Browsing by Author "Sharma, Manisha"
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Publication Speciation and Fluconazole Susceptibility of Candida Isolates from Clinical Samples in a Tertiary Hospital in Nepal(Institute of Medicine, Tribhuvan University, 2024) Sapkota, Jyotshna; Aryal, Kiran; Adhikari, Ram Prasad; Khadka, Sushila; Pandey, Ritu; Khanal, Laxmi Kant; Shrestha, Deepti; Sharma, ManishaAbstract: Introduction Candida species, commonly present as human commensals, are notable opportunistic pathogens responsible for superficial and invasive infections, particularly in hospitalized patients. This study aimed to characterize the distribution and antifungal susceptibility patterns of Candida species isolated from various clinical specimens at a tertiary care hospital in Nepal. Methods A descriptive cross-sectional, laboratory-based study was conducted in the Clinical Microbiology Laboratory of Nepal Medical College Teaching Hospital between July 2023 and June 2024. Clinical specimens yielding Candida species over the one-year period were included. Growth on Sabouraud dextrose agar was analyzed for colony morphology, Gram staining, germ tube production, and urea hydrolysis. Speciation of Candida isolates was performed using CHROMagar. Additionally, fluconazole susceptibility testing was conducted following Clinical and Laboratory Standards Institute guidelines. Results A total of 72 Candida isolates were identified from samples such as sputum, urine, and high vaginal swabs. Candida albicans was the most prevalent species 45 (62.5%), followed by non-albicans Candida (NAC) species, including C. glabrata 14 (19.4%), 9 C. tropicalis (12.5%), and 4 C. parapsilosis (5.6%). Fluconazole resistance was observed in 22.2% of total isolates of Candida, with C. glabrata exhibiting the highest resistance 12, (86%), whereas 4 (9%) of C. albicans demonstrated resistance to it. Conclusion The findings highlight a shift in epidemiology toward NAC species and raise concerns about rising fluconazole resistance. These results underscore the need for routine species identification and antifungal susceptibility testing to guide effective management strategies. The study advocates for antifungal stewardship programs and ongoing surveillance to address emerging resistance trends in Candida infections.Publication Vitamin D Deficiency among Blood Transfusion-Dependent Beta Thalassemia Children Admitted to Tertiary Level Pediatric Hospital in Nepal: A Descriptive Cross-Sectional Study(Nepal Medical Association, 2024) Shrestha,Anil Kumar; Sherpa, Sangay Chultim; Gyawali, Bindu; Sharma, Manisha; Adhikari, Santosh; Shrestha, Suchitra; Bhattarai, Susan; Thapa, Sagar; Sharma, Devashish; Paudel, Prajwal; Gyawali, SushilAbstract Introduction: Children with beta thalassemia are on regular blood transfusions, which could result in iron deposition in the liver causing decreased synthesis of Vitamin D-25OH. There are limited publications on the association of Vitamin D deficiency with blood transfusion-dependent thalassemia in the Nepalese population. This study aims to determine the prevalence of Vitamin D deficiency among blood transfusion-dependent beta-thalassemia patients. Methods: This was a descriptive cross-sectional study conducted among beta-thalassemia major patients under 15 years of age, receiving regular blood transfusion, from July 17, 2022, to July 16, 2023, after attaining ethical approval from Ethical Review Committee, (reference number 155). Data were collected using convenience sampling, and descriptive analyses were performed using Microsoft Excel and Statistical Package for Social Sciences (SPSS) 2024. Results: A total of 127 blood transfusion-dependent beta-thalassemia major patients were included in the study, of whom 82 (64.56%) were female. Among these patients, 104 (81.88%) were aged between 5 and 14 year. Among 127, 41 (32.28%) had Vitamin D insufficiency, and 31 (24.40%) had Vitamin D deficiency. There were 12 (9.44%) underweight children. Conclusions: Vitamin D deficiency was seen in more than half of the children with blood transfusion dependent beta thalassemia major.