Browsing by Author "Sharma, Supriya"
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Publication Incidental Finding of Dextrocardia with Situs Inversus and Absent Left Kidney: A Case Report(Nepal Medical Association, 2022) Karki, Sital; Khadka, Nasatya; Kashyap, Basant; Sharma, Supriya; Rijal, Samita; Basnet, ArchanaAbstract: Dextrocardia is an unusual inherent positioning of the heart: during fetal life, the heart is flipped to the right side rather than the usual left side. Situs inversus is a rare congenital ailment in which the main internal organs are rearranged or reflected from their natural positions, and when both conditions are present, it is called situs inversus totalis. The majority of the people with situs inversus totalis are unaware of the situation they have because most of them are asymptomatic. It is usually discovered incidentally when they consult the doctor for an unrelated condition. We are reporting a case of a 55-year-old woman who was found to have a situs inversus totalis with an absent left kidney.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; Banjara, Megha Raj; 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