Browsing by Author "Rijal, Komal Raj"
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Publication Epidemiological Characteristics of Hepatitis C Patients Attending a Tertiary Care Hospital(Nepal Health Research Council, 2024) Kattel, Hari Prasad; Sharma, Sangita; Alfsnes, Kristian; Pathak, Rahul; Rijal, Komal Raj; Ghimire, Prakash; Andreassen, Ashild K; Banjara, Megha RajBackground: Hepatitis C infection is a major public health concern in Nepal. Epidemiological information on hepatitis C virus along with the status of co-infection with hepatitis B virus and human immunodeficiency virus is essential to controlling the hepatitis C burden. The objective of this study was to determine the sero-prevalence of hepatitis C virus infections, proportions of co-infections with human immunodeficiency virus and hepatitis B virus, and identify the demographic characters, and routes of transmission. Methods: A cross-sectional study was conducted from December 2019 to February 2024 at Tribhuvan University Teaching Hospital. The serological tests were performed by enzyme-linked immunosorbent assays from 25133 patients’ serum in four years. Results: The sero-prevalence of hepatitis C virus -infected patients was 0.8% (211/25133). Among them, 6.6% (14/211) were co-infected with human immunodeficiency virus and 1.4% (3/211) with hepatitis B virus. Among 211 hepatitis C virus patients, 174 (82.5%) were male, 156 (73.9%) were young aged 15–47 years with various professions, 167 (79.1%) were literate, and almost one-third of the patients (33.2%, 70/211) were regular alcoholics. Needle sharing among intravenous drug users (45.5%, 96/211) and sexual intercourse (28%, 59/211) were the most common modes of transmission. Conclusions: Although the prevalence of hepatitis C infections is less than 1%, it is more common among young male intravenous drug users. Awareness of the spread of hepatitis C infections among this population needs to be emphasized to control hepatitis C in Nepal. Keywords: characters; co-infection; hepatitis C, sero-prevalence.Publication Multidrug resistant Escherichia coli isolated at National Public Health Laboratory, Nepal(2025) Acharya, Jyoti; Shrestha, Anjana; Rijal, Nisha; Jha, Runa; Rijal, Komal Raj; Sharma, Supriya; Raj Banjara, Megha; Ghimire, PrakashBackground: Antimicrobial resistance in Escherichia coli is mostly associated with ß-lactamases and carbapenemases enzyme production resulting in treatment challenges. This study was conducted with the aim to detect and characterize antimicrobial resistance in E. coli isolates. Methods: A cross-sectional study was conducted during 2018-2022, at National Public Health Laboratory where the clinical specimens (24636) received were processed for identification and characterization of antimicrobial resistance following conventional & advanced methods. Antibiotic susceptibility tests were performed by Modified Kirby Bauer disc diffusion and Minimum inhibitory concentrations using VITEK2 compact (Biomeriux). The isolates were tested for extended-spectrum ?-lactamases and Carbapenemase production following Clinical Laboratory Standards Institute guidelines. Results: Bacterial growth was observed in 9% (2166/24636) of the specimens, of which 44% (959) were E. coli. Among the 959 E. coli isolates, 320 were reconfirmed with VITEK-MS (Biomeriux). Phenotypic multi-drug resistance was observed in 75% (240/320) of the isolates with 62% (197/320) extended-spectrum ?-lactamases, 12% (39/320) AmpC-ß-lactamase, 10% (31/320) serine carbapenemases and 7% (22/320) Metallo-ß-lactamase while 3% (9/320) produced three types of enzymes. The extended-spectrum-?-lactamase producing E. coli were sensitive to Tigecycline (100%), Amikacin (92%), Imipenem (87%), and Meropenem (84%). Carbapenemase producers were sensitive to Tigecycline (100%), with 61% to Amikacin. Extensive-drug resistance was observed in 2% (7/320) of the isolates, with Colistin resistance in one. Conclusions: The findings highlight alarmingly high antimicrobial resistance in E. coli posing significant challenges in treatment. Early detection of multi-drug resistant isolates in healthcare settings is crucial to combat antimicrobial resistance. Keywords: ?-lactamase; carbapenemases; extensive-drug resistance; metallo-ß-lactamase; multidrug resistance