Browsing by Author "Sharma, Damodar"
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Publication Antimicrobial Resistance among Older Patients Attending Rapti Academy of Health Sciences: A Retrospective Study(Rapti Academy of Health Sciences (RAHS), 2025) Kandel, Ramesh; Pokhrel, Subrata; Sharma, DamodarAbstract: Introduction: Antimicrobial resistance (AMR) is an escalating global health concern, particularly in developing countries like Nepal. Older adults are disproportionately affected due to immunosenescence, frequent hospital admissions, and repeated antibiotic exposure. However, limited region-specific data exist on AMR patterns among older adults in Nepal. This study aims to evaluate the microbiological profile and antibiotic resistance patterns, including the prevalence of multidrug-resistant organisms (MDROs), in individuals aged 60 years and above in a tertiary care center in Lumbini Province. Methods: A retrospective descriptive analysis was conducted on 495 clinical culture samples obtained from patients aged ≥60 years over a one-year period. Data were retrieved from microbiology records and analyzed using SPSS version 16. Descriptive statistics were used to determine organism prevalence, sample sources, and resistance patterns. MDROs were defined as resistance to at least one antimicrobial in three or more drug classes. Results: The mean age of patients was 71.8 years(SD±8.0), with females comprising 77% of the sample. Urine was the most common specimen (94.3%). Escherichia coli(59.6%) was the predominant isolate, followed by Klebsiella spp.(8.9%) and Acinetobacter spp.(5.9%). MDROs accounted for 62% of isolates. E. coli and Klebsiella exhibited high resistance to penicillins(85–92%) and cephalosporins(70–77%). Acinetobacter demonstrated extensive resistance across multiple antibiotic classes. Conclusion: This study reveals a high burden of MDROs among older adults, highlighting the urgent need for targeted antimicrobial stewardship, infection control, and development of localized treatment protocols to combat AMR in this vulnerable population.Publication Prevalence of Pulmonary Tuberculosis in HIV-Infected Individuals(Nepal Health Research Council, 2026) Pokhrel, Shisir; Regmi, Sanjib Mani; Ghimire, Kripa; Paudel, Samjhana; Paudel, Aarjawee; Timilsina, Sanjog; Shrestha, Nirmala; Paudel, Amrita; Pokhrel, Bedana; Sharma, Damodar; Koirala, Bidhya; Bhattarai, Sudip; Joshi, Pratikshya; Bhatta, RoshanAbstract: Background: Tuberculosis (TB) is a significant cause of mortality among people living with HIV (PLWH), in Nepal. HIV increases the risk of progression from latent to active TB, increasing mortality. Despite established TB control programs, there is a significant lack of recent data measuring the tuberculosis burden among PLWH specially within the Western region of Nepal. This study was conducted to assess the prevalence of pulmonary tuberculosis among HIV-positive patients attending a tertiary care centre in Gandaki Province, Nepal. Methods: A hospital-based cross-sectional study was conducted at Western Regional Hospital, Pokhara Academy of Health Sciences, from August 2025 to January 2026. First, HIV-positive patients attending the ART clinic were screened, and those aged ?18 years without prior tuberculosis were included. Next, participants were recruited using convenience sampling. After obtaining informed consent, sociodemographic and clinical data were collected through a structured questionnaire and medical record review. Subsequently, CD4 counts were measured using the PIMA CD4 analyser, and sputum samples were examined using Ziehl–Neelsen staining for acid-fast bacilli. Finally, data were analysed using SPSS version 22, with p < 0.05 considered statistically significant. Results: Prevalence of pulmonary TB was found to be 5.1% among 137 participants. TB co-infection was found to be higher among males and in the 20-29 years and >70 years age groups. TB was more common among those with CD4 counts <200 cells/µL, but was not statistically significant. Conclusions: The study found a 5.1% prevalence of pulmonary TB among PLWH in western Nepal and highlights the need for regular TB screening. Keywords: CD4 count; pulmonary tuberculosis Nepal; TB–HIV co-infection.