Title of project: "The incidence of DVT and PE in the ALS population"
Description: A retrospective study looking at the incidence of DVT and PE in the patients with ALS admitted to the hospital over 5 years. Based on the results of this study, a second part may be initated as a prospective study looking at screening the ALS population.
Mentor: John Volpi, M.D.
Title of project: "Prognosis in Partial Status Epilepticus. Presented at AES"
Mentors: Dr. Makoto Kawai and Aparajitha Verma, M.D.
Title of project: "Simultaneous EEG and fMRI in patients with Epilepsy: Evaluation of the resting state default mode network and sleep patterns; evaluation of correlates of interictal discharges with fMRI BOLD signal change; Simultaneous EEG and fMRI in presurgical evaluation of epilepsy patients"
Mentors: Amit Verma, M.D. and Christof Karmonik, Ph.D.
Title of project: "Determining the role of first time FVC (forced vital capcity)/MIP (maximal inspiratory pressure) in stratifying patients with ALS"
Description of project: In 2009, the AAN published updated evidence-based guidelines for the management of ALS patients. The AAN parameters use FVC <50%
as an indication for NIPPV initiation. Although, FVC is routinely used, MIP may be a more sensitive measurement of pulmonary/diaphragmatic function. Baseline FVC, MEP and MIP are known predictors of tracheostomy free survival. If they have any predictive value regarding timing of non-invasive positive pulmonary ventilation( NIPPV) initiation and percutaneous endoscopic gastrostomy (PEG) is unknown. More data on the role NIPPV compliance plays in FVC and MIP of ALS patients is needed. We set up to answer these questions by database and chart review of the most recent group of ALS patients diagnosed at the Houston Methodist Hospital, Houston, TX.
Mentors: Ericka P. Simpson, M.D.; Aparajitha Verma, M.D.
Abstracts submitted: Abstracts submitted and accepted for AAN meeting San Diego 2013 and MND/ALS meeting Milan 2013. Poster presented in San Diego.
Title of project: "A Mystery Case of Severe Recurrent Neutropenia"
Description of project: A Case report and poster presentation to discuss an interesting case of medication induced neutropenia.
Mentor: Lawrence Rice, M.D.
Abstract submitted: Poster submitted/accepted/presented to American College of Physicians Poster Day at Houston Methodist Hospital Februar 2013.
Title of project: "Case Report: Neuromyelitis Optica - Devic's Disease"
Description of project: A Case report about an interesting pediatric case of NMO.
Mentor: Johanan Levine, M.D.
Poster submitted/accepted/presented: El Paso County Medical Society and El Paso Physician Journal Vol 34 No. 5.
Upcoming projects: "Co-investigator of POINT trial and THERAPY trial"
Point: A multi-center randomized controlled clinical trial comparing dual anti platelet therapy vs. single anti platelet therapy in the management of secondary stroke prevention.
Theraphy: A randomized controlled clinical trial to determine the utility of endovascular management in acute stroke patients receiving tPA.
Upcoming submission by David Chiu, M.D. to BMS regarding a study of Apixaban
Project title: "A retrospective analysis looking at the incidence of MRI negative strokes in post tPA patients, with specific concentration on stroke mimics such as seizure"
Aim: To determine a true incidence in our cohort population of tPA patients of averted strokes, with comparison of a wide range of baseline factors, including history or new onset seizure, NIHSS, time to tPA, age, among other baseline characteristics.
Title of project: "Evaluating the influence of NIPPV in ALS patients"
Project Description: We will compare the quality of life scores and pulmonary function testing (FVC and MIP) of ALS patinet using NIPPV regularly to those of patients who are noncompliant or abstaing from this therapy.
Mentor: Aparajitha Verma, M.D.
Title of project: "Evaluation of Safety Outcomes in TPA Patients"
Project Description:We evaluated door-to-result times for critical labs in potential TPA patients as part of a patient safety and quality improvement project. The data was compared to the rate of delayed treatments and rate of adverse events. In addition, we evaluated the safety of treating patients before the required lab results were obtained. Final results will be presented to the Emergency Department, Neurology Department, and Stroke Care Management and Performance Improvement committees.
