Prakash Ghimire - Profile on Academia.edu (original) (raw)

Papers by Prakash Ghimire

IntroductionThe COVID-19 pandemic was a major public health threat and posed tremendous pressure ... more IntroductionThe COVID-19 pandemic was a major public health threat and posed tremendous pressure to develop a cure for it. Apart from ongoing efforts in developing vaccines, a lot of empirical treatments were recommended, that may have expedited the use of antimicrobials. The main objective of this study was to explore if and how the pandemic posed pressure on antimicrobials in Nepal using semi-structured interviews (SSIs) among patients, clinicians and drug dispensers.MethodsA total of 30 stakeholders (10 each among clinicians, dispensers and COVID-19 patients) were identified purposively and were approached for SSIs. Clinicians and dispensers working in three tertiary hospitals in Kathmandu were first approached and were asked for their support to reach out to COVID-19 patients who were on follow-up at their out-patient department. SSIs were audio recorded, translated and transcribed into English, and were analyzed for thematic synthesis.ResultsOver-the-counter (OTC) uses of antib...

Viruses

The largest dengue outbreak in the history of Nepal occurred in 2022, with a significant number o... more The largest dengue outbreak in the history of Nepal occurred in 2022, with a significant number of casualties. It affected all 77 districts, with the nation’s capital, Kathmandu (altitude 1300 m), being the hardest hit. However, the molecular epidemiology of this outbreak, including the dengue virus (DENV) serotype(s) responsible for this epidemic, remain unknown. Here, we report the epidemic trends, clinico-laboratory features, and virus serotypes and their viral load profiles that are associated with this outbreak in Nepal. Dengue-suspected febrile patients were investigated by routine laboratory, serological, and molecular tools, including a real-time quantitative polymerase chain reaction (qRT-PCR). Of the 538 dengue-suspected patients enrolled, 401 (74.5%) were diagnosed with dengue. Among these dengue cases, 129 (32.2%) patients who required hospital admission had significant associations with myalgia, rash, diarrhea, retro-orbital pain, bleeding, and abdominal pain. DENV-1, -...

Diseases

The global burden of tuberculosis (TB), particularly with multidrug resistance (MDR), is escalati... more The global burden of tuberculosis (TB), particularly with multidrug resistance (MDR), is escalating and has become a major health challenge. It is well known that acid-fast bacilli (AFB) smear-negative TB patients are the major source of spreading TB to healthy individuals when left untreated. Early diagnosis of TB and rapid detection of drug resistance are important for the proper management of drug-resistant TB (DR-TB). Therefore, a laboratory based cross-sectional study was conducted from July to December 2019 at the National Tuberculosis Centre, Thimi, Nepal, with the objective of evaluating the diagnostic performance of Xpert MTB/RIF assay, Mycobacterium tuberculosis (MTB) culture and line probe assay (LPA) for the detection of MDR-TB in AFB smear-negative sputum samples. We evaluated a total of 222 AFB smear-negative sputum specimens, of which 21.6% (n = 48) showed MTB positive with Xpert MTB/RIF assay and, while culturing on Lowenstein–Jensen (LJ) media, 21.2% (n = 47) were M...

Tribhuvan University Journal of Microbiology

Objective: Increasing antifungal resistance and biofilm formation among Candida species is an int... more Objective: Increasing antifungal resistance and biofilm formation among Candida species is an intimidating public health concern, especially at the hospital settings. In light of this, the current study was designed to assess the biofilm-forming ability of clinically isolated Candida albicans and determine their antifungal susceptibility against both the planktonic and sessile forms. Methods: A total of 58 Candida isolates from different clinical samples received at the Microbiology laboratory of KIST Medical College and Teaching Hospital, Lalitpur, Nepal in between April to October 2018 were included in the study. Isolation and identification of C. albicans was done following standard microbiological procedures that comprised of microscopic observations along with germ tube formation and biochemical tests. Besides qualitative investigation of biofilm by tube method, it was also investigated quantitatively by crystal violet staining method and metabolic activity of the biofilm was a...

