Browsing by Author "Shrestha, Deepti"
Now showing 1 - 8 of 8
Results Per Page
Sort Options
Publication Antimicrobial Susceptibility Pattern of Acinetobacter calcoaceticus-Acinetobacter baumannii Complex Isolated from Sputum in a Tertiary Care Hospital(Institute of Medicine, 2019) Sapkota, Jyotshna; Sharma, Manisha; Shrestha, Deepti; Jha, BeenaABSTRACT Introduction Acinetobacter calcoaceticus-Acinetobacter baumanni (ACB) complex is one of the commonest cause of hospital acquired and ventilator associated pneumonia. Multidrug resistant Acinetobacter species have become a matter of huge concern. This study was done to find out the antibiotic susceptibility pattern of Acinetobacter calcoaceticus-Acinetobacter baumanii complex from sputum samples. Methods This descriptive cross-sectional study was carried out in Clinical Microbiology laboratory from July 2018 to Jan 2019 after ethical approval. Acinetobacter calcoaceticus-Acinetobacter baumannii complex was identified on the basis of its microscopy and morphological characteristics followed by biochemical tests. Antibiotic sensitivity test of isolated pathogens was done using Muller Hinton Agar by Kirby-Bauer method. Results Of the 384 culture positive sputum specimen, 76 (19.80%) were Acinetobacter calcoaceticus-Acinetobacter baumannii complex. Most of the isolates were resistant to commonly used antibiotics, 72.36% of the isolates were multidrug resistance and 3.95% isolates were resistant to tigecycline. Conclusion This study provides valuable information regarding prevalence of Acinetobacter calcoaceticus-Acinetobacter baumannii complex from sputum specimen. The alarming number of Multidrug resistance isolates is worrisome finding. Antibiotics like Tigecycline and Colistin which is still sensitive to isolates should be cautiously used only in MDR cases. Keywords: Acinetobacter, ACB complex, antibiotic resistance, MDR, NepalPublication Comparative Study on Effectiveness and Safety of Atorvastatin with Rosuvastatin in Hyperlipidemic Patients at a Tertiary Care Hospital in Nepal(Institute of Medicine, 2020) Raut, Binod; Paudel, Nimesh; Shrestha, Deepti; Bhosekar, AnantABSTRACT Introduction: Hyperlipidemia is one of the most contributing factors to coronary heart diseases. Statins have become standard medicine in clinical practice to reduce total cholesterol, low density lipoprotein and to increase high density lipoprotein cholesterol. This study is conducted to compare the effectiveness and safety of atorvastatin with rosuvastatin in hyperlipidemic patients. Methods: This is a prospective observational study involving 150 patients conducted in the Department of Internal Medicine of Kathmandu Medical College and Teaching Hospital from July 2019 to March 2020. Patients newly diagnosed with hyperlipidemia were enrolled. Patients that were prescribed with 10 mg of atorvastatin and 5 mg of rosuvastatin by the treating physician once daily for 6 weeks were divided into two groups. Data was recorded in the customized proforma and the SPSS package version 20 was used for analysis. Results: Patients that were prescribed with atorvastatin were put in group I and those prescribed with rosuvastatin were included in group II with 75 participants in each group. The mean age of the patients were 50.56± 10.08 years in group I and 52.45±10.20 years in group II with male to female ratio of 3:1. The mean BMI of group I was 25.36±1.74 and that of group II was 26.48±2.21 before therapy. There was a significant main effect of duration (F1,74=401.02, p<0.001) on the TG and TC levels (F1,74=1134.23, p<0.001) as well as (F1,74=614.99, p<0.001) on the LDL and HDL levels (F1,74=146.38, p<0.001). Conclusion: Rosuvastatin was significantly more effective than atorvastatin in reducing levels of TG, TC and LDL-C. Rosuvastatin also significantly increased the level of HDL. Keywords: Atorvastatin, hyperlipidemia, rosuvastatinPublication Knowledge Regarding Antibiotic Use, its Resistance and Consequences among Higher Secondary Students in Private Schools of Kathmandu Valley(Institute of Medicine, 2019) Deo, Satish K; Gautam, Naveen; Gyawali, Siddinath; Shrestha, Deepti; Yadav, ShikhaABSTRACT Introduction The lack of awareness on the appropriate use of antibiotics, its dose and duration is one of the leading causes of global antimicrobial resistance (AMR). AMR poses a growing threat to public health, as infections from resistant strains of microbes become increasingly difficult to treat, resulting in prolonged illness and greater risk of death. Hence, this study would be an important reference for determining the scope of the problem which will be essential for formulating and monitoring an effective response to antibiotic use and its problem of resistance. Methods