Introduction: Surgical site infections (SSIs) are one of the major causes of morbidity and mortality in developing countries despite recent advances in aseptic techniques. The SSIs due to emerging multidrug resistance (MDR) bacteria isolates are considered as grave threats to the public health worldwide. Each hospital has specific type of microbial flora from which infection initiates. In such condition microorganism shows unique type of antibiotic susceptibility and resistance pattern. In this study we report on the microbiological spectrum of SSIs and the antimicrobial susceptibility pattern with a view to provide guide to the clinicians for making rational decision over the choice of antibiotics in the management of surgical site infection. Material and Methods: This cross-sectional study was carried out in a tertiary care hospital and the 560 samples were collected, processed in the microbiology laboratory and evaluated for the study. Results: Out of 376 growth positive samples, Gram Negative Bacilli (GNB) were isolated from 271 (72%) samples and Gram Positive Cocci (GPC) were isolated from 105 (28%) samples. Among the isolated GNB, only 5 to 10% were sensitive to third generation Cephalosporins. Sensitivity to Fluroquinolones (Ciprofloxacin and Levofloxacin) was also low (Only 5% to 10% were sensitive). Only 3 to 15% of the GNB were found sensitive to Co-amoxiclav and 6.5% to 23% were sensitive to Ampicillin-Sulbactam. About 60% of the Pseudomonas aeruginosa and about 40% of the Klebsiella spp and Acinetobacter baumanii were found resistant to Meropenem. Conclusion: Gram Negative Bacilli predominated over Gram Positive Cocci in surgical site infections in our set up. Very low sensitivity to 3rd generation Cephalosporins, Ampicillin, Co-amoxiclav and Fluroquinolones was noted among GNB isolates and an increasing pattern of resistance to Aminoglycosides and Carbapenems was also noted among MDR Pseudomonas aeruginosa and Acinetobacter baumanii isolates. More than 50% of the MDR Acinetobacter spp. were was found sensitive to Ampicillin-Sulbactam and Minocycline.

Background: Prescription audit is one of the methods to assess the drug utilization pattern and rational use of drugs. In our country the value of drugs prescribed is in crores but a significant proportion of drugs is prescribed irrationally. This is probably due to defect in prescription pattern, lack of knowledge in health care personnel, pressure from drug manufacturing companies and many more. To promote rational use of drugs, standard policies must be set and this can be achieved only after auditing current prescription practices.Methods: A prospective study was carried out in Medical college hospital, Raigarh in the month of January 2018. Around 1000 prescriptions were collected randomly from pharmacy and the prescriptions were analysed on various parameters like patient’s demography, parts of a prescription, information related to doctor and drugs.Results: In this study, we found that percentage of generic drugs were 58.02% and 70.43% drugs were from essential drug list. Only 13.19% FDCs were used. 34 prescriptions were illegible and capital letters were used only in 26 prescriptions. We also found deficiency in parts of a prescription like inscription part (13.3%), subscription part (26.9%) and in doctor’s identity (33.2%). The majority of drugs were antimicrobials (23.81%) followed by anti-inflammatory and analgesics (21.1%).Conclusions: This study shows that the use of generic drugs and essential drugs is on the lower side as compared to standard guidelines. The prescription pattern was defective in many prescriptions. This study shows incompleteness of prescriptions and proper steps are needed to guide the physicians to promote rational use of drugs.

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Rational use of corticosteroids is very essential for improving patient safety on long term use. The present study aimed to study the prescribing usage pattern of corticosteroids in a tertiary care hospital. A prospective observational study was conducted in the department of dermatology, gynecology and general medicine in a tertiary care teaching hospital for the period of 6 months (August-February). All patients receiving any category of Steroid therapy were included and the prescribing and tapering pattern of steroids were reviewed. Prescribing pattern was observed and analysed in 132 participants during the study period. Cases were collected from the departments of Dermatology, General Medicine, Pediatrics and Gynecology in Gandhi Hospital, Secunderabad. All the prescriptions containing steroids were included in this study and the parameters evaluated were gender distribution, age of the patients, types of steroids according to the route of administration, number of prescribed daily dose (PDD) where compared with defined daily dose (DDD). In the collected 132 cases, 162 times corticosteroids were prescribed. The steroid utilization was found to be more in female patients, the maximum number of cases with corticosteroids was found in Dermatology department (39.4%). Particularly Injection Dexamethasone (24.7%) and Tablet Prednisolone (24.7%) are mostly prescribed. Most drugs were prescribed rationally although some factors like improper history,drug administration time and tapering were deviating away from rationality. Although most of the drugs were prescribed rationally, involvement of a Clinical pharmacist in patient care can help in more rational prescribing along with prevention and early detection of ADRs which can directly promote drug safety and better patient outcomes.

This paper contained some notations connected with algebraic number theory and indicates some of its applications in the Gaussian field namely K(i) = √((-1) )..