A5000030831- Global Maternal and Child Health
- Hepatitis B Virus Studies
- Liver Disease Diagnosis and Treatment
- Global Health and Surgery
- Global Health Care Issues
- Hepatitis C virus research
- Inflammatory Bowel Disease
- Healthcare Systems and Reforms
- Global Health Workforce Issues
- HIV/AIDS Research and Interventions
- Maternal and Perinatal Health Interventions
- Liver Disease and Transplantation
- Biomedical and Engineering Education
- Diagnosis and treatment of tuberculosis
- Tuberculosis Research and Epidemiology
- Quality and Safety in Healthcare
- Drug-Induced Hepatotoxicity and Protection
- Global Public Health Policies and Epidemiology
- Hepatitis Viruses Studies and Epidemiology
- Economic and Financial Impacts of Cancer
- Global Healthcare and Medical Tourism
- Healthcare Policy and Management
- Gastric Cancer Management and Outcomes
- Chronic Disease Management Strategies
- Liver Diseases and Immunity
Harvard University
2015-2025
Mass General Brigham
2025
Massachusetts General Hospital
2014-2024
Mount Auburn Hospital
2020-2023
Brigham and Women's Hospital
2011-2023
Nick Simons Institute
2019-2023
Lemuel Shattuck Hospital
2022
University of Massachusetts Boston
2014
Colonoscopy for colorectal cancer screening is endoscopist dependent, and colonoscopy quality improvement programs aim to improve efficacy. This study evaluated the clinical benefit safety of using a computer-aided detection (CADe) device in procedures.This randomized prospectively use CADe at 5 academic community centers by US board-certified gastroenterologists (n = 22). Participants aged ≥40 scheduled or surveillance (≥3 years) were included; exclusion criteria included incomplete...
Non-communicable diseases (NCDs) cause a large burden of disease globally. Some infectious an increased risk developing specific NCDs. Although the NCD from some causes has been quantified, in this study, we aimed to more comprehensively quantify global NCDs causes.In modelling identified with established factors and long-term non-communicable sequelae, did narrative reviews between April 11, 2018, June 10, 2020, obtain relative risks (RRs) or population attributable fractions (PAFs) studies...
Universal HealtH
Adherence to the American Association for Study of Liver Disease (AASLD) guidelines management chronic hepatitis B (CHB) has not been systematically assessed. We sought comprehensively evaluate adherence five key areas these guidelines. also evaluated physician and patient factors underlying nonadherence, predictors nonadherence such as type, demographic factors, phase CHB infection.Nine hundred sixty-two adult patients were retrospectively identified. Each chart was reviewed in detail. The...
What few people thought possible little more than a decade ago is now reality: scientific and operational advances are greatly reducing the number of deaths from HIV. The infant infections has decreased by 58% between 2001 2013 mother-to-child transmission (MTCT) HIV might well be eliminated in next years.1 By contrast, prevention management hepatitis B virus (HBV) infection lags behind, at least sub-Saharan Africa.
Interview with Dr. Ruma Rajbhandari on the need for increased investment in district hospitals low- and lower-middle-income countries. (07:52)Download Advancing emerging surgery, noncommunicable-disease, quality agendas global health will be possible only if investments are aimed at strengthening an undervalued component of systems countries: hospital.
Summary We examined the impact of HBV / HIV coinfection on outcomes in hospitalized patients compared to those with or monoinfection. Using 2011 US Nationwide Inpatient Sample, we identified who had been monoinfection using ICD ‐9‐ CM codes. liver‐related admissions between three groups. Multivariable logistic regression was performed identify independent predictors in‐hospital mortality, length stay and total charges. A 72 584 discharges monoinfection, 133 880 8156 were included. associated...
Problem In hospitals in rural, resource-limited settings, there is an acute need for simple, practical strategies to improve healthcare quality. Setting A district hospital remote western Nepal. Key measures improvement To provide a mechanism systems-level reflection so that staff can identify targets quality delivery. Strategies change develop morbidity and mortality conference (M&M) initiative aims facilitate structured analysis of patient care barriers providing care, which...
Over the last decade, extensive scientific and policy innovations have begun to reduce "quality chasm" - gulf between best practices actual implementation that exists in resource-rich medical settings. While limited data exist, this chasm is likely be equally acute deadly resource-limited areas. health systems scaled up impoverished areas, scale-up just foundation necessary deliver effective healthcare poor. This perspective piece describes a vision for global quality improvement movement...
Abstract Background Medical equipment plays a crucial role in the provision of quality healthcare services, despite this more than 50% developing countries are non-functioning due to lack appropriate human resources maintain. To address problem some government hospitals Nepal have deployed mid-level technical cadre called 'Biomedical Equipment Technician' (BMET). This study aims evaluate effectiveness deploying BMET on functionality medical rural Nepal. Methods We used mixed-methods approach...
To establish the epidemiology and patterns of care Crohn’s Disease in low- lower-middle-income countries. A cross-sectional survey gastroenterology providers countries where world’s poorest billion live was conducted to learn more about state diagnostic treatment capacity for Crohn’s. Quantitative data were analyzed R Excel. total 46 responses from 15 received, giving a response rate 54.8%. All collected practicing Africa South Asia. The mean number patients with cared last year 89.5 overall...
Summary Assiduous measures are taken to prevent perinatal transmission of hepatitis B virus ( HBV ) infants; it is unclear whether the mothers receive appropriate care for their chronic . We sought assess quality in surface antigen HB sAg)‐positive following pregnancy. sAg‐positive women n = 243) who had prenatal at Massachusetts General Hospital were retrospectively identified and charts reviewed. The primary outcome was adherence American Association Study Liver Diseases AASLD College...
Background While Nepal’s maternal mortality ratio (MMR) has improved overall, the proportion of deaths occurring in health facilities and attended to by skilled birth attendants (SBAs), nearly doubled over 12 years. Although there are numerous socioeconomic, environmental other factors at play, one possible explanation for this discrepancy between utilization care services outcomes lies quality being provided SBAs. The objective study is determine how competent SBAs after training, across...
Summary Background Little is known about outcomes of Hepatitis B virus ( HBV )‐related hospitalisations. Aim To compare the characteristics and hospitalised patients to those with C HCV ) infection alcoholic liver disease ALD ), examine variables associated poor outcomes. Methods Using 2011 US Nationwide Inpatient Sample, we identified , or ‐related admissions using ICD ‐9‐ CM codes. We compared liver‐related complications between three groups. Multivariable regression was performed identify...
The Lancet Commission on Global Surgery (LCoGS) recommends using specialist surgical workforce density as one of 6 core indicators for monitoring universal access to safe, affordable and anaesthesia care. Using Nepal a case study, we explored the capacity generalist (led by family physician or MD general practitioner non-physician anaesthetist) enable effective delivery through task-shifting. multiple-methods approach, retrospectively mapped essential care enabling environment surgery in 39...
Background Direct obstetric causes of maternal mortality account for approximately 86% all global deaths. In Nepal, 12% deaths women reproductive age are due to preventable complications in significant part the limited distribution and skill level human resources.