COMPARATIVE CLINICAL STUDY OF KUMARIKA VATI AND MEFENAMIC ACID IN UDAVARTINI YONIVYAPAD (SPASMODIC DYSMENORRHEA)

Menstruation is a normal physiological process when it is accompanied by pain is called Dysmenorrhea. It is one of the commonest gynaecological complaints. Dysmenorrhea is painful menstruation, which is the pratyatma lax- ana of Udavartini yoni vyapad i.e., spasmodic dysmenorrhea. It is a common cause of distress in women. Here the main reason for pain is the vitiation of vata dosha (apana vata), viloma/pratiloma gati leading to vedna yukta artava munchan and to manage this pratiloma vata, one needs to use drugs that have anulomana properties and vedna samak. Kumarika vati is used as vedana shamaka aushadha to give symptomatic relief. Hence the topic was selected for the study. Objectives: To compare the effect of Kumarika Vati with Mefenamic Acid in the man- agement of Udavartini Yonivyapad (Spasmodic Dysmenorrhea). Materials & Methods: 20 patients of Group A were treated with Kumarika Vati, a dose of 250mg BD 5 days before menstruation & 5 days during menstruation. 20 patients of Group B were treated with a Mefenamic Acid dose of 250mg BD for 3 days during menstruation. Result: The data of both groups were collected according to the objective and subjective parameters and analyzed using the most appropriate statistical test (repeated measures of ANOVA test and Mann –Whitney U test). The efficacy is statically significant within the group at P<0.001 and statistically insignificant between the group at P>0.05 among all the parameters. Interpretation and Conclusion: On comparison of Kumarika Vati with Mefenamic acid both have equal effectiveness in relieving the pain intensity, pain duration, site of pain, nature of pain and associated complaints. Keywords: Udavartini Yoni Vyapad, Dysmenorrhea, Kumarika Vati, Mefenamic Acid.

A comparison of Lidocaine and Ketamine for prevention withdrawal from injection of Rocuronium.

Aim : To make comparison of the effects of lidocaine and ketamine in preventing withdrawal moments linked with IV injection of rocuronium . Methods: About sixty candidates (ASA I & II) were chosen for this case research and categorized into two groups via aid of random number table in such a manner that each group contained 30 individuals. Candidates belonging to group A were administered ketamine in the dosage of 0.5mg/kg that was diluted in 2ml whereas group B candidates were administered 2ml of 1% lidocaine. On the dorsum of the hand, 20 gauge cannula will be inserted intravenously and candidate will be administered midazolamin doage of 0.02mg/kg intravenously for five minutes before coming into in the Operation theatre. After arrival of candidate , non-invasive routine monitoring of the candidates will be carried out and free fluid flow fluid via cannula will be assured by gravity with aid of IV fluid as normal saline. At room temperature, the syringes will be placed. Administration of drugs will be carried out via the injection port of intravenously cannula with a free fluid flow intravenously. Results: In case of ketamine , the prevalence withdrawal movements was recorded as 43.3% and lidocaine as 40%. In case of both research groups, the mean withdrawal scores were similar (P value two tailed = 1.0 (>0.05). Two candidates among these individuals i-e one from each groups depicted generalized response (3.3%). No noteworthy difference was recorded in case of lidocaine and ketamine for preventing withdrawal moments after administration of injection of rocuronium. Conclusion: Equal effectiveness of lidocaine 1% and Ketamine 0.5mg/kg 2ml (20mg) was recorded in deducing withdrawal moments after administration of injection of rocuronium intravenously . Keywords: Lidocaine, ketamine, withdrawal movements

An Open Labelled Comparative Clinical Study to Evaluate the Effect of Go-Ghrita Tarpana and Triphala-Ghrita Tarpana on Antero-Posterior Diameter in Axial-Myopia