A descriptive cross-sectional study was done among higher secondary level students from selected schools in Kathmandu valley. Baseline data was collected after a tutorial session through semi-structured questionnaires which was based on past researches and verified using expert consultation. Ethical consideration was maintained throughout the study. Descriptive statistics was used to find out the KAP level including knowledge score and attitude-practice score of the selected population. Results Among 465 participants conducted in our research, the overall average knowledge score of the participants was found to be 73.3% while the attitude-practice score was 60.53%. It was found that 80.86% of the participants had heard the term “antibiotic resistance”. The knowledge score percentage among the students of grade 10 and 11 had no significant difference (p value= 0.592). Conclusion Our study concludes that if topics like antibiotics and their judicial use is well covered in school curriculum, it can produce measurable change in knowledge, attitude and practice level of the students. Keywords: Attitude, antibiotics, antimicrobial resistance, knowledge, practicePublication Prescribing Pattern of Antibiotics among Hospitalized Patients with Urinary Tract Infection(Nepal Health Research Council, 2022) Shrestha, Deepti; Sapkota, Jyotshna; Poudel, Rekha; Gurung, Rashmi Shakya; Aryal, KiranAbstract Background: Urinary tract infection is one of the most common bacterial infections worldwide. It has become one of the most common cause for the hospitalization and sepsis. It is generally treated with antimicrobial agents and fluids. This study was conducted to study the prescribing pattern of antibiotic among hospitalized patients with urinary tract infection. Methods: A descriptive cross-sectional study was conducted in Nepal Medical College Teaching Hospital, Attarkhel, Kathmandu from January 2022 to April 2022. Patients aged 18 years or above of both sex, admitted to various departments with the provisional diagnosis of urinary tract infection prescribed with antibiotics were included in the study. Results: Out of 146 patients admitted with a diagnosis of urinary tract infection, the most commonly prescribed antibiotics during hospital stay were cephalosporin in 102 (69.9%) patients followed by combination of penicillin and beta-lactamase inhibitors (31, 21.2%) and fluoroquinolones (15, 10.3%). Ceftriaxone (78, 53.4%) alone was the most commonly prescribed antibiotic as empirical therapy followed by combination of piperacillin and tazobactam (22, 15.1%). One hundred and forty four (78.6%) patients were prescribed antibiotics from the watch group followed by the access group (21, 11.5 %). E. coli was the most common organism isolated in 29 (76.3%) patients. Conclusions: Cephalosporin was the commonest antibiotic group prescribed in hospitalized patients among which ceftriaxone was commonly prescribed as an empirical therapy. Among AWaRe classification, antibiotics from the watch group were commonly prescribed. Keywords: Antibiotics; ceftriaxone; urinary tract infectionPublication Profile and Antibiotic Susceptibility Pattern of Bacterial Isolates from Mobile Phones of Healthcare Workers in a Tertiary Care Centre of Nepal(Institute of Medicine, 2020) Sapkota, Jyotshna; Jha, Beena; Mishra, Bhavesh; Shrestha, Deepti; Barakoti, Achut; Sharma, ManishaABSTRACT Introduction: Nosocomial infection is a serious problem worldwide. Healthcare workers mobile phones may act as vehicle for nosocomial infections. Mobile phones are rarely cleaned and healthcare workers frequently use them thorough out their time in hospitals. The objective of this study is to determine the rate of contamination of mobile phones, prevalent microorganisms and their antibiotic sensitivity pattern. Methods: The descriptive cross-sectional study was carried out in Clinical Microbiology laboratory from July 2019 to September 2019 after ethical approval. Samples were collected aseptically by rolling sterile swabs over the exposed surfaces of the mobile phones and inoculated on the agar plates and incubated aerobically. After incubation, plates were examined for growth. Bacteria were identified by standard microbiological procedure and antibiotic sensitivity test of isolated pathogens was done using Muller Hinton Agar by Kirby-Bauer method. Statistical analysis was done by Excel 2018. Results: Of the 198 mobile phones sample cultures, 112 (56.6%) samples showed 7 different types of bacteria. Mixed growth was observed in 3 mobile phones and total of 115 bacterial isolates were identified. Staphylococcusspecies (74.7%) were predominant organism followed by Acinetobacter spp, Klebsiella pneumoniae, E. coli, Citrobacter and