As the Baloch issue continues to be handled militarily rather than politically a peaceful resolution is unlikely

Following the attack on a police training college in Quetta, Sajjan Gohel discusses the security challenges in Balochistan and the wider implications for Pakistan. He writes that given that the province is important to broader regional peace it should be accorded more attention in academic and policy discourse

As the Taliban increase the tempo of violence in Afghanistan they face new competition from the rising Wilayat Khorasan

The recent attack on the Hazara Shiite community was claimed by ISIS, revealing the growing penetration of its Afghan affiliate Wilayat Khorasan. In this article, Sajjan Gohel discusses the significance of the latest attack, outlines the origins of Wilayat Khorasan and discusses the escalating rivalry between the new group and the Afghan Taliban

Cost-effectiveness of treatments for superficial venous refluxin patients with chronic venous ulceration.

Background Venous leg ulcers impair quality of life significantly, with substantial costs to health services. The aim of this study was to estimate the cost‐effectiveness of interventional procedures alongside compression therapy versus compression therapy alone for the treatment of chronic venous leg ulceration. Methods A Markov decision analytical model was developed. The main outcome measures were quality‐adjusted life‐years (QALYs) and lifetime costs per patient, from the perspective of the UK National Health Service at 2015 prices. Resource use included the initial procedures, compression therapy, primary care and outpatient consultations. The interventional procedures included superficial venous surgery, endothermal ablation and ultrasound‐guided foam sclerotherapy (UGFS). The study population was patients with a chronic venous ulcer who were eligible for either compression therapy or an interventional procedure. Data were obtained from systematic review and meta‐analysis of RCTs. Results Surgery gained 0·112 (95 per cent c.i. −0·011 to 0·213) QALYs compared with compression therapy alone, with a difference in lifetime costs of €−1330 (−3570 to 1262). Given the expected savings in community care, the procedure would pay for itself within 4 years. There was insufficient evidence regarding endothermal ablation and UGFS to draw conclusions. Discussion This modelling study found surgery to be more effective and less costly than compression therapy alone. Further RCT evidence is required for both endothermal ablation and UGFS

Afghanistan: losses, setbacks and impending challenges (part 2)

Ahead of the critical NATO Summit in Belgium on 25 May, 2017, Dr Sajjan Gohel discusses the security conditions and challenges in Afghanistan. In this post, he discussed how the Haqqani Network and the ISIS-affiliated Wilayat Khorasan are making their sizeable presence felt, and the geo-strategic agendas of Afghanistan’s neighbours which are further complicating the situation. In this context, he stresses the political and military decisions made by NATO leaders in 2017 could well decide Afghanistan’s future direction in what remains one of the longest lasting protracted conflicts in the world. This is the second part of of Dr Gohel’s two-part analysis. Read Part 1 on the Taliban’s recent expansion and proposals by the U.S. commander of the Resolute Support Mission in Afghanistan, General John W. Nicholson Jr. to stem the deterioration here

Predicting subsequent contralateral slipped capital femoral epiphysis: an evidence-based approach.

PurposeThe purpose of this study was to identify risk factors for developing a subsequent contralateral slipped capital femoral epiphysis (SCFE) and provide a prediction score to quantify risk of subsequent slip at the time of initial presentation.MethodsThis retrospective study included patients that presented with a unilateral SCFE between 2006 and 2017. Chart and radiographic review were performed to collect demographic, clinical and radiographic risk factors. Descriptive statistics, univariate analyses and multivariate regression analysis were used to compare risk factors between patients that did or did not develop a subsequent contralateral SCFE.ResultsThis study included 183 patients and 33 patients (18%) developed a subsequent contralateral SCFE. Younger age at time of initial presentation, lower modified Oxford Score and smaller difference in epiphyseal-diaphyseal angle between both sides during index presentation were significant predictors of subsequent contralateral SCFE. Specifically, age ≤ 11 years, modified Oxford Score ≤ 20 and difference in epiphyseal-diaphyseal angle of ≤ 21° between both hips were predictive of a contralateral slip (Area Under the Curve = 0.78; p < 0.05). The presence of each risk factor increased the risk of subsequent contralateral SCFE and having all three risk factors increased the risk to 73%.ConclusionThere is a significant risk of subsequent contralateral SCFE in patients with unilateral SCFE, and predictive risk factors include younger age, lower modified Oxford Score and smaller difference in epiphyseal-diaphyseal angle between the affected and unaffected hips.Level of evidenceLevel III

Deciphering Ayman Al-Zawahiri and Al-Qaeda’s strategic and ideological imperatives

This research paper explores the current strategic and ideological agenda of al-Qaeda leader, Ayman al- Zawahiri. To better understand how al-Zawahiri aims to retain international relevance, survival and sustainability, the paper assesses al-Zawahiri’s speeches and actions in recent years that articulate his world-view objectives. Importantly, this paper will argue that although the “Far Enemy” remains a priority, and will not be abandoned by al-Qaeda, al-Zawahiri has renewed the terrorist group’s emphasis on the “Near Enemy” and seeks to create safe bases across the Islamic world for al-Qaeda and its affiliates to function and grow. This paper will also illustrate that it would be naive to dismiss al-Zawahiri and al-Qaeda’s relevance as a global threat as the Egyptian is laying the foundations for al-Qaeda’s future. The paper also compares and contrasts al-Zawahiri’s historical motivations and how that fits into his current doctrine. Lastly, this paper dissects al-Zawahiri’s paradoxical nature and mixed messaging which could impact on al-Qaeda’s attempts to replenish the terrorist group’s ranks

Despite security challenges, Afghanistan's education system has come a long way

On 10 July 2017, the LSE's Department of International Development hosted an event on The Role of Higher Education in Ensuring Afghanistan's Prosperous Future. The participants included Dr Kenneth Holland, President at the American University of Afghanistan (AUAF); Dr Said Tayeb Jawad, Ambassador of Afghanistan to the UK; and award winning anchor and correspondent Yalda Hakim. Here, the co-chair of the event Dr Sajjan Gohel discusses the role education can serve to build the human capital necessary to place the country on a secure and stable path, and what role the international community can play to support Afghanistan at this critical juncture

The nexus of local and international extremist networks in Bangladesh

The Dhaka attack is the biggest act of terrorism Bangladesh has seen in recent times, but it was not an isolated incident. Sajjan Gohel discusses the wider context of extremism and writes that Bangladesh is in the grips of a battle between the JMB and ABT, affiliated with ISIS and Al-Queda respectively

Telomerase-associated apoptotic events by mushroom Ganoderma lucidum on premalignant human urothelial cells

Author name used in this publication: Mayur Danny I. Gohel2007-2008 > Academic research: refereed > Publication in refereed journalAccepted ManuscriptPublishe