Pattern of prescribing practices in the Madhya Pradesh, India.

OBJECTIVES: To find out the current status of the 'prescribing practices' in the Primary Health Care facilities of Madhya Pradesh. MATERIAL AND METHODS: The cross-sectional survey was conducted in 26 Primary Health Care facilities of the Madhya Pradesh. Consecutive random sampling method was applied for collection of prescriptions from the health facilities. OBSERVATION: Overall the average number of drugs prescribed per prescription was 2.8; most commonly prescribed drugs were NSAIDs, antibiotics, multivitamins and antihistaminics. Drugs prescribed by generic name were 48.5% (1409/2906), prescription with antibiotics and injections were 60.9% (641/1052) and 13.6% (143/1052) respectively. Drugs prescribed from Essential Drug List were 66.9% (1944/2906). CONCLUSION: The prescribing practices of the Madhya Pradesh is more of an irrational types like polypharmacy, overuse of antibiotics and injection, less number in generic names and prescribed from Essential Drug List. There is an urgent need for some interventions to improve the situation.

Assessment of transcervical chorion villus aspiration biopsy in early pregnancy.

BACKGROUND. Chorionic villus sampling for prenatal diagnosis is a relatively new technique and variable success rates have been reported by different authors depending on the methods and instruments used. We describe our experience with chorionic villus sampling in Bombay. METHODS. The procedure was attempted on 62 women before termination of their pregnancy via the transcervical route, under constant real-time ultrasound guidance. A metallic cannula was negotiated through the cervix into the uterine cavity to reach the chorionic frondosum and chorionic villi were aspirated by creating a negative pressure in the syringe attached to the cannula. The villus tissue was checked under a dissecting microscope. We calculated the success rate for obtaining a sample depending on the site of the chorionic frondosum, the physique of the mother, the position of the uterus and the size of the cannula. RESULTS. Villus tissue was aspirated in 47 of the 62 cases. The success rates of sampling at the first and second attempts were 48% and 27% respectively. The factors which were associated with a higher success rate were when the chorionic frondosum was situated posteriorly rather than anteriorly (61% v. 48%; p < 0.01), when the patient was thin rather than fat (58% v. 25%; p < 0.001), when the uterus was anteverted rather than retroverted (53% v. 41%). The commonest complication was bleeding which occurred in 15% of patients. CONCLUSION. Transcervical chorionic villus sampling is associated with a high success rate except in fat women with a retroverted uterus and in those with the chorionic frondosum situated in the fundus.