ROSHAN KHATRI - Academia.edu (original) (raw)

Papers by ROSHAN KHATRI

Research paper thumbnail of Jnma I Vol 52 I No. 5 I Issue 189 I

The eponym 'Amyand hernia' coined in recognition of Claudius Amyand, the first surgeon to... more The eponym 'Amyand hernia' coined in recognition of Claudius Amyand, the first surgeon to successfully perform appendectomy in a hernia sac containing appendix, refers to the vermiform appendix within inguinal hernia. Here, we present a rare case, of Amyand's hernia in an 18 month-old boy who was brought with an inguino-scortal swelling which later on exploration was left sided Amyand's hernia with sliding component. Amyand's hernia is not very often seen in the clinical practice and its pre-operative diagnosis is very difficult hence awareness of this disease condition is essential for preoperative suspicion and even diagnosis of the condition.

Research paper thumbnail of Jnma I Vol 52 I No. 5 I Issue 189 I

Introduction: Mechanical revascularization by percutaneous coronary interventions has now become ... more Introduction: Mechanical revascularization by percutaneous coronary interventions has now become an established and preferable method of revascularization in patients with acute coronary syndromes. The aim of the study was to identify the clinical indications for percutaneous coronary interventions and in-hospital outcomes of percutaneous coronary interventions in a tertiary-level hospital without onsite cardiac surgery backup.

Research paper thumbnail of Public & Non-profit Partnership for Universal Health Coverage in Rural Nepal: Assessment of Dhulikhel Hospital Outreach Centers

Thesis (Master's)--University of Washington, 2019The Government of Nepal aims to achieve its ... more Thesis (Master's)--University of Washington, 2019The Government of Nepal aims to achieve its targets of Universal Health Coverage and Primary Health Care through the engagement of public and private health sectors. The private sector occupies a major share of the country’s health care, but its contributions has not been fully analyzed. A mixed methods study to analyze Dhulikhel hospital out-reach centers, a not-for-profit private health care provider and their collaboration with the Primary Health Care Centers of the public sector was performed in rural Nepal. The study showed that these outreach centers are contributing to improve access to quality care for the rural population but are underutilized. The patient’s preference of a particular service center, private or public, was not determined by the cost and they perceived quality of care at both centers. The existing level of communication and collaboration between thes sectors were inadequate demonstrating gaps between policies and practices. Platforms for better communication and coordination of services need to be established. Private sector should focus on complementing and filling these gaps, while public sector formulates and implement practical polices to diversify resources to serve the population in need

Research paper thumbnail of Implementing Self Sustained Quality Control Procedures in a Clinical Laboratory

Journal of Nepal Medical Association, 2013

Introduction: Quality control is an essential component in every clinical laboratory which mainta... more Introduction: Quality control is an essential component in every clinical laboratory which maintains the excellence of laboratory standards, supplementing to proper disease diagnosis, patient care and resulting in overall strengthening of health care system. Numerous quality control schemes are available, with combinations of procedures, most of which are tedious, time consuming and can be “too technical” whereas commercially available quality control materials can be expensive especially for laboratories in developing nations like Nepal. Here, we present a procedure performed at our centre with self prepared control serum and use of simple statistical tools for quality assurance. Methods: The pooled serum was prepared as per guidelines for preparation of stabilized liquid quality control serum from human sera. Internal Quality Assessment was performed on this sample, on a daily basis which included measurement of 12 routine biochemical parameters. The results were plotted on Levey-...

Research paper thumbnail of Impact of Evidence‐Based Stroke Care on Patient Outcomes: A Multilevel Analysis of an International Study

Journal of the American Heart Association, 2019

Background The uptake of proven stroke treatments varies widely. We aimed to determine the associ... more Background The uptake of proven stroke treatments varies widely. We aimed to determine the association of evidence‐based processes of care for acute ischemic stroke ( AIS ) and clinical outcome of patients who participated in the HEADPOST (Head Positioning in Acute Stroke Trial), a multicenter cluster crossover trial of lying flat versus sitting up, head positioning in acute stroke. Methods and Results Use of 8 AIS processes of care were considered: reperfusion therapy in eligible patients; acute stroke unit care; antihypertensive, antiplatelet, statin, and anticoagulation for atrial fibrillation; dysphagia assessment; and physiotherapist review. Hierarchical, mixed, logistic regression models were performed to determine associations with good outcome (modified Rankin Scale scores 0–2) at 90 days, adjusted for patient and hospital variables. Among 9485 patients with AIS, implementation of all processes of care in eligible patients, or “defect‐free” care, was associated with improved...

