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  1. Article ; Online: mRNA vaccines as a revolutionary approach to combat cancer.

    Mainali, Nischal / Shrestha, Abhigan Babu / Shrestha, Shubham / Chapagain, Sanskriti / Khanal, Barsha / Shrestha, Lok Bahadur / Shrestha, Sajina / Jaiswal, Vikash

    Postgraduate medical journal

    2024  Volume 100, Issue 1183, Page(s) 279–282

    MeSH term(s) Humans ; Neoplasms/prevention & control ; mRNA Vaccines ; Cancer Vaccines/therapeutic use ; Vaccines, Synthetic
    Chemical Substances mRNA Vaccines ; Cancer Vaccines ; Vaccines, Synthetic
    Language English
    Publishing date 2024-04-22
    Publishing country England
    Document type Editorial ; Journal Article
    ZDB-ID 80325-x
    ISSN 1469-0756 ; 0032-5473
    ISSN (online) 1469-0756
    ISSN 0032-5473
    DOI 10.1093/postmj/qgad138
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  2. Article ; Online: Role of Biofilm in Bacterial Infection and Antimicrobial Resistance

    Khilasa Pokharel / Bishwa Raj Dawadi / Lok Bahadur Shrestha

    Journal of Nepal Medical Association, Vol 60, Iss

    2022  Volume 253

    Abstract: Biofilm refers to the complex, sessile communities of microbes found either attached to a surface or buried firmly in an extracellular matrix as aggregates. Microbial flora which produces biofilm manifests an altered growth rate and transcribes genes ... ...

    Abstract Biofilm refers to the complex, sessile communities of microbes found either attached to a surface or buried firmly in an extracellular matrix as aggregates. Microbial flora which produces biofilm manifests an altered growth rate and transcribes genes that provide them resistance to antimicrobial and host immune systems. Biofilms protect the invading bacteria against the immune system of the host via impaired activation of phagocytes and the complement system. Biofilm-producing isolates showed greater multidrug resistance than non-biofilm producers. Biofilm causes antibiotic resistance through processes like chromosomally encoded resistant genes, restriction of antibiotics, reduction of growth rate, and host immunity. Biofilm formation is responsible for the development of superbugs like methicillin-resistant Staphylococcus aureus, vancomycin-resistant Staphylococcus aureus, and metallo-beta-lactamase producing Pseudomonas aeruginosa. Regular monitoring of antimicrobial resistance and maintaining hygiene, especially in hospitalized patients are required to control biofilm-related infections in order to prevent antimicrobial resistance.
    Keywords antibiotic resistance ; bacterial infections ; biofilm ; MRSA ; Medicine (General) ; R5-920
    Subject code 616
    Language English
    Publishing date 2022-08-01T00:00:00Z
    Publisher Nepal Medical Association
    Document type Article ; Online
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  3. Article ; Online: Role of Biofilm in Bacterial Infection and Antimicrobial Resistance.

    Pokharel, Khilasa / Dawadi, Bishwa Raj / Shrestha, Lok Bahadur

    JNMA; journal of the Nepal Medical Association

    2022  Volume 60, Issue 253, Page(s) 836–840

    Abstract: Biofilm refers to the complex, sessile communities of microbes found either attached to a surface or buried firmly in an extracellular matrix as aggregates. Microbial flora which produces biofilm manifests an altered growth rate and transcribes genes ... ...

