A Comparative Study of the Efficacy and Tolerability of Solifenacin and Tolterodine in Over Active Bladder

INTRODUCTION: Over active bladder [OAB] is becoming an internationally “hot topic”. The tremendous number of patients with this problem is just now becoming recognized, and the potential economic impact is staggering. World wide, OAB is known to affect 50-100 million people. The condition is probably under reported and under treated, since patients have not become totally aware that they are suffering from OAB. More over the patients do not recognize that their condition is not normal and needs treatment. In the United States alone, there are an estimated 32 or 33 million people affected by OAB. It costs an estimated $26 billion a year in the United States to manage loss of bladder control. With continued ageing of the populations in all developed countries, the problems associated with bladder control will certainly continue to increase. OBJECTIVES: 1. To compare the efficacy of solifenacin (5 mg once daily) and tolterodine (2 mg twice daily) in reducing the number of micturitions per day (24hours), number of incontinence episodes, urgency episodes in patients with over active bladder (OAB). 2. To compare the efficacy of solifenacin and tolterodine on volume voided per void in patients with OAB. 3. To evaluate the tolerability of solifenacin and tolterodine in OAB. MATERIALS AND METHODS: Study Center: Department of Urology, Government General Hospital and Department of Urology, Kasturba Gandhi Government Hospital for Women & Children, Madras Medical College, Chennai. Study Design: Open label, comparative, randomized, parallel group, prospective study. Study duration: 4 weeks. Study period: 01-05-05 to 15-06-2006. Study sample: 30 patients. Inclusion Criteria: 1. Age between 18 to 75 years. 2. Sex: both males & female. 3. Urine culture should be negative for microorganisms. 4. Patients with overactive bladder must have experienced frequency of micturition on an average of >8 times per 24hours and > 3 episodes of urgency or incontinency during the 3 days, immediately prior to randomization. Exclusion criteria: 1. Patients with ❖ History of hypersensitivity to the study drugs solifenacin & tolterodine and other anticholinergic drugs. ❖ History of stress incontinence, urinary outflow obstruction recurrent or symptomatic urinary tract infection, interstitial cystitis, uninvestigated haematuria or haematuria due to malignant disease. ❖ Presence of neurological cause for detrusor muscle over activity. ❖ Any condition in which the use of anti muscarinic therapy is contraindicated. such as patients with urinary retention, gastric retention or uncontrolled narrow- angle glaucoma. ❖ An indwelling catheter or use of intermittent catheterization. ❖ QT interval prolongation in ECG. ❖ Significant hepatic, cardiac, renal, hematological, neurological, psychiatric or endocrinological disorder. ❖ History of Diabetes mellitus, hypertension and tuberculosis. 2. Patients who have ❖ Received previous pelvic irradiation or currently have malignant diseases of the pelvic organ. ❖ Received treatment with any anti muscarinic drug or any drug for urinary incontinence or any non- pharmacological treatment for over active bladder including electro- stimulation or bladder training within two weeks before the study. ❖ Taken part in any other investigational study in the last one-month prior to enrollment. 3. Urine culture positive growth for microorganisms. 4. Pregnant or breast-feeding woman or woman of child bearing potential not using a reliable method of contraception. CONCLUSION: From our study we conclude that solifenacin 5mg once daily is effective and well tolerated than tolterodine 2mg twice a day in the management of over active bladder by ❖ Reducing the number of micturitions per day (24 hours), number of incontinence episodes, urgency episodes. ❖ More effective in increasing the volume voided per void. ❖ Better tolerance

Goldbach’s Conjecture on ECDSA Protocols

In this paper, an algorithm on Goldbach’s conjecture is newly defined for computing a large even number as a sum of two primes or a sum of prime and composite. Using the conjecture, an ECDSA (Elliptic Curve Digital Signature Algorithm) protocol is newly proposed for authentication. The protocol describes the process of key generation, signature generation and signature verification as well as security issues

PRESCRIPTION ANALYSIS AND PREVALENCE OF POTENTIALLY INAPPROPRIATE MEDICATION USE IN OLDER ADULTS; AN OBSERVATIONAL STUDY

Objective: The objectives of the present study were to determine the prevalence of Potentially Inappropriate Medications and Adverse Drug Reactions in older adults and to collect doctors’ responses regarding the PIM list or any other criteria to treat older adults in India. Methods: This was an observational study conducted in different tertiary care hospitals of two districts, Erode and Salem after obtaining approval of the Institutional Ethics Committee. A sample of 250 older adults (60 y and above) and 97 doctors were included during the study period of 6 mo from February 2019 to July 2019. Inappropriate medications were identified by using 2019 updated Beer’s criteria. The causality of the adverse events was assessed by Naranjo Adverse Drug Reaction Probability Scale. Results: Out of the 250 prescriptions, only 86(34.4%) of the prescriptions were appropriate and 164(65.6%) were inappropriate. The most commonly inappropriate prescribed medications were diuretics, ranitidine, and tramadol. A total of 74 ADRs was observed in 74 patients. Of these, 57(22.8%) ADRs were due to inappropriate medications listed in Beers criteria. There was a significant association between the occurrence of ADRs and the use of PIMs listed in 2019 updated Beer’s criteria [χ2 = 6.08, P = 0.013 (df = 1)]. Conclusion: The study shows that there is a high prevalence of inappropriate medications and adverse drug reactions in hospitalized older adults. Beer’s criteria can be used as a guideline by the physicians while prescribing the drugs to the geriatric population

