Effect of electrode location and thickness ratio of flange and web on I cross section piezoelectric cantilever beam for its actuation capability

Present work deals with the numerical investigation of a cantilever beam having I cross section made up of piezoelectric material for its actuation capability. The beam is modeled under the assumption of Euler’s Bernoulli equation. Eight cases are considered for different electrode locations. The beam was subjected to voltage loads at different locations. It was noticed that tip deflection increases with increasing applied voltage across the electrodes. Maximum tip deflection was achieved with the increase in voltage with particular electrode arrangement. In this report we have also demonstrated that for downward tip deflection, there are two values of thickness ratio of flange and web for a given tip deflection at a given applied voltage

Performance Comparison of Automated Warehouses Using Simulation

The purpose of this study is to compare the performance of two types of warehouses, both of which use autonomous vehicles (AVs). One warehouse uses movable racks (MR) for storing mini-loads, whereas the other uses fixed racks (FR). In general, warehouse automation not only increases the speed of the fulfillment process but also makes the picking process more accurate. We simulate three scenarios for the MR and FR systems using Simio. Four performance measures are considered for the comparison – the average order processing time (WR), the average utilization of AVs (U), the average order processing queue length (Nq) and the average distance travelled by AVs (d). We also estimate the capital costs of both systems and use it to compare the two systems. On the basis of our assumptions and simulation results, we find that the FR system not only requires an average 56 % less capital investment than the MR system, but it also provides a more efficient warehousing automation option with relatively lower utilization of AVs, lower order processing time and lower average number of orders waiting to be processed

Testicular Vein Syndrome and Its Treatment with a Laparoscopic Approach

A laparoscopic approach was found to be safe and effective for the treatment of a patient with testicular vein syndrome

Retrospective review of profile of intensive care unit admissions and outcomes in a tertiary care hospital of Himalayan region

Background: An Intensive care unit (ICU) is an area where highest level of care is given with close invasive and non-invasive monitoring to a critically ill patient. Medical audit is must to assess the quality care provided and lay down policies for future. Objectives: To review retrospectively the profile of patients admitted to ICU and assess their outcome.Methods: From January 2016 to December 2016, ICU records of all admissions, referred, discharges, and deaths were utilized for the purpose of this study. Data extracted from the records included age, sex, diagnosis and outcome.Results: A total of 2316 patients were admitted to ICU. Males were 1489 (64.3%) and females were 827 (35.7%). Most of the patients (42.8%) were between 46-70 years. Most of the patients were shifted from emergency (48.5%) and it was associated with better outcome. A total of 49.6% patients were shifted out of ICU in stable condition while mortality was 28.6%. Around 21.8% patients left ICU against Medical advice.Conclusions: Majority patients admitted to ICU were of general medicine and neurosurgery. Survival was inversely related to age. Mortality was not associated with sex. Outcome was also related to the source from where patient was admitted

Role of pharmaco-epidemiology in psychopharmacology: a study in psychiatric out-patient department of a tertiary care teaching hospital at Dehradun, Uttarakhand

Background: Prescription auditing studies are a part of drug utilization studies, are beneficial in clinical practice for rational prescribing of drugs and helpful for minimizing the medication errors. They are important tool to promote rational prescribing.Methods: This wasa prospective drug utilization study conducted by the Department of Pharmacology in Psychiatry out-patient department at Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun for a period of 6 months. A total of 311 prescriptions were evaluated for prescribing pattern using World Health Organization drug indicators and National Essential Medicine List (NEML) 2011.Results: A total of 311 prescriptions were evaluated, 157 (50.48%) were females, and 154 (49.52%) were males, mean age was 37.14±0.8 years. Majority of patients were married 207 (66.56%), housewife 116 (37.30%) and belong to middle socioeconomic group 205 (65.92%). A total of 1250 drugs were prescribed, anti-anxiety (anti-A) 379 (30.32%), anti-depressants (anti-Ds) 348 (27.84%), anti-psychotics (anti-Ps) 118 (9.44%), anti-epileptics (anti-Es) 64 (5.12%), mood stabilizer 20 (1.6%), anti-cholinergics 28 (2.24%) and others 293 (23.44%). Oral formulations 1247 (99.76%), 4.02 drugs/prescription, 100% drugs were prescribed by brand names. 220 (17.6%) fixed dose combinations were prescribed. Most frequently prescribed among anti-A drugs were propranolol 160 (42.22%) and diazepam 105 (27.70%), among anti-Ds drugs were amitriptyline 65 (18.68%) and escitalopram 59 (16.95%) and among anti-Ps risperidone 49 (41.53%) and olanzapine 38 (32.20%), respectively. About 51.36% drugs were prescribed from the NEML 2011. Result has revealed polypharmacy in the practice.Conclusions: Anti-A drugs were the most commonly prescribed drugs followed by anti-Ds, anti-Ps and anti-Es respectively. Rational prescribing requires further consideration with special reference to polypharmacy and providing feedback to the physicians

Study on drug usage pattern of anxiolytics in psychiatric department in a tertiary care teaching hospital at Dehradun, Uttarakhand, India

