***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background Variceal bleeding is a medical emergency with 20 % mortality at 6 weeks . The role of vasoactive agents in achieving hemostasis and preventing rebleeding has been well documented . The optimal duration of these agents has not been well established . There are no previous studies yielding the exact duration of octreotide to be administered to prevent rebleed and mortality from esophageal varices . The aim of this study is to evaluate the effect of combination therapy ( octreotide and endoscopy ) , the exact duration of  octreotide  infusion , its cost-effectiveness , and the outcome in terms of rebleed and mortality . Patients and methods This was a r and omized clinical trial including 124 patients with acute variceal bleeding who underwent endoscopic therapy ;  they were assigned r and omly to 2 days ( n=62 ) and 5 days ( n=58 ) of continuous octreotide infusion ( 50 & mgr;g/kg ) . Early rebleeding ( within 42 days of index bleed according to Baveno IV consensus guidelines ) , transfusion requirement , and mortality were assessed . Results The study had predominantly male patients , average age 47 years . Among the patients in the 2-day group , 3 ( 4.8 % ) showed early rebleed versus 5 ( 8.6 % ) in the 5-day group , but the difference was not statistically significant ( P>0.05 ) . Among the patients in the 2-day group , one patient died after 3 weeks and all the patients in the 5-day group survived till 6 weeks on follow-up , and the survival rates were comparable ( P>0.05 ) . The treatment in the 5-day group was 2.5 times costlier than that for the 2-day group as shown by a cost-wise analysis . Conclusion Two days of octreotide infusion following endoscopic therapy is sufficient and as efficacious as 5 days of infusion in preventing early rebleed , with reasonably better cost-effectiveness Objective : To estimate and compare the cost-effectiveness and safety of nebivolol with sustained-release metoprolol in reducing blood pressure by 1 mm of Hg per day in hypertensive patients . Material s and Methods : This was a prospect i ve , r and omized , open label , observational analysis of cost-effectiveness , in a question naire-based fashion to compare the cost of nebivolol ( 2.5 mg , 5 mg , 10 mg ) and sustained released metoprolol succinate ( 25 mg , 50 mg , 100 mg ) in hypertensive patients using either of the two drugs . A total of 60 newly detected drug naïve hypertensive patients were considered for the comparison , of which 30 patients were prescribed nebivolol and the other 30 were prescribed metoprolol succinate as per the recommended dosage . Based on the data , statistical analysis was carried out using GraphPad Prism 5 and MS Excel Spreadsheet 2007 . Result : The cost of reducing 1 mm of Hg blood pressure per day with nebivolol was 0.60 , 0.70 , and 1.06 INR , whereas that of metoprolol succinate was 0.93 , 1.18 , and 1.25 INR at their respective equivalent doses , hence significantly lower with the nebivolol group as compared to the metoprolol group ( P < 0.05 ) . Conclusion : This pharmacoeconomic analysis shows that nebivolol is more cost-effective as compared to metoprolol when the cost per reduction in blood pressure per day is considered . This may affect the patients economically during their long-term use of these molecules for the treatment of hypertension Objectives : Benzodiazepines ( BZDs ) are the first-line drugs in alcohol-withdrawal syndrome ( AWS ) .  Baclofen , a gamma-aminobutyric acidB ( GABAB ) agonist , controls withdrawal symptoms without causing significant adverse effects . The objective of this study was to compare the cost-effectiveness of baclofen and chlordiazepoxide in the management of uncomplicated AWS . Material s and Methods : This was a r and omized , open label , st and ard controlled , parallel group study of cost-effectiveness analysis ( CEA ) of baclofen and chlordiazepoxide in 60 participants with uncomplicated AWS .  Clinical efficacy was measured by the Clinical Institute Withdrawal Assessment for alcohol ( CIWA-Ar ) scores .  