Comparison of different brands of centrally acting skeletal muscle relaxants: a cost analysis study

Background: Skeletal muscle relaxants are structurally distinct drugs prescribed for reducing muscle spasms, pain, and hyperreflexia. Centrally acting skeletal muscle relaxants are manufactured by various pharmaceutical companies with variable price. The present study, aimed to analyze the cost variation of various brands of centrally acting skeletal muscle relaxants, so as to help the physician to choose the cost effective treatment.Methods: Current index of medical stores (CIMS) April 2018 and online literature were used as information guide to review the prices of drugs used in the treatment of musculo skeletal pain and spastic neurological disorders.Results: Among anti spasmodic group, thiocolchicoside 4 mg shows maximum price variation of 337.5%, whereas carisoprodol 350 mg shows the least variation of 0.1%. It is evident from antispastic group that baclofen 10 mg shows maximum price variation of 93.91% and 5 mg of Baclofen shows the least variation of 11.22%. It is observed that, among anti spastic group, a percentage prize variation of 93.91 for 10 mg and 11.22 for 5 mg baclofen. Largest % prize variation is seen in metaxalone + diclofenac sodium (400+50) mg as 525% and the least variation is observed in tolperisone+ paracetamol (150+325) mg as 3.88%.Conclusions: Centrally acting orally effective skeletal muscle relaxants are commonly prescribed for painful musculoskeletal and spastic neurological disorders. Physicians should give due importance for the cost of the drugs while selecting appropriate drug for musculo skeletal disorders

Preclinical toxicological evaluation of Aloe vera health drinks in wistar rats

Human consumption of Aloe vera as a beverage has recently increased in popularity. These benefits are controversial with some sources pointing out that the putative effects of aloe are unsupported by clinical studies; it is important that marketed products be tested for toxicities following oral consumption. Hence this study was designed to evaluate the toxicological effect of marketed aloe health drinks. Thirty either sex Wistar rats (200-300gm) were enrolled in this study and are divided into 5 groups. Group I receives Normal saline serves as vehicle control, Group II and III receives Product A- Low dose (0.5 ml twice daily, p.o) and High dose (1.0 ml twice daily, p.o) respectively. Group IV and V receives Product B- Low dose (0.5 ml twice daily, p.o) and High dose (1.0 ml twice daily, p.o) respectively. Weekly body weight and daily feed intake were measured. On 28th day total urine output volume, faecal consistency, Haematological, biochemical, and organ weight were measured to assess the toxicity of aloe health drinks. The result of this study shows that continuous usage of aloe health drinks showed milder weight reduction, significant improvement in erythropoiesis also it increases the WBC count and increases the weight of spleen it may confirm the immune modulatory effect of aloe health drink. At the higher doses, it increased the SGOT, SGPT, serum urea and creatinine it may lead to the hepatotoxicity and nephrotoxicity. In gastrointestinal tract on prolonged uses, it produced few lesions and diarrhoea. It might be concluded that prolonged consumption of unprocessed aloe health drink contains latex, an ingredient which has many health risks associated with it. So it can aggravate health problems

Investigation and validation of PV fed reduced switch asymmetric multilevel inverter using optimization based selective harmonic elimination technique

Pulse width modulation for Selective Harmonics Elimination (SHE) is mostly employed in the reduction of lower order harmonics. The PV system in this research provides input voltage to the reduced switch 31-level inverter, which is based on the Artificial Bee Colony algorithm. With a high gain DC-DC single-ended primary-inductor converter (SEPIC), the PV panel output voltage is kept constant. The Grey wolf optimization algorithm (GWO) approach is used to get the most power out PV scheme. Multi Carrier modulation, a high-frequency modulation technology, is also used in this novel design of the inverter to reduce upper order harmonics. The suggested Artificial Bee Colony (ABC) algorithm, harmonics is compared to a SHE technique based on a genetic algorithm. The hardware findings were confirmed using DSPIC30F2010 controller simulation, and the recommended system was validated using Matlab simulation

Feasibility of an Alcohol Intervention Programme for TB Patients with Alcohol Use Disorder (AUD) - A Qualitative Study from Chennai, South India