Pseudomonas aeruginosa. Total 37.5% of Staphylococcus aureus were methicillin-resistant Staphylococcus aureus (MRSA). Conclusion: Mobile phones may have potential pathogenic microorganisms on their surface and can act as vector in spread of infectious agents in hospital settings. It is recommended to disinfect mobile phones regularly and to implement hand washing practices and regulations around the use of mobile phones in hospital settings. Keywords: Acinetobacter species, mobile phones, MRSA, nosocomial infections, Staphylococcus speciesPublication 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 Topical Corticosteroids Utilisation and Cost Variation in Dermatology Outpatient of a Tertiary Hospital in Kathmandu(Institute of Medicine, 2021) Shrestha, Deepti; Joshi, Smita; Gurung, Rashmi Shakya; Poudel, Rekha; Upreti, Anup RABSTRACT Introduction: Topical corticosteroids (TCs) are one of the important drugs prescribed in skin diseases. Cost is an important factor for compliance to treatment. Cost analysis provides the variation of costs which helps in economic benefit in the use of drugs. Thus the aim of the study was to assess the TC utilisation in Dermatology department and study its cost variation. Methods: A descriptive cross-sectional study was conducted in the out-patient of Department of Dermatology, Nepal Medical College Teaching Hospital. Patient demographic, disease, name of topical steroid, vehicle, strength, single or combination, cost of the different brands of TCs were analysed. Results: Out of 216 patients, 109 (50.5%) were females and 67 (31%) were of 21-30 years age group . Dermatitis was the most common skin condition encountered (106, 49.1%). Most common TC prescribed as single therapy was mometasone furoate 0.1%, (51, 23.6%) and betamethasone valerate 0.1% with fusidic acid, (48, 22.2%) as combination therapy. Mometasone furoate 0.1% cream, (15 gm) showed the maximum cost variation (94.7%) in single drug product while clobetasol propionate 0.05% with salicylic acid ointment (20 gm) showed the maximum cost variation (95.55%) in a combination product. Conclusion: The commonest indication of TCs use in Dermatology outpatient during our study was dermatitis, with commonest TCs prescribed being mometasone furoate. Cream was the most favoured vehicle. Cost variation was as high as 95% . Reduction in this cost variation would ease the financial burden on patients which will help in improving the patient compliance in a resource limited population. Keywords: Cost analysis, cost variation, dermatology, topical corticosteroidsPublication Trend of Antihypertensive Use and Blood Pressure Control Among Hypertensive Patients in a Tertiary Care Hospital of Kathmandu(Institute of Medicine, 2022) Shrestha, Deepti; Shrestha, Shirish L; Poudel, Rekha; Gurung, Rashmi Shakya; Yadav, Radhay Shyam; Shrestha, Lava35ABSTRACT Introduction: Hypertension is a global burden and prevalence of hypertension increases with age. Various antihypertensive drugs are available for the management of hypertension. The aim of this study is to assess the trend of antihypertensive drugs used and blood pressure (BP) control among patients with hypertension. Methods: A cross sectional study was conducted among patients with hypertension prescribed with antihypertensive drugs in Department of Medicine, Nepal Medical College Teaching Hospital. Antihypertensive drugs, number of antihypertensive drugs prescribed in each individual and BP were analyzed. Results: Out of 218 patients, 61.5% were female and 38.5% were male. Common age group range from 51-60 years in 28.4% of patients. Diabetes mellitus (23.4%) was the most common comorbid condition. Dual therapy (47.6%) followed by monotherapy (45.9%) was the most common therapy prescribed for patients with hypertension. Most commonly prescribed antihypertensive as monotherapy was Calcium Channel Blockers (CCBs), 29.4% and in dual therapy, CCBs and Angiotensin Receptor Blockers (ARBs), 38.6% were the most commonly prescribed medications. Fixed dose combination of antihypertensive drugs were prescribed in 81.4% patients receiving multiple therapy. Good BP control was observed in 61.2% of patients with hypertension. Conclusion: Dual therapy followed by monotherapy was the most common therapy prescribed for the management of hypertension. Calcium channel blockers as monotherapy and CCBs and ARBs as combination therapy were the most common antihypertensive drugs prescribed for hypertension. More than half the patients had controlled BP. A therapeutic audit with more parameters of analysis to provide regular feedback to researchers and prescribers may encourage rational prescribing in hypertension. Keywords: Antihypertensives, blood pressure, hypertension