Browsing by Author "Bharati, L"
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Publication Complications of warfarin in post operative heart valve surgery(Institute of Medicine, 2013) Pradhan, N; Bhandari, NR; Bharati, LAbstract Introduction: Thromboembolic complications and bleeding are the major complications of warfarin. The aim of the study was to focus on the complication of warfarin and monitoring post-valve surgery. Methods: A combined retrospective and prospective study was done in post mechanical heart valve surgery patients at Manmohan Cardiothoracic Vascular and Transplant Center. The study was carried out for 4 months by interviewing patients with self-administered structured questionnaire about any complications during their follow up in OPD and monitoring for their INR values. Results: The majority of patients studied wer male 42 and 56 were female. 55 patients underwent mitral valve replacement, 22 underwent double valve replacement and 46 underwent aortic valve replacement. There were a total of 59 cases of bleeding complications. Hemoptysis was the most common bleeding event .Pericardial bleeding was the most common major bleeding complication with 3.1%. In patients taking warfarin major bleeding complication was 10.2% and minor bleeding was 50%. Out of total INR reading 47% were out of the target INR range, with 19.5% above range and 27.5% below range. Conclusion: Minor bleeding was the most common type of bleeding. A system for proper monitoring of warfarin can bring improvement in better dose adjustment to achieve more appropriate INR values and eventually minimizing warfarin related complications. Introducing pharmacist monitored anticoagulant clinic can reduce the work load of physicians and overcome the time barrier. Keywords: Minor bleeding, Major bleeding, INR, ThromboembolismPublication Side effects and efficacy of oral mifepristone plus sublingual misoprostol regimen in early medical abortion (gestation up to 63 days)(Institute of Medicine, 2018) Kshetri, R; Bharati, L; Pandey, S; Sapkota, B; Pandey, SAbstract Introduction: Medical abortion with mifepristone and misoprostol has few side effects that cannot be avoided. Efficacy of medical abortion varies with the routes of administration and the doses of mifepristone and misoprostol. This study aimed to investigate the side effects and abortifacient efficacy of 200 mg oral mifepristone and 800 mcg sublingual misoprostol regimen in termination of early pregnancy. Methods: A descriptive cross-sectional study was carried out at Marie Stopes Clinic, Gongabu, Kathmandu. Altogether 103 women with a period of gestation (POG) up to 63 days were selected by purposive sampling technique and were interviewed using two sets of the semi-structured questionnaire. Each woman received 200 mg mifepristone at the clinic. Then 800 mcg misoprostol was taken sublingually at home after 48 hours. Confirmation of abortion was done by ultrasonography. Association between efficacy and POG was calculated by using Chi-square and/or Fisher’s exact test. Results: Side effects reported were nausea, vomiting, diarrhoea, dizziness, fever, chills/shivering, headache, lower abdominal pain, anorexia, lower back pain. The overall efficacy of the regimen was 98.1%. Rates of complete abortion were 98.8% in ≤49 days’ POG and 95.0% in >49days’ POG. The differences were not statistically significant (p-value >0.05). Conclusion: Medical abortion done by using this regimen had few side effects, but no serious side effects or complications were reported. Efficacy of this regimen was high. This study will help to estimate the possible side effects, complications and effectiveness of the given regimen required for proper counselling to the women who opt for medical abortion. Keywords: Efficacy, Medical abortion, Mifepristone, Misoprostol, Side effects, SublingualPublication Study on hypoglycemic effect of Berberis aristata on type 2 diabetic model rats(Institute of Medicine, 2013) Bharati, L; Amatya, S; Bhoumik, A; Gharti, KP; Rokeya, BAbstract Introduction: Berberis aristata is one of the herbs mentioned in all ancient scriptures of Ayurveda. It is a well-known medicinal plant in hilly areas of Nepal and its occurrence is reported from middle altitude areas. It is used traditionally for treating various disorders including diabetes mellitus. Methods: The experiment was carried out for duration of 28 days on a total of 27 rats. The rats were divided into 4 groups – type 2 water control, type 2 glibenclamide treated, type 2 extract treated and normal treated group. Blood glucose, lipid profile and serum insulin level of all groups were compared at 0 day and 28 day. The renal function, liver function liver glycogen, MDA and GSH concentration value of all groups were compared on 28 day. Results: The study revealed that type 2 rats treated with extract showed decrease in blood glucose level at 120 mins. The significant decrease was found in normal rat treated with extract in comparison to water control, glibenclamide and type 2 rats extract treated group when fed simultaneously with glucose on the 15 day. There was significant decrease in fasting glucose level in both type 2 and normal rat treated with extract on 28 day in comparison to 0 day. Conclusion: Berberis aristata dry stem powder 80% ethanolic extract possesses significant hypoglycemic activity in Type 2 diabetic model rats and normal rats. Keywords: berberis aristata, ethanolic extract, hypoglycemia, hyperglycemia