Browsing by Author "Shrestha, Sabina"
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Publication Post-Transplant Fecal Carriage of Antibiotic Resistant and ?-Lactamases-Producing Enterobacteriales among Renal Transplant Recipients(Nepal Health Research Council, 2023) Joshi, Bindira; Yadav, Santosh Kumar; Hada, Manju Shree Shakya; Shrestha, Sabina; Shrestha, Kalpana Kumari; Shrestha, Pukar Chandra; Awal, Bal KrishnaAbstract Background: The intestinal colonization and transmission of antibiotic-resistant Enterobacteriales to renal transplant recipients may pose a threat to them because they are profoundly immunocompromised and vulnerable to infection. Hence, it is crucial to identify these antibiotic-resistant fecal Enterobacteriales harboring high-risk populations. The objective of this study was to determine antibiotic resistance as well as ?-lactamases production in fecal Enterobacteriales among renal transplant recipients. Methods: The stool samples, one collected from each transplant recipient, were processed for isolation and identification of Enterobacteriales and were tested for their antibiotic susceptibility, extended-spectrum ?-lactamase, and metallo-?-lactamase production by standard methods. Results: A total of 103 Enterobacteriales comprising of Escherichia coli (86.4%), Klebsiella species (11.7%), and Citrobacter species (1.9%) were isolated and more than 60% of the E. coli were found resistant to ceftazidime and ciprofloxacin and around half of the Klebsiella species were resistant to ceftazidime and fluroquinolones. The extended-spectrum ?-lactamase production was seen in 3.4% and 8.3% and metallo-?-lactamase production in 24.7% and 33.3% of E. coli and Klebsiella species, respectively. The high proportion of ?-lactamase-producers were resistant to piperacillin-tazobactam, meropenem, gentamicin, and amikacin than ?-lactamases non-producers. Conclusion: Since the antibiotic resistance is higher in fecal Enterobacteriales, each renal transplant recipient should be screened for these highly resistant intestinal colonizers after transplantation in order to prevent infections and to reduce the rate of transplant failure due to infections. Keywords: Antibiotic resistance; ?-lactamases; enterobacteriales; fecal carriage; renal transplantation. Author Biographies Bindira Joshi, Department of Pathology, Shahid Dharmabhakta National Transplant Centre, Bhaktapur, Nepal Santosh Kumar Yadav, Province Public Health Laboratory, Madhesh Province, Janakpurdham, NepalPublication Visual Functions in Patients with Optic Neuritis Pre and Post Treatment: An Observational Study(Nepal Medical Association, 2025) Malla, Shailiya; Shrestha, SabinaAbstract Introduction: Optic neuritis is an inflammatory condition affecting the optic nerve. It presents with sudden diminution of vision, also affecting colour vision, contrast sensitivity and stereoacuity. Steroids are given in optic neuritis to reduce inflammation of optic nerve. The aim of this study was to compare the visual functions in patients with optic neuritis before and after treatment with steroid therapy. Methods: This prospective study was conducted from November 2021 to October 2022 in the Department of Ophthalmology of a tertiary-level hospital. Thirty-seven eyes affected by optic neuritis of were included in the study. All the patients were given IV methylprednisolone for 3 consecutive days followed by oral prednisolone for 11 days in tapering doses. Visual functions such as visual acuity, colour vision, contrast sensitivity and stereoacuity at presentation and after treatment were compared. Results: Among 37 eyes, 24 (64.86%) had best corrected visual acuity <1/60-perception of light at presentation, improving after six weeks with 21 (56.76%) achieving visual acuity 6/6-6/18. At presentation, only 1 (2.71%) had normal colour vision while at six weeks, 9 (24.32%) had normal colour vision. Contrast sensitivity could not be assessed in 29 (78.37%) cases at presentation due to poor vision, which reduced to 12 (32.43%) at six weeks. None had good stereoacuity at presentation; however, 6 (16.22%) had good stereoacuity after six weeks. Conclusions: The study showed that steroid therapy improved visual functions in patients with optic neuritis.