Background and Objective: Axial-myopia is characterized by blurriness of vision for distance caused by increased in A-P diameter. Usual treatment for myopia is optical correction by optical glass and contact lens. To restore distance vision, surgical intervention like, LASIK is adopted, which has complications like dry eye syndrome and astigmatism. The Ayurvedic approach of the disease mainly concentrates on treating the disease and preventing the progression of the disease. There are many hypothetical theories regarding mode of action of Tarpana on Myopia and Timira. In this study, an attempt is made to observe the effect of Tarpana on A-P diameter of eyeball and to know the difference between Tarpana by plain Go-Ghrita and Triphala Ghrita. Materials and Methods: 20 patients of Group A, were treated with Go-Ghrita Tarpana (two sittings of 7 days each, with the gap of 14 days) and in Group B, 20 patients were treated with Triphala-Ghrita Tarpana (two sittings of 7 days each, with the gap of 14 days). Results: The data of both the groups were collected according to the objective and subjective parameters and analyzed using the most appropriate statistical test (repeated measures of ANOVA, Bonferroni Test and Mann- Whitney U Test). The efficacy is statistically significant within the group at P <0.001and statistically insignificant between the groups at P >0.05 among all the parameters. Interpretation and Conclusion: On comparison of Go-Ghrita Tarpana with Triphala-Ghrita Tarpana, both have an equal effectiveness on distant vision, Optical correction and A-P diameter.

The Effectiveness of Herringbone and SQ4R as Techniques in Teaching Reading Comprehension to Students with Visual and Auditory Learning Styles

Applying the effective teaching techniques to teach reading comprehension is a must in order to overcome students’ obstacles in comprehending a texts. This study tries to analyze the effectiveness of Herringbone and SQ4R to teach reading comprehension to visual and auditory students at SMPN 2 Sedong. This study belongs to quantitative research with quasi-experimental design applying 2 x 2 factorial design with ANOVA. There are two classes chosen as samples; VIII A as the experimental class I and VIII G as the experimental class II. This study revealed that there is no interaction among techniques, reading comprehension, and learning styles in teaching reading comprehension to the visual and auditory students. Herringbone and SQ4R are effective to teach reading comprehension to students with visual and auditory learning styles. Both visual and auditory students had an equal improvement treated with herringbone and SQ4R since there is no significant difference in the improvement between visual and auditory students in reading comprehension treated by herringbone and SQ4R. Conversely, both herringbone and SQ4R had an equal effectiveness to teach reading comprehension to the visual and auditory students since there is no significant difference of effectiveness between herringbone and SQ4R to the visual and auditory students.

Shorter and longer courses of antibiotics for common infections and the association with reductions of infection-related complications including hospital admissions

Background Antimicrobial resistance is a serious global health concern that emphasises completing treatment course. Recently, the effectiveness of short versus longer antibiotic courses has been questioned. This study investigated the duration of prescribed antibiotics, their effectiveness and associated risk of infection-related complications. Methods Clinical Practice Research Datalink identified 4 million acute infection episodes prescribed an antibiotic in primary care between January 2014 – June 2014, England. Prescriptions were categorised by duration. Risk of infection-related hospitalisations within 30 days was modelled overall and by infection type. Risk was assessed immediately after or within 30 days follow-up to measure confounders given similar and varying exposure respectively. An interaction term with follow-up time assessed whether hazards ratios (HR) remained parallel with different antibiotic durations. Results The duration of antibiotic courses increased over the study period (5.2-19.1%); 6-7 days were most common (66.9%). Most infection-related hospitalisations occurred with prescriptions of 8-15 days (0.21%), accompanied by greater risk of infection-related complications compared to patients that received a short prescription (HR 1.75 [95% CI 1.54-2.00]). Comparing HRs in the first 5 days versus remaining follow-up showed longer antibiotic courses were no more effective than shorter courses (1.02 [95% CI 0.90-1.16] and 0.92 [95% CI 0.75-1.12]). No variation by infection-type was observed. Conclusion Equal effectiveness was found between shorter and longer antibiotic courses and the reduction of infection-related hospitalisations. Stewardship programmes should recommend shorter courses of antibiotics for acute infections. Further research is required for treating patients with a complex medical history.

