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How do you do? topamax 50 mg price in pakistan But many Asian leaders are skeptical that the U.S. is serious about the “pivot.” They see Obama fixated on Middle East problems like Egypt, Syria and Iran. And they have now seen him cancel three trips to their region: Obama scrubbed two trips in his first term, also because of domestic political crises (the passage of his health care bill and the BP oil spill). Here’s hoping that the phrase three strikes and you’re out doesn’t translate across the Pacific.