    Abstract Biofilm refers to the complex, sessile communities of microbes found either attached to a surface or buried firmly in an extracellular matrix as aggregates. Microbial flora which produces biofilm manifests an altered growth rate and transcribes genes that provide them resistance to antimicrobial and host immune systems. Biofilms protect the invading bacteria against the immune system of the host via impaired activation of phagocytes and the complement system. Biofilm-producing isolates showed greater multidrug resistance than non-biofilm producers. Biofilm causes antibiotic resistance through processes like chromosomally encoded resistant genes, restriction of antibiotics, reduction of growth rate, and host immunity. Biofilm formation is responsible for the development of superbugs like methicillin-resistant Staphylococcus aureus, vancomycin-resistant Staphylococcus aureus, and metallo-beta-lactamase producing Pseudomonas aeruginosa. Regular monitoring of antimicrobial resistance and maintaining hygiene, especially in hospitalized patients are required to control biofilm-related infections in order to prevent antimicrobial resistance.
    MeSH term(s) Humans ; Anti-Bacterial Agents/pharmacology ; Anti-Bacterial Agents/therapeutic use ; Methicillin-Resistant Staphylococcus aureus/genetics ; Staphylococcus aureus/genetics ; Staphylococcal Infections/microbiology ; Drug Resistance, Bacterial ; Biofilms ; Microbial Sensitivity Tests
    Chemical Substances Anti-Bacterial Agents
    Language English
    Publishing date 2022-09-01
    Publishing country Nepal
    Document type Journal Article
    ZDB-ID 2209910-4
    ISSN 1815-672X ; 0028-2715
    ISSN (online) 1815-672X
    ISSN 0028-2715
    DOI 10.31729/jnma.7580
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  4. Article ; Online: Standard Operating Procedure for Specimen Collection, Packaging and Transport for Diagnosis of SARS-COV-2

    Lok Bahadur Shrestha / Khilasa Pokharel

    Journal of Nepal Medical Association, Vol 58, Iss

    2020  Volume 228

    Abstract: Coronavirus disease-19 is caused by severe acute respiratory syndrome coronavirus-2 (SARSCoV-2). Specimen quality, and proper transportation is vital for accurate diagnosis. This standard operating procedure is designed to educate the clinicians, nurses, ...

    Abstract Coronavirus disease-19 is caused by severe acute respiratory syndrome coronavirus-2 (SARSCoV-2). Specimen quality, and proper transportation is vital for accurate diagnosis. This standard operating procedure is designed to educate the clinicians, nurses, paramedics, and laboratory personnel regarding proper methods of sample collection, packaging, and transportation. Nasopharyngeal swabs and/or oropharyngeal swabs should be collected for real-time quantitative polymerase chain reaction to detect SARS-CoV-2. The sample should be collected wearing proper personal protective equipment, packed in a triple packaging system, and transported maintaining cold chain.
    Keywords nasopharyngeal swab ; SARS-CoV-2 ; sop ; Medicine (General) ; R5-920 ; covid19
    Language English
    Publishing date 2020-08-01T00:00:00Z
    Publisher Nepal Medical Association
    Document type Article ; Online
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  5. Article ; Online: Standard Operating Procedure for Specimen Collection, Packaging and Transport for Diagnosis of SARS-COV-2.

    Shrestha, Lok Bahadur / Pokharel, Khilasa

    JNMA; journal of the Nepal Medical Association

    2020  Volume 58, Issue 228, Page(s) 627–629

    Abstract: Coronavirus disease-19 is caused by severe acute respiratory syndrome coronavirus-2 (SARSCoV-2). Specimen quality, and proper transportation is vital for accurate diagnosis. This standard operating procedure is designed to educate the clinicians, nurses, ...

    Abstract Coronavirus disease-19 is caused by severe acute respiratory syndrome coronavirus-2 (SARSCoV-2). Specimen quality, and proper transportation is vital for accurate diagnosis. This standard operating procedure is designed to educate the clinicians, nurses, paramedics, and laboratory personnel regarding proper methods of sample collection, packaging, and transportation. Nasopharyngeal swabs and/or oropharyngeal swabs should be collected for real-time quantitative polymerase chain reaction to detect SARS-CoV-2. The sample should be collected wearing proper personal protective equipment, packed in a triple packaging system, and transported maintaining cold chain.
    MeSH term(s) Betacoronavirus/isolation & purification ; COVID-19 ; COVID-19 Testing ; Clinical Laboratory Techniques ; Coronavirus Infections/diagnosis ; Humans ; Pandemics ; Pneumonia, Viral/diagnosis ; Real-Time Polymerase Chain Reaction ; SARS-CoV-2 ; Specimen Handling
    Keywords covid19
    Language English
    Publishing date 2020-07-31
    Publishing country Nepal
    Document type Journal Article
    ZDB-ID 2209910-4
    ISSN 1815-672X ; 0028-2715
    ISSN (online) 1815-672X
    ISSN 0028-2715
    DOI 10.31729/jnma.5260
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  6. Article ; Online: Antimicrobial Susceptibility Pattern in Opportunistic Pathogens Isolated from Immunocompromised Patients.