RICHARD CAUSTON (b. 1971)The Flea (2000)

This chapter discusses Richard Causton’s The Flea (2000). This is a very different and ostensibly simpler setting of this wonderful text by John Donne from that of Krenek, but one that conveys its wit and sardonic humour with equal effectiveness. Causton, a highly experienced and gifted composer of broad musical tastes, understands the voice very well and has wisely kept to a comfortable tessitura to allow the smallest details and nuances to tell. The tonality is based firmly on C, at the lower and upper octave, and, once begun, the singer should have no difficulty in keeping pitches safely anchored, since this ‘tonic’ is frequently and reassuringly revisited throughout the piece. Medium range encourages a warm, resonant quality, but the singer must not allow vibrato to become too rich, obscuring detail or word clarity. Changes of time signature help to give a feeling of flexibility, but, as always in unaccompanied pieces, it is very important to keep a sense of pulse and forward impetus, especially through the rests which pepper the opening paragraphs.

Discontinuation and switching of postpartum contraceptive methods over twelve months in Burkina Faso and the Democratic Republic of the Congo: a secondary analysis of the Yam Daabo trial

Introduction Women who use contraceptive methods sometimes stop early, use methods intermittently, or switched contraceptive methods. All these events (discontinuations and switching) contribute to the occurrence of unwanted and close pregnancies. This study aimed to explore contraceptive discontinuation and switching during the Yam-Daabo project to measure the effect of interventions on the continuation of contraceptive methods use. Methods We conducted a secondary analysis of the Yam-Daabo trial data. We choose the discontinuation and switching of a modern contraceptive method as outcome measures. We performed a survival analysis using the Stata software package to estimate the effect of the interventions on contraceptive discontinuation. We also studied the main reasons for discontinuation and switching. Results In total, 637 out of the 1120 women used at least one contraceptive method (of any type), with 267 women in the control and 370 in the intervention group. One hundred seventy-nine women of the control group used modern methods compared to 279 women of the intervention group with 24 and 32 who discontinued, respectively. We observed no statistically significant association between interventions and modern methods discontinuation and switching. However, modern methods’ discontinuation was higher in pills and injectables users than implants and IUDs users. The pooled data comparison showed that, in reference to the women who had not switched while using a modern method, the likelihood of switching to a less or equal effectiveness method among the women of the control group was 3.8(95% CI: 1.8–8.0) times the likelihood of switching to a less or equal effectiveness method among the women of the intervention group. And this excess was statistically significant (p < 0.001). The main reason for discontinuation and switching was method-related (141 over 199), followed by partner opposition with 20 women. Conclusion The results of this study show no statistically significant association between interventions and modern methods discontinuation. Discontinuation is more related to the methods themselves than to any other factor. It is also essential to set up specific actions targeting women’s partners and influential people in the community to counter inhibiting beliefs. Trial registration Pan African Clinical Trials Registry (PACTR201609001784334, https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=1784).

Discontinuation and switching of postpartum contraceptive methods over twelve months in Burkina Faso and the DRC: a secondary analysis of the Yam-Daabo trial

