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TOKARCHUK A, ABENAVOLI L, KOBYLIAK N, KHOMENKO M, REVUN M, DOLGAIA N, MOLOCHEK N, TSYRYUK O, GARNYTSKA A, KONAKH V, PELLICANO R, FAGOONEE S, OSTAPCHENKO L, FALALYEYEVA T. Nutrition program, physical activity and gut microbiota modulation: a randomized controlled trial to promote a healthy lifestyle in students with vitamin D3 deficiency. Minerva Med 2022; 113:683-694. [DOI: 10.23736/s0026-4806.22.07992-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Rivera-Mancilla E, Al-Hassany L, Villalón CM, MaassenVanDenBrink A. Metabolic Aspects of Migraine: Association With Obesity and Diabetes Mellitus. Front Neurol 2021; 12:686398. [PMID: 34177788 PMCID: PMC8219973 DOI: 10.3389/fneur.2021.686398] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 04/29/2021] [Indexed: 12/24/2022] Open
Abstract
Migraine is a disabling neurovascular disorder, characterized by moderate to severe unilateral headaches, nausea, photophobia, and/or phonophobia, with a higher prevalence in women than in men, which can drastically affect the quality of life of migraine patients. In addition, this chronic disorder is related with metabolic comorbidities associated with the patient's lifestyle, including obesity and diabetes mellitus (DM). Beyond the personal and socioeconomic impact caused by migraine, obesity and DM, it has been suggested that these metabolic disorders seem to be related to migraine since: (i) they are a risk factor for developing cardiovascular disorders or chronic diseases; (ii) they can be influenced by genetic and environmental risk factors; and (iii) while clinical and epidemiological studies suggest that obesity is a risk factor for migraine, DM (i.e., type 1 and type 2 DM) have been reported to be either a protective or a risk factor in migraine. On this basis, and given the high worldwide prevalence of migraine, obesity, and DM, this article provides a narrative review of the current literature related to the association between the etiology and pathophysiology of migraine and these metabolic disorders, considering lifestyle aspects, as well as the possible involvement of neurotransmitters, neuropeptides, and/or sex hormones. While a link between migraine and metabolic disorders has been suggested, many studies are contradictory and the mechanisms involved in this association are not yet sufficiently established. Therefore, further research should be focused on understanding the possible mechanisms involved.
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Affiliation(s)
- Eduardo Rivera-Mancilla
- Division of Vascular Medicine and Pharmacology, Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Linda Al-Hassany
- Division of Vascular Medicine and Pharmacology, Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, Netherlands
| | | | - Antoinette MaassenVanDenBrink
- Division of Vascular Medicine and Pharmacology, Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, Netherlands
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Patel U, Yousuf S, Lakhani K, Raval P, Kaur N, Okafor T, Shah C, Singh H, Martin M, Nwodika C, Yogarajah A, Rakholiya J, Patel M, Chakinala RC, Shah S. Prevalence and Outcomes Associated with Vitamin D Deficiency among Indexed Hospitalizations with Cardiovascular Disease and Cerebrovascular Disorder-A Nationwide Study. MEDICINES (BASEL, SWITZERLAND) 2020; 7:medicines7110072. [PMID: 33266477 PMCID: PMC7700427 DOI: 10.3390/medicines7110072] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 11/08/2020] [Accepted: 11/19/2020] [Indexed: 04/12/2023]
Abstract