Mentor: John Volpi, M.D.
Title of project: "Evaluation of the Safety and Efficacy of CPAP in obstructive sleep apnea patients immediately following cerebrovascular accident" (future project)
Project Description: In particular, we collect data on the rate of aspiration pneumonia in patients with long-term CPAP use who are continued on this therapy during stroke admission. A control group of patients will be established from those who screen positive for sleep apnea symptoms at time of admission but who are naive to CPAP therapy.
Mentor: John Volpi, M.D.; Aparajitha Verma, M.D.
Previous Posters: Smith SV, Simpson EP. "A Complicated Case of GAD Antibody Syndrome" Carrell-Krusen Neuromuscular Symposium. February 14, 2013. Abstract and poster presentation.
Mentor: Dr. Ericka Simpson
Smith SV, Lai EC. "Neurosyphilis Mimicking Herpes Encephalitis: A not-so-rare presentation commonly misdiagnosed clinically and radiographically" Texas Neurologic Society Winter Meeting. February 23, 2013. Abstract and poster presentation.
Mentor: Eugene C. Lai, M.D., Ph.D.
Previous Publication -in medical school:
Smith SV, Benz MS, Brown DM."Cystoid Macular Edema Secondary to Albumin-Bound Paclitaxel Therapy" Arch Ophthalmol. 2008 Nov; 126(11):1605-6. PMID: 19001234
Basic Science Project: "Retinal Nerve Fiber Layer Changes in Multiple Sclerosis and other Neurodegenerative Diseases: Pathophysiology, Assessment, and Clinical Application"
Mentors: Andrew Lee, M.D.; David M. Brown, M.D., Olga Waln, M.D.
Title of project: "Intravenous Immunoglobulin (IVIG) in Chronic Inflammatory Demyelinating Polyradiculoneuropathy"
Description: To study the clinical and immunomodulatory effects of IVIG therapy in patients with chronic inflammatory demyelinating polyradiculoneuropathy.
Mentor:Ericka P. Simpson, M.D.
Title of project: "Intravenous Immunoglobulin (IVIG) in Myasthenia Gravis"
Description: To determine the effectiveness of long-term IVIG maintenance therapy in patients with myasthenia gravis.
Mentors: Ericka P. Simpson, M.D.; Milvia Y. Pleitez, M.D.
Chen WC, Kassi M, Saeed U, Frenette CT. A Rare Case of Amatoxin Poisoning in the State of Texas. Case Reports in Gastroenterology, 2012; 6(2): 350-357
Khatri IA, Saeed U. Cluster like headache in an elderly patient with lateral medullary infarct--does the clue lie somewhere else? Journal of Pakistan Medical Association, 2011; 61(10): 1022-4
"Bilateral Carotid Body Tumors presenting as Amaurosis Fugax-an unusual presentation" Texas Neurological Institute Meeting in Austin, TX- Feb 22-24, 2013.
"A Rare Case of Amatoxin Poisoning in the State of Texas' American College of Physician Associate Day – March 24, 2012
"Bilateral Carotid Body Tumors presenting as Amaurosis Fugax-an unusual presentation" American College of Physician Associate Day – March 24, 2012
Publications in Submission:
Saeed U, Renjifo ME, Radaideh M. "Herpes zoster encephalitis: an unusual presentation in a patient with HIV infection" Submitted to Neurology
Renjifo ME, Saeed U, Radaideh M. "An interesting case of Neuro-Behçet Disease" Submitted to Neurology
Saeed U, Chiu D, Forouzandeh F. "Bilateral Carotid Body Tumors presenting as Amaurosis Fugax-an unusual presentation"
Ongoing IRB-Approved Research Projects: "Effect of various risks factors including age, gender, etc on circle of Willis collaterals in humans" An angiographic study.
Mentor: John Volpi, M.D.
Abstract submitted: "Aging is associated with progressive insufficiency of circle of Willis collaterals in humans" to International Stroke Conference (ISC) Feb, 2014.