Background: Psychopharmacology is a rapidly growing field, in which the number of patients is continuously increasing. Newly introduced drugs are projected as the better alternative to the traditional psychiatric medicines. The utilization and consequences on real life effectiveness and safety of antianxiety drugs in actual clinical practice need continuous monitoring. Aim of the present study was to analyze the pattern of various anxiolytic drugs prescribed to the patients in psychiatric department of a tertiary care teaching hospital.Methods: The present study was conducted by the department of pharmacology, in the department of psychiatry at SGRRIM and HS, Dehradun, for a period of 6 months from June 2016 to December 2016. Prescriptions of patients diagnosed with anxiety were analysed, using WHO drug use indicators.Results: A total of 603 prescriptions with anxiety disorder were collected. The mean age was 35.46±0.88 years. Majority of the patients were in 31-50 years age group 309 (51.24%). Male:Female ratio was 1:0.69. Disease pattern observed during the study were 177 (29.35%) generalized anxiety disorder, 147 (24.38%) depression, 99 (16.42%) obsessive compulsive disorder (OCD), 81 (13.43%) psychotic illness, 63 (10.45%) bipolar disorders and 36 (5.97%) patients categorized as others category respectively. A total of 1974 psychotropic drugs were prescribed, 654 (33.13%) antianxiety drugs, 648 (32.83%) antidepressants, 240 (12.16%) antipsychotics, 198 (10.03%) antiepileptics and 234 (11.85%) miscellaneous drugs were prescribed. 552 (91.54%) patients received monotherapy and 51 (8.46%) were given polytherapy of anxiolytics. All (100%) anxiolytics were orally prescribed. A total of 30 fixed dose combinations (FDCs) of anxiolytics were prescribed. The numbers of anxiolytics per prescription were 1.085. The anxiolytics prescribed from National Essential Medicine List 2015 were 555 (84.86%). The percentage of anxiolytics with brand names were 618 (94.5%).Conclusions: Most of the prescriptions were rational but there is a need to encourage prescribing by generic names so that more cost-effective and rational treatment can be provided to the patients

Epithelial-myoepithelial carcinoma of the base of tongue: Pathology and management

Epithelial-myoepithelial carcinoma is a rare tumor which makes up about 0.2% of epithelial neoplasms of the salivary glands; parotid gland being the most common primary site of origin. The tumor may also very rarely originate in minor salivary glands of the base of the tongue. Due to rarity of its occurrence, histogenesis and clear cut therapeutic guidelines are not defined. The present report describes the case of a 48 year old male who was diagnosed to have a tubular variant of epithelial-myoepithelial carcinoma of the base of tongue, Stage T3 N0 M0 (Stage group III). The patient was treated with neoadjuvant chemotherapy followed by radical radiotherapy (Rt) and is alive with no evidence of disease 14 months following end of treatment

Recent scenario on psychotropic drug usage pattern among patients attending psychiatric outpatient department of a tertiary care teaching hospital in Nepal

Background: Due to increasing burden of psychiatric illnesses, it is essential to study the psychotropic drug utilization pattern in actual clinical practice. The objective of the study was to study the psychotropic drug usage pattern among patients attending psychiatric OPD of a tertiary care teaching hospital in Nepal.Methods: This observational retrospective study was conducted in Nepal Gunj Medical College, Nepal for a period of 6 months from January 2016 to June 2016. A total of 282 prescriptions from Psychiatric OPD were analysed for drug usage pattern. Prescriptions containing at least one psychotropic drug were included. Data was measured for number and percentage of prescriptions or drugs, using selected World Health Organization (WHO) drug use indicators.Results: A total of 282 prescriptions from Psychiatric OPD were analysed. Patients had a mean age of 35.01±1.17 years. Male and Female %age was 41.49% and 58.51% respectively. Majority of the patients (47.52%) were in 31-45 years age group. 70.57% patients were literate. Depression was the leading psychiatric illness seen in 144 (51.06%) patients followed by Anxiety disorders which were seen in 60 (21.28%) patients. A total of 2463 drugs were prescribed which included 591 (23.99%) antipsychotic drugs followed by 462 (18.76%) antidepressants, 390 (15.83%) antiepileptics, 312 (12.67%) supplements, 276 (11.21%) antianxiety, 171 (6.94%) antacids, 165 (6.7%) anticholinergics, 96 (3.9%) drugs in miscellaneous category. Drugs prescribed per prescription were 8.73 and psychotropic drugs per prescription were 6.09. Number of oral and injectable drugs were 2313 (93.91%) and 150 (6.09%) respectively. 87 fixed dose combinations (FDCs) of psychotropic drugs were prescribed. 903 (36.66%) drugs were prescribed from WHO’s 18th List of Essential Medicines.Conclusions: Depression was the most common psychiatric illness and antipsychotics were the most commonly prescribed medicines in psychiatry OPD. Majority of the prescriptions revealed polypharmacy

Comparative evaluation of cost-effectiveness between typical antipsychotic haloperidol and atypical antipsychotics olanzapine, risperidone and aripiprazole in the treatment of stable schizophrenia

Background: Schizophrenia patients mostly require life-long treatment. For such long-term treatments, cost is an important factor. Estimate of cost in terms of efficacy can give idea to prescribers about the relative financial burden posed by various typical and newer antipsychotics in schizophrenic patients.Methods: A total of 98 stable schizophrenic patients were enrolled in this open label study over a period of 1 year. Patients were divided in four groups, group-I received Haloperidol (n=24), group-II received Olanzapine (n=25), group-III received Risperidone (n=25) and group-IV received Aripiprazole (n=24). The patients were given drugs on the basis of physician’s discretion, depending upon the condition of the patient at the time of presentation. Patients were followed up to 16 weeks. Direct treatment costs and efficacy of treatment in terms of Clinical Global Impression - Efficacy Index CGI (EI) noted and average cost-effectiveness worked out.Results: In this open label study, the mean age of patients was 35.05±1.30. The average cost-effectiveness ratio was 26.25 for haloperidol, 10.12 for Olanzapine, 9.83 for Risperidone and 25.92 for Aripiprazole.Conclusions: Risperidone was found to be most cost-effective, followed by olanzapine, then by aripiprazole, whereas haloperidol was found least cost effective