Drug Utilization Study Of Antibacterial In The Medical Intensive Care Unit (Micu) Of A Chitwan Medical College Teaching Hospital(Cmcth), Bharatpur, Chitwan, Nepal

Background: High utilization and irrational use of antibiotics in an intensive care unit increases microbial resistance, morbidity, mortality, and costs. Objective: This study aimed to evaluate the utilization, sensitivity and cost analysis of antibiotics used in the medical intensive care unit of a tertiary care teaching hospital of Nepal. Methods: A prospective cohort study was conducted on patients admitted to the medical intensive care unit at a tertiary care teaching hospital in central Nepal from July to September 2016. Antibiotic utilization, defined daily dose per 100 bed-days and the cost of antibiotics per patient were calculated. Descriptive statistics were performed using IBM-SPSS 20.0. Results: A total of 365 antibiotics were prescribed in 157 patients during the study period, with an average of 2.34 prescriptions per patient. Total antibiotic utilization in terms of defined daily dose per 100 bed-days was 49.5. Piperacillin/tazobactam (45.2%) was the most commonly prescribed antibiotic, and meropenem was the most expensive antibiotics (US$4440.70). The median (interquartile range) cost of antibiotics used per patient was US$47.67 (US$63.73). Escherichia coli, Acinetobacter, and Pseudomonas sp. were the common organisms isolated and were found to be resistant to some of the commonly used antibiotics. Conclusion: This study suggests that the utilization and cost of antibiotics are high in medical intensive care unit of the hospital and E. coli was resistant to multiple antibiotics. The findings highlight an urgent need for the implementation of antibiotic stewardship program in order to improve antibiotic utilization in such hospital settings.

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Mortality Profile of Critical Patients in Medical Intensive Care Unit of Government Medical College of Central India

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/48350.14687 ◽

2021 ◽

Author(s):

Jyoti Tiwari ◽

Sumit Rawat ◽

Anju Jha ◽

Ramesh Pandey

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Medical Intensive Care Unit ◽

Central India ◽

P Value ◽

Elderly Male ◽

Female Ratio ◽

Medical College ◽

Medical Intensive Care ◽

One Year

Introduction: Mortality rate is always very high in Intensive Care Units (ICU) even with the best possible set ups, we should try to cater the need of the society according to the disease burden so that better care can be provided. Aim: To estimate the prevalence of various medical disease mortality profile of critically ill patients admitted in Medical Intensive Care Unit (MICU) of our institution. Materials and Methods: This was a retrospective observational study done at MICU of Bundelkhand Medical College and Hospital Sagar, Madhya Pradesh, India for a duration of one year (1st January 2019 to 31st December 2019). Data was retrieved from Medical Records Department (MRD) and total data of 349 deaths were registered. Disease was classified based upon ICD 10 (International Statistical classification of Diseases and related health problems) Score. Results: A total of 349 deaths occurred in MICU during the period of one year at the institution, out of which male deaths were 55.9% and Female deaths were 44.1%. MICU deaths occurred in higher numbers in males with Male: Female ratio of 1.2:1. This difference in ratio of male and female mortality was not statistically significant (p-value >0.05). Mean age of males at time of death was 58.4±16.3 years whereas mean age of females were 55.2±19.7 years. This difference in mortality with age and gender was not statistically significant (p-value >0.05). In present study, most common systemic causes of mortality were cardiovascular (29.8%), followed by respiratory (17.5%), renal (16.5%) and cerebrovascular diseases (13.8%). Mortality was documented in 276 (79%) individuals within duration of seven days of admission, whereas mortality in 46 (13.1%) and 27 (7.7%) cases were documented within 8 to 14 days and >14 days, respectively. The present study documented no statistically significant association between length of stay and age of patients (p-value >0.05). Conclusion: Cardiovascular diseases are the most common causes leading to mortality especially in elderly male patients. Also, higher number of deaths is reported within seven days of admission signifying severity of illness at the time of admission.

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Prevalence and nature of psychiatric referrals from Intensive Care Unit of a teaching hospital

Journal of Psychiatrists Association of Nepal ◽

10.3126/jpan.v7i1.22941 ◽

2018 ◽

Vol 7 (1) ◽

pp. 57-62

Author(s):

R. Poudel ◽

M. Belbase

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Teaching Hospital ◽

College Teaching ◽

Referral Rate ◽

Next Of Kin ◽

Psychiatry Department ◽

Medical College ◽

Common Diagnosis ◽

The Difference

Introduction: Patients admitted to intensive care unit (ICU) are diagnosed with various disorders. There is limited literature on the prevalence of psychiatry disorders in patients admitted to ICU. The aim of the study was toestimate the prevalence and nature of psychiatric referrals from ICU. Material and Method: Hundred consecutive patient admitted to the ICU (both medical ICU and CCU) in Nepalgunj Medical College Teaching Hospital (NGMCTH), Kohalpur, Nepal and referred to psychiatry department were enrolled for the study. Study was conducted from October 14, 2017 to June 14, 2018. Informed consent was taken and patients were interviewed by two psychiatrists in different occasions separately and other relevant history was obtained from next of kin. Socio-demographic variables, referring department, reason for referral, purpose of referral, major symptom for referral were the major variables. Psychiatric diagnosis was made using the ICD-10. Data was analyzed using Statistical Package for the Social Sciences (SPSS) version 21.0 for Windows. Results: During the study period the total patients admitted to the ICU was 787 among which 100 were referred to psychiatry department. Psychiatry referral rate was 7.87%, average patients referred were 2.4 per day. Psychiatry morbidity was 8.11%. The mean age was 36.87+12.81 years. Most of the patients were female, and from urban background. The most common diagnosis was alcohol use disorder (AUD) followed by intentional self harm (ISH) and delirium respectively. Organic disorder and dissociative disorder were the only disorders significantly associated (p<0.05) with the age of the patient. AUD (p=0.007) and ISH (p=0.011) was common in female compared to males and the difference was statistically significant. Conclusion: Psychiatric referral rate and psychiatry morbidity was low.

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