- Pediatric Infectious Diseases
Clinical Assistant Professor, Pediatrics - Infectious Diseases
Board Certification: American Board of Pediatrics, Pediatric Infectious Diseases (2021)
Fellowship: Stanford University Pediatric Infectious Disease Fellowship (2021) CA
Residency: Rutgers Robert Wood Johnson Pediatric Residency (2018) NJ
Medical Education: Hebrew University Hadassah Medical School (2015) Israel
- A 10-Month-Old Female With Complicated Mastoiditis Due to Fusobacterium necrophorum: A Case Report and Literature Review. Journal of the Pediatric Infectious Diseases Society 2020
- Enthesitis-Related Juvenile Idiopathic Arthritis. Pediatrics in review 2019; 40 (5): 256-258
Effects of Immigration on Infant Feeding Practices in an Inner City, Low Socioeconomic Community.
Journal of the National Medical Association
2019; 111 (2): 153-157
Infant feeding practices have been shown to differ between immigrants and non-immigrants in the United States. Our study characterizes feeding practices of infants of immigrant versus American-born mothers followed in an inner city Pediatric continuity clinic serving predominantly low socioeconomic status families.A survey was given to 102 parents of infants ranging from 12 to 15 months of age who attended the clinic. Parents were asked about their country of origin, ethnic background and time since immigration to the US. They were also asked about their breastfeeding and early infant feeding practices. Statistical significance was estimated using chi-squared tests.Not only were breastfeeding rates higher among immigrant mothers compared to American-born mothers (88% vs. 63%, p-value 0.008) but they introduced commercially available baby food less frequently (37% vs. 52%, p-value 0.03) and rarely fed their infants fast food (22% vs. 50%, p-value<0.001). Moreover, breast feeding rates decreased with duration of residence in the United States. 53% of immigrant mothers who have been in the United States for less than 5 years breastfed for over 6 months versus 22% of immigrant mothers who resided more than 5 years in the United States (p-value 0.02). The vast majority of immigrant mothers who switched to formula did so because they felt their milk production was insufficient (93%) whereas the vast majority of American-born mothers stopped breastfeeding because they perceived it to be painful (64%, p value 0.001).Infant feeding practices differ between immigrant and American-born mothers and the differences diminish the longer the mothers reside in the United States. These differences stem from differences in cultural perceptions of breastfeeding. Therefore, in educating mothers about infant feeding, physicians should strongly consider cultural and ethnic factors.
View details for DOI 10.1016/j.jnma.2018.07.006
View details for PubMedID 30177281
Autoimmune-induced glutamatergic receptor dysfunctions: conceptual and psychiatric practice implications.
European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology
2013; 23 (12): 1659-71
Glutamatergic neurotransmission is mediated via complex receptorial systems including N-methyl-d-aspartate (NMDA), alpha-amino-3-hydroxy-5-methyl-4-isoxazolpropionic acid (AMPA) and metabotropic receptor subtypes and plays a critical role in the modulation of synaptic plasticity, mood, cognitive processes and motor behavior. Glutamatergic function deficits are hypothesized to contribute to the pathogenesis of neuropsychiatric disorders, including schizophrenia, mood and movement disorders. Accumulating data are rapidly leading to the characterization of specific types of autoimmune encephalitis in which the receptors and proteins critically involved in glutamatergic neurotransmission, e.g., NMDA, AMPA receptors, are antigen targets. Characteristic of these syndromes, antibodies alter the structure and/or function of the corresponding neuronal antigen resulting in clinical pictures that resemble pharmacological disease models. Presently the best characterized autoimmune glutamatergic disorder is anti-NMDA receptor encephalitis. This disorder manifests with intertwined psychiatric and neurological features, defines a new syndrome, reclassifies poorly defined clinical states and extends previous hypotheses, such as hypo-NMDA receptor function in schizophrenia. The characterization of autoimmune-induced glutamatergic receptor dysfunctions (AGRD) is likely to have a substantial conceptual impact upon our understanding of neuropsychiatric disorders including schizophrenia, affective and movement dysfunctions. Further definition of AGRD will provide additional guidelines for psychiatric diagnoses, identification of homogeneous patient subtypes within broad phenomenological classifications and will contribute to the development of personalized treatments. The body of knowledge already accumulated on anti-NMDA receptor encephalitis highlights the need for wide dissemination of these concepts among psychiatrists, and in suspected cases, for early recognition, prompt clinical and laboratory investigation and efficient interface between mental health and medical teams.
View details for DOI 10.1016/j.euroneuro.2013.05.008
View details for PubMedID 23791073
HIV/AIDS among Palestinians: detection, clinical presentation, prognosis and HIV testing patterns, 1994-2010.
International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases
2011; 15 (6): e377-81
To describe the detection, clinical presentation, and prognosis of West Bank and East Jerusalem Palestinians infected with HIV/AIDS, and HIV testing patterns of Palestinians in the Jerusalem area.This was a case-control analysis comparing all 33 Palestinian HIV/AIDS patients who were referred to the Hadassah AIDS Center (HAC) over 17 years (1994-2010) with 77 non-Palestinian patients seen over the same period. The systematic sampling method was used to select the control group. Patterns of HIV testing were observed for the years 2002 and 2007.Many Palestinian patients (36%) were diagnosed during their initial hospitalization, while 47.1% of non-Palestinians were diagnosed as outpatients. Significantly more opportunistic infections were detected during diagnosis among Palestinians (48.5%) than among non-Palestinians (9.1%, p<0.001). Overall mortality among Palestinian patients was 36.4% (12/33) vs. 6.5% (5/77) among non-Palestinians (p<0.001). No significant differences in the initial CD4 counts and viral load levels were noted between Palestinians and non-Palestinians (256/mm(3) and log 4.58 copies/ml vs. 271/mm(3) and log 4.49 copies/ml, respectively). Follow-up visits were more infrequent among Palestinians than among non-Palestinians: 9.8 (± 1.0) compared with 23.4 (± 12.9), respectively (p<0.001), over a median follow-up of 2.7 years for Palestinians and 8.1 years for non-Palestinians (p<0.001). With regard to HIV testing, 7.3% (72/989) of individuals tested in 2002 and 10.9% (202/1851) in 2007 were Palestinians. The most frequent reason for being tested among Palestinians was 'medical' (e.g., before in vitro fertilization, 69.4% in 2007); among non-Palestinians it was 'intimate relationships' (31% in 2007).These results show that despite an overall small number of Palestinian HIV/AIDS patients, late diagnosis and high mortality are very much in evidence.
View details for DOI 10.1016/j.ijid.2010.12.012
View details for PubMedID 21466966