Kathmandu University medical journal, 2017

Background Seasonal influenza is one of the increasing public health burdens in Nepal. Objective ... more Background Seasonal influenza is one of the increasing public health burdens in Nepal. Objective The objective of this study was to isolate and characterize the influenza virus type and subtypes of Nepal. Method A total of 1536 throat swab specimens were collected from January to December 2012. Total ribonucleic acid was extracted using Qiagen viral nucleic acid extraction kit and polymerase chain reaction assay was performed following the US; CDC Real-time PCR protocol. Ten percent of positive specimens were inoculated onto Madin-Darby Canine Kidney cells. Isolates were characterized by using reference ferret antisera. Result Of the total specimens (n=1536), influenza virus type A was detected in 196 (22%) cases; of which 194 (99%) were influenza A (H1N1) pdm09 and 2 (1 %) were influenza A/H3 subtype. Influenza B was detected in 684 (76.9%) cases. Influenza A (H1N1) pdm09, A/H3 and influenza B virus were antigenically similar to the recommended influenza virus vaccine candidate of ...

Journal of Nepal Medical Association, 2004

The study was conducted with the objectives to compare the Acid Fast Bacilli (AFB) staining and C... more The study was conducted with the objectives to compare the Acid Fast Bacilli (AFB) staining and Culture for the diagnosis of extra-pulmonary tuberculosis and to find out the burden of extra-pulmonary tuberculosis from the different site of the body in suspected TB patients. The standard Ziehl-Neelsen Technique was done for AFB staining and culture was done in Ogawa Medium. Of the 292 extra-pulmonary samples examined by AFB smear only 2(0.7%) were positive and of the 1058 extra-pulmonary samples cultured 20 (1.9%) were positive. The isolation rate for extra-pulmonary samples was three fold higher in culture in comparison to AFB Smear. The confirmation rate of extra-pulmonary tuberculosis was approximately 1/ 8th of the pulmonary tuberculosis by conventional bacteriological diagnostic methods. Of the extra-pulmonary tuberculosis renal, endometrial or pelvic and cold abscess were common in this study. M.tuberculosis was also isolated from peritoneal fluid, pericardial fluid, Synovial f...

BMC Research Notes, 2020

Objective Bacterial meningitis is a life threatening condition that requires prompt recognition a... more Objective Bacterial meningitis is a life threatening condition that requires prompt recognition and treatment. Currently, Gram stain is widely used for the microscopic detection of bacterial pathogens in cerebrospinal fluid (CSF). In Nepal, fluorescent microscopes have been installed in laboratories as a part of the National tuberculosis control program. However, information on the utility of the acridine orange (AO) stain for the direct detection of bacteria in CSF samples in Nepal is not available. Therefore, this study aims to compare Gram stain and AO stain for the rapid detection of bacterial pathogens in CSF of clinically suspected meningitis cases in Kathmandu, Nepal. Results Bacterial pathogens were detected in 9.30% (36/387) by either of the three tests, 9.04% (35/387) by AO stain, 8.27% (32/387) by culture and 6.46% (25/387) by Gram’s stain. Considering culture as a gold standard, the sensitivity of AO stain was higher than Gram stain. The specificity of AO stain was 98.87...

Veterinary Record Open, 2020

BackgroundIn Nepal, knowledge of proper handling, management and causes of cattle diseases is sti... more BackgroundIn Nepal, knowledge of proper handling, management and causes of cattle diseases is still limited. The main objective of this study was to explore the impact of deworming on milk production and its effect on milk qualities.MethodsA total of 200 faecal samples (100 buffaloes and 100 cows) were collected and analysed for parasitic burden. Half of the infected cattle (buffaloes, Bos bubalis; cow native, B indicus; European, B taurus) were then dewormed with Levamisole Hydrochloride-Oxyclozanide bolus, and the remaining 50 per cent were left untreated. The milk yield from both infected and dewormed cattle was recorded for 30 days and the qualities of milk were analysed.ResultsThe prevalence of parasitic infection was found to be 22.0 per cent. Fasciola hepatica was the predominant parasite (81.8 per cent), followed by Toxocara vitulorum (34.1 per cent), Strongyloidespapillosus (6.8 per cent) and Bunostomum phlebotomum (4.5 per cent). The average milk yield (litre/day/cow) sign...

