Publications by authors named "Saima Rashid"

17 Publications

  • Page 1 of 1

Analysis of Feasibility and Acceptability of an E-Learning Module in Anatomy.

Anat Sci Educ 2021 Apr 29. Epub 2021 Apr 29.

Postgraduate Department of Anatomy, Government Medical College Srinagar, Srinagar, India.

Recent advance in medical education is in correlation with the advances in information technology and thus computer-based learning is being increasingly employed. The objective of the present study was to design and evaluate an e-learning module in anatomy and assess the perceptions of students and faculty about this e-learning module. The participating students were randomized into three groups by block stratified randomization and Google groups were created for each of the three groups. The e-learning module was implemented in three sessions by rotating the three groups. Validated questionnaires were sent to faculty and participating students via Google forms to obtain feedback. The results of ANOVA showed that there was a significant difference among the groups in terms of marks obtained with conventional (F = 2.403, P = 0.103), online (F = 6.050, P = 0.005), and blended (F = 5.801, P = 0.006). Post hoc comparisons using the Tukey HSD test, about the gain of knowledge, indicated that the results were insignificant when comparing the conventional group with the online group, but were significant when comparing the blended group with the conventional and online group. The qualitative data regarding the perception of students toward e-learning were analyzed using thematic analysis. The introduction of an interactive e-learning module in anatomy was effective and well received by the students and faculty. The study showed that blended learning has a positive impact on the students' learning by improving cognitive gain and receptive perception for e-learning.
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http://dx.doi.org/10.1002/ase.2096DOI Listing
April 2021

New formulation for discrete dynamical type inequalities via $ h $-discrete fractional operator pertaining to nonsingular kernel.

Math Biosci Eng 2021 Feb;18(2):1794-1812

Department of Mathematics, Faculty of Science, Taif University, P. O. Box 11099, Taif 21944, Saudi Arabia.

Discrete fractional calculus (DFC) use to analyse nonlocal behaviour of models has acquired great importance in recent years. The aim of this paper is to address the discrete fractional operator underlying discrete Atangana-Baleanu (AB)-fractional operator having $\hbar$-discrete generalized Mittag-Leffler kernels in the sense of Riemann type (ABR). In this strategy, we use the $\hbar$-discrete AB-fractional sums in order to obtain the Gr\"{u}ss type and certain other related variants having discrete generalized $\hbar$-Mittag-Leffler function in the kernel. Meanwhile, several other variants found by means of Young, weighted-arithmetic-geometric mean techniques with a discretization are formulated in the time domain $\hbar\mathbb{Z}$. At first, the proposed technique is compared to discrete AB-fractional sums that uses classical approach to derive the numerous inequalities, showing how the parameters used in the proposed discrete $\hbar$-fractional sums can be estimated. Moreover, the numerical meaning of the suggested study is assessed by two examples. The obtained results show that the proposed technique can be used efficiently to estimate the response of the neural networks and dynamic loads.
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http://dx.doi.org/10.3934/mbe.2021093DOI Listing
February 2021

Frequency of and Factors Associated With Nonmedical Opioid Use Behavior Among Patients With Cancer Receiving Opioids for Cancer Pain.

JAMA Oncol 2021 Mar;7(3):404-411

Department of Palliative Care, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston.

Importance: One of the main aims of research on nonmedical opioid use (NMOU) is to reduce the frequency of NMOU behaviors through interventions such as universal screening, reduced opioid exposure, and more intense follow-up of patients with elevated risk. The absence of data on the frequency of NMOU behavior is the major barrier to conducting research on NMOU.

Objective: To determine the overall frequency of and the independent predictors for NMOU behavior.

Design, Setting, And Participants: In this prognostic study, 3615 patients with cancer were referred to the supportive care center at MD Anderson Cancer Center from March 18, 2016, to June 6, 2018. Patients were eligible for inclusion if they had cancer and were taking opioids for cancer pain for at least 1 week. Patients were excluded if they had no follow-up within 3 months of initial consultation, did not complete the appropriate questionnaire, or did not have scheduled opioid treatments. After exclusion, a total of 1554 consecutive patients were assessed for NMOU behavior using established diagnostic criteria. All patients were assessed using the Edmonton Symptom Assessment Scale, the Screener and Opioid Assessment for Patients with Pain (SOAPP), and the Cut Down, Annoyed, Guilty, Eye Opener-Adapted to Include Drugs (CAGE-AID) survey. Data were analyzed from January 6 to September 25, 2020.

