Browsing by Author "Aryal, Sushant"
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Publication Assessment of Adequacy of Analgesics in Post-Operative Orthopedic In-patients using Visual Analogue Scale(Institute of Medicine, 2025) Gupta, Mayuri; Aryal, Sushant; Shrestha, AmritABSTRACT Introduction: Adequate post-operative pain management in orthopedic patients is essential for optimizing recovery and reducing complications. This study aimed to evaluate the adequacy of analgesic use among post-operative orthopaedic inpatients using the visual analogue scale (VAS). Methods: An observational cross-sectional study was conducted on 240 post-operative orthopedic in-patients at Patan Hospital, Lalitpur, Nepal. Analgesic administration patterns were analysed, and pain intensity was assessed at 6 hours and the next morning at 10 am post-operative using VAS score. SPSS 16 was used to evaluate analgesic adequacy and its association with age, gender, surgery type, and anatomical site. Results: The majority of patients were male 134 (55.8%) with a mean age of 41.03 ± 16.60 years. The most frequently used analgesics were Pethidine 67 (27.92%) and ketorolac 64 (26.67%). The mean VAS score decreased from 6.43 at 6 hours post-operatively to 4.96 the next morning in major surgeries (p <0.001), and similar statistically significant reductions were observed in other surgical categories and anatomical sites, including spine and pelvis. VAS scores showed a significant reduction in pain across all sites and surgical types, particularly in spine and pelvic surgeries. Major surgeries had higher initial VAS scores, which improved significantly by the next day (p < 0.001). Conclusion: Analgesic use in this setting was effective in pain reduction observed among post-operative orthopedic in-patients. These results indicate that timely and appropriate analgesic administration effectively controls post-operative pain in orthopedic in-patients and highlight the importance of protocol-based pain management strategies tailored to surgical invasiveness. Keywords: Analgesics; orthopedic surgery; pain management; post-operative pain; visual analogue scale (VAS)Publication Utilization of Antimicrobial Agents in Intensive Care Units of Tertiary Care Hospital: An Observational Study(Nepal Medical Association, 2025) Aryal, Sushant; Joshi, Mili; Gupta, Mayuri; Uprety, Bipashwi Nath; Shrestha, Ram Krishna; Shah, Pranita; Rajbhandari, PiyushAbstract Introduction: The rising incidence of antibiotic resistance is a global threat. Monitoring antibiotic use is one of the strategies to address this issue. Intensive Care Units (ICUs) have high prevalence of antibiotic use and multidrug-resistant organisms. This study aims to study the status of antibiotic usage within the ICU in a tertiary care center. Methods: An observational cross-section study was conducted from July 15, 2021 to December 20, 2021 in the adult ICU and record section of a tertiary care hospital of Nepal after approval from Institutional Review Committee. Data were collected from medical records of patients admitted to the ICU from January 1, 2018 to December 31, 2020 and who received antibiotics. Data were presented in terms of days of therapy per 1000 patient days (DOT/1000PD). Results: Total antibiotic consumption increased from 324.2 DOT/1000 PD in 2018 to 564.25 DOT/1000 PD in 2020. Consumption of Watch group antibiotic nearly doubled from 248.21 to 473.23 DOT/1000 PD, while Access antibiotics increased from 49.09 to 73.5 DOT/1000 PD. In contrast, Reserve group antibiotic usage declined from 26.91 to 17.49 DOT/1000 PD. In 2018, highest consumed antibiotics were piperacillin/tazobactam 57.89 (17.89%), azithromycin 53.98 (16.70%), ceftriaxone 49.58 (15.34%) and vancomycin 43.87 (13.57%) DOT/1000 PD. By 2020, their usage increased to 129.87 (23.02%),69.38 (12.30%), 94.29 (16.71%), and 87.77 (15.55%) DOT/1000 PD respectively. Conclusions: Total antibiotic consumption increased over the years. There was a substantial rise in the use of Watch group antibiotics, particularly piperacillin/tazobactam, ceftriaxone, azithromycin and vancomycin. Meanwhile, the use of Reserve group antibiotics declined during the same period.