Browsing by Author "Tamang, Basanta"
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Publication Antibiotic Susceptibility and Biofilm Production among Coagulase Negative Staphylococci Isolated from Clinical Samples at Tertiary Care Hospital(Nepal Health Research Council, 2023) Shah, Pradeep Kumar; Bhandari, Niru; Tamang, Basanta; Joshi, Rajendra DAbstract Background: Coagulase Negative Staphylococci have been widely associated with medical device implant treatment and immune-compromised patients. Despite having increasing interest in Coagulase Negative Staphylococci, few studies from Nepal have reported the association of these organisms with urinary tract infections, conjunctivitis, high vaginal swabs, and cerebrospinal fluid. This study was carried out to determine antibiotic susceptibility pattern and biofilm production among Coagulase Negative Staphylococci isolated from clinical samples at tertiary care hospital. Methods: This study was a hospital based cross-sectional study in which 3690 clinical samples were included. Isolation and identification of isolates was done following standard microbiological protocol. Coagulase Negative Staphylococci were identified phenotypically on the basis of gram staining, slide and tube coagulase test and by various sugar fermentation tests. Antibiotic susceptibility test was done following Kirby Bauer disk diffusion method (Clinical and Laboratory Standards Institute 2020). Biofilm production was determined by Tissue Culture Plate technique. Results: A total of 113 isolates of Coagulase Negative Staphylococci were detected. Among them S. epidermidis (45.1%), S. saprophyticus (23.9%), S. haemolyticus (16.8%), S. hominis (5.3%), S. capitis (2.7%), S. cohini (1.8%), S. lugdunensis (1.8%) and S. sciuri (2.7%) were identified phenotypically. All isolates were found to be resistant against Ampicillin and 111 (98.2%) were sensitive against Linezolid.23.9% of CoNS were strong biofilm producers, 19.5% moderate and 56.6 % were non/weak biofilm producers. Conclusions: It requires susceptibility test for prescribing antibiotics against Coagulase Negative Staphylococci in hospital and the misuse of antibiotics should be prevented. Keywords: Clinical samples, CoNS, antibiotic susceptibility, biofilmPublication Co-infection of Uropathogenic Escherichia coli among COVID-19 Patients Admitted to a Tertiary Care Centre: A Descriptive Cross-sectional Study(Nepal Medical Association, 2022) Basnet, Ajaya; Chand, Arun Bahadur; Shrestha, Lok Bahadur; Pokhrel, Nayanum; Karki, Lochan; Shrestha, Sailendra Kumar Duwal; Tamang, Basanta; Shrestha, Mahendra Raj; Dulal, Maina; Rai, Junu RichhinbungAbstract: Introduction: Simultaneous infection of antibiotic-resistant uropathogens in patients with COVID-19 has necessitated the revision of the prescription of broad-spectrum antibiotics on the grounds of evidence-based studies and antimicrobial stewardship principles. The objective of this study was to find out the prevalence of uropathogenic Escherichia coli co-infection among hospital-admitted COVID-19 patients of a tertiary care centre. Methods: This descriptive cross-sectional study was conducted in urinary tract infection suspected COVID-19 patients admitted to a tertiary care hospital, from 25th June to 24th December 2021 after ethical clearance from the Institutional Review Committee with registration number 207707860. Convenience sampling was used. Serum procalcitonin levels were also measured. Data analysis was performed using the Statistical Package for the Social Sciences software version 17.0. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data, and mean and standard deviation for continuous data. Results: Among the 49 hospital-admitted COVID-19 patients, 3 (6.12%) (0.59-12.83 at 95% Confidence Interval) were co-infected with uropathogenic Escherichia coli. Absolute non-susceptibility of Escherichia coli to antibiotics such as ceftriaxone, cotrimoxazole, nalidixic acid, gentamicin, and ampicillin was observed. All isolates were multidrug-resistant. All co-infected patients were female and had a median age of 35 years. Mean±SD value for procalcitonin in patients with co-infection (6.13±7.88 ng/ml) was six times higher than for the patients without co-infection (0.95±1.11 ng/ml). Conclusions: Escherichia coli co-infection in hospitalised COVID-19 patients was less frequent as compared to published literature. The serum procalcitonin value in patients with co-infection was substantially higher than that of patients without co-infection.Publication Dengue among Patients Visiting Department of Medicine in a Secondary Care Centre: A Descriptive Cross-sectional Study(Nepal Medical Association, 2023) Tamang, Basanta; Basnet, Ajaya; Khadka, Sudip; Joshi, Pramod; Jha, Roshan Kumar; Joshi, Rijuta; Rai, Shiba KumarAbstract