Results: A total of 1554 patients (median [interquartile range (IQR)] age, 61 [IQR, 52-69] years; 816 women [52.5%]; 1124 White patients [72.3%]) were evaluable for the study, and 299 patients (19.2%) had 1 or more NMOU behaviors. The median (IQR) number of NMOU behaviors per patient was 1 (IQR, 1-3). A total of 576 of 745 NMOU behaviors (77%) occurred by the first 2 follow-up visits. The most frequent NMOU behavior was unscheduled clinic visits for inappropriate refills (218 of 745 [29%]). Eighty-eight of 299 patients (29.4%) scored 7 or higher on SOAPP, and 48 (16.6%) scored at least 2 out of 4 points on the CAGE-AID survey. Results from the multivariate model suggest that marital status (single, hazard ratio [HR], 1.58; 95% CI, 1.15-2.18; P = .005; divorced, HR, 1.43; 95% CI, 1.01-2.03; P = .04), SOAPP score (positive vs negative, HR, 1.35; 95% CI, 1.04-1.74; P = .02), morphine equivalent daily dose (MEDD) (HR, 1.003; 95% CI, 1.002-1.004; P < .001), and Edmonton Symptom Assessment Scale pain level (HR, 1.11; 95% CI, 1.06-1.16; P < .001) were independently associated with the presence of NMOU behavior. In recursive partition analysis, single marital status, MEDD greater than 50 mg, and SOAPP scores greater than 7 were associated with a higher risk (56%) for the presence of NMOU behavior.

Conclusions And Relevance: This prognostic study of patients with cancer taking opioids for cancer pain found that 19% of patients developed NMOU behavior within a median duration of 8 weeks after initial supportive care clinic consultation. Marital status (single or divorced), SOAPP score greater than 7, higher levels of pain severity, and MEDD level were independently associated with NMOU behavior. This information will assist clinicians and investigators designing clinical and research programs in this important field.
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http://dx.doi.org/10.1001/jamaoncol.2020.6789DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7791402PMC
March 2021

Rate of cannabis use in older adults with cancer.

BMJ Support Palliat Care 2020 Nov 11. Epub 2020 Nov 11.

Department of Supportive Care Medicine, Moffitt Cancer Center, Tampa, Florida, USA

Objectives: Older adults with cancer are increasingly inquiring about and using cannabis. Despite this, few studies have examined cannabis use in patients with cancer aged 65 years and older as a separate group and identified characteristics associated with use. The current study sought to determine the rate of cannabis use in older adult patients with cancer and to identify demographic and clinical correlates of use.

Methods: We conducted a retrospective review of patients with cancer referred for specialised symptom management between January 2014 and May 2017 who underwent routine urine drug testing for tetrahydrocannabinol as part of their initial clinic visit.

Results: Approximately 8% (n=24) of patients with cancer aged 65 years and older tested positive for tetrahydrocannabinol compared with 30% (n=51) of young adults and 21% (n=154) of adults. At the univariate level, more cannabis users had lower performance status than non-users (p=0.02, Fisher's exact test). There were no other demographic and clinical characteristics significantly associated with cannabis use in older adults.

Conclusions: Older adult patients made up nearly 25% (n=301) of the total sample and had a rate of cannabis use of 8%. As one of the first studies to assess cannabis use via objective testing rather than self-report, this study adds significantly to the emerging literature on cannabis use in people aged 65 years and older. Findings suggest the rate of use in older adults living with cancer is higher than that among older adults in the general population.
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http://dx.doi.org/10.1136/bmjspcare-2020-002384DOI Listing
November 2020

Effect of Pharmacological Agents Administered for Attenuating the Extubation Response on the Quality of Extubation: A Systematic Review.

Cureus 2019 Dec 20;11(12):e6427. Epub 2019 Dec 20.

Anaesthesiology, Aga Khan University, Karachi, PAK.

