. Predominant precipitating cause was acute illness, mostly viral syndrome in 22% of all cases, and non-compliance to insulin regimen was in 79% of  the diagnosed diabetic cases. Blood glucose, pH, anion gap, serum osmolality, serum potassium, and serum phosphate showed the highest change during the initial 6 hours of management, while trends of serum bicarbonate and blood urea nitrogen demonstrated a predominant change in the initial 12 hours.

Conclusion: The notable findings in this study, such as, higher mean age of presentation, high rate of non-compliance to insulin as the cause of precipitation, and a high prevalence of abdominal pain at presentation should be followed up with further comparative studies.
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http://dx.doi.org/10.15537/smj.2015.1.9763DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4362198PMC
January 2015

Characteristics of pediatric diabetic ketoacidosis patients in Saudi Arabia.

Saudi Med J 2015 Jan;36(1):20-5

Department of Pediatrics, King Abdulaziz Medical City, PO Box 22490, Riyadh 11426, Kingdom of Saudi Arabia. Tel. +966 (11) 8011111 Ext. 12841. Fax. +966 (11) 2520088 Ext. 11640. E-mail.

Objectives: To evaluate the clinical and biochemical characteristics of children with diabetic ketoacidosis (DKA).

Methods: In this retrospective study conducted between June 2012 and November 2013 at the King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia, we evaluated pediatric DKA admissions from 1995-2008 (Phase 1). From the case files, we obtained information related to patients' age, gender, weight, presenting complaints, serum biochemical profile, and management.

Results: This study included 373 DKA admissions with a median age of 11 years (interquartile range [IQR]: 8-13). The patients in the subgroup of age more than 10 years old had the highest proportion of admissions (n=250, 67%, p<0.000). The median duration of diagnosis of diabetes mellitus (DM) was 3 years (IQR: 2-6). New-onset DM was 47%. Predominant precipitating cause was acute illness, mostly viral syndrome in 22% of all cases, and non-compliance to insulin regimen was in 79% of  the diagnosed diabetic cases. Blood glucose, pH, anion gap, serum osmolality, serum potassium, and serum phosphate showed the highest change during the initial 6 hours of management, while trends of serum bicarbonate and blood urea nitrogen demonstrated a predominant change in the initial 12 hours.

Conclusion: The notable findings in this study, such as, higher mean age of presentation, high rate of non-compliance to insulin as the cause of precipitation, and a high prevalence of abdominal pain at presentation should be followed up with further comparative studies.
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http://dx.doi.org/10.15537/smj.2015.1.9763DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4362198PMC
January 2015

Methicillin-resistant Staphylococcus aureus colonization is not associated with higher rate of admission to pediatric intensive care unit.

Am J Emerg Med 2013 Apr 8;31(4):727-9. Epub 2013 Feb 8.

Deparment of Peds, Division PICU, King Abdulaziz Medical City, Riyadh, Saudi Arabia.

Purposes: Methicillin-resistant Staphylococcus aureus (MRSA) colonization is consistently rising. The question whether the MRSA colonization places the patients at higher risk, requiring higher levels of care when being admitted, has never been studied. We conducted this study to determine the impact of MRSA colonization status on the required level of care upon admission to hospital.

Basic Procedures: We conducted a retrospective chart review in 1000 plus-bed tertiary care academic institute. Our study population composed of all the patients who were admitted from January 2011 to March 2011. We found 7413 pediatric admissions that were identified as the study subjects. We assessed and divided study subjects into 2 groups, MRSA colonized and MRSA noncolonized. Methicillin-resistant Staphylococcus aureus-colonized patients were further grouped into those admitted to either pediatric intensive care unit (PICU) or ward, and these 2 groups were analyzed using P value, Fisher exact test, relative risks, and odds ratios.

Main Findings: We found a total of 7413 admissions, 753 were admitted in PICU (average pediatric risk of mortality score 18), and 6660 were admitted in pediatric wards (average pediatric risk of mortality score, 5). We found that MRSA colonization was 20 (2.66%) of 753 in PICU admissions and 155 (2.33%) of 6660 in ward admissions. We found that rate of admissions difference between MRSA colonized and MRSA noncolonized groups was clinically insignificant (P > .05).

Principal Conclusions: We conclude that MRSA colonization does not increase the need of care in PICU upon admission to hospital from emergency department. However, these preliminary results need to be confirmed through larger, multicenter, and multicountry data analysis.
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http://dx.doi.org/10.1016/j.ajem.2012.12.033DOI Listing
April 2013

Department of Homeland Security national planning scenarios: a spectrum of imaging findings to educate the radiologists.

Emerg Radiol 2010 Jul 20;17(4):275-84. Epub 2009 Nov 20.

Eisenhower Army Medical Center, 300 Hospital Road, Ft. Gordon, GA, 30905-5650, USA.

Following the events of the September 11th attack, there has been an increasing concern about the possibility of a future attack on our homeland. In response, the United States Department of Homeland Defense has planned for a future attack by formulating multiple scenarios which may occur in the event of such a disaster. Radiology will play a key role in each of these scenarios, assisting with triage, diagnosis, and therapy of the large populations which potentially could be involved. This article describes some of these scenarios as well the response which will be expected of the radiology community in the event of such a disaster.
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http://dx.doi.org/10.1007/s10140-009-0849-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7101611PMC
July 2010