Cost variation analysis of commonly prescribed anti-diabetic drugs available in Indian market: a pharmaco-economic study

Background: Diabetes mellitus (DM) is a chronic metabolic disorder requiring lifelong treatment. Due to rapid expansion of urbanization, unhealthy diet habits and sedentary lifestyle, the incidence of DM is increasing. The chronic nature of DM causes significant personal suffering and economic difficulty to families. The was aimed at investigating the cost difference in various brands of the same oral anti-diabetic drug.Methods: The minimum and the maximum cost in rupees (INR) of a particular anti-diabetic drug manufactured by various pharmaceutical companies were obtained from current index of medical specialties (CIMS) website, Indian drug review (IDR) 2021 issue and National pharmaceutical pricing authority-pharma sahi daam. The cost ratio and percentage cost variation were noted for each brand.Results: Amongst single drug therapy, metformin 500 mg sustained release showed highest price variation (3668%). Minimum cost variation was found with glipizide 2.5 mg (65%). Amongst the fixed dose combinations, highest cost variation was seen with glimepiride 2 mg+metformin 1000 mg (2703%) while minimum cost variation was found with repaglinide 1 mg+voglibose 0.3 mg (29%).Conclusions: A noticeable cost variation was found in different brands of the same anti-diabetic drug. Prescribing a more expensive brand when a cheaper one is available can burden the patient financially and thus reduce patient compliance. In addition, the Government should also include more anti-diabetic drugs under the price control policy to ensure that affordable and efficacious medicines are available to all.Background:  Diabetes mellitus (DM) is a chronic metabolic disorder requiring lifelong treatment. Due to rapid expansion of urbanization, unhealthy diet habits and sedentary life style, the incidence of DM is increasing .The chronic nature of DM causes significant personal suffering and economic difficulty to families. The present study aims at investigating the cost difference in various brands of the same oral anti-diabetic drug.Methods: The minimum and the maximum cost in rupees (INR) of a particular anti-diabetic drug manufactured by various brands were obtained from Current Index of Medical Specialties (CIMS) website, Indian Drug Review (IDR) 2021 issue and National Pharmaceutical Pricing Authority – Pharma sahi daam. The cost ratio and percentage cost variation were noted for each brand.Results: Amongst single drug therapy, Metformin 500mg Sustained Release showed highest price variation (3668%). Minimum cost variation was found with Glipizide 2.5mg (65%).Amongst the fixed dose combinations, highest cost variation was seen with Glimepiride 2mg + Metformin 1000mg (2703%) while minimum cost variation was found with Repaglinide 1mg + Voglibose 0.3mg (29%). Conclusions: A noticeable cost variation was found in different brands of the same anti-diabetic drug. Prescribing a more expensive brand when a cheaper one is available can burden the patient financially and thus reduce patient compliance. In addition, the Government should also include more anti-diabetic drugs under the price control policy to ensure that affordable and efficacious medicines are available to all. Keywords: Anti-diabetic agents, Cost variation, Pharmaco-economics, Adherence, Brands   Background:  Diabetes mellitus (DM) is a chronic metabolic disorder requiring lifelong treatment. Due to rapid expansion of urbanization, unhealthy diet habits and sedentary life style, the incidence of DM is increasing .The chronic nature of DM causes significant personal suffering and economic difficulty to families. The present study aims at investigating the cost difference in various brands of the same oral anti-diabetic drug.Methods: The minimum and the maximum cost in rupees (INR) of a particular anti-diabetic drug manufactured by various brands were obtained from Current Index of Medical Specialties (CIMS) website, Indian Drug Review (IDR) 2021 issue and National Pharmaceutical Pricing Authority – Pharma sahi daam. The cost ratio and percentage cost variation were noted for each brand.Results: Amongst single drug therapy, Metformin 500mg Sustained Release showed highest price variation (3668%). Minimum cost variation was found with Glipizide 2.5mg (65%).Amongst the fixed dose combinations, highest cost variation was seen with Glimepiride 2mg + Metformin 1000mg (2703%) while minimum cost variation was found with Repaglinide 1mg + Voglibose 0.3mg (29%). Conclusions: A noticeable cost variation was found in different brands of the same anti-diabetic drug. Prescribing a more expensive brand when a cheaper one is available can burden the patient financially and thus reduce patient compliance. In addition, the Government should also include more anti-diabetic drugs under the price control policy to ensure that affordable and efficacious medicines are available to all. Keywords: Anti-diabetic agents, Cost variation, Pharmaco-economics, Adherence, Brands   Background:  Diabetes mellitus (DM) is a chronic metabolic disorder requiring lifelong treatment. Due to rapid expansion of urbanization, unhealthy diet habits and sedentary life style, the incidence of DM is increasing .The chronic nature of DM causes significant personal suffering and economic difficulty to families. The present study aims at investigating the cost difference in various brands of the same oral anti-diabetic drug.Methods: The minimum and the maximum cost in rupees (INR) of a particular anti-diabetic drug manufactured by various brands were obtained from Current Index of Medical Specialties (CIMS) website, Indian Drug Review (IDR) 2021 issue and National Pharmaceutical Pricing Authority – Pharma sahi daam. The cost ratio and percentage cost variation were noted for each brand.Results: Amongst single drug therapy, Metformin 500mg Sustained Release showed highest price variation (3668%). Minimum cost variation was found with Glipizide 2.5mg (65%).Amongst the fixed dose combinations, highest cost variation was seen with Glimepiride 2mg + Metformin 1000mg (2703%) while minimum cost variation was found with Repaglinide 1mg + Voglibose 0.3mg (29%). Conclusions: A noticeable cost variation was found in different brands of the same anti-diabetic drug. Prescribing a more expensive brand when a cheaper one is available can burden the patient financially and thus reduce patient compliance. In addition, the Government should also include more anti-diabetic drugs under the price control policy to ensure that affordable and efficacious medicines are available to all. Keywords: Anti-diabetic agents, Cost variation, Pharmaco-economics, Adherence, Brands        