Background Several drugs have been tried to obtund the hemodynamic extubation response but all have variable side effects that may affect the quality of short-term recovery. Objective Our primary objective was to evaluate the effect of pharmacological agents, such as dexmedetomidine, local anesthetics, and so on, administered for attenuating the extubation response on the quality of extubation, as judged by the presence or absence of cough, sedation, and laryngospasm/bronchospasm in adult patients who had undergone general anesthesia. A secondary objective was to evaluate the effect of these drugs on other immediate post-extubation complications such as respiratory depression, desaturation, bradycardia, hypotension, and nausea and vomiting (PONV). Methods This is a systematic review of (randomized controlled trials)RCTs with meta-analysis. The Medical Literature Analysis and Retrieval System Online (MEDLINE), Cumulative Index of Nursing and Allied Health Literature (CINAHL), and Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched for RCTs on the effect of pharmacological agents on both the hemodynamic extubation response as well as the quality of extubation. Results Fourteen out of 24 included studies were subjected to a meta-analysis. The risk of cough was less likely in the intervention group as compared to control groups (OR 0.26, 95% CI 0.15 to 0.46, p<0.00001, I=35%). Sedation, hypotension (OR= 10.47; 95% CI: 1.86, 58.80, p=0.008, I=0%), and bradycardia (OR= 6.57; 95% CI: 2.09, 20.64, p=0.001, I=0%) were reported with dexmedetomidine. Only one study reported laryngospasm with dexmedetomidine and two studies with opioids. Conclusion Dexmedetomidine 0.4 to 0.5 ug/kg was associated with smooth extubation, minimal coughing, no laryngospasm/ bronchospasm, and with stable hemodynamics, without causing respiratory depression, PONV, and desaturation. However, in higher doses (more than 0.5 ug/kg), it caused bradycardia, hypotension, and sedation. Other pharmacological agents, such as local anesthetics, calcium channel blockers, and opioids, did not attenuate cough associated with extubation.
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http://dx.doi.org/10.7759/cureus.6427DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6970457PMC
December 2019

Prognostication in Anoxic Brain Injury.

Am J Hosp Palliat Care 2018 Nov 3;35(11):1446-1455. Epub 2018 Apr 3.

3 Department of Palliative Care, Wellmont Health System, Kingsport, TN, USA.

Cardiac arrest is a common cause of coma with frequent poor outcomes. Palliative medicine teams are often called upon to discuss the scope of treatment and future care in cases of anoxic brain injury. Understanding prognostic tools in this setting would help medical teams communicate more effectively with patients' families and caregivers and may promote improved quality of life overall. This article reviews multiple tools that are useful in determining outcomes in the setting of postarrest anoxic brain injury.
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http://dx.doi.org/10.1177/1049909118767881DOI Listing
November 2018

Autonomy and Withdrawal of Treatment in a Patient With Depression.

Am J Hosp Palliat Care 2018 Jun 15;35(6):908-914. Epub 2017 Oct 15.

1 Wellmont Health System, Kingsport, TN, USA.

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http://dx.doi.org/10.1177/1049909117735308DOI Listing
June 2018

Is There a Role for 5-HT Receptor Antagonists in the Treatment of Opioid-Induced Pruritus?

Am J Hosp Palliat Care 2018 Apr 11;35(4):740-744. Epub 2017 Oct 11.

4 Hospice and Palliative Medicine, Wellmont Health System, Kingsport, TN, USA.

Pruritus is an unpleasant irritation symptom that can be related to various systemic and dermatological conditions. Although underreported, pruritus is a common adverse event noted after use of opioid pain medications. This article reviews the current understanding of the mechanism of opioid-induced pruritus (OIP) and various pharmacological therapies. 5-Hydroxytryptamine 3 (5-HT) receptor antagonists are potentially effective for treating OIP and may be a valuable treatment option if further controlled studies are encouraging.
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http://dx.doi.org/10.1177/1049909117736062DOI Listing
April 2018

Serum Bovine Immunoglobulin for Chemotherapy-Induced Gastrointestinal Mucositis.

Am J Hosp Palliat Care 2018 May 11;35(5):814-817. Epub 2017 Oct 11.