The negative influences of alcohol on TB management with regard to delays in seeking care as well as non compliance for treatment has been well documented. This study is part of a larger study on the prevalence of AUD (Alcohol Use Disorder) among TB patients which revealed that almost a quarter of TB patients who consumed alcohol could be classified as those who had AUD. However there is dearth of any effective alcohol intervention programme for TB patients with Alcohol Use Disorder (AUD).This qualitative study using the ecological system model was done to gain insights into the perceived effect of alcohol use on TB treatment and perceived necessity of an intervention programme for TB patients with AUD. We used purposive sampling to select 44 men from 73 TB patients with an AUDIT score >8. Focus group discussions (FGDs) and interviews were conducted with TB patients with AUD, their family members and health providers.TB patients with AUD report excessive alcohol intake as one of the reasons for their vulnerability for TB. Peer pressure has been reported by many as the main reason for alcohol consumption. The influences of alcohol use on TB treatment has been elaborated especially with regard to the fears around the adverse effects of alcohol on TB drugs and the fear of being reprimanded by health providers. The need for alcohol intervention programs was expressed by the TB patients, their families and health providers. Suggestions for the intervention programmes included individual and group sessions, involvement of family members, audiovisual aids and the importance of sensitization by health staff.The findings call for urgent need based interventions which need to be pilot tested with a randomized control trial to bring out a model intervention programme for TB patients with AUD

Influence of Temperature and Humidity on Pregnancy Rate of Murrah Buffaloes under Subtropical Climate

Heat stress has adverse effects on fertility of dairy animals. Decline in fertility is linearly associated with an increase in combination of both temperature and humidity. The purpose of this study was to investigate the relationship between temperature humidity index (THI) and the pregnancy rate of Murrah buffaloes in a subtropical climate. The effects of genetic and non-genetic factors viz., sire, parity, period of calving and age group at first calving were found non-significant on pregnancy rate. The effect of THI was found significant (p<0.001) on pregnancy rate of Murrah buffaloes calved for first time and overall pregnancy rate. The threshold THI affecting the pregnancy rate was identified as THI 75. The months from October to March showed THI<75 and considered as non heat stress zone (NHSZ), while months from April to September were determined as heat stress zone (HSZ) with THI≥75. The lowest overall pregnancy rate (0.25) was obtained in July with THI 80.9, while the highest overall pregnancy rate (0.59) was found in November with THI 66.1. May and June were identified as critical heat stress zone (CHSZ) within the HSZ with maximum decline (−7%) in pregnancy rate with per unit increase in THI. The highest overall pregnancy rate was estimated as 0.45 in NHSZ with THI value 56.7 to 73.2. The pregnancy rate was found to have declined to 0.28 in HSZ with THI 73.5 to 83.7. However, the lowest pregnancy rate was estimated as 0.27 in CHSZ with THI value 80.3 to 81.6

Activating the knowledge-to-action cycle for geriatric care in India

Despite a rapidly aging population, geriatrics - the branch of medicine that focuses on healthcare of the elderly - is relatively new in India, with many practicing physicians having little knowledge of the clinical and functional implications of aging. Negative attitudes and limited awareness, knowledge or acceptance of geriatrics as a legitimate discipline contribute to inaccessible and poor quality care for India's old. The aim of this paper is to argue that knowledge translation is a potentially effective tool for engaging Indian healthcare providers in the delivery of high quality geriatric care. The paper describes India's context, including demographics, challenges and current policies, summarizes evidence on provider behaviour change, and integrates the two in order to propose an action plan for promoting improvements in geriatric care

The DECIDE project: from surveillance data to decision-support for farmers and veterinarians

Farmers, veterinarians and other animal health managers in the livestock sector are currently missing sufficient information on prevalence and burden of contagious endemic animal diseases. They need adequate tools for risk assessment and prioritization of control measures for these diseases. The DECIDE project develops data-driven decision-support tools, which present (i) robust and early signals of disease emergence and options for diagnostic confirmation; and (ii) options for controlling the disease along with their implications in terms of disease spread, economic burden and animal welfare. DECIDE focuses on respiratory and gastro-intestinal syndromes in the three most important terrestrial livestock species (pigs, poultry, cattle) and on reduced growth and mortality in two of the most important aquaculture species (salmon and trout). For each of these, we (i) identify the stakeholder needs; (ii) determine the burden of disease and costs of control measures; (iii) develop data sharing frameworks based on federated data access and meta-information sharing; (iv) build multivariate and multi-level models for creating early warning systems; and (v) rank interventions based on multiple criteria. Together, all of this forms decision-support tools to be integrated in existing farm management systems wherever possible and to be evaluated in several pilot implementations in farms across Europe. The results of DECIDE lead to improved use of surveillance data and evidence-based decisions on disease control. Improved disease control is essential for a sustainable food chain in Europe with increased animal health and welfare and that protects human health