Background: According to past studies, recovery and survival following severe vascular events such as acute myocardial infarction and stroke are negatively impacted by vitamin D deficiency. However, the national estimate on disability-related burden is unclear. We intend to evaluate the prevalence and outcomes of vitamin D deficiency (VDD) among patients with cardiovascular disease (CVD) and cerebrovascular disorder (CeVD). Methods: We performed a cross-sectional study on the Nationwide Inpatient Sample data (2016-2017) of adult (≥18 years) hospitalizations. We identified patients with a secondary diagnosis of VDD and a primary diagnosis of CVD and CeVD using the 9th revision of the International Classification of Diseases, clinical modification code (ICD-10-CM) codes. A univariate and mixed-effect multivariable survey logistic regression analysis was performed to evaluate the prevalence, disability, and discharge disposition of patients with CVD and CeVD in the presence of VDD. Results: Among 58,259,589 USA hospitalizations, 3.44%, 2.15%, 0.06%, 1.28%, 11.49%, 1.71%, 0.38%, 0.23%, and 0.08% had primary admission of IHD, acute MI, angina, AFib, CHF, AIS, TIA, ICeH, and SAH, respectively and 1.82% had VDD. The prevalence of hospitalizations due to CHF (14.66% vs. 11.43%), AIS (1.87% vs. 1.71%), and TIA (0.4% vs. 0.38%) was higher among VDD patients as compared with non-VDD patients (p < 0.0001). In a regression analysis, as compare with non-VDD patients, the VDD patients were associated with higher odds of discharge to non-home facilities with an admission diagnosis of CHF (aOR 1.08, 95% CI 1.07-1.09), IHD (aOR 1.24, 95% CI 1.21-1.28), acute MI (aOR 1.23, 95% CI 1.19-1.28), AFib (aOR 1.21, 95% CI 1.16-1.27), and TIA (aOR 1.19, 95% CI 1.11-1.28). VDD was associated with higher odds of severe or extreme disability among patients hospitalized with AIS (aOR 1.1, 95% CI 1.06-1.14), ICeH (aOR 1.22, 95% CI 1.08-1.38), TIA (aOR 1.36, 95% CI 1.25-1.47), IHD (aOR 1.37, 95% CI 1.33-1.41), acute MI (aOR 1.44, 95% CI 1.38-1.49), AFib (aOR 1.10, 95% CI 1.06-1.15), and CHF (aOR 1.03, 95% CI 1.02-1.05) as compared with non-VDD. Conclusions: CVD and CeVD in the presence of VDD increase the disability and discharge to non-home facilities among USA hospitalizations. Future studies should be planned to evaluate the effect of VDD replacement for improving outcomes.
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Affiliation(s)
- Urvish Patel
- Department of Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (S.Y.); (M.M.)
- Correspondence: ; Tel.: +1-(201)-936-6715
| | - Salma Yousuf
- Department of Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (S.Y.); (M.M.)
| | - Komal Lakhani
- Department of Internal Medicine, Lenox Hill Hospital, Northwell Health, New York, NY 10075, USA;
| | - Payu Raval
- siParadigm Diagnostic Informatics, Pine Brook, NJ 07058, USA;
- Pramukhswami Medical College, Shree Krishna Hospital, Anand, Gujarat 388325, India
| | - Nirmaljot Kaur
- Department of Internal Medicine, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab 143501, India; (N.K.); (H.S.)
| | - Toochukwu Okafor
- Department of Internal Medicine, Larkin Community Hospital, Hialeah, FL 33012, USA;
| | - Chail Shah
- Department of Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA;
- Brooklyn Cancer Care, Brooklyn, NY 11203, USA
| | - Harmandeep Singh
- Department of Internal Medicine, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab 143501, India; (N.K.); (H.S.)
| | - Mehwish Martin
- Department of Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (S.Y.); (M.M.)