2 Department of Hospice and Palliative Medicine, Wellmont Health System, Kingsport, TN, USA.

Cancer treatments including chemotherapy and radiotherapy treat cancer by targeting rapidly dividing cells. Although these forms of treatment damage rapidly dividing cancer cells, they are also toxic to the cells of the gastrointestinal tract, leading to inflammation of the mucosal layer (mucositis) and causing nausea, vomiting, diarrhea, and abdominal pain. Improvement in symptoms may allow patients to have better performance status permitting ongoing treatment and possibly a better prognosis. This article describes the pathophysiology of chemotherapy-induced mucositis and includes 3 case reports of treatment of mucositis with serum bovine immunoglobulin.
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http://dx.doi.org/10.1177/1049909117735831DOI Listing
May 2018

Subcutaneous Botulinum Toxin Injection for Post-Thoracotomy Pain Syndrome in Palliative Care: A Case Report.

Am J Hosp Palliat Care 2018 Mar 23;35(3):511-513. Epub 2017 Jun 23.

2 Hospice and Palliative Medicine, Wellmont Health System, Kingsport, TN, USA.

Post-thoracotomy pain syndrome (PTPS) is a traumatic neuropathy that can affect as many as 50% of patients undergoing thoracotomy. Patients are often refractory to conservative management and may require multiple analgesics for adequate pain control. Botulinum toxin, derived from Clostridium botulinum, has many uses in treating conditions involving spasticity, dystonia, chronic migraine, and a variety of pain disorders including neuropathies. Botulinum toxin type A injections may provide an alternative or adjunct to improve symptom management in patients with PTPS.
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http://dx.doi.org/10.1177/1049909117716460DOI Listing
March 2018

Silicone Foley's catheter as an effective alternative to Hunter's rod in staged flexor tendon reconstruction of the hand.

Indian J Plast Surg 2016 Sep-Dec;49(3):322-328

Department of Plastic and Reconstructive Surgery, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India.

Context: Staged flexor tendon reconstruction is most suitable treatment method for extensive zone II tendon injuries. The Hunter's rod used in this procedure is costly and not easily available, which adds to the miseries of both patients as well as treating surgeon.

Aims: The aim of this study is to evaluate the results of staged zone II flexor tendon repair using silicone Foley's catheter as a cheaper and readily available alternative to Hunter's rod.

Settings And Design: This was a prospective study.

Materials And Methods: Seventy digits in 35 patients were treated by the staged flexor tendon reconstruction using silicone Foley's catheter in place of Hunter's rod, and the patients were followed for an average period of 18 months. Early controlled motion exercise protocol was instituted in all cases.

Results: As per the Strickland scale, total active motion obtained was excellent in 70%, good in 20%, fair in 7.1% and poor in 2.9% of patients.

Conclusions: Silicone Foley's catheter is cheaper, easily available and an effective alternative to Hunter's rod in staged flexor tendon reconstruction procedure, yielding high rates of excellent and good results with fewer complications.
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http://dx.doi.org/10.4103/0970-0358.197232DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5288906PMC
February 2017

Feasibility of Intraoperative Extubation in Pediatric Heart Transplantation.

World J Pediatr Congenit Heart Surg 2017 09 11;8(5):650-653. Epub 2016 Aug 11.

1 Department of Cardiovascular Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.

Based on described benefits of fast-tracking and early extubation in children undergoing congenital heart surgery, we applied this concept to selected children following uncomplicated orthotopic heart transplantation (OHT). In this case series, we report four patients who were extubated immediately after surgery in the operating room. A mild respiratory acidosis and hypercapnia were noted on the initial arterial blood gases, were well tolerated, and were normalized within 6 to 12 hours. There was no mortality among patients who were extubated in the operating room, and no patients required reintubation. We conclude that operating room extubation is feasible in selected patients undergoing OHT.
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http://dx.doi.org/10.1177/2150135116656978DOI Listing
September 2017

INCIDENCE, OUTCOME AND RISK FACTORS FOR SEPSIS--A TWO YEAR RETROSPECTIVE STUDY AT SURGICAL INTENSIVE CARE UNIT OF A TEACHING HOSPITAL IN PAKISTAN.

J Ayub Med Coll Abbottabad 2016 Jan-Mar;28(1):79-83

Background: Sepsis is amongst the leading causes of admission to the intensive care units and is associated with a high mortality. However, data from developing countries is scares. Aim of conducting this study was to determine the incidence, outcome and risk factors for sepsis on admission to surgical intensive care unit (SICU) of a teaching hospital in Pakistan.

Methods: Two year retrospective observational study included all consecutive adult admissions to the surgical intensive care unit (SICU) of a University Hospital, from January 2012 to December 2013.

