Pharmacoeconomic analysis of brimonidine/timolol and travoprost 0.004% in the treatment of primary open angle glaucoma in Indian settings

Background: As we know primary open angle glaucoma need lifelong treatment. It possess financial burden to patient. We have done this study to compare the monthly cost and cost effectiveness of brimonidine /timolol fixed combi-nation and Travoprost 0.004% eye drops in patients of primary open angle glaucoma.Methods: Drops were dispensed at room temperature from 2.5-mL bottles of Travoprost, and 5ml of Brimonidine/Timolol. Two determinations of drop count were taken, each made from bottles held vertically and at a 45-degree angle. The total volumes of medication dispensed from each bottle were measured. Drops in five new bottles were counted and averaged for each drug. Drugs given to patients and asked them to come back with empty bottles for follow up after 2, 4, 8, 12 wks. IOP was measured and another bottle of drug is given. Average retail price was determined by survey of different brands available in market. Drop count, average retail price, and IOP reduction data were used to compute annual cost and cost effectiveness (annual cost per mmHg of IOP reduction) of both of the drugs.Results: Drops per 2.5ml bottle averaged 83 for Travoprost 0.004% and 100 drops per 5ml bottle for Brimonidine/Timolol. Average retail cost per bottle was 498 for Travoprost 0.004% and 204 for Brimonidine/Timolol. Annual re-tail cost was 3545 for Brimonidine/Timolol and 4910 for Travoprost 0.004%. Cost effectiveness ranges were 328 to 361 for Brimoni-dine/Timolol and 629 to 637 for Travoprost 0.004%.Conclusions: Brimonidine/Timolol had the lower monthly cost and annual cost and it is more cost effective than Travoprost 0.004%

Evaluation of analgesic activity of Aegle marmelos steam bark in experimental animals

Background: Alleviation of pain has always remained a prime concern of medicine. Numbers of anti-inflammatory and analgesic drugs like aspirin, indomethacin, phenylbutazone etc. are in practice, but because of their side effects, there is extensive search for new drugs and molecules with fewer side effects. Search for newer anti-inflammatory and analgesic agents having better or at least equal efficacy with minimal side effects is continuing throughout the world. Therefore, the search should continue and it is felt that herbal medicine has still a lot in store. Aegle marmelos is one of the most frequently used plant in the traditional and folklore systems of medicine and in religious rituals. Various activities of different parts like roots, leaves, flowers, fruits and seeds of AM were evaluated. It has analgesic, anti-inflammatory, antipyretic, antidiabetic, antioxidant, hepatoprotective and many other activities.Methods: Analgesic activities of AMSBAE (50,100 and 200 mg/kg p.o.) were studied using tail flick test and acetic acid-induced writhes in rats and mice respectively.Results: AMSBAE produces dose dependent analgesic activity in the tail flick test and acetic acid-induced writhing in mice (P<0.05).Conclusions: AMSBAE has analgesic activity. The analgesic activity of AMSBAE was comparable to that of tramadol and Aspirin. Hence, AMSBAE could be a possible alternative to NSAIDs

Effect of composition and thermal history on deformation behavior and cluster connections in model bulk metallic glasses

The compositional dependence and influence of relaxation state on the deformation behavior of a Pt-Pd-based bulk metallic glasses model system was investigated, where platinum is systematically replaced by topologically equivalent palladium atoms. The hardness and modulus increased with rising Pd content as well as by annealing below the glass transition temperature. Decreasing strain-rate sensitivity and increasing serration length are observed in nano indentation with increase in Pd content as well as thermal relaxation. Micro-pillar compression for alloys with different Pt/Pd ratios validated the greater tendency for shear localization and brittle behavior of the Pd-rich alloys. Based on total scattering experiments with synchrotron X-ray radiation, a correlation between the increase in stiffer 3-atom cluster connections and reduction in strain-rate sensitivity, as a measure of ductility, with Pd content and thermal history is suggested

Kinematic, Dynamic and Gait Analysis for Navigation of NAO Humanoid Robot in a Cluttered Environment

Today’s humanoid robots are viewed as an entertainment robot in a larger sense and as a human assistive robot to some extent. Due to its wide popularity amongst the community, it poses a challenge for researchers to mimic the human dexterity in an artificial biped locomotion system. With the growing technology, these robots are being developed for planetary exploration along with other mobile robots to further improve the maneuverability in a cluttered environment. Also, it represents the platform to incorporate the biomechanics of human locomotion to aid prosthetics and aesthetics. This dissertation underwent the kinematic, dynamic and gait analysis of humanoid robot walking. The kinematics of humanoid robot is analyzed on NAO humanoid robot in a simulation environment that involves forward and inverse kinematics. The analysis is performed in a view to demonstrate the relationship between the end-effector position and joint angles of the kinematic linkage (legs). Following the kinematics, Zero Moment Point (ZMP) and dynamics of the humanoid robot have been analyzed that focuses on the physics of biped walking in a simulation environment. Additionally, using pseudo inverse kinematics method, a robust gait for NAO robot has been generated and implemented on NAO in the simulation. The applicability of the derived gait has been validated on NAO humanoid robot. Finally, a hybrid GA-ANFIS intelligent method has been derived and implemented for path planning of humanoid robot in a cluttered environment

Incidence of hemidiaphragmatic paresis after peripheral nerve stimulator versus ultrasound guided interscalene brachial plexus block

Background and Aims: We compared interscalene brachial plexus block (ISBPB) using peripheral nerve stimulation (PNS) and ultrasound (US) techniques. The primary outcomes were the incidence of hemidiaphragmatic paresis (HDP) and the duration of the block. Secondary outcomes were the block success rate, time to conduct the block, onset of sensory block, and dermatomal spread, postoperative pain by Numeric Rating Scale (NRS), duration of postoperative analgesia and incidence of complications. Material and Methods: We conducted a prospective, randomized, and observer-blinded study in 60 patients undergoing shoulder arthroscopy under block plus general anesthesia. ISBPB was performed with 10 ml of 0.5% bupivacaine using either PNS (Group PNS, n = 30) or US (Group US, n = 30). Hemidiaphragmatic function, the primary outcome, was assessed by ultrasonographic evaluation of diaphragmatic movement and pulmonary function tests using a bedside spirometer (forced vital capacity, forced expiratory volume in 1 s and peak expiratory flow rate). General anesthesia was administered to all the patients for surgery. P < 0.05 test was considered to be statistically significant. Results: Twelve patients in Group PNS had HDP and none in Group US (P < 0.0001). PFTs were also significantly reduced in Group PNS (P < 0.0001). The time to conduct the block and sensory onset time both were less in Group US (P < 0.05). The groups did not differ in block success rate, duration of analgesia, and NRS. Other complications like incidence of Horner′s syndrome and vascular puncture were comparable in both the groups. Conclusions: PNS guided ISBPB with 10 ml of 0.5% bupivacaine is associated with a higher incidence of HDP as compared to US guided ISBPB. There is no significant difference in quality or duration of analgesia in the two groups