Dr.Bharat Kumar yadav - Academia.edu (original) (raw)

Papers by Dr.Bharat Kumar yadav

Research paper thumbnail of Prevalence of Stress among Pregnant Women Attending Antenatal Care in a Tertiary Maternity Hospital in Kathmandu

Journal of Women's Health Care, 2014

Objective: One of the important factors that have always been overlooked is the stress during pre... more Objective: One of the important factors that have always been overlooked is the stress during pregnancy. Psychosocial stress during pregnancy has been linked as a predictor of adverse pregnancy outcome in various studies. One of the important factors that have always been overlooked is the stress during pregnancy. Psychosocial stress during pregnancy has been linked as a predictor of adverse pregnancy outcome in various studies. Methodology: A cross-sectional prospective observational study was conducted among the pregnant women attending Antenatal Checkup at the general Antenatal Clinic of Department of Obstetrics and Gynaecology of Patan Hospital. Data was collected by using self-structured questionnaire using General Health Questionnaire (GHQ-12) and 21 item modified life events inventory during the late first trimester and early third trimester. Sample size calculated was based on the existing data of 25% and 10% prevalence of LBW among the stressed and non-stressed women. Data was entered using Epidata and analyzed using R 2.10.1 software. Results and discussion: Most of the respondents were among the age group of 20-29 years with mean age of 25 years. The mean score on GHQ-12 was 9.79 and 9.69 in the first and third trimester respectively. Prevalence of stress during pregnancy was 35% in the first trimester and 34.2% in the third trimester. Conclusion: There was high prevalence of stress among the women attending ANC clinic at Patan Hospital. As this is the data from one of the urban population of Nepal, the prevalence of stress in the rural areas might be even more than this number.

Research paper thumbnail of An Open Randomized Comparison of Gatifloxacin versus Cefixime for the Treatment of Uncomplicated Enteric Fever

PLoS ONE, 2007

Objective. To assess the efficacy of gatifloxacin versus cefixime in the treatment of uncomplicat... more Objective. To assess the efficacy of gatifloxacin versus cefixime in the treatment of uncomplicated culture positive enteric fever. Design. A randomized, open-label, active control trial with two parallel arms. Setting. Emergency Room and Outpatient Clinics in Patan Hospital, Lagankhel, Lalitpur, Nepal. Participants. Patients with clinically diagnosed uncomplicated enteric fever meeting the inclusion criteria. Interventions. Patients were allocated to receive one of two drugs, Gatifloxacin or Cefixime. The dosages used were Gatifloxacin 10 mg/kg, given once daily for 7 days, or Cefixime 20 mg/kg/day given in two divided doses for 7 days. Outcome Measures. The primary outcome measure was fever clearance time. The secondary outcome measure was overall treatment failure (acute treatment failure and relapse). Results. Randomization was carried out in 390 patients before enrollment was suspended on the advice of the independent data safety monitoring board due to significant differences in both primary and secondary outcome measures in the two arms and the attainment of a priori defined endpoints. Median (95% confidence interval) fever clearance times were 92 hours (84-114 hours) for gatifloxacin recipients and 138 hours (105-164 hours) for cefixime-treated patients (Hazard Ratio[95%CI] = 2.171 [1.545-3.051], p,0.0001). 19 out of 70 (27%) patients who completed the 7 day trial had acute clinical failure in the cefixime group as compared to 1 out of 88 patients (1%) in gatifloxacin group(Odds Ratio [95%CI] = 0.031 [0.004-0.237], p,0.001). Overall treatment failure patients (relapsed patients plus acute treatment failure patients plus death) numbered 29. They were determined to be (95% confidence interval) 37.6 % (27.14%-50.2%) in the cefixime group and 3.5% (2.2%-11.5%) in the gatifloxacin group (HR[95%CI] = 0.084 [0.025-0.280], p,0.0001). There was one death in the cefixime group. Conclusions. Based on this study, gatifloxacin is a better treatment for uncomplicated enteric fever as compared to cefixime. Trial Registration. Current Controlled Trials ISRCTN75784880

Research paper thumbnail of Embedding social accountability in the medical school and its curricula: Patan Academy of Health Sciences, Nepal

Journal of Patan Academy of Health Sciences

Introduction: Patan Academy of Health Sciences (PAHS) was established in 2008 with a social accou... more Introduction: Patan Academy of Health Sciences (PAHS) was established in 2008 with a social accountability mandate and the mission to produce competent and committed health professionals to serve the rural and underserved population. Enrolment of undergraduate medical students started from 2010. This article describes the context and process for the establishment of the Academy, the approaches taken and some of the early outputs. Method: The information was collected from the policy documents, PAHS website, meeting minutes/ discussions, feedbacks and medial school records. All the information were compiled and presented under different headings/subheadings in a phase wise manner. Result: PAHS has been actively engaged in a multitude of partnerships from local to global and has chosen the best and most applicable innovations from around the world. The integrated suite of innovations the Academy has developed includes its admission policy, teaching-learning methodologies, community-b...