Research paper thumbnail of Left Sided Amyand’s Hernia with Sliding Component

Journal of Nepal Medical Association, 2013

The eponym ‘Amyand hernia’ coined in recognition of Claudius Amyand, the first surgeon to success... more The eponym ‘Amyand hernia’ coined in recognition of Claudius Amyand, the first surgeon to successfully perform appendectomy in a hernia sac containing appendix, refers to the vermiform appendix within inguinal hernia. Here, we present a rare case, of Amyand’s hernia in an 18 month-old boy who was brought with an inguino-scortal swelling which later on exploration was left sided Amyand’s hernia with sliding component. Amyand’s hernia is not very often seen in the clinical practice and its pre-operative diagnosis is very difficult hence awareness of this disease condition is essential for preoperative suspicion and even diagnosis of the condition. Keywords: Amyand’s hernia; acute appendicitis; hernial repair.

Research paper thumbnail of Vitamin D and its implication in neurofibromyalgia

Sunsari Technical College Journal, 2013

New and emerging roles of Vitamin D are being uncovered, except for its known traditional roles i... more New and emerging roles of Vitamin D are being uncovered, except for its known traditional roles in Bone mineralisation and Calcium metabolism. Evidences associating it with cell proliferation and multiplication have linked with its potential role in cancer causation and treatment modality. Vitamin D is also finding its importance in mental disorders, proper immune functioning, and cognitive performances. Here we present a review article on association of Vitamin D with common but infrequently diagnosed cases non specific musculoskeletal pain, Neurofibromyalgia.DOI: http://dx.doi.org/10.3126/stcj.v1i1.7987 Sunsari Technical College Journal Vol.1(1) 2012 45-47

Research paper thumbnail of Jnma I Vol 52 I No. 5 I Issue 189 I

The eponym 'Amyand hernia' coined in recognition of Claudius Amyand, the first surgeon to... more The eponym 'Amyand hernia' coined in recognition of Claudius Amyand, the first surgeon to successfully perform appendectomy in a hernia sac containing appendix, refers to the vermiform appendix within inguinal hernia. Here, we present a rare case, of Amyand's hernia in an 18 month-old boy who was brought with an inguino-scortal swelling which later on exploration was left sided Amyand's hernia with sliding component. Amyand's hernia is not very often seen in the clinical practice and its pre-operative diagnosis is very difficult hence awareness of this disease condition is essential for preoperative suspicion and even diagnosis of the condition.

Research paper thumbnail of Jnma I Vol 52 I No. 5 I Issue 189 I

Introduction: Mechanical revascularization by percutaneous coronary interventions has now become ... more Introduction: Mechanical revascularization by percutaneous coronary interventions has now become an established and preferable method of revascularization in patients with acute coronary syndromes. The aim of the study was to identify the clinical indications for percutaneous coronary interventions and in-hospital outcomes of percutaneous coronary interventions in a tertiary-level hospital without onsite cardiac surgery backup.

Research paper thumbnail of Public & Non-profit Partnership for Universal Health Coverage in Rural Nepal: Assessment of Dhulikhel Hospital Outreach Centers

Thesis (Master's)--University of Washington, 2019The Government of Nepal aims to achieve its ... more Thesis (Master's)--University of Washington, 2019The Government of Nepal aims to achieve its targets of Universal Health Coverage and Primary Health Care through the engagement of public and private health sectors. The private sector occupies a major share of the country’s health care, but its contributions has not been fully analyzed. A mixed methods study to analyze Dhulikhel hospital out-reach centers, a not-for-profit private health care provider and their collaboration with the Primary Health Care Centers of the public sector was performed in rural Nepal. The study showed that these outreach centers are contributing to improve access to quality care for the rural population but are underutilized. The patient’s preference of a particular service center, private or public, was not determined by the cost and they perceived quality of care at both centers. The existing level of communication and collaboration between thes sectors were inadequate demonstrating gaps between policies and practices. Platforms for better communication and coordination of services need to be established. Private sector should focus on complementing and filling these gaps, while public sector formulates and implement practical polices to diversify resources to serve the population in need