Himalayan Journal of Science and Technology, 2018

The primary infection of Toxoplasma gondii, Rubella virus, Cytomegalovirus (CMV) and Herpes simpl... more The primary infection of Toxoplasma gondii, Rubella virus, Cytomegalovirus (CMV) and Herpes simplex virus (HSV) abbreviated as TORCH has remained a major problem in the women of childbearing age in Nepal. The main objective of this study was to determine the seroprevalence of TORCH infections among the women of childbearing age visiting the National Public Health laboratory (NPHL), Teku, Kathmandu. A total of 314 blood samples were collected and tested for TORCH infections by Chemiluminescent Immunoassay (CLIA). Of the total 314 patients, different patterns were observed in the requested test series. Highest number of patients (243) requested for CMV IgM test while only 195 requested for the same for Rubella. The IgM seroprevalence rates were 4.20% (9/214) for Toxoplasma gondii, 5.12% (10/195) for Rubella, 4.91% (12/244) for Cytomegalovirus and 5.56% (13/234) for Herpes Simplex virus. Significant portion of the test exhibited the equivocal result making this latest technology furthe...

Malaria Journal, 2016

Background: Malaria continues to be a major burden in the endemic regions of Kenya. Health outcom... more Background: Malaria continues to be a major burden in the endemic regions of Kenya. Health outcomes associated with case management are dependent on the use of appropriate diagnostic methods. Rapid diagnostic tests (RDTs) have provided an important tool to help implement the WHO recommended parasite-based diagnosis in regions where expert microscopy is not available. One of the questions that must be answered when implementing RDTs is whether these tests are useful in a specific endemic region, as well as the most appropriate RDT to use. Data on the sensitivity and specificity of RDT test kits is important information to help guide test selection by national malaria control programmes. Methods: This study evaluated the diagnostic performance of RDTs including First Response (FR), CareStart (CS), SD Bioline (SD), and Binax Now (BN). The performance of these malaria kits was compared to microscopy, the gold standard, for the detection of malaria parasites. The malaria RDTs were also compared to PCR which is a more sensitive reference test. Five-hundred participants were included in the study through community screening (50 %) and testing suspected malaria cases referred from health facilities. Of the 500 participants recruited, 33 % were malaria positive by microscopy while 51.2 % were positive by PCR. Compared to microscopy, the sensitivity of eight RDTs to detect malaria parasites was 90.3-94.8 %, the specificity was 73.3-79.3 %, the positive predictive value was 62.2-68.8 %, and the negative predictive value was 94.3-96.8 %. Compared to PCR, the sensitivity of the RDTs to detect malaria parasites was 71.1-75.4 %, the specificity was 80.3-84.4 %, the positive predictive value was 80.3-83.3 %, and the negative predictive value was 73.7-76.1 %. The RDTs had a moderate measure of agreement with both microscopy (>80.1 %) and PCR (>77.6 %) with a κ > 0.6. The performance of the evaluated RDTs using field samples was moderate; hence they can significantly improve the quality of malaria case management in endemic regions in Kenya by ensuring appropriate treatment of malaria positive individuals and avoiding indiscriminate use of anti-malarial drugs for parasite negative patients.

