DIRECT COST OF TREATMENT OF DIABETES MELLITUS TYPE 2 IN PAKISTAN

Objective: Diabetes is a serious illness. It is a key and growing threat to the health of the global world. The prime concern of this research was to estimate the cost-of-illness of type 2 diabetes in Karachi, a major metropolitan city of Pakistan. This study was performed on the basis a community perspective to calculate the economic burden of diabetes mellitus type 2 in Pakistan. Methods: This study was conducted in all districts of Karachi, the patients were taken from all economic segment of society from low income group, average revenue and high revenue group. A preliminary test questionnaire was used to collect the data directly from patients and in some locations conducted interviews with patients due to lack of understanding and un-educated patients. The total of 885diabetes patients was selected with convenient random sampling. Results: The average direct cost of all these expense bear by diabetic patient in Pakistan is Pak Rupees Rs.5542 per month. The cost range starts from Rs. 650/month to 20000 per month on the basis of patient economic condition and disease state. The average appointment fee of a physician, laboratory test and medicines came to Rs. 700/visit, 400/test, and 1100/visit precisely. The average travel and food spent was Rs.200/visit and 1000/month. Medicine accounted for largest cost followed by consultation with the physician. Conclusion: This is clearly indicated by this study that considerable cost is amounted by diabetes, it is suggested that a huge amount of resources could be prevented by taking care, initial understanding of the disease and a decrease in diabetes co-morbidities and complications through better diabetes mellitus treatment. Very extensive and cost-effective programs should be started to maximize health benefits and to diminish the prevalence of this epidemic

Modeling and online parameter estimation of intake manifold in gasoline engines using sliding mode observer

NoModel based control of automotive engines for fuel economy and pollution minimization depends on accuracy of models used. A number of mathematical models of automotive engine processes are available for this purpose but critical model parameters are difficult to obtain and generalize. This paper presents a novel method of online estimation of discharge coefficient of throttle body at the intake manifold of gasoline engines. The discharge coefficient is taken to be a varying parameter. Air mass flow across the throttle body is a critical variable in maintaining a closer to stoichiometric air fuel ratio; which is necessary to minimize the pollution contents in exhaust gases. The estimation method is based on sliding mode technique. A classical first Sliding mode observer is designed to estimate intake manifold pressure and the model uncertainty arising from the uncertain and time varying discharge coefficient is compensated by the discontinuity/switching signal of sliding mode observer. This discontinuity is used to compute coefficient of discharge as a time varying signal. The discharge coefficient is used to tune/correct the intake manifold model to engine measurements. The resulting model shows a very good agreement with engine measurements in steady as wells transient state. The stability of the observer is shown by Lyapunov direct method and the validity of the online estimation is successfully demonstrated by experimental results. OBD-II (On Board Diagnostic revision II) based sensor data acquisition from the ECU (Electronic Control Unit) of a production model vehicle is used. The devised algorithm is simple enough to be designed and implemented in a production environment. The online estimation of parameter can also be used for engine fault diagnosis work. (c) 2012 Elsevier B.V. All rights reserved