Research paper thumbnail of Implementing Self Sustained Quality Control Procedures in a Clinical Laboratory

Journal of Nepal Medical Association, 2013

Introduction: Quality control is an essential component in every clinical laboratory which mainta... more Introduction: Quality control is an essential component in every clinical laboratory which maintains the excellence of laboratory standards, supplementing to proper disease diagnosis, patient care and resulting in overall strengthening of health care system. Numerous quality control schemes are available, with combinations of procedures, most of which are tedious, time consuming and can be “too technical” whereas commercially available quality control materials can be expensive especially for laboratories in developing nations like Nepal. Here, we present a procedure performed at our centre with self prepared control serum and use of simple statistical tools for quality assurance. Methods: The pooled serum was prepared as per guidelines for preparation of stabilized liquid quality control serum from human sera. Internal Quality Assessment was performed on this sample, on a daily basis which included measurement of 12 routine biochemical parameters. The results were plotted on Levey-...

Research paper thumbnail of Impact of Evidence‐Based Stroke Care on Patient Outcomes: A Multilevel Analysis of an International Study

Journal of the American Heart Association, 2019

Background The uptake of proven stroke treatments varies widely. We aimed to determine the associ... more Background The uptake of proven stroke treatments varies widely. We aimed to determine the association of evidence‐based processes of care for acute ischemic stroke ( AIS ) and clinical outcome of patients who participated in the HEADPOST (Head Positioning in Acute Stroke Trial), a multicenter cluster crossover trial of lying flat versus sitting up, head positioning in acute stroke. Methods and Results Use of 8 AIS processes of care were considered: reperfusion therapy in eligible patients; acute stroke unit care; antihypertensive, antiplatelet, statin, and anticoagulation for atrial fibrillation; dysphagia assessment; and physiotherapist review. Hierarchical, mixed, logistic regression models were performed to determine associations with good outcome (modified Rankin Scale scores 0–2) at 90 days, adjusted for patient and hospital variables. Among 9485 patients with AIS, implementation of all processes of care in eligible patients, or “defect‐free” care, was associated with improved...

Research paper thumbnail of Left Sided Amyand’s Hernia with Sliding Component

Journal of Nepal Medical Association, 2013

The eponym ‘Amyand hernia’ coined in recognition of Claudius Amyand, the first surgeon to success... more The eponym ‘Amyand hernia’ coined in recognition of Claudius Amyand, the first surgeon to successfully perform appendectomy in a hernia sac containing appendix, refers to the vermiform appendix within inguinal hernia. Here, we present a rare case, of Amyand’s hernia in an 18 month-old boy who was brought with an inguino-scortal swelling which later on exploration was left sided Amyand’s hernia with sliding component. Amyand’s hernia is not very often seen in the clinical practice and its pre-operative diagnosis is very difficult hence awareness of this disease condition is essential for preoperative suspicion and even diagnosis of the condition. Keywords: Amyand’s hernia; acute appendicitis; hernial repair.

Research paper thumbnail of Vitamin D and its implication in neurofibromyalgia

Sunsari Technical College Journal, 2013

New and emerging roles of Vitamin D are being uncovered, except for its known traditional roles i... more New and emerging roles of Vitamin D are being uncovered, except for its known traditional roles in Bone mineralisation and Calcium metabolism. Evidences associating it with cell proliferation and multiplication have linked with its potential role in cancer causation and treatment modality. Vitamin D is also finding its importance in mental disorders, proper immune functioning, and cognitive performances. Here we present a review article on association of Vitamin D with common but infrequently diagnosed cases non specific musculoskeletal pain, Neurofibromyalgia.DOI: http://dx.doi.org/10.3126/stcj.v1i1.7987 Sunsari Technical College Journal Vol.1(1) 2012 45-47