| | - Chika Nwodika
- Department of Internal Medicine, Oba Okunade Sijuade College of Medicine, Igbinedion University Okada, Edo State 23401, Nigeria;
| | | | - Jigisha Rakholiya
- Department of Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA;
| | - Maitree Patel
- Department of Internal Medicine, Advent Health Orlando, Orlando, FL 32803, USA;
| | | | - Shamik Shah
- Department of Neurology, Stormont Vail Health, Topeka, KS 66604, USA;
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Sharma A, Rakholiya J, Madapu A, Sharma S, Jha A. Trend and Predictors of the Utilization of Endoscopic Retrograde Cholangiopancreatography in Acute Pancreatitis Hospitalizations. Cureus 2020; 12:e11420. [PMID: 33312816 PMCID: PMC7727773 DOI: 10.7759/cureus.11420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Patel UK, Malik P, Kodumuri N, Patel P, Pitti V, Tyagi G, Chauhan B, Lunagariya A, Kothari R, Sen S. Chronic Periodontitis is Associated With Cerebral Atherosclerosis -A Nationwide Study. Cureus 2020; 12:e11373. [PMID: 33304705 PMCID: PMC7721345 DOI: 10.7759/cureus.11373] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2020] [Indexed: 01/02/2023] Open
Abstract
Introduction Chronic periodontitis and atherosclerosis share common risk factors and produce the same inflammatory markers. Many studies found a high prevalence of chronic periodontitis in patients with atherosclerosis but there is no strong evidence to support a specific association of chronic periodontitis with cerebral atherosclerosis. We aimed to study the concurrent prevalence and association of chronic periodontitis with cerebral atherosclerosis and cerebrovascular diseases among the US population. Methods We performed a cross-sectional analysis of a Nationwide Inpatient Sample with adult hospitalizations to identify the primary diagnosis of cerebrovascular diseases [acute ischemic stroke (AIS), hemorrhagic stroke (HS), and transient ischemic attack (TIA)] with concurrent cerebral atherosclerosis and chronic periodontitis. Multivariate survey logistic regression models were fitted to evaluate the linkage of chronic periodontitis with cerebral atherosclerosis and cerebrovascular diseases. Results Of total 56,499,788 hospitalizations, 0.01% had chronic periodontitis. Prevalence of chronic periodontitis was higher in 50-64 years (36.18% vs. 23.91%), males (59.19% vs. 41.06% in females), Afro-Americans (25.93% vs. 15.21%), and 0-25th percentile median-household-income-category (38.31% vs. 30.15%) compared to non-chronic periodontitis. There was significantly higher prevalence of cerebral atherosclerosis (0.71% vs. 0.41%; p<0.0001) with weak evidence of high prevalence of cerebrovascular diseases (AIS:2.21% vs. 1.97%; p=0.1563; HS:0.57% vs. 0.46%; p=0.1560) among chronic periodontitis compared to non-chronic periodontitis. In regression analysis, odds of having cerebral atherosclerosis were 2.48-folds higher in patients with chronic periodontitis compared to that without-chronic periodontitis, and cerebral atherosclerosis patients were associated with higher odds of TIA (aOR:2.40; p<0.0001), AIS (aOR:3.35; p<0.0001), and HS (aOR:1.51; p<0.0001) compared to without-cerebral atherosclerosis. No significant relationship between chronic periodontitis and cerebrovascular diseases was observed. Conclusion Although chronic periodontitis may not directly increase the risk of cerebrovascular diseases, it increases the burden of cerebrovascular diseases by evidently increasing the risk of cerebral atherosclerosis. Early identification of chronic periodontitis and atherosclerotic risk factors may help to mitigate the risk of cerebrovascular diseases.