Introduction : Women who use contraceptive methods sometimes stop early, use methods intermittently or switched contraceptive methods. All these events (discontinuations and switching) contribute to the occurrence of unwanted and close pregnancies. This study aimed to explore contraceptive discontinuation and switching during the Yam-Daabo project to measure the effect of interventions on the continuation of contraceptive methods use.Methods: We conducted a secondary analysis of the Yam-Daabo trial data. We choose the discontinuation and switching of a modern contraceptive method as outcome measures. We performed a survival analysis by using the Stata software package to estimate the effect of the interventions on contraceptive discontinuation. We also studied the main reasons for discontinuation and switching.Results: In total, 637 out of the 1,120 women used at least one contraceptive method (of any type), with 267 women in the control and 370 in the intervention group. Modern methods were used by 179 women of control group compared to 279 women of intervention group with 24 and 32 who discontinued, respectively. We observed no statistically significant association between interventions and modern methods discontinuation and switching. However, the discontinuation of modern methods was higher in pills and injectables users than implants and IUDs users. The pooled data comparison showed that, in reference to the women who had not switched while using a modern method, the likelihood of switching to a less or equal effectiveness method among the women of the control group was 3.8(95% CI: 1.8-8.0) times the likelihood of switching to a less or equal effectiveness method among the women of the intervention group. And this excess was statistically significant (p<0.001). The main reason for discontinuation and switching was method-related (141 over 199), followed by partner opposition with 20 women.Conclusion: The results of this study show no statistically significant association between interventions and modern methods discontinuation. Discontinuation is more related to the methods themselves than to any other factor. It is also important to set up specific actions targeting women's partners and influential people in the community to counter inhibiting beliefs.Trial registration: Pan African Clinical Trials Registry (PACTR201609001784334, https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=1784).

Community Policing: An approach for Countering Youth Radicalization in Eastleigh Area of Nairobi County

Community policing approaches have been used successfully to prevent crime, reduce the fear of crime, and improve public safety. A raging debate, however, is emerging as to whether this approach can be used with equal effectiveness in the prevention of terrorism. Over the last sixteen years, Kenya has tried several approaches to “the war against terrorism.” However, none of the approaches has succeeded in stamping out terrorism. The purpose of this study, therefore, was to find out ways in which the philosophy of community policing could be modelled to fit a citizen based-counter terrorism strategy. The study established that community policing principles can be used to create sustainable partnerships between law enforcement agencies and residents, thus facilitating the identification of root causes of youth radicalization. Training of police officers on community policing principles and trends in youth radicalization was strongly recommended. Further, police officers should invest more in trust-building initiatives in establishing a joint early warning system with the local communities they serve. The study further recommends an intensive public awareness campaign on the nature, indicators, and symptoms of youth radicalization within Eastleigh and the country at large.

Discontinuation and Switching of Postpartum Contraceptive Methods Over Twelve Months in Burkina Faso and the DRC: A Secondary Analysis of the Yam-Daabo trial

Introduction: Women who use contraceptive methods sometimes stop early, use methods intermittently or switched contraceptive methods. All these events (discontinuations and switching) contribute to the occurrence of unwanted and close pregnancies. This study aimed to explore contraceptive discontinuation and switching during the Yam-Daabo project to measure the effect of interventions on the continuation of contraceptive methods use.Methods: We conducted a secondary analysis of the Yam-Daabo trial data. We choose the discontinuation and switching of a modern contraceptive method as outcome measures. We performed a survival analysis by using the Stata software package to estimate the effect of the interventions on contraceptive discontinuation. We also studied the main reasons for discontinuation and switching.Results: In total, 637 out of the 1,120 women used at least one contraceptive method (of any type), with 267 women in the control and 370 in the intervention group. Modern methods were used by 179 women of control group compared to 279 women of intervention group with 24 and 32 who discontinued, respectively. We observed no statistically significant association between interventions and modern methods discontinuation and switching. However, the discontinuation of modern methods was higher in pills and injectables users than implants and IUDs users. The pooled data comparison showed that, in reference to the women who had not switched while using a modern method, the likelihood of switching to a less or equal effectiveness method among the women of the control group was 3.8(95% CI: 1.8-8.0) times the likelihood of switching to a less or equal effectiveness method among the women of the intervention group. And this excess was statistically significant (p<0.001). The main reason for discontinuation and switching was method-related (141 over 199), followed by partner opposition with 20 women.Conclusion: The results of this study show no statistically significant association between interventions and modern methods discontinuation. Discontinuation is more related to the methods themselves than to any other factor. It is also important to set up specific actions targeting women's partners and influential people in the community to counter inhibiting beliefs.Trial registration: Pan African Clinical Trials Registry (PACTR201609001784334, https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=1784).