Lorazepam was used as supplement medication if withdrawal symptoms could not be controlled effectively by the study drugs alone . Both direct and indirect medical costs were considered and the CEA was analyzed in both patient 's perspective and third-party perspective . Results : The average cost-effectiveness ratio ( ACER ) in patient 's perspective of baclofen and chlordiazepoxide was Rs . 5,308.61 and Rs . 2,951.95 per symptom-free day , respectively . The ACER in third-party perspective of baclofen and chlordiazepoxide was Rs . 895.01 and Rs . 476.29 per symptom-free day , respectively . Participants on chlordiazepoxide had more number of symptom-free days when compared with the baclofen group on analysis by Mann-Whitney test ( U = 253.50 , P = 0.03 ) . Conclusion : Both study drugs provided relief of withdrawal symptoms .  Chlordiazepoxide was more cost-effective than baclofen . Baclofen was relatively less effective and more expensive than chlordiazepoxide Bronchiectasis is an abnormal permanent dilatation distortion and destruction of the airways with both pulmonary and extrapulmonary side-effects . The aim of the study was to find out the presenting features , aetiologies and socioeconomic factors in patients of bronchiectasis . It is a prospect i ve observational study comprising 53 patients over aperiod of two years . Aetiologies were determined using Kuppuswamy 's socioeconomic scale . Number of exacerbations and mortality were noted . The age ranged from 14 to 80 years ( mean : 43.33 ± 16.37 years ) . There were 35 males ( 66 % ) and 18 females ( 34 % ) . Clubbing was seen in 58 % cases ( n = 31 ) ; 11 % patients ( n = 6 ) had haemoptysis . Bilateral involvement was seen in 64 % cases ( n = 34 ) . Allergic bronchopulmonary aspergillosis and post-tuberculous sequelae were the commonest causes ( n = 12 , 23 % each ) . The range of household medical expenditure in these patients varied from 6 % to 47 % . Lower the Kuppuswamy scale poorer the follow-up ( p-value < 0.05 ) . Multiple exacerbations were seen in all classes of patients ( p-value 0.09 ) . Death occurred in 4 patients . It is concluded that bronchiectasis is a chronic illness with significant morbidity and socioeconomic implication s. Lower the socio-economic scale , poorer the compliance of therapy Objective : To estimate cost-effectiveness ratios and net costs of a training intervention to reduce morbidity among porters who carry loads without mechanical assistance in a developing country informal sector setting . Methods : Pre- and post-intervention survey data ( n = 100 ) were collected in a prospect i ve study : differences in physical/mental composite scores and pain scale scores were computed . Costs and economic benefits of the intervention were monetized with a net-cost model . Results : Significant changes in physical composite scores ( 2.5 ) , mental composite scores ( 3.2 ) , and pain scale scores ( −1.0 ) led to cost-effectiveness ratios of $ 6.97 , $ 5.41 , and $ 17.91 , respectively . Multivariate analysis showed that program adherence enhanced effectiveness . The net cost of the intervention was −$5979.00 due to a reduction in absenteeism . Conclusions : Workplace ergonomic training is cost-effective and should be implemented wherein other engineering-control interventions are precluded due to infrastructural constraints AIM Cancer remains a major health problem in all communities worldwide . Rising healthcare costs associated with treating advanced cancers present a significant economic challenge . It is a need of the hour that the health sector should devise cost-effective measures to be put in place for better affordability of treatments . To achieve this objective , information generation through indigenous hospital data on unit cost of in-patient cancer chemotherapy in medical oncology became imperative and thus hallmark of this study . DESIGN AND SETTING The present prospect i ve hospital based study was conducted in Medical Oncology Department of tertiary care teaching hospital . MATERIAL S AND METHODS After permission from the Ethical Committee , a prospect i ve study of 6 months duration was carried out to study the cost of treatment provided to in- patients in Medical Oncology .  Direct costs that include the cost of material , labor and laboratory investigations , along with indirect costs were calculated , and data analyzed to compute unit cost of treatment . RESULTS The major cost components of in-patient cancer chemotherapy are cost of drugs and material s as 46.88 % and labor as 48.45 % . The average unit cost per patient per bed day for in-patient chemotherapy is Rs . 