Introduction: Dengue, caused by the dengue virus, has a wide range of clinical features, including fever, body ache, lethargy, nausea, and vomiting. Blood-based biomarkers in patients with dengue virus infection reflect a variety of clinical spectrums, from bleeding manifestations to liver abnormalities, and can serve as an essential tool for clinicians. This study aimed to determine the prevalence of dengue among patients visiting the Outpatient Department in a secondary care centre. Methods: A descriptive cross-sectional study was conducted among patients visiting the Outpatient Department from 16 May 2022 to 15 November 2022. Ethical approval was obtained from the Institutional Review Committee (Reference number: 20790202). The socio-demographic details and biochemical and haematological findings of dengue virus-infected patients diagnosed with rapid diagnostic tests were collected. Convenience sampling was done. Point estimate and 95% Confidence Interval were calculated. Results: Out of 706 individuals, the prevalence of dengue was 83 (11.76%) (9.38-14.14, 95% Confidence Interval). The median age of dengue virus-infected patients was 40 years, and the majority were males 54 (65.06%). Conclusions: The prevalence of dengue was found to be lower than in other studies done in similar settings.Publication Role of Tocilizumab in the Treatment of COVID-19 Patients with Cytokine Storm: A Case Series(Nepal Medical Association, 2022) Basnet, Ajaya; Shrestha, Mahendra Raj; Thapa, Rossu; Tamang, Basanta; Shrestha, Apurba; Rawal, Prabhat; Shrestha, Sailendra Kumar Duwal; Karki, Lochan; Rai, Shiba KumarAbstract The in-hospital mortality in patients with COVID-19 could be correlated with severe acute respiratory syndrome coronavirus-2 induced hyper-inflammation, which is attributed to an unconstrained inflammatory cytokine storm. The pro-inflammatory cytokine, specifically, interleukin-6 plays a prominent role in the cytokine storm and may result in alveolar-capillary blood-gas exchange dysfunction. Therefore, the method to block the signal transduction pathway of interleukin-6 could be a potential treatment for severe COVID-19 patients. In this case series of three patients with severe COVID-19, we focus on the rationale for utilization of tocilizumab, an anti-interleukin-6 receptor antibody, which could block the signal transduction pathway of interleukin-6. The observations from this study allowed us to hypothesize that the infusions of tocilizumab may not reduce the elevated level of interleukin-6, and hence may not be a significant therapeutic for reducing in-hospital mortality associated with COVID-19. Additionally, it could also be speculated that interleukin-6 may not be a potentially actionable target cytokine to treat COVID-19-associated cytokine storms.Publication Stress Fractures among Paramilitary Trainee Visiting a Paramilitary Hospital of Nepal: A Descriptive Cross-sectional Study Authors(Nepal Medical Association, 2022) Shrestha, Sailendra Kumar Duwal; Basnet, Ajaya; Karki, Netra Bahadur; Nepal, Prabin; Karki, Umash; KC, Samir; Shrestha, Kumar; Tamang, Basanta; Shrestha, Mahendra RajAbstract: Introduction: Young paramilitary recruits, who undergo strenuous exercise during basic training, are often presented with stress fractures, which could be due to an inadequate vitamin D (25-hydroxyvitamin D) intake. This study aimed to find the prevalence of stress fracture among young paramilitary trainees visiting the orthopedic outpatient department of a paramilitary hospital. Methods: This was a descriptive cross-sectional study done among paramilitary trainees in a paramilitary Hospital of Nepal between April 2019 to April 2021. The study was approved by the Ethical Review Board (Reference number: 1003) of the Nepal Health Research Council. Convenience sampling was used. Anthropometric variables, serum 25-hydroxyvitamin D level, and bone mineral density of spine and hip were determined. Data analysis was performed using the Statistical Package for the Social Sciences software version 17.0. Point estimate at 95% Confidence Interval was calculated along with frequency, proportion for binary data and mean, standard deviation for continuous data. Results: Among 417 young paramilitary trainees, 24 (5.76%) (3.52-7.99 at 95% Confidence Interval) were found to have a stress fracture. The stress fracture patients had a serum 25-hydroxyvitamin D level of 21.47ng/mL±6.98. Similarly, the bone mineral density value of the spine and hip among the patients was -1.34g/cm2±1.37 and 0.36g/cm2±1.24, respectively. Conclusions: The prevalence of stress fracture among young paramilitary trainee was high compared to previous studies. Additionally, average Vitamin D and the bone mineral density value of the spine and the total hip among stressed fractured patients were also low.