Browsing by Author "Shah, P"
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Publication Evaluation of Latex Agglutination Test for Rapid Identification of Staphylococcus aureus Isolated from Pyogenic Wound Infections at a Tertiary Care Hospital(Kathmandu University, 2023) Shah, P; Sah, R; Sharma, A; Khanal, B; Bhattarai, NRABSTRACT Background Staphylococcus aureus infections are increasingly reported worldwide. It is a major clinical problem and imposes significant morbidity and mortality due to widespread emergence of multidrug resistant pathogens like methicillin resistant Staphylococcus aureus. Thus, rapid and reliable identification of Staphylococcus aureus is essential for timely and effective management of patient. Objective The performance of Latex agglutination test (Staphaurex Plus) was compared to conventional method tube coagulase test which is gold standard too for the identification of Staphylococcus aureus. Method This study was conducted at B.P. Koirala Institute of Health Sciences. Following standard microbiological methods, isolation and identification was done in the Department of Microbiology. MRSA detection was performed following Clinical and Laboratory Standard Institute. All the isolates of Staphylococci were subjected for Latex agglutination test and was performed according to manufacturer’s instructions using Staphaurex Plus kit. Result Out of 377 (methicillin sensitive Staphylococcus aureus – 142; methicillin resistant Staphylococcus aureus - 233; Coagulase Negative Staphylococci –2) isolates of Staphylococci, Latex agglutination test was found to be positive in 138 (97.1%) of methicillin sensitive Staphylococcus aureus (MSSA) and 220 (94.4%) of methicillin resistant Staphylococcus aureus (MRSA). Overall sensitivity, specificity, positive predictive value and negative predictive value of Latex agglutination test was found to be 95.46%, 100%, 100%, 10.52% respectively. Conclusion In conclusion, Latex agglutination test is a rapid and reliable test for the identification of Staphylococcus aureus. KEY WORDS Latex agglutination test, Staphylococcus aureus, tube coagulase testPublication Health Care Associated Infection and Trend of Antimicrobial Resistance in Tertiary Care Hospital -A Study in Low Income Setting(Kathmandu University, 2019) Shrestha, R; Koju, P; Xinliang, Liu; Maharjan, B; Madhup, S; Shah, P; Hao, LiABSTRACT Background Antimicrobial resistance (AMR) and healthcare-associated infections (HAIs) are among the most serious public health problems and overall estimate indicates that at any point, over 1.4 million people are suffering from health care associated infection globally. According to the WHO report, the frequency of nosocomial infection is 10% in South East Asia where as 7% in developed countries. The increasing trend of AMR in pathogenic bacteria leads to complication to treat HAIs and failure in treatment and rise in mortality. Objective The study was conducted with the objective of to explore the incidence of different types of HAIs and AMR pattern in the patients admitted in a tertiary care hospital. Method The cross-sectional study was conducted at the tertiary care hospital and the patient who are one year or older and admitted for more than 48 hours were included in this study. The criteria for classification of HAIs were adapted from Centers for Disease Control. All the samples were collected then antibiotic sensitivity testing was conducted according to CLSI standards. Data were collected using a structured data collection form. Data were entered in EpiData software and analyzed using SPSS version 22. Result Among 2326 patients, female was slightly higher than male patients, where 77 (3.3%) patients experienced at least one episode of HAIs. The surgical site infection (71.42%) is the most common infection followed by Catheter Associated Urinary Tract Infection (18.18%) and Health Care Associated Pneumonia (6.49%). Mean hospitalization days is higher with HAI (14.5 days) compared to non-HAI (6.6 days). Out of 909 specimens, urine, sputum and blood were higher in numbers, where 217 bacterial isolates were isolated with Escherichia coli (83 isolates) was the most common bacteria. It is found that Escherichia coli bacterial isolates were resistance to most common antibiotics. Conclusion The study concludes that surgical site infection is the most common healthcare- associated infection and Escherichia coli is the most common bacteria responsible for HAIs. Further, surgical site infection