Browsing by Author "Sah, Anil Kumar"
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Publication Association Between Vitamin D Levels and Vitamin D Receptor (VDR) Gene Polymorphisms in Nepalese Population(Nepal Health Research Council, 2025) Baidya, Sujata; Kandel, Pratibha; Rajkarnikar, Smrity; Sah, Anil Kumar; Niraula, Apeksha; Tuladhar, Eans Tara; Shakya, Yagya Laxmi; Bam, Niraj; Sharma, Vijay Kumar; Yadav, Binod KumarAbstract: Background: Vitamin D deficiency is a global public health concern. Small variations in the proteins involved in vitamin D metabolism affect levels and physiological roles of vitamin D. However, there is a paucity of data regarding such factors in our population. This study was designed to assess the distribution of polymorphisms of vitamin D Receptor (VDR) gene (rs2238136 and rs731236) in vitamin-D deficient Nepalese population. Methods: A total of 400 apparently healthy individuals visiting our center were enrolled. Five ml of blood was collected in gel vial and EDTA vial. The 25(OH)D levels were estimated in ABBOTT Architect autoanalyzer. After extracting genomic DNA, the VDR gene polymorphism (rs2238136 and rs731236) was analyzed using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). The amplified products, 135 bp and 716 bp were digested using restriction enzymes Bpu10IA and TaqI for rs2238136 and rs731236, respectively, electrophoresed on 2% agarose gel and visualized under UV illuminator. Statistical analysis was done using SPSS version 21.0. Results: The distribution of both rs2238136 and rs731236 followed Hardy-Weinberg equilibrium. There were 24 AA, 238 GG, and 138 AG genotypes found in rs2238136, whereas 226 TT, 34 CC, and 140 TC genotypes were found in rs731236. In contrast to rs731236, vitamin D levels varied among genotypes of rs2238136. Conclusions: In our population, there was a higher prevalence of GG genotype (rs2238136) and TT genotype (rs731236). Increased prevalence of vitamin D deficiency in our region may be due to these genetic variations.Publication Detection of blaoxa-23 Gene from Carbapenem-resistant Acinetobacter Baumannii(Nepal Health Research Council, 2022) Neupane, Laxmi; Sah, Anil Kumar; Rayamajhee, Binod; Pokhrel, Anil; Singh, AnjanaAbstract Background: Antibiotic resistance is a great concern for public health and Acinetobacter baumannii-associated infections are increasing in many parts of the world, including Nepal. However, limited data is available on the prevalence of A. baumannii harboring blaOXA-23 from Nepal. Methods: A hospital-based cross-sectional study was designed to detect the blaOXA-23 gene from carbapenem-resistant A. baumannii isolates in Nepal. A total of 380 clinical specimens were collected and processed following standard microbiological procedures. Antibiotic susceptibility test was performed as per the protocol of the Kirby-Bauer disk diffusion technique and the CLSI guidelines, while screening of carbapenemase production was assessed by the Modified Hodge Test using meropenem (10µg) disc. The presence of the blaOXA-23 gene in carbapenemase-positive A. baumannii was confirmed by PCR. Results: Among 380 specimens analyzed, 210 (55.3%) samples were positive for bacterial growth, where 33(15.7% of total growth) of the isolates were A. baumannii, and most of them were isolated from the ICU patients (20/33, 60.6%) and sputum (16/33, 48.5%). Thirty-two isolates (97%) were colistin sensitive, while only four (12.1%) isolates were sensitive to meropenem and imipenem. Twenty-three (69.7%) of A. baumannii were carbapenemase positive as revealed by the Modified Hodge Test test, and 19 of them (57.6% of total A. baumannii) harbored the blaOXA-23 gene. Conclusions: A high prevalence of the blaOXA-23 gene among carbapenem-resistant A. baumannii isolates were found. Systematic network surveillance should be established to check the spread of such isolates, especially in the intensive care units of tertiary care hospitals in Nepal. Keywords: Acinetobacter baumannii; antibiotic-resistant; blaOXA-23; carbapenemase; NepalPublication Phenotypic and Genotypic Detection of Metallo-b Lactamase