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Affiliation(s)
- Urvish K Patel
- Neurology and Public Health, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Preeti Malik
- Public Health, Icahn School of Medicine at Mount Sinai, New York, USA
- Neurology, Massachusetts General Hospital, Andover, USA
| | - Nishanth Kodumuri
- Neurology, Palmetto Health-University of South Carolina School of Medicine, Columbia, USA
| | | | - Varun Pitti
- Dentistry, Rutgers School of Dental Medicine, Newark, USA
| | - Gaurav Tyagi
- Dentistry, Rutgers School of Dental Medicine, Newark, USA
| | - Bindi Chauhan
- Public Health, Long Island University, New York, USA
| | | | - Ravish Kothari
- Neurology, Palmetto Health-University of South Carolina School of Medicine, Columbia, USA
| | - Souvik Sen
- Neurology, Palmetto Health-University of South Carolina School of Medicine, Columbia, USA
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Patel UK, Malik P, Shah D, Sharma A, Bhela J, Chauhan B, Patel D, Khan N, Kapoor A, Kavi T. The Opioid Epidemic and Primary Headache Disorders: A Nationwide Population-Based Study. Cureus 2020; 12:e9743. [PMID: 32944458 PMCID: PMC7489777 DOI: 10.7759/cureus.9743] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Introduction The opioid epidemic has been linked to several other health problems, but its impact on headache disorders has not been well studied. We performed a population-based study looking at the prevalence of opioid use in headache disorders and its impact on outcomes compared to non-abusers with headaches. Methodology We performed a cross-sectional analysis of the Nationwide Inpatient Sample (years 2008-2014) in adults hospitalized for primary headache disorders (migraine, tension-type headache [TTH], and cluster headache [CH]) using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes. We performed weighted analyses using the chi-square test, Student's t-test, and Cochran-Armitage trend test. Multivariate survey logistic regression analysis with weighted algorithm modelling was performed to evaluate morbidity, disability, and discharge disposition. Among US hospitalizations during 2013-2014, regression analysis was performed to evaluate the odds of having opioid abuse among headache disorders. Results A total of 5,627,936 headache hospitalizations were present between 2008 and 2014 of which 3,098,542 (55.06%), 113,332 (2.01%), 26,572 (0.47%) were related to migraine, TTH, and CH, respectively. Of these headache hospitalizations, 128,383 (2.28%) patients had abused opioids. There was a significant increase in the prevalence trend of opioid abuse among patients with headache disorders from 2008 to 2014. The prevalence of migraine (63.54% vs. 54.86%), TTH (2.29% vs. 2.01%), and CH (0.59% vs. 0.47%) was also higher among opioid abusers than non-abusers (p<0.0001). Opioid abusers with headaches were more likely to be younger (43 years old vs. 50 years old), men (30.17% vs. 24.78%), white (80.83% vs. 73.29%), Medicaid recipients (30.15% vs. 17.03%), and emergency admissions (85.4% vs. 78.51%) as compared to opioid non-abusers with headaches (p<0.0001). Opioid abusers with headaches had higher prevalence and odds of morbidity (4.06% vs. 3.70%; adjusted odds ratio [aOR]: 1.48; 95% CI: 1.39-1.59), severe disability (28.14% vs. 22.43%; aOR: 1.58; 95% CI: 1.53-1.63), and discharge to non-home location (17.13% vs. 18.41%; aOR: 1.35; 95% CI: 1.30-1.40) as compared to non-abusers. US hospitalizations in years 2013-2014 showed the migraine (OR: 1.61; 95% CI: 1.57-1.66), TTH (OR: 1.43; 95% CI: 1.22-1.66), and CH (OR: 1.34; 95% CI: 1.01-1.78) were linked with opioid abuse. Conclusion Through this study, we found that the prevalence of migraine, TTH, and CH was higher in opioid abusers than non-abusers. Opioid abusers with primary headache disorders had higher odds of morbidity, severe disability, and discharge to non-home location as compared to non-abusers.