    Basnet, Ajaya / Chand, Arun Bahadur / Pokhrel, Nayanum / Acharya, Sadikchya / Gurung, Parbati / Khanal, Laxmi Kant / Shrestha, Kundu / Shrestha, Lok Bahadur / Raghubanshi, Bijendra Raj

    Journal of Nepal Health Research Council

    2023  Volume 20, Issue 3, Page(s) 664–671

    Abstract: Background:  Brought with the advancements in transplantation science and the development of immunosuppressive agents, immunocompromised patients characterized with defective immunity have increased throughout the world with increased risk for ... ...

    Abstract Background:  Brought with the advancements in transplantation science and the development of immunosuppressive agents, immunocompromised patients characterized with defective immunity have increased throughout the world with increased risk for opportunistic infections. This study provides an overview of the antimicrobial susceptibility pattern among opportunistic pathogens isolated from immunocompromised patients.  Methods: Clinical and laboratory records of immunocompromised patients [patients with chronic kidney disease neutropenia, diabetes, rheumatic heart disease acquired immune deficiency syndrome hepatitis B, hepatitis C, who were subjected to microbiological culture analysis in the Department of Clinical Microbiology, KIST Medical College and Teaching Hospital, for 2 years (January 2019 and December 2020) were analyzed.
    Results:  Out of 8,402 immunocompromised patients, 954 (11.4%) patients were subjected to microbiological culture analysis. Among 954 patients, 253 (26.5%) patients [median(interquartile range) age: 52(31-67) years; male 138 (54.5%)] were infected. A total of 295 pathogens were isolated from 1,331 cultured samples. Infections due to Escherichia coli (n=71, 24.1%), Klebsiella spp. (n=55, 18.6%), Acinetobacter calcoaceticus-baumannii complex (n=35, 11.9%), Candida albicans (n=30, 10.2%), and Staphylococcus aureus (n=28, 9.5%) were frequently observed. Among the bacterial isolates (n=239), 81.6% (n=195) of bacteria were β-lactamase producers, 51.0% (n=122) were multi-drug resistant, 9.2% (n=195) were extensively-drug resistant, 0.8% (n=195) were pan-drug resistant, and 35.7% (n=10) of S. aureus were methicillin-resistant Staphylococcus aureus.
    Conclusions:  The majority of infection in immunocompromised patients is caused by Gram-negative bacteria, and is often associated with a higher number of β-lactamase producers and multi-drug resistant organisms. Prescriptions of antibiotics on the grounds of antimicrobial stewardship might help to reduce the burden of antimicrobial resistance.
    MeSH term(s) Humans ; Male ; Middle Aged ; Aged ; Methicillin-Resistant Staphylococcus aureus ; Staphylococcus aureus ; Drug Resistance, Bacterial ; Microbial Sensitivity Tests ; Nepal ; Gram-Negative Bacteria ; beta-Lactamases ; Anti-Bacterial Agents/pharmacology
    Chemical Substances beta-Lactamases (EC 3.5.2.6) ; Anti-Bacterial Agents
    Language English
    Publishing date 2023-03-09
    Publishing country Nepal
    Document type Journal Article
    ZDB-ID 2551251-1
    ISSN 1999-6217 ; 1999-6217
    ISSN (online) 1999-6217
    ISSN 1999-6217
    DOI 10.33314/jnhrc.v20i3.4047
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  7. Article ; Online: Metallo-β Lactamase Producing Non-Fermentative Gram-Negative Bacilli from Various Clinical Isolates in a Tertiary Care Hospital: A Descriptive Cross-sectional Study.

