ABSTRACT
Background: Chronic kidney disease can progress to end-stage kidney failure (ESRD), which is fatal without artificial filtering (dialysis) or a kidney transplant.Methods: The ESRD patients of either gender age >18 years who were diagnosed by nephrologist as ESRD and are on haemodialysis regularly included for the study.Results: The blood urea, serum creatinine, phosphorous, potassium levels were reduced significantly in post – haemodialysis condition, but, there was not much weight reduction after haemodialysis. Serum albumin, serum sodium and blood haemoglobin levels were almost unchanged in post – haemodialysis state. There was no significant difference between the pre and post haemodialysis parameters- serum Na+ serum albumin and blood hemoglobulin. Out of 75 ESRD patients, almost all patients 74 (98.7%) prescribed tablet Livogen, 73 (97.3%) patients given Inj. EPO, 55 (73.3%) tab Nicardia, 54 (76%) tab Sodamint, 43 (57.3%) capsule Alpha D3, 40 (53.3%) tab Shelcal. While between 12 (16%) to 20 (26%) patients prescribed tab Nodosis, tab Metoprolol, tab Febuget, tab Ecosprin, and tab Rantac. Only 1 (1.3%) to 9 (12%) patients received tablet Augmentin, tab Arkamine, tab Carvedilol, tab Para 500, tab Atorvas, Human mixtard, tab Calcicard, tab Minipress XL, tab Dytor, and tab Clopilet.Conclusions: The available two models of treatment, i.e., haemodialysis and poly pharmacy at hospital setup to face the challenges associated with the ESRD, and even outcome after application of both these two models of therapies did not provide optimal normal healthy life status to ESRD patients.
ABSTRACT
Background: Intensive Care Unit is used to treat patients closer to their beds, in order to observe them more as distinct people to almost all the critically-ill patients.Methods: One hundred admitted patients in the ICU, 25 each sets of the patients observed their prophylactic management to prevent stress ulcer, pressure ulcer, UTI and chest infection, observations noted for the 7 days, directly by seeing and by cross-checked patient’s case-sheets.Results: There were 2 (8%) patients developed stress ulcer, 1 (4%) Catheter associated bacteriuria, 2 (8%) patients grade II pressure ulcer, and 5 (20%) patient’s done endotracheal intubation. All these 5 (20%) report of sputum culture found Ps. Aeruginosa, Klebsiella sensitive for Ceftriaxone + Sulbactum. The standard nursing care done by the on duty nursing staffs, i.e., no one given Ryle’s tube feeding for the stress ulcer cases, advised soft, palatable, non-spicy oral diet, Pressure ulcer’s 8% patients shifted on the air-bed mattress, ulcer’s cleaned with normal water soaked soft-napkin and applied sterile pad compressed dressing locally. For the ventilator in-situ patient’s, endotracheal tube cleaned 8-12 times within 12 hours. The Inbuilt Ventilator tube cleaned, and its filter changed and kept ready by the following standard aseptic precaution before using the ventilator. The chest physiotherapy was done by the chest medicine specialist of the all 5 ventilated patients. Prophylactic medication provided, i.e., Injection Pantoprazole 40mg once daily, Injection Ciprofloxacin 400mg twice daily, and Injection Inj. Ceftriaxone + Sulbactum gm 12 hourly interval administered daily.Conclusions: Standard nursing care was prime intervention as an Intensive Care Unit Prophylaxis along with Injection Pantoprazole 40mg once daily provided to prevent stress ulcer. Injection Ciprofloxacin 400mg twice daily provided to prevent Catheter Associated Bacteriuria. Injection Ceftriaxone + Sulbactum 1gm 12 hourly provided to prevent Ventilator Associate Pneumonia and pressure ulcer. Injection Ceftriaxone + Sulbactum 1gm 12 hourly interval. Intensive Care Unit’s Prophylactic measures helped to prevent further complication and reduced morbidity.
ABSTRACT
Background: The Drug utilization research (DUR) compares drug use between different countries and regions and is used to assess the rationality of prescribing pattern of the drug therapy. With this background we decided to evaluate antipsychotic drugs prescribing pattern in the psychiatric patients in a tertiary care hospital.Methods: The study was carried out at Department of Psychiatry, DSMCH. It was open label, cross - sectional, prescribed Documents based study. Duration of the study was one month (May-2017). Out-Patient number, age, sex, diagnosis, prescribed generic name, brand name, dose, route of administration, duration of therapy obtained from the Prescription register of Out - Patient Department of the Psychiatry.Results: The clinical experiences of the Psychiatrist I, II and III were 17 years, 35 years and 10 years respectively. The Psychiatrist I, II and III prescribed treatment for 36 (31.9%), 61 (54%) and 16 (14.2%) patients respectively. Among overall (n=113) patients (average age 38.9 years), male n=56 (49.6%) and female=57 (50.4%) were treated by all the three psychiatrists. The percentage of prescription of various drugs used were: Escitalopram (15.7%), Clonazepam (14.6%), Sertraline (8.7%), Risperidone (7.5%), Propranolol (6.7%), Olanzapine (6.3%), Quetiapine (5.9%), Trihexyphenidyl (5.5%), Amitriptyline (5.1%) and Other prescribed drugs, were between (0.4 to 2.8%).Conclusions: From this study, it can conclude that rational usage of drugs were followed in this study. All three prescribers (Psychiatrist I, II, and III) prescriptions were found to be rationale.