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Affiliation(s)
- Urvish K Patel
- Neurology and Public Health, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Preeti Malik
- Public Health, Icahn School of Medicine at Mount Sinai, New York, USA.,Pediatrics, The Children's Hospital at Montefiore, Bronx, USA
| | - Dhaivat Shah
- Clinical Research, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Ashish Sharma
- Internal Medicine, Yuma Regional Medical Center, Yuma, USA
| | - Jatminderpal Bhela
- Psychiatry, MetroHealth System, Case Western Reserve University School of Medicine, Cleveland, USA
| | - Bindi Chauhan
- Public Health, Long Island University, New York, USA
| | - Deepkumar Patel
- Public Health, School of Health Sciences and Practice, New York Medical College, Valhalla, USA
| | - Nashmia Khan
- Internal Medicine, MultiCare Tacoma General Hospital, Tacoma, USA
| | - Ashish Kapoor
- Neurology, Bayonne Medical Center - CarePoint Health & Jersey City Medical Center - RWJBarnabas Health, Jersey City, USA
| | - Tapan Kavi
- Neurology, Cooper Neurological Institute, Cooper University Hospital, Camden, USA
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Nowaczewska M, Wiciński M, Osiński S, Kaźmierczak H. The Role of Vitamin D in Primary Headache-from Potential Mechanism to Treatment. Nutrients 2020; 12:E243. [PMID: 31963460 PMCID: PMC7019347 DOI: 10.3390/nu12010243] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 01/02/2020] [Accepted: 01/14/2020] [Indexed: 12/13/2022] Open
Abstract
Some studies have suggested a link between vitamin D and headache; however, the underlying physiological mechanisms are unclear. We aimed to summarize the available evidence on the relationship between vitamin D and the various subtypes of primary headaches, including migraines and tension-type headaches. All articles concerning the association between primary headache and vitamin D published up to October 2019 were retrieved by searching clinical databases, including: EMBASE, MEDLINE, PubMed, Google scholar, and the Cochrane library. All types of studies (i.e., observational, cross-sectional, case-control, and clinical trials) were included. We identified 22 studies investigating serum vitamin D levels in association with headaches. Eight studies also evaluated the effect of vitamin D supplementation on the various headache parameters. Among them, 18 studies showed a link between serum vitamin D levels and headaches, with the strongest connection reported between serum vitamin D levels and migraine. Overall, there is not enough evidence to recommend vitamin D supplementation to all headache patients, but the current literature indicates that it may be beneficial in some patients suffering headaches, mainly migraineurs, to reduce the frequency of headaches, especially in those with vitamin D deficiency.
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Affiliation(s)
- Magdalena Nowaczewska
- Department of Pathophysiology of Hearing and Balance System, Faculty of Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, M. Curie 9, 85-090 Bydgoszcz, Poland
- Department of Otolaryngology, Head and Neck Surgery, and Laryngological Oncology, Ludwik Rydygier, Collegium Medicum in Bydgoszcz Nicolaus Copernicus University, M. Curie 9, 85-090 Bydgoszcz, Poland
| | - Michał Wiciński
- Department of Pharmacology and Therapeutics, Faculty of Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, M. Curie 9, 85-090 Bydgoszcz, Poland
| | - Stanisław Osiński
- Department of Otolaryngology, Head and Neck Surgery, and Laryngological Oncology, Ludwik Rydygier, Collegium Medicum in Bydgoszcz Nicolaus Copernicus University, M. Curie 9, 85-090 Bydgoszcz, Poland
| | - Henryk Kaźmierczak
- Department of Otolaryngology, Head and Neck Surgery, and Laryngological Oncology, Ludwik Rydygier, Collegium Medicum in Bydgoszcz Nicolaus Copernicus University, M. Curie 9, 85-090 Bydgoszcz, Poland
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Patel UK, Shah D, Malik P, Hussain M, Chauhan B, Patel D, Sharma S, Khan N, Patel K, Kapoor A, Kavi T. A Comprehensive Assessment of Vascular and Nonvascular Risk Factors Associated with Migraine. Cureus 2019; 11:e6189. [PMID: 31890393 PMCID: PMC6919944 DOI: 10.7759/cureus.6189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 11/18/2019] [Indexed: 01/03/2023] Open