Research paper thumbnail of Prevalence of Stress among Pregnant Women Attending Antenatal Care in a Tertiary Maternity Hospital in Kathmandu

Journal of Women's Health Care, 2014

Objective: One of the important factors that have always been overlooked is the stress during pre... more Objective: One of the important factors that have always been overlooked is the stress during pregnancy. Psychosocial stress during pregnancy has been linked as a predictor of adverse pregnancy outcome in various studies. One of the important factors that have always been overlooked is the stress during pregnancy. Psychosocial stress during pregnancy has been linked as a predictor of adverse pregnancy outcome in various studies. Methodology: A cross-sectional prospective observational study was conducted among the pregnant women attending Antenatal Checkup at the general Antenatal Clinic of Department of Obstetrics and Gynaecology of Patan Hospital. Data was collected by using self-structured questionnaire using General Health Questionnaire (GHQ-12) and 21 item modified life events inventory during the late first trimester and early third trimester. Sample size calculated was based on the existing data of 25% and 10% prevalence of LBW among the stressed and non-stressed women. Data was entered using Epidata and analyzed using R 2.10.1 software. Results and discussion: Most of the respondents were among the age group of 20-29 years with mean age of 25 years. The mean score on GHQ-12 was 9.79 and 9.69 in the first and third trimester respectively. Prevalence of stress during pregnancy was 35% in the first trimester and 34.2% in the third trimester. Conclusion: There was high prevalence of stress among the women attending ANC clinic at Patan Hospital. As this is the data from one of the urban population of Nepal, the prevalence of stress in the rural areas might be even more than this number.

Research paper thumbnail of An Open Randomized Comparison of Gatifloxacin versus Cefixime for the Treatment of Uncomplicated Enteric Fever

PLoS ONE, 2007

Objective. To assess the efficacy of gatifloxacin versus cefixime in the treatment of uncomplicat... more Objective. To assess the efficacy of gatifloxacin versus cefixime in the treatment of uncomplicated culture positive enteric fever. Design. A randomized, open-label, active control trial with two parallel arms. Setting. Emergency Room and Outpatient Clinics in Patan Hospital, Lagankhel, Lalitpur, Nepal. Participants. Patients with clinically diagnosed uncomplicated enteric fever meeting the inclusion criteria. Interventions. Patients were allocated to receive one of two drugs, Gatifloxacin or Cefixime. The dosages used were Gatifloxacin 10 mg/kg, given once daily for 7 days, or Cefixime 20 mg/kg/day given in two divided doses for 7 days. Outcome Measures. The primary outcome measure was fever clearance time. The secondary outcome measure was overall treatment failure (acute treatment failure and relapse). Results. Randomization was carried out in 390 patients before enrollment was suspended on the advice of the independent data safety monitoring board due to significant differences in both primary and secondary outcome measures in the two arms and the attainment of a priori defined endpoints. Median (95% confidence interval) fever clearance times were 92 hours (84-114 hours) for gatifloxacin recipients and 138 hours (105-164 hours) for cefixime-treated patients (Hazard Ratio[95%CI] = 2.171 [1.545-3.051], p,0.0001). 19 out of 70 (27%) patients who completed the 7 day trial had acute clinical failure in the cefixime group as compared to 1 out of 88 patients (1%) in gatifloxacin group(Odds Ratio [95%CI] = 0.031 [0.004-0.237], p,0.001). Overall treatment failure patients (relapsed patients plus acute treatment failure patients plus death) numbered 29. They were determined to be (95% confidence interval) 37.6 % (27.14%-50.2%) in the cefixime group and 3.5% (2.2%-11.5%) in the gatifloxacin group (HR[95%CI] = 0.084 [0.025-0.280], p,0.0001). There was one death in the cefixime group. Conclusions. Based on this study, gatifloxacin is a better treatment for uncomplicated enteric fever as compared to cefixime. Trial Registration. Current Controlled Trials ISRCTN75784880

Research paper thumbnail of Embedding social accountability in the medical school and its curricula: Patan Academy of Health Sciences, Nepal

Journal of Patan Academy of Health Sciences

Introduction: Patan Academy of Health Sciences (PAHS) was established in 2008 with a social accou... more Introduction: Patan Academy of Health Sciences (PAHS) was established in 2008 with a social accountability mandate and the mission to produce competent and committed health professionals to serve the rural and underserved population. Enrolment of undergraduate medical students started from 2010. This article describes the context and process for the establishment of the Academy, the approaches taken and some of the early outputs. Method: The information was collected from the policy documents, PAHS website, meeting minutes/ discussions, feedbacks and medial school records. All the information were compiled and presented under different headings/subheadings in a phase wise manner. Result: PAHS has been actively engaged in a multitude of partnerships from local to global and has chosen the best and most applicable innovations from around the world. The integrated suite of innovations the Academy has developed includes its admission policy, teaching-learning methodologies, community-b...