An autonomous strawberry‐harvesting robot: Design, development, integration, and field evaluation

This paper presents an autonomous robot capable of picking strawberries continuously in polytunnels. Robotic harvesting in cluttered and unstructured environment remains a challenge. A novel obstacle‐separation algorithm was proposed to enable the harvesting system to pick strawberries that are located in clusters. The algorithm uses the gripper to push aside surrounding leaves, strawberries, and other obstacles. We present the theoretical method to generate pushing paths based on the surrounding obstacles. In addition to manipulation, an improved vision system is more resilient to lighting variations, which was developed based on the modeling of color against light intensity. Further, a low‐cost dual‐arm system was developed with an optimized harvesting sequence that increases its efficiency and minimizes the risk of collision. Improvements were also made to the existing gripper to enable the robot to pick directly into a market punnet, thereby eliminating the need for repacking. During tests on a strawberry farm, the robots first‐attempt success rate for picking partially surrounded or isolated strawberries ranged from 50% to 97.1%, depending on the growth situations. Upon an additional attempt, the pick success rate increased to a range of 75–100%. In the field tests, the system was not able to pick a target that was entirely surrounded by obstacles. This failure was attributed to limitations in the vision system as well as insufficient dexterity in the grippers. However, the picking speed improved upon previous systems, taking just 6.1 s for manipulation operation in the one‐arm mode and 4.6 s in the two‐arm mode

Elastic property evaluation of jute-glass fibre hybrid composite using experimental and CLT approach

435-442Elastic properties are the basic quantities that are required during design and optimization of a laminated structure. Though the literature on elastic properties of conventional single fibre composite is well published, the same is scanty in the case of natural and hybrid composites. This work is focused on evaluation of in-plane elastic properties of untreated woven jute and jute-glass fabric hybrid polyester composites, under tension. The specimens have been fabricated by hand-lay-up technique with different relative weight fraction of jute and glass fibre. Theoretically, the laminate elastic properties are predicted by using the classical lamination theory (CLT) and rule of hybrid mixture model, using the resin and fibre properties together with the volume fraction (micromechanics). Experimentally, the elastic properties have been evaluated by tension test in warp and weft direction and in-plane shear test as per ASTM standards. The results indicated that the Young’s modulus in both warp and weft direction improve by the inclusion of glass fibre, where as Poisson’s ratio is decreased. Prediction by CLT and model showed close agreement with experimental values with a maximum deviation of about 20%. The possible causes for this deviation are discussed

Design of LQR controller for active suspension system

173-179The present paper aims at developing an active suspension for a passenger car by designing a controller using linear quadratic optimal control theory. In this work, two different control approaches are proposed, viz., conventional method (CM) and acceleration dependent method (ADM). A quarter car model with 3 degrees-of-freedom has been considered for the analysis. The performance of the active suspension system with two control approaches has been compared with that of passive one. It is concluded that active suspension system has a better potential to improve both the ride comfort and road holding, since the RMS (Root Mean Square) passenger acceleration has been reduced by 54.23% for active CM system and by 93.88% for active ADM system compared to passive one, and suspension travel has also reduced to about 37.5%

Static analysis and fatigue life prediction of steel and composite leaf spring for light passenger vehicles

128-134This paper describes static and fatigue analysis of steel leaf spring and composite multi leaf spring made of glass fibre reinforced polymer. Primary objective is to compare the load carrying capacity, stiffness and weight savings of composite leaf spring with that of steel leaf spring. The design constraints are stresses and deflections. Finite element analysis with full bump load on 3-D model of composite multi leaf spring was done using ANSYS 7.1 and analytical results were compared with experimental results. Composite leaf spring had 67.35% lesser stress, 64.95% higher stiffness and 126.98% higher natural frequency than that of existing steel leaf spring. A weight reduction of 68.15 % was also achieved by using composite leaf spring. Fatigue life of composite leaf spring (10, 00,000 cycles) was more than that of conventional steel leaf spring (2, 00,000 cycles)

Linear quadratic regulator controller design for active suspension system subjected to random road surfaces

213-226Present work aims at developing an active suspension for a passenger car by designing a controller using linear quadratic optimal control theory, based on two different control approaches [conventional method (CM), acceleration dependent method (ADM)]. Performance of the active suspension system of a quarter car model with 3 degrees-of-freedom with two control approaches has been compared with that of passive one. Active suspension system had a better potential to improve both the ride comfort and road holding, since the passenger acceleration has been reduced for active CM system (19.58%) and for active ADM system (34.08%) compared to passive one. Also suspension travel has reduced (37.5%)

An investigation on high speed drilling of glass fibre reinforced plastic (GFRP)

189-195High speed machining is now recognised as one of the key manufacturing technologies for higher productivity and throughput. An experimental investigation has been performed on GFRP using carbide drill with different drill geometries, namely standard twist drill, double cone drill, Zhirov-point drill and multifacet drill. A series of experiments are conducted using wide range of cutting parameters namely, speed and feed rate. Thrust force and surface roughness are measured and studied in the test trials. The analysis of variance (ANOVA) technique is employed to investigate the cutting characteristics of different drilling geometries. Relation between spindle speed and feed rate on thrust force and surface roughness is established. It is found that Zhirov point drill and multifacet drill could be used at high spindle speed which generates less thrust force. Surface finish of the drilled hole could be achieved to 2-6.1 μm with Zhirov drill. The investigation reveals the use of special geometry drills which improve the hole quality in GFRP composites drilled at high spindle speed