    Shrestha, Mahendra / Baral, Ratna / Shrestha, Lok Bahadur

    JNMA; journal of the Nepal Medical Association

    2021  Volume 59, Issue 241, Page(s) 875–880

    Abstract: Introduction: Non-fermentative gram-negative bacilli are common causes of human infections especially nosocomial infections. These organisms are usually resistant to multiple antimicrobial agents including carbapenems. The study aimed to find out the ... ...

    Abstract Introduction: Non-fermentative gram-negative bacilli are common causes of human infections especially nosocomial infections. These organisms are usually resistant to multiple antimicrobial agents including carbapenems. The study aimed to find out the prevalence of metallo-β-lactamase producing non-fermentative gram-negative bacilli among the samples which yielded growth of bacteria in a tertiary care hospital.
    Methods: This is a descriptive cross-sectional study conducted in a tertiary care hospital from February 2017 to May 2017. Convenience sampling method was used. Bacterial identification, characterization and antimicrobial susceptibility testing were done by following standard microbiological guidelines. Metallo-β-lactamase production was detected by using combined disk diffusion test and double-disc synergy test. Data were analyzed by using Statistical Package of Social Science software version 16. Point estimate at 95% confidence interval was calculated along with frequency and proportion for binary data.
    Results: Among 628 samples which yielded growth of bacteria, 118 (18.79%) at 95% Confidence Interval (15.74-21.84) were metallo-β-lactamase producing non-fermentative gram-negative bacilli. Among them, 54 (45.76%) were Pseudomonas aeruginosa and 64 (54.24%) were Acinetobacter baumannii.
    Conclusions: A high prevalence of metallo-β-lactamase production was observed among the nonfermentative gram-negative bacilli than the study done in similar settings. It is mandatory to perform routine monitoring of metallo-β-lactamase producing isolates in clinical laboratories in order to help the clinicians prescribe proper antibiotics.
    MeSH term(s) Anti-Bacterial Agents/therapeutic use ; Carbapenems ; Cross-Sectional Studies ; Gram-Negative Bacteria ; Humans ; Microbial Sensitivity Tests ; Tertiary Care Centers ; beta-Lactamases
    Chemical Substances Anti-Bacterial Agents ; Carbapenems ; beta-Lactamases (EC 3.5.2.6)
    Language English
    Publishing date 2021-09-11
    Publishing country Nepal
    Document type Journal Article
    ZDB-ID 2209910-4
    ISSN 1815-672X ; 0028-2715
    ISSN (online) 1815-672X
    ISSN 0028-2715
    DOI 10.31729/jnma.6408
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  8. Article ; Online: Antimicrobial Susceptibility Pattern in Opportunistic Pathogens Isolated from Immunocompromised Patients

    Ajaya Basnet / Arun Bahadur Chand / Nayanum Pokhrel / Sadikchya Acharya / Parbati Gurung / Laxmi Kant Khanal / Kundu Shrestha / Lok Bahadur Shrestha / Bijendra Raj Raghubanshi

    Journal of Nepal Health Research Council, Vol 20, Iss

    2023  Volume 3

    Abstract: ...

    Abstract .
    Keywords Public aspects of medicine ; RA1-1270
    Language English
    Publishing date 2023-03-01T00:00:00Z
    Publisher Nepal Health Research Council
    Document type Article ; Online
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  9. Article ; Online: Metallo-β Lactamase Producing Non-Fermentative Gram-Negative Bacilli from Various Clinical Isolates in a Tertiary Care Hospital

    Mahendra Shrestha / Ratna Baral / Lok Bahadur Shrestha

    Journal of Nepal Medical Association, Vol 59, Iss

    A Descriptive Cross-sectional Study

    2021  Volume 241

    Abstract: Introduction: Non-fermentative gram-negative bacilli are common causes of human infections especially nosocomial infections. These organisms are usually resistant to multiple antimicrobial agents including carbapenems. The study aimed to find out the ... ...