Abstract
INTRODUCTION Migraine is a chronic disabling neurological disease, with an estimated expense of $15-20 million/year. Several studies with a small number of patients have studied risk factors for migraine such as cardiovascular disorders, stroke, smoking, demographic, and genetic factors but this is the first comprehensive study for evaluation of vascular and nonvascular risk factors. It is important to evaluate all the risk factors that help to prevent the healthcare burden related to migraine. Methodology: We performed a retrospective cross-sectional analysis of the Nationwide Inpatient Sample (NIS) (years 2013-2014) in adult (>18-years old) hospitalizations in the United States. Migraine patients were identified using ICD-9-CM code to determine the demographic characteristics, vascular, and nonvascular risk factors. Univariate analysis was performed using the chi-square test and a multivariate survey logistic regression analysis was performed to identify the prevalence of the risk factors and evaluate the odds of prevalence of risk factors amongst migraine patients compared to nonmigraine patients, respectively. RESULTS On weighted analysis, after removing missing data of age, gender and race, from years 2013 to 2014, of the total 983,065 (1.74%) migraine patients were identified. We found that younger (median age 48-years vs. 60-years), female (82.1% vs. 58.5%; p<0.0001), white population (76.8% vs. 70.5%; p<0.0001), and privately insured (41.1% vs. 27.4%; p<0.0001) patients were more likely to have migraine than others. Cerebral atherosclerosis, diabetes mellitus, ischemic heart disease, atrial fibrillation, and alcohol abuse were not significantly associated with migraine. Migraineurs had higher odds of having hypertension [odds ratio (OR): 1.44; 95% confidence interval (CI): 1.43-1.46; 44.49% vs. 52.84%], recent transient ischemic attack (TIA) (OR: 3.13; 95%CI: 3.02-3.25; 1.74% vs. 0.67%), ischemic stroke (OR: 1.40; 95%CI: 1.35-1.45; 2.06% vs. 1.97%), hemorrhagic stroke (OR: 1.11; 95%CI: 1.04-1.19; 0.49% vs. 0.46%), obesity (OR: 1.46; 95%CI: 1.44-1.48; 19.20% vs. 13.56%), hypercholesterolemia (OR: 1.33; 95%CI: 1.30-1.36; 5.75% vs. 5.54%), substance abuse (OR: 1.51; 95%CI: 1.48-1.54; 7.88% vs. 4.88%), past or current consumption of tobacco (OR: 1.40; 95%CI: 1.38-1.41; 31.02% vs. 27.39%), AIDS (OR: 1.13; 95%CI: 1.04-1.24; 0.33% vs. 0.41%), hypocalcemia (OR: 1.09; 95%CI: 1.03-1.14; 0.77% vs. 0.89%), and vitamin D deficiency (OR: 1.93; 95%CI: 1.88-1.99; 2.47% vs. 1.37%) than patients without migraine. Female patients were at a higher risk of migraine (OR: 3.02; 95%CI: 2.98-3.05) than male. CONCLUSION In this study, we have identified significant risk factors for migraine hospitalizations. Early identification of these risk factors may improve the risk stratification in migraine patients.
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Affiliation(s)
- Urvish K Patel
- Neurology and Public Health, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Dhaivat Shah
- Clinical Research, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Preeti Malik
- Pediatrics, The Children's Hospital at Montefiore, Bronx, USA
| | - Maryam Hussain
- Public Health, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Bindi Chauhan
- Public Health, Long Island University, New York, USA
| | - Deepkumar Patel
- Public Health, New York Medical College, School of Health Science and Practice, Valhalla, USA
| | - Shivani Sharma
- Internal Medicine, SUNY Downstate Medical Center, Brooklyn, USA
| | - Nashmia Khan
- Internal Medicine, Multicare Tacoma General Hospital, Tacoma, USA
| | - Kulin Patel
- Nursing, Holy Family University, School of Nursing, Philadelphia, USA
| | - Ashish Kapoor
- Neurology, Bayonne Medical Center‑ Carepoint Health & Jersey City Medical Center‑ RWJ Barnabas Health, Jersey City, USA
| | - Tapan Kavi
- Neurology, Cooper Neurological Institute, Cooper University Hospital, Camden, USA
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