Results: Two hundred and twenty-nine patients met the inclusion criteria. Average age of the patients was 46.35 ± 18.23 years (16-85), mean Acute Physiology and Chronic Health Evaluation II (APACHE II) score was 15.92 ± 8.13 and males were 67.6%. Median length of ICU stay was 4 [IQR 5]. 43% patients fulfilled the criteria of sepsis at the time of admission to the SICU and incidence of severe sepsis/septic shock was 35%. Abdominal sepsis was the most frequent source of infection (57.5%). The overall intensive care unit mortality was 32.31% but the mortality of sepsis-group was 51.15% as compared to 17.7% of the non- sepsis group. Stepwise logistic regression model showed that increasing age, female gender, non-operative admission, admission under general surgery and co-morbidities like ischaemic heart disease and chronic kidney disease were significant predictors of sepsis.

Conclusion: The incidence of sepsis and severe sepsis/septic shock, on admission to SICU is high and mortality of the sepsis group is nearly three times the mortality of the non-sepsis group.
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August 2016

A case of anesthesia mumps after sacral laminectomy under general anesthesia.

Saudi J Anaesth 2015 Jul-Sep;9(3):332-3

Department of Anesthesiology, Aga Khan University Hospital, Karachi, Pakistan.

Acute transient parotid gland enlargement in association with general anesthesia is a rare complication and has also been called anesthesia mumps. Unilateral or bilateral parotid or submandibular swelling usually develops during surgery under anesthesia or, a few hours later and usually resolves in a few days with no sequelae. It has been reported as a complication after general anesthesia in patients undergoing spinal surgeries in prone and lateral decubitus position, even after cesarean section in the supine position and also reported in Intensive Care Unit patients. We present a case of a unilateral parotid swelling noticed in immediate postoperative course, in a patient who underwent spine surgery.
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http://dx.doi.org/10.4103/1658-354X.154743DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4478833PMC
August 2015

Large ventral lateral neurons modulate arousal and sleep in Drosophila.

Curr Biol 2008 Oct 4;18(20):1537-45. Epub 2008 Sep 4.

Department of Physiology and Biophysics, University of California, Irvine, California 92697, USA.

Background: Large ventral lateral clock neurons (lLNvs) exhibit higher daytime-light-driven spontaneous action-potential firing rates in Drosophila, coinciding with wakefulness and locomotor-activity behavior. To determine whether the lLNvs are involved in arousal and sleep/wake behavior, we examined the effects of altered electrical excitation of the LNvs.

Results: LNv-hyperexcited flies reverse the normal day-night firing pattern, showing higher lLNv firing rates at night and pigment-dispersing-factor-mediated enhancement of nocturnal locomotor-activity behavior and reduced quantity and quality of sleep. lLNv hyperexcitation impairs sensory arousal, as shown by physiological and behavioral assays. lLNv-hyperexcited flies lacking sLNvs exhibit robust hyperexcitation-induced increases in nocturnal behavior, suggesting that the sLNvs are not essential for mediation of arousal.

Conclusions: Light-activated lLNvs modulate behavioral arousal and sleep in Drosophila.
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http://dx.doi.org/10.1016/j.cub.2008.08.033DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2597195PMC
October 2008

Preparation of high purity nickel film from industrial effluent by the distribution of charge over microelectrodes using newly designed free electrolytic diffusion approach.

J Hazard Mater 2008 Sep 16;157(2-3):564-8. Epub 2008 Jan 16.

Institute of Chemistry, University of the Punjab, Lahore, Pakistan.

The present work deals with the development of a newly designed free electrolytic diffusion approach (the distribution of charge over microelectrodes) for the purification of metals and was successfully applied for the purification of nickel from the industrial effluent containing high proportion of nickel. Atomic absorption spectrophotometer (AAS) analyzed the purified nickel deposited on working microelectrodes. The results obtained show that the purity of nickel was enhanced from 95% to 99.9% with traces of copper etc. It was concluded that distribution of charge over the microcathodes at a rate of 50 cycles per second (cps) shows better results for the production of high purity (HP) nickel as compared to 25 cycles per second (cps).
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http://dx.doi.org/10.1016/j.jhazmat.2008.01.021DOI Listing
September 2008
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