Browsing by Author "Shrestha, Rajeev"
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Publication Diagnostic Accuracy of Artificial Intelligence-Based Chest X-Ray reading for screening of Tuberculosis(Nepal Health Research Council, 2024) Shrestha, Ruby Maka; Paudel, Ram Chandra; Adhikari, Puspanjali; Ghimire, Ram Hari; Gurung, Karma; Shrestha, RajeevBackground: Tuberculosis remains a public health challenge in Nepal and ranks as the seventh leading cause of death in the country. The END Tuberculosis strategy stresses - the screening for symptoms alone may not suffice; additional screening tools such as a chest radiograph may facilitate referral for diagnosis of tuberculosis. The study aims to evaluate the diagnostic accuracy of artificial intelligence (AI) based Chest X-ray and compare it with the human reading (radiologist), using GeneXpert-MTB RIF Assay for tuberculosis case detection. Methods: Tuberculosis-suspected patients with a history of cough were screened using chest X-rays at two study sites (Dhulikhel Hospital and Nobel Medical College). The reading of AI qXR software was compared with radiologists reading who were blinded of the results generated by the software. Results: The sensitivity of the test by qXR-based AI reading was 100%, (95% CI: 40 – 100%) and specificity 80% (95% CI: 73 – 87%), whereas the sensitivity of the test by the radiologist was 100%, (95% CI: 40 – 100%); and specificity 62% (95% CI: 53 – 70%). Conclusions: Higher sensitivity and specificity were observed for both qXR-based AI and Radiographer readings for the diagnosis of TB. Keywords: Artificial Intelligence; chest X-ray; diagnostic accuracy; screening; tuberculosis.Publication Genomic analysis of SARS-CoV-2 Circulating during Second and Third Wave of COVID-19 in Nepal(Nepal Health Research Council, 2023) Tamrakar, Dipesh; Katuwal, Nishan; Adhikari, Navin; Madhup, Surendra Kumar; Dhimal, Meghnath; Shrestha, RajeevAbstract Background: In Nepal, since the first detection of COVID-19 case in January 2020, the total cases have rose to almost a million with more than 12,000 deaths. Till now, WHO has classified 5 variants of SARS-Cov2 as variant of concerns at different time points causing many waves in different countries and regions at different time points. Nepal had also faced three distinct waves of COVID-19 caused by different variant of COVID 19. The objective of this study was to perform whole-genome sequencing of SARS-CoV-2 circulating in different waves of COVID-19 in Nepal and investigate its variant or lineage. Methods: In this study, samples from 49 SARS-CoV-2 infected subjects from May 2021 to January 2022, were investigated. The methodology followed RNA extraction, real-time PCR for confirmation and whole-genome sequencing. The consensus genomes were interpreted with appropriate bioinformatics tools and databases. Results: Sequence analysis of 49 genomes revealed to be of Delta (n=27) and Omicron Variant (n=22). The mutations in the consensus genomes contained the defining mutations of the respective lineages/variants. There were 20 genomes of Omicron sub-lineage BA.2, 1 of BA.1.1 and 1 of B.1.1.529. Conclusions: This study provides concise genomic evidence of presence of Delta and Omicron variant of COVID-19 in Nepal. Delta and Omicron variants were driving the second wave and the third wave of COVID-19 respectively in Nepal. Therefore, the genomic surveillance must be increased to clearly map out the pandemic and strategize vaccination approaches in the country. Keywords: COVID-19; delta, omicron; Nepal;SARS-CoV-2; whole-genome sequencing