Terahertz Logic Gate Operations in a Toroidal Metasurface

The applications of terahertz metamaterials are being actively explored in recent times for applications in high-speed communication devices, miniature photonic circuits, and bio-chemical devices because of their wide advantages. The toroidal resonance, a new type of metasurface resonance, has been examined with great interest to utilize its properties in terahertz metasurface applications. The study reports a proof of concept design of a toroidal metasurface that experimentally demonstrates logic gate operations in the terahertz frequency regime by passive tuning of the split ring resonators compromising the meta-atom design. The amplitude modulation is utilized as a method of determining the Boolean logic output of the system. The proposed metasurface could be further optimized for high amplitude modulations, as well as for active logic gate operations using tunable materials including graphene and ITO. The proposed metasurface consists of three split-ring resonators, and the near-field coupling between the adjacent resonators dictates the logic gate operations. The toroidal excitation in the metasurface is determined by a multipole analysis of the scattered powers of terahertz radiation. The proposed metasurfaces experimentally define AND Boolean logic gate at 0.89 terahertz, and OR Boolean logic gate at 0.97 terahertz. Numerical simulations support the experimentally obtained results. Additionally, we numerically report the excitation of NAND gate at 0.87 THz. Such toroidal logic-gate metasurfaces in the terahertz region could find applications in digitized terahertz circuits for photonic device applications

Intubation of a neonate with glossopalatine ankylosis using a paraglossal approach and a laryngoscope with a straight blade

Glossopalatine ankylosis presents a challenge to the anaesthesiologist because of its intraoral attachment which obstructs the view of the oral cavity. When preoperative assessment by direct laryngoscopy is possible, a paraglossal approach using a straight blade can be used in such cases. We share our anaesthesia experience of a neonate with glossopalatine ankylosis.Keywords: glossopalatine ankylosis, paraglossal straight blade laryngoscopy, glossopalatine bands, direct laryngoscopy, endotracheal intubatio

Practice and problems regarding oral hygiene: study among female medical undergraduate students of tertiary care hospital, Pune, India

Background:As a health provider to community, a doctor should himself be aware of his oral health and undergraduate medical students who are future health professionals should also be well aware of their dental hygiene. Hence with an aim to assess the practice and problems about dental hygiene amongst female medical undergraduate students, this study was planned. Objective of the study was to assess the practices and problems regarding oral hygiene among female undergraduate medical students and efforts taken by them to solve these problems.Method: A cross-sectional study was undertaken among female undergraduate medical students residing in a hostel of a medical college.Results: 56.7% girls were using soft tooth brush, 69.3% students change their tooth brush every 6 monthly and 63.3% of them were brushing only once in a day. 79.3% were rinsing teeth after snack or meal. The percentage of students who were using mouth wash and tongue cleaner was 27.3% and 52% respectively. Bad breath was faced by only 9.33% of students, 39.33% were having cavities and 49.33% were having problem of plaque. 25.3% had never visited dentist. Scaling was performed by only 24.7% students and among them only 1.33% did it 6 monthly. It was observed that students using mouth wash 22.2% had significantly less problem of bad breath as compared to students who were not using 6.7%. Significantly larger numbers of students, with problem of cavities were observed to use mouth wash 60% and floss 68% as compared to those who did had this complaint.Conclusion: The study highlights the fact that preventive behaviour among medical students increased after they experienced some or the other oral health problem for which they were advised to follow these preventive practices so that the severity and extent of the disease does not progress. Further research is required on a larger scale so that the ways to increase the promotive and preventive oral health practices can be identified (e.g. behaviour change communication) to prevent the occurrence of oral health problems.

