Articles

Prescription Pattern of Cholelithiasis at Surgery Ward in Tertiary Care Hospital

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Background: Cholelithiasis is a chronic recurrent disease of the hepatobiliary system. The impaired metabolism of cholesterol, bile acids and bilirubin are characterized by gallstone formation.The number of surgical procedures for cholelithiasis has risen markedly in developed countries since 1950. An estimated 90% of cholecystectomies are now performed by the laparoscopic approach worldwide.

Objectives: The aim of the study was to study prescription pattern of Cholelithiasis at surgery ward in B&C medical college teaching hospital and research Centre Pvt. Ltd.

Materials and Methods: A Retrospective study was conducted and data of Cholelithiasis cases admitted at Surgery ward from 2077/01/01 BS to 2077/12/31 BS were collected. Coding of data , result and interpretation of data were drawn using SPSS version 16 and MS Excel 2016 .

Result: The present study included 137 patients.Among them,80.3% were females and 19.7% were males. The high incidence of cholelithiasis was found in the age group 30-39 years (27%). 98.5% of total hospitalized patient were prescribed with antibiotics followed by Proton Pump inhibitors (93.4%) and NSAIDS(92%) .Among antibiotics, Ceftriaxone (65.7%) were the most prescribed one. During discharge , antibiotics (98.5%) were the most prescribed group of medicine followed by Proton Pump Inhibitors (88.3%) and NSAIDS(67.9%). And among antibiotics, Cefixime (52.6%) were mostly prescribed. While analyzing prescription pattern of discharge medication it was found that percentage of drugs prescribed by generic name was 13.86% and percentage of drugs prescribed from essential drug list was 43.36%.

Conclusion: The present study revealed that there was greater incidence of Cholelithiasis in females (80.3%) than in males and in the age group 30-39 years (27%) .The results obtained from this study showed that most commonly prescribed medicines were antibiotics. Prescription through generic name and essential drug list was low. Therefore, prioritization on prescribing drugs by generic name and from essential drug list needs to be encouraged.

Thromboembolic Complications and Its Relationship with the State of the Blood Coagulation and Anticoagulation System in Acute Calculous Cholecystitis

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Postoperative thromboembolic complications worldwide tend to increase in frequency, which is the cause of disability and mortality. The authors note that the risk of developing feasibility study can vary significantly depending on the nature of the operation, its duration, the type of anesthesia and the general somatic background of the patient. There are no existing schemes for the use of drugs for this disease, and methods for the prevention of feasibility studies are carried out without taking into account the state of the blood coagulation and anti–coagulation system. Patients suffering from obesity are most prone to EFT. Among obese individuals, calculous cholecystitis is more common than in people with normal body weight. Therefore, there is an urgent need for further study of the state of the blood coagulation and anticoagulation system in obese patients with ACC.

The Current State of Epidemiological Aspects and Medical and Social Significance of the Problem of Cholelithiasis and its Complications

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In terms of prevalence, frequency of surgical intervention and economic losses, cholelithiasis belongs to one of the most costly areas of world health care and occupies one of the leading positions in the structure of morbidity. Many authors have proven the leading risk factors for cholelithiasis. However, to this day, there are often difficulties in the timely differential diagnosis of cholelithiasis and breast syndrome. The use of modern highly sensitive research methods does not exclude diagnostic errors that occur in 10–42% of cases.

To date, to help surgeons, further study of this problem is required, because they are aimed at improving the results of surgical treatment of this group of patients.

Assessment of Nurses’ Knowledge Regarding Management of Patient’s with Cholelithiasis Disease

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Cholelithiasis affects approximately 15% of the US population. Rising trends in obesity and metabolic syndrome have contributed to an increase in diagnosis of cholelithiasis. There are several risk factors for cholelithiasis, both modifiable and non modifiable. Women are more likely to experience cholelithiasis than are men. Pregnancy, increasing parity, and obesity during pregnancy further increase the risk that a woman will develop cholelithiasis. The classic presentation of persons experiencing cholelithiasis, specifically when gallstones obstruct the common bile duct, is right upper quadrant pain of the abdomen that is often elicited upon palpation during physical examination and documented as a positive Murphy’s sign Descriptive Cross-Sectional Design is adopted in the current study to achieve the early stated objectives. The study started from January   2nd, 2021 until May, 20th, 2021.  A Non-Probability (Convenience Sample) of (60) nurses were including in the present study. Sample collect from 1, 3,4) and emergency department The results of the present study indicated that the majority of the samples (93.33%) have deficit knowledge, which agree with the results of the study showed that the reasons for lack of nurses’ knowledge regarding from the researchers’ point of view “might be related to lack of continuing educational programs or sessions about Cholelithiasis, supervision, continuous evaluation of nurses’ practice, and cooperation between multidisciplinary health care team members (nurses-physicians). Conclusions according to the present study findings, the researcher can mention the following conclusions:Most of nurses in medical units had knowledge deficit concerning management of cholelithiasis nursing management. It is found that the most of nurses are middle age group within (35-39) years old. It is concludes that the most of nurses are institute and college graduated, most of the nurses years’ experience in medical wards(1-10 years). most of the sample have participating in the sessions training in medical wards  but no related to cholelithiasis nursing management. Encouraging nurses to update their information by participating in training sessions and conference inside and outside Iraq to improve their knowledge regarding cholelithiasis nursing management which working in medical wards.