being the most common infection, there is an urgent need to take effective infection prevention and control prevention. KEY WORDS Antimicrobial resistance, Healthcare-associated infections, Surgical site infectionPublication Prevalence of Refractive Error and Spectacle Compliance in Children of Tokha Municipality(Kathmandu University, 2024) Kaiti, R; Shyangbo, R; Singh, S; Pandey, C; Shah, P; Bogati, B; Poudel, B; Mishra, AABSTRACT Background Refractive error is considered as an important component of the priority disease “childhood blindness” within the Vision 2020’ initiative to eliminate avoidable blindness. The large majority of vision impairment in school aged children is due to uncorrected refractive error. Hence, refractive errors are considered as a public health challenge. The aim of this study was to estimate the prevalence of refractive error and spectacle compliance among children in Tokha municipality, Kathmandu. Objective The aim of this study was to estimate the prevalence of refractive error and spectacle compliance among children from Tokha municipality, Kathmandu. Method A descriptive, cross-sectional study was conducted by enrolling 1366 children from Tokha municipality from 1st to 3rd week of April 2022 after obtaining the Institutional Review Board (Reference number:60/2079/80). Assent was taken from all children and informed consent was signed by the legal guardians of the children. All the samples underwent a comprehensive ocular history taking, visual acuity and refraction and ocular health assessments. The inclusion criteria was school going children within age group 5-16 years. Result Out of a total of 1366 samples, 10.91% (149) of the school children were identified to have refractive error. The primary type of refractive error observed was compound myopic astigmatism, which accounted for 52.3% (78) of the cases. A spectacle compliance rate of 72.15% was found. Conclusion Refractive error prevalence in this study is consistent with findings from other part of Nepal. The most common type of refractive error was compound myopic astigmatism. The frequency of refractive errors was notably higher among individuals who frequently use electronic devices, attend private schools, and reside in densely populated areas. It is recommended to organize regular community eye camps and conduct vision screenings to identify and promptly address refractive errors in children. KEY WORDS Ametropia, Prevalence, Refractive error, Visual impairment, Vision screeningPublication Prevalence Survey of Antimicrobial Use among Admitted Patients in Tertiary Care hospital: An observational study(Kathmandu University, 2025) Aryal, S; Joshi, M; Uprety, BN; Shrestha, RK; Gupta, M; Shah, P; Rajbhandari, P; Amatya, R; Shrestha, P; Ojha, ARABSTRACT Background Monitoring the antimicrobial use is one of the key strategies to address the growing global threat of antimicrobial resistance. Objective To find out antimicrobial usage at tertiary care hospital of Lalitpur, Nepal. Result An observational cross-sectional study was carried out at the Patan Academy of Health Sciences, Lalitpur, Nepal on September 25 and 26, 2023. World Health Organization point prevalence survey methodology was used with minor modification to meet hospital’s context. The data on antimicrobial usage were collected from the medical records of patients admitted at or before 08:00 am on the day of the study in the acute care ward. Result The study involved 324 inpatients, with females comprising 176 (54.3%) and males 148(45.7%). The mean age was 37.89 years ± 24.87. Antibiotics usage was 78.1%. A total of 471 drug was prescribed of which 312 (66.2%) was used for therapeutic purpose and 159 (33.8%) for prophylaxis. Of 312 antibiotics, 283 (90.7%) were utilized empirically. Majority of prescribed medications belonged to watch group 16 (48.5%). Ceftriaxone was the most frequently prescribed antibiotic 142 (30.1%) and was the preferred choice for surgical prophylaxis 68 (94.4%). A total of 24 (72.7%) drugs were prescribed from the National List of Essential Medicines and 432 (91.7%) prescriptions were written using generic names. Conclusion The use of antibiotic was high, with good adherence to essential medicines and generic prescribing. Strengthening antimicrobial stewardship and evidence-based practices can further optimize prescribing, enhance patient safety and help combat antimicrobial resistance effectively. KEY WORDS Antibiotic, Nepal, Point prevalence survey, Tertiary care hospital