in Non-Fermenting Gram Negative Bacilli Obtained from Clinical Samples in a Tertiary Care Hospital in Nepal(Institute of Medicine, Tribhuvan University, 2025) Sapkota, Jyotshna; GC, Divya Shree; Adhikari, Ram Prasad; Khadka, Shusila; Pandey, Ritu; Sah, Anil Kumar; Khanal, Laxmi KantAbstract: Introduction Non-fermenting Gram-negative bacilli, including Pseudomonas aeruginosa and Acinetobacter baumannii, are significant nosocomial pathogens with limited treatment options due to their intrinsic and acquired resistance mechanisms. Among these, metallo-β-lactamases are of major concern which hydrolyze carbapenems and contribute to antimicrobial resistance. This study aimed to determine the prevalence of Metallo-β-Lactamase-producing non-fermenting gram negative bacilli in clinical specimens using both phenotypic and genotypic methods. Methods A descriptive cross-sectional study was conducted at Nepal Medical College Teaching Hospital from January 2024 to December 2024. A total of 16,954 clinical specimens were processed for culture and sensitivity testing. NFGNB were identified using standard microbiological methods. Antimicrobial susceptibility testing was conducted using the Kirby-Bauer disk diffusion method following Clinical and Laboratory Standards Institute guidelines. MBL production was detected phenotypically using the Imipenem-EDTA combined disc method. The presence of IMP and VIM genes was confirmed by conventional PCR. Results Among 16,954 specimens, 163 (0.96%) NFGNB isolates were identified, with Pseudomonas aeruginosa (52.1%) being the most prevalent, followed by Acinetobacter species (39.3%) and Burkholderia species (8.6%). MBL production was detected in 22 (13.5%) isolates: Pseudomonas aeruginosa (59.1%), and Acinetobacter species (40.9%). Genotypically IMP and VIM genes were found in 36.4% and 31.8% of MBL-positive isolates, respectively, while one isolate harbored both genes. Notably, 27.3% of phenotypic MBL producers tested negative for both IMP and VIM, suggesting the potential involvement of other MBL genes. Conclusion The significant prevalence of MBL-producing NLFGNB, particularly among Pseudomonas aeruginosa and Acinetobacter species, highlights a serious challenge for antimicrobial therapy and underscores an urgent need for robust infection control and antimicrobial stewardship strategies.Publication Postherpetic Psoriasis: A Rare Case Report Authors(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2025) Shrestha, Samir; Sah, Anil Kumar; Khadka, Varsha; Sitaula, Sabina; Gurung, KushalAbstract: Wolf’s isotopic response describes the phenomenon where a new, different skin disorder occurs at the site of a previously healed skin lesion. The most common primary and secondary diseases are herpes zoster and granuloma annulare, respectively. Psoriasis vulgaris is rare as a secondary disease, with only two cases reported. Here, we report another rare case of psoriasis vulgaris following a herpes zoster.Publication Radical Cystectomy for Intradiverticular Bladder Carcinoma: A Case Report(Nepal Medical Association, 2021) Sah, Anil Kumar; Maharjan, Bipin; Adhikari, Mahesh Bahadur; Rana, Reena; Basnet, Sunila; Panta, Rajesh; Aryal, GopiAbstract: Herniation of bladder mucosa through the bladder wall muscle layer is known as bladder diverticulum. The incidence of bladder diverticulum is 1.7. About 0.8 to 10% of the urinary bladder diverticulum develops carcinoma. Transitional cell carcinoma is the most common. Painless hematuria is the most common clinical presentation. Different imaging modalities along with cystoscopy are the key to accurate diagnosis and staging. High grade multifocal urothelial carcinoma in the bladder diverticulum is better managed by radical cystectomy and standard pelvic lymph node dissection with an ileal conduit. Here we report a case of a 66-year old gentleman of high grade multifocal urothelial carcinoma in bladder diverticulum managed with radical cystectomy and standard pelvic lymph node dissection with an ileal conduit. Such cases have been addressed adequately in the literature, but we did not find such cases from our country.