GC-47 Key Professional Dataset - Dataspider

The purpose of this project is to build a Web Crawler to extract personal information from a public website like Reddit and LinkedIn. We completed the Instagram crawling as a bonus for the project. The team will be using MySQL or any other open source relational database to organize the data and conduct a quantitative data analysis on it.Advisors(s): Dr. Han - Professor IT7993 Capstone Jing Wang -Project SponsorTopic(s): Data/Data AnalyticsIT799

Machine Learning Based Method to Design a Facial Emotion Detection and Chat Bot System

One of the active areas of research trends is recognizing emotions in images. This project aims to identify facial emotions. The research concept in Emotion Recognition is included in the flow of our emotion recognition. These involve image acquisition, image pre-processing, face detection, feature extraction, and classification, with the machine being applied after the emotion have been classified.  Our framework relies on already-existing still images. This project aims to improve automated facial emotion recognition and build interaction between the system and the user (bot)

Optical Spectroscopy of the environment of a ULX in NGC 7331

Optical photometric and spectroscopic data are presented that show an association of an ultraluminous X-ray source in NGC 7331 with a young star cluster of mass 1.1e5 solar masses and age 4.25 Myr. If the ULX is part of the bright stellar cluster, then the mass of the progenitor of the compact accretor must have been greater than about 40-50 solar masses in order to already have evolved through the supernova stage to a compact object. The companion star is also likely an evolved massive star. The emission line spectrum of the nebula surrounding the cluster can be interpreted as a result of photoionization by the cluster OB stars with an additional source of shock excitation producing strong [SII], [OI] and NII lines. This additional source appears to be as much as five times more powerful than the supernovae and stellar winds in the cluster can provide. Additional mechanical energy input associated with the ULX itself can help explain the residual shock excited line luminosities of the emission region.Comment: 17 pages, accepted to Ap

Review of ectopic pregnancy at tertiary care center: 2 years analysis

Background: Ectopic pregnancy is defined as any intra or extra-uterine pregnancy in which the fertilized ovum implants at an aberrant site which is inconducive to its growth and development. It is a catastrophic and life-threatening condition and one of the commonest acute abdominal emergencies affecting approximately 2% of all pregnancies. The purpose of this study is to review cases of ectopic pregnancy and determine: incidence, high risk factors, types of clinical presentation, diagnostic methods, management, morbidity and mortality.Methods: The present study, conducted over a period of 2-year, total number of deliveries was 16,144 and total number of ectopic pregnancies was 116. More than half of the cases (56.04%) had one or the other identifiable risk factor. Results: Amongst the various risk factors studied, history of previous pelvic surgery (15.43%), history of Pelvic inflammatory disease (PID) (12.9%), use of Intrauterine contraceptive device (IUCD) (10.3%) and either spontaneous or induced abortion (7.76%) has been found. History of self-administered medical termination of pregnancy (MTP) pill was present in 3.45%. Repeat ectopic pregnancies were seen in 1.72%. There was no identifiable risk factor in 49.63% of cases.Conclusion: Ectopic pregnancy is a major challenge in obstetrical practice because of its varied clinical presentation. It can be diagnosed early by keeping a high index of suspicion. Undue delay in referral reduces significant morbidity and improves the chances of preserving future fertility. Mass education regarding safe abortion practices and post abortal care should be promoted. Unsupervised usage of MTP pill intake should be condemned.

Congenital Anterior Urethral Diverticulum in Children: A Case Report and Review

Congenital anterior urethral diverticulum (CAUD) is an uncommon condition in children. We describe 2 patients of CAUD who presented with ventral penile swelling; in one, the site of swelling was just proximal to corona which is quite rare. The diagnosis was made on USG and MCU. Both patients had normal renal function. Open diverticulectomy and primary repair was done in both patients

Properties of the Chandra Sources in M81

The Chandra X-ray Observatory obtained a 50-ks observation of the central region of M81 using the ACIS-S in imaging mode. The global properties of the 97 x-ray sources detected in the inner 8.3x8.3 arcmin field of M81 are examined. Roughly half the sources are concentrated within the central bulge. The remainder are distributed throughout the disk with the brightest disk sources lying preferentially along spiral arms. The average hardness ratios of both bulge and disk sources are consistent with power law spectra of index Gamma~1.6 indicative of a population of x-ray binaries. A group of much softer sources are also present. The background source-subtracted logN-logS distribution of the disk follows a power law of index ~ -0.5 with no change in slope over three decades in flux. The logN-logS distribution of the bulge follows a similar shape but with a steeper slope above ~4.0e+37 ergs/s. There is unresolved x-ray flux from the bulge with a radial profile similar to that of the bulge sources. This unresolved flux is softer than the average of the bulge sources and extrapolating the bulge logN-logS distribution towards weaker sources can only account for 20% of the unresolved flux. No strong time variability was observed for any source with the exception of one bright, soft source.Comment: 5 pages, 3 color PS figures, to appear in ApJ