African Journal of Microbiology Research, 2016

Staphylococcus aureus (MSSA) and methicillin resistant S. aureus (MRSA) infections. So, it is utm... more Staphylococcus aureus (MSSA) and methicillin resistant S. aureus (MRSA) infections. So, it is utmost important to perform the susceptibility test for erythromycin and clindamycin. And, there is concern on use of this antibiotic in the presence of erythromycin resistance because of the possibility of induction of cross-resistance among members of macrolide, lincosamide and streptogramin B (MLS B ) group. During August 2011 to May 2012, a total of 207 isolates of S. aureus were isolated and among which 29.47% (61) isolates were confirmed as MRSA by cefoxitin (30 µg) disc. All the isolates were further processed for MLSB resistance test by double disc diffusion test of erythromycin (2 µg) and clindamycin (15 µg) at a distance of 15 and 22 mm between them. This study result show 12.56% (26) and 14.49% (30) of inducible macrolide-lincosamide-streptogramin B phenotype (iMLS B ) resistance type at 22 and 15 mm disc distance, respectively, showing 15 mm disc distance is potential than 22 mm and 17.39% (36) of cMLS B resistance type. Similarly, both iMLSB and cMLSB are greater in MRSA than MSSA and constitutes 18.05 (11) and 36.06% (22), respectively. Thus, this study concludes that D-test should be used as a mandatory method and is more potential in 15 mm disc apart.

The Journal of Infectious Diseases, 2019

Background Plasmodium vivax is the main cause of malaria in Nepal. Relapse patterns have not been... more Background Plasmodium vivax is the main cause of malaria in Nepal. Relapse patterns have not been characterized previously. Methods Patients with P. vivax malaria were randomized to receive chloroquine (CQ; 25 mg base/kg given over 3 days) alone or together with primaquine (PQ; 0.25 mg base/kg/day for 14 days) and followed intensively for 1 month, then at 1- to 2-month intervals for 1 year. Parasite isolates were genotyped. Results One hundred and one (49%) patients received CQ and 105 (51%) received CQ + PQ. In the CQ + PQ arm, there were 3 (4.1%) recurrences in the 73 patients who completed 1 year of follow-up compared with 22 of 78 (28.2%) in the CQ-only arm (risk ratio, 0.146 [95% confidence interval, .046–.467]; P < .0001). Microsatellite genotyping showed relatively high P. vivax genetic diversity (mean heterozygosity, 0.843 [range 0.570–0.989] with low multiplicity of infection (mean, 1.05) reflecting a low transmission preelimination setting. Of the 12 genetically homolog...

Urinary tract infection (UTI) is one of the commonest domiciliary and nosocomial bacterial infect... more Urinary tract infection (UTI) is one of the commonest domiciliary and nosocomial bacterial infections comprising of a variety of clinical conditions caused by microbial invasion of tissue lining of the urinary tract, which extends from renal cortex to the urethral meatus19. Urinary tract infection (UTI) is one of the most important causes of morbidity in the general population, and it is the second most common cause of hospital visits. Recurrent infections are common and can lead to

Additional file 1 of Epidemiology of dengue virus infections in Nepal, 2006–2019

Additional file 1: Table S1. District wise cases of dengue in 2016, 2017, 2018 and 2019 in Nepal.

Additional file 2 of Epidemiology of dengue virus infections in Nepal, 2006–2019

Additional file 2: Table S2. Negative binomial regression for predictors of dengue fever case inc... more Additional file 2: Table S2. Negative binomial regression for predictors of dengue fever case incidence at the district level, stratified by year.