5725.12 ( $ 125.96 ) . This includes expenditure incurred both by the hospital and the patient ( out of pocket ) . CONCLUSION The economic burden of cancer treatment is quite high both for the patient and the healthcare provider . Modalities in the form of health insurance coverage need to be established and strengthened for pooling of re sources for the treatment and transfer of risks of these patients BACKGROUND Breast cancer is associated with substantial medical and economic burden . This study assisted the expenditure incurred by the subjects on diagnosis and treatment till the period of follow-up . MATERIAL S AND METHODS This is a prospect i ve study ; a case series of patients studied at the time of diagnosis and followed after 6 months . The study was conducted at one of Hospitals in India , from January 2006 to December 2007 . One hundred and seventy-two women with new primary breast cancer were included in the study . During the study period 69 subjects were lost to follow-up . The comparative analysis was done for 103 subjects . Cost implication s of breast cancer include direct medical costs and indirect costs . Question naire for the data collection was used . Descriptive statistics and correlation analysis were used . RESULTS The median total direct and indirect expenditure was Rs . 12,100 ( US$ 1 = Rs 50 ) with the range of Rs . 0 - 54000 . The largest component of total direct medical costs was in stage I ( median Rs . 6530 ) , total indirect costs ( median Rs . 7500 ) , and median total cost was Rs . 17,600 . The total expenditures ( median Rs . 13,100 ) were the highest in younger age group ( < 40 ) . The median direct expenditure was higher in the subjects who visited private setup before coming to Hospital ( Rs . 8250 ) than those who came directly ( Rs . 4500 ) . CONCLUSIONS Cost of treatment for breast cancer depends on many factors , including the stages of the cancer , the woman 's age , perhaps the costs of treatment , private hospital and insurance Psoralen + ultraviolet A ( PUVA ) therapy is an established modality for psoriasis . As India is a tropical country that has good availability of natural sunlight psoralen + sunlight ( PUVAsol ) may be a more convenient option . To compare the efficacy and cost-effectiveness of PUVA versus PUVAsol in chronic plaque psoriasis . Cases of chronic plaque psoriasis with body surface area ≥10 % or Psoriasis Area and Severity Index ( PASI ) ≥10 , excluding erythrodermic or pustular psoriasis , were r and omized to receive either  PUVA or PUVAsol , with endpoint being the achievement of PASI 90 or completion of 12 weeks treatment , whichever is earlier . Cost analysis was also undertaken . Thirty-six cases ( 16 in PUVA and 20 in PUVAsol group ) completed treatment . In the PUVA group , 15 cases ( 93.75 % ) responded to therapy while in the PUVAsol group , 15 ( 75 % ) responded ( P = 0.29 ) . Mean baseline PASI in the PUVA and PUVAsol groups was 16 and 14.4 , respectively , and at endpoint was 1.62 and 3.77 . There was a significantly greater reduction in PASI in the PUVA group at 2 and 4 weeks but at 8 and 12 weeks and endpoint , it was comparable . Treatment failure occurred in 6.25 % and 25 % of cases respectively ( P = 0.29 ) . Side effects were higher with  PUVA . Total cost of therapy was significantly higher in the PUVA group ( P = 0.002 ) . Cost-effectiveness ratio was US$ 0.72 with PUVA and US$ 0.37 with PUVAsol . Both PUVA and PUVAsol were equally efficacious , with PUVAsol being twice as cost effective . Hence , PUVAsol may be recommended as treatment for psoriasis in a developing economy such as India Abstract Aims : The aim of this analysis was to assess the cost-effectiveness of switching from biphasic human insulin 30 ( BHI ) , insulin glargine ( IGlar ) , or neutral protamine Hagedorn ( NPH ) insulin ( all ± oral glucose-lowering drugs [ OGLDs ] ) to biphasic insulin aspart 30 ( BIAsp 3 
    Output:
    
Conclusions The results indicate the lack of engagement of economists generally and health economists in particular in research on NCDI in India .