    Abstract Introduction: Non-fermentative gram-negative bacilli are common causes of human infections especially nosocomial infections. These organisms are usually resistant to multiple antimicrobial agents including carbapenems. The study aimed to find out the prevalence of metallo-β-lactamase producing non-fermentative gram-negative bacilli among the samples which yielded growth of bacteria in a tertiary care hospital. Methods: This is a descriptive cross-sectional study conducted in a tertiary care hospital from February 2017 to May 2017. Convenience sampling method was used. Bacterial identification, characterization and antimicrobial susceptibility testing were done by following standard microbiological guidelines. Metallo-β-lactamase production was detected by using combined disk diffusion test and double-disc synergy test. Data were analyzed by using Statistical Package of Social Science software version 16. Point estimate at 95% confidence interval was calculated along with frequency and proportion for binary data. Results: Among 628 samples which yielded growth of bacteria, 118 (18.79%) at 95% Confidence Interval (15.74-21.84) were metallo-β-lactamase producing non-fermentative gram-negative bacilli. Among them, 54 (45.76%) were Pseudomonas aeruginosa and 64 (54.24%) were Acinetobacter baumannii. Conclusions: A high prevalence of metallo-β-lactamase production was observed among the nonfermentative gram-negative bacilli than the study done in similar settings. It is mandatory to perform routine monitoring of metallo-β-lactamase producing isolates in clinical laboratories in order to help the clinicians prescribe proper antibiotics.
    Keywords beta-lactamase ; multidrug resistant ; Pseudomonas aeruginosa ; Medicine (General) ; R5-920
    Language English
    Publishing date 2021-09-01T00:00:00Z
    Publisher Nepal Medical Association
    Document type Article ; Online
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  10. Article ; Online: Broadly-Neutralizing Antibodies Against Emerging SARS-CoV-2 Variants.

    Shrestha, Lok Bahadur / Tedla, Nicodemus / Bull, Rowena A

    Frontiers in immunology

    2021  Volume 12, Page(s) 752003

    Abstract: The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants have become a major concern in the containment of current pandemic. The variants, including B.1.1.7 (Alpha), B.1.351 (Beta), P1 (Gamma) and B.1.617.2 (Delta) have ... ...

    Abstract The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants have become a major concern in the containment of current pandemic. The variants, including B.1.1.7 (Alpha), B.1.351 (Beta), P1 (Gamma) and B.1.617.2 (Delta) have shown reduced sensitivity to monoclonal antibodies, plasma and/or sera obtained from convalescent patients and vaccinated individuals. Development of potent therapeutic monoclonal antibodies (mAbs) with broad neutralizing breadth have become a priority for alleviating the devastating effects of this pandemic. Here, we review some of the most promising broadly neutralizing antibodies obtained from plasma of patients that recovered from early variants of SARS-CoV-2 that may be effective against emerging new variants of the virus. This review summarizes several mAbs, that have been discovered to cross-neutralize across Sarbecoviruses and SARS-CoV-2 escape mutants. Understanding the characteristics that confer this broad and cross-neutralization functions of these mAbs would inform on the development of therapeutic antibodies and guide the discovery of second-generation vaccines.
    MeSH term(s) Animals ; Antibodies, Viral/blood ; Antibodies, Viral/immunology ; Antibody Specificity ; Binding Sites, Antibody ; Broadly Neutralizing Antibodies/blood ; Broadly Neutralizing Antibodies/immunology ; COVID-19/blood ; COVID-19/immunology ; COVID-19/virology ; Cross Reactions ; Host-Pathogen Interactions ; Humans ; Mutation ; SARS-CoV-2/genetics ; SARS-CoV-2/immunology ; SARS-CoV-2/pathogenicity
    Chemical Substances Antibodies, Viral ; Broadly Neutralizing Antibodies
    Language English
    Publishing date 2021-09-27
    Publishing country Switzerland
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 2606827-8
    ISSN 1664-3224 ; 1664-3224
    ISSN (online) 1664-3224
    ISSN 1664-3224
    DOI 10.3389/fimmu.2021.752003
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