HIV/AIDS - Research and Palliative Care, 2019

Introduction: Opportunistic bacterial and fungal infections are the major cause of morbidity and ... more Introduction: Opportunistic bacterial and fungal infections are the major cause of morbidity and mortality among immune suppressed HIV-positive patients. The main objective of this study was to determine bacterial and fungal organisms causing respiratory infections and their susceptibility to commonly prescribed antimicrobials among HIV patients attending a tertiary infectious disease hospital in Kathmandu. Methods: Sputum samples were collected from the HIV-positive patients attending Sukraraj Tropical and Infectious Disease Hospital (STIDH) from August 2017 to March 2018. A total of 100 sputum samples were cultured on conventional bacterial and fungal culture media. Bacterial and fungal isolates were identified based on their colony characteristics, microscopic morphology and various biochemical tests. Antibiotic susceptibility test (AST) of bacterial isolates was performed by modified Kirby Bauer disc diffusion method. Results: Out of 100 sputum samples cultured, 24% (n=24) showed bacterial growth, 42% (n=42) showed fungal growth and 10% (n=10) had both bacterial and fungal growth. Among bacteria, 91.6% (n=22) were monomicrobial and 8.4% (n=2) were polymicrobial in growth, of which, Klebsiella pneumoniae (37.5%) were predominant isolates, followed by Pseudomonas aeruginosa (29.2%), and Escherichia coli (16.7%). The antibiotic susceptibility test (AST) showed 68% (17/25) of bacterial isolates were multi-drug resistant (MDR) and among them 41.2% (7/17) were found to be extended spectrum β lactamase (ESBL) producers. Fungal growth was observed in 42% of samples (42/100). A total of six different species of Candida and four different genera of molds were identified. On species differentiation, Candida albicans (20%) were followed by Candida parapsilosis (4%), and Candida dubliniensis (3%); and various molds were Aspergillus fumigatus (4%), Aspergillus flavus (2%), and Penicillium species (5%). CD4 count was inversely associated with bacterial and fungal infections. Fifty percent of the patients with the fungal infections had a CD4 count below 200. No fungal organisms were isolated from HIV-positive patients under antifungal drug treatment. Conclusion: HIV-positive patients with a CD4 count less than 200 cells/µL are more vulnerable to opportunistic infections of bacterial and fungal origin. Early isolation, identification and appropriate treatment can reduce mortality due to co-infections. Routine screening of opportunistic pathogens is critical to contain the disease progression.

Additional file 1 of Antibiotic resistance and detection of plasmid mediated colistin resistance mcr-1 gene among Escherichia coli and Klebsiella pneumoniae isolated from clinical samples

Additional file 1: Table S1. Characteristics of infected patients and samples.

Nepal Medical College journal : NMCJ, 2011

18F-fluorodeoxyglucose positron emission tomography (FDG-PET) has been widely incorporated in can... more 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) has been widely incorporated in cancer management. Although, it has increased sensitivity, 18F-FDG is not tissue specific thus posing diagnostic dilemma in certain situations. False positivity in pulmonary nodules have been seen in various inflammatory, infective as well as post operative conditions while false negativity is common with adenomas, low grade lymphomas, bronchoalveolar carcinomas and carcinoid tumors. We present two cases of granulomatous diseases as pulmonary cryptococcosis and tuberculosis showing false positivity in a resected colorectal cancer patient and highlight the importance of recognition of this entity in an endemic region for granulomatous infections.

Purification and partial characterization of PfHRP-II protein of Plasmodium falciparum

The Southeast Asian journal of tropical medicine and public health

International Journal of Advances in Pharmacy and Biotechnology, 2020

The primary aim of carrying out stability studies of drug products is to determine the expiration... more The primary aim of carrying out stability studies of drug products is to determine the expiration date and to promise the product standardized for efficacy, safety and elegance throughout its shelf-life. ICH, WHO, ASEAN and separate agencies issued the guidelines for stability studies, which are requisite to be demeanour in a deliberate way and are wise as prerequisite for regulatory fill and approval of any medicinal product. Stability investigating provides the collection on stability strikingness of drug product including the belief of various environmental factors, packaging method etc. ensuring that it remain within planted specification to hold its degree and present the desirable performance consistently and in a way comforting for the usefulness of its intentional use all finished the retest or expiry date. This canvas types of stability studies, guidelines issue for stability investigation and forecasting of shelf life of medicine products along with flowing trends in stability studies.