ABSTRACT
Pain is an unpleasant sensation as a consequence of injury, disease along with emotional disorder occurring in varying degrees of severity. Poor control of pain is complete unethical, clinically unsound and economically disastrous. Effective pain control in postoperative period is one of the essential components of post-operative care for those patients who have undergone surgery. Inadequate and inappropriate pain control results in significant increase in post-operative morbidity or mortality. Methods: An prospective, observational analytical study by collection of data without intervention was done. Ethical committee’s approval was duly taken. Data were collected in the post- operative ward of department of general surgery from the bed side tickets of the patients. Results: In our current study we observed out of 515 postoperative patients 49.5% (255) were male and 50.5 % (260) were female, on the other hand more Hindu(85.4%) than Muslim(14.6%). On the day of surgery Monotherapy was prescribed for 440(67%) patients and 33% received both combination analgesic therapies. A total of 33% patients who received dual analgesic therapy immediate post-operative period most commonly used combination was Tramadol+Diclofenac (130/170), followed by Tramadol+ Paracetamol (40/170). In the following post-operative days increase in use of Diclofenac+Paracetamol was noted. No Triple drug therapy observed in this study. Conclusion: The results of current study shows that diclofenac was the most commonly prescribed analgesic. It is due to high efficacy of diclofenac in post operative pain control with better safty profile; i.e. lesser side effects compared to other analgesic.
ABSTRACT
Cholecystectomy, one of the most common operative procedures done in our institution. In a developing country like India, choice of antibiotics should be rational to reduce the burden of cost. There are no standard treatment guidelines to follow regarding antibiotic usage causing indiscriminate use of this antibiotic. Methods: An observational, prospective analytical study by collection of data without intervention was done. Ethical committee’s approval was duly taken. Data were collected in the department of general surgery from the bed side tickets of the patients after taking a short history and informed consent from the patient. Cost of the therapy was calculated from CIMS (Current Index of Medical Specialities) and institutional pharmacy. Results: More commonly single antibiotic (190/320) prescribe followed by two antibiotic (80/320) and three antibiotic (50/320). Piperacillin + Tazobactum most commonly prescribe antibiotic as a single agent and overall. Ceftriaxone / Tazobactum + Metronidazole preferred combination when two antibiotic use at a time. Mean hospital stay 3.78 days. Average duration for prescribing of antibiotic 3.25 days. Mean cost for antibiotic in 984 INR, with a range 115-2700 INR. The average duration of stay in open Cholecystectomy was 7 days whereas the mean duration of stay in cases of laparoscopic Cholecystectomy was reduced to 3.07 days. Average antibiotic prescribing duration was 4.75 days significantly higher than Lap. Cholecystectomy (1.4 days). Conclusion: As there is no standard treatment protocol and antibiotic policy to follow antibiotics are used as pick and choose method due to lack of standard treatment protocol.
ABSTRACT
Background: Antimicrobials form the cornerstone of prescriptions for treating infection. Surgical management cannot be possible without the use of antibiotics. Severity of infection, suspected spectrum of organisms and their sensitivity, co-morbidities of the patient, route of antibiotic administration are the important parameter to consider before selecting antibiotic.Methods: Cross-sectional, hospital based, descriptive study was conducted in the ward of Surgery Department of IQ City Medical college, Durgapur over a period of 1 year. The relevant information was entered into the pretested preformats (containing name, age, sex, diagnosis, ongoing treatment as recorded from patients’ prescription slips or CRFs) and analyzed. Necessary permission was granted by the Institutional Ethical Committee and written informed consent was obtained from the patients prior to collecting their prescription slips/CRF.Results: Commonest cause of hospitalization was cholelithiasis (318 (32.7%)). Antimicrobials were the most commonly prescribed drugs (1626 (31.6%)). Single antibiotic prescribing frequency are similar to two antibiotic prescribing (both 44%). Piperacillin+Tazobactum combination most commonly prescribe antibiotic.Conclusions: Beta lactam antibiotic specifically Piperacillin (ATC class: J01D) were the most commonly prescribed antibiotic agents both before and after surgical procedures.