Our standard policy for the management of retention of urine due to prostatic hypertrophy is that the patient is catheterised and sent home, later to be seen and assessed in the Out-patient Department where he is given an admission date for operation. A detailed audit of 166 patients cared for in this way is presented and the results compared with those in 25 patients who remained in hospital in the interval between catheterisation and operation and in 402 patients not previously catheterised. Although the mortality rate was significantly higher in the retention group (3.3 vs 0.25%), we feel that this is a reflection of the fitness of the patients with retention rather than a consequence of the management policy. The advantages of the "catheterise and send home" policy are discussed.

CONTEXT: The acquisition of antibiotic without a prescription by the general population is a typical practice found in community pharmacies across India, which is a notable contributor of antimicrobial resistance. According to the present regulation in India, sale of certain antimicrobials included in schedule H1 without prescription is unlawful. In this contest, a program was organized by the Drug Control Administration, Government of Andhra Pradesh, to educate pharmacists regarding schedule H1. AIMS: The aim of our study is to assess the impact of the program on the rate of antibiotics dispensed at community pharmacies. SETTINGS AND DESIGN: A cross-sectional study was designed to investigate the nonprescription sale of antibiotics, from September to December 2018 through 200 community pharmacies located in and around Guntur city located in the state of Andhra Pradesh in India. SUBJECTS AND METHODS: A simulated client methodology was used in this study. A total of 3 female actors including an author of this present study are prior trained to present a standardized simulation of clinical conditions (sore throat, urinary tract infection, cold, and fever) to the pharmacist at the community pharmacies. STATISTICAL ANALYSIS USED: Microsoft excel sheet was used for data analysis. RESULTS: The simulated patients successfully obtained antibiotic from 78% pharmacies with the highest rate of urinary tract infection when compared to other conditions. Pharmacists who objected to dispense antibiotics (22%) are found in developed locations in the city and appeared well qualified. CONCLUSIONS: The present study revealed that the antibiotics are continued to be sold without prescription even after the education program on schedule H1. The deregulation of the act is definitely the problem to be addressed by the government.

Anticoagulants used for many indications, both prophylaxis and therapeutic treatment, are associated with high risk, hence drug utilization evaluation is essential. Objective: The objectives of the study were to evaluate the drug utilization of anticoagulants, assessment of anticoagulant cost in the prescription, identify and assess drug interactions with the use of anticoagulants. Method: This is a 6 months, prospective cross sectional study, evaluating 263 patients for their prescriptions containing anticoagulants in a tertiary care hospital in south India. Results: During the study period, among anticoagulants prescribed, Heparin is found most commonly prescribed for treatment as well as prophylaxis mainly in the cardiology and neurology wards. Acenocoumarol was the second most prescribed anticoagulant followed by Dalteparin Warfarin and Rivaroxaban. Intravenous heparin was prescribed in majority of inpatients of all the departments followed by Acenocoumarol and Enoxaparin. Only few Patients from departments other than cardiology and neurology are prescribed with Enoxaparin, Dalteparin Warfarin and Rivaroxaban. In the discharge prescriptions, Acenocoumarol and Enoxaparin were mainly observed. Among all the prescriptions, 7 cases are found to be prescribed with anticoagulants without any indication, which may increase treatment cost burden on patients. Dose adjustment for lower molecular weight heparin for patients with renal impairment was observed in the present hospital. But the monitoring parameters PT, PTT & INR are performed only in few patients. Moderate drug interactions are found in the prescriptions with mainly heparin and Acenocoumarol.

Identifying the targets for improving antimicrobial prescription and development of antimicrobial stewardship interventions can better serve to combat the situation of antimicrobial resistance. The primary objective was to determine the prevalence of antimicrobial use at tertiary care teaching hospital with both acute and long-term care patients. A periodical point prevalence survey was done in a tertiary care hospital of South India during 2019 using manual and webbased GLOBAL-PPS tool. Of 945 patients eligible for the study, 645 (69.5 %) received at least one antibiotic, with highest rates in the adult surgical ward and pediatrics. Of 645 therapeutic antibiotic prescriptions, 58.6% prescriptions have an infectious indication of them, 62.6% are community-acquired infections. Third-generation cephalosporins were the most prescribed antibiotics. The prevalence of antibiotic use is very high, and our study evidence that the country needs a robust antimicrobial stewardship intervention program.