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

Record of the largest big eye hound shark Iago omanensis (Norman, 1939) from Gujarat, North West Coast of India

A female specimen of big eye hound sharkIago omanensis measuring 66 cm was landed at Mangrol fishing harbor on 17th September 2013. The specimen was collected along with 13 others of the same species. I. omanensis was not recorded earlier from Gujarat

Feeding habits of milk shark, Rhizoprionodon acutus (Ruppell, 1837) in the Gujarat coastal waters of north-eastern Arabian Sea

The feeding habit of milk shark Rhizoprionodon acutus was investigated in 684 specimens collected along Gujarat coast (India) of north-eastern Arabian Sea from January 2013 to December 2014. The length range of females was 32–89.6 cm and males 33.5–89 cm. The shark foraged on diversified prey items which were pooled into four distinct groups i.e., teleosts, crustaceans, mollusks and annelids. Teleosts (Dietary coefficient, %QI = 83.05 and index of relative importance, %IRI = 78.40) were found to be the preferred food items followed by crustaceans (%QI = 16.21; %IRI = 19.78), which formed the secondary food item group. Mollusks (%QI = 0.74; %IRI = 1.69) and annelids (%QI = 0.01; %IRI = 0.14) constituted the accidental or accessory food items. The species, though is a pelagic predator, probably performs vertical movements in search of prey items. The shark also showed some sorts of preference and selectivity for clupeids, engraulids and carangids. Females though showed significantly lower index of relative fullness (IRF) (P ≤ 0.5) and comparatively lower vacuity index and lower mean number of preys per stomach compared to the males, the preference for prey items was not found to be significantly different between the females and males. Juveniles were found to have significantly higher IRF (P ≤ 0.5) and comparatively higher vacuity index than that of the adults, whereas the mean preys per stomach was found to be lower than that of the adults. Moreover, the prey preference was also significantly different between the juveniles and adults. The study provides necessary baseline information about the feeding habits of the shark in the region which will be helpful in understanding the trophodynamics of the species under the influence of overfishing and climate change

New Geographical Record for Muraenid Eels (Anguilliformes: Muraenidae) along the Northeast Arabian Sea, Western Indian Ocean

Fishes of family Muraenidae, popularly known as moray eels, are one of the most diverse groups among true eels. Gymnothorax is the most predominant genus in terms of diversity along Indian coastline (31 species including recent description and distributional records), but they rarely form the fishery of commercial importance. Gymnothorax dorsalis, species of elongated unpatterned moray eels characterized by eight to nine pre-dorsal vertebrae, three infraorbital pores and low dorsal and anal fin united with caudal fins is reported for the first time from the west coast of India. Gymnothorax reticularis, reticulated patterned eel with 18–19 vertical dark bars, five pre-dorsal vertebrae and 10–11 vomerine teeth is also reported for the first time from the northwest coast of India

Commercially Important Rays and Skates of Gujarat

Commercially Important Rays and Skates of Gujara

A randomized trial of early endovenous ablation in venous ulceration

BACKGROUND Venous disease is the most common cause of leg ulceration. Although compression therapy improves venous ulcer healing, it does not treat the underlying causes of venous hypertension. Treatment of superficial venous reflux has been shown to reduce the rate of ulcer recurrence, but the effect of early endovenous ablation of superficial venous reflux on ulcer healing remains unclear. METHODS In a trial conducted at 20 centers in the United Kingdom, we randomly assigned 450 patients with venous leg ulcers to receive compression therapy and undergo early endovenous ablation of superficial venous reflux within 2 weeks after randomization (early-intervention group) or to receive compression therapy alone, with consideration of endovenous ablation deferred until after the ulcer was healed or until 6 months after randomization if the ulcer was unhealed (deferred-intervention group). The primary outcome was the time to ulcer healing. Secondary outcomes were the rate of ulcer healing at 24 weeks, the rate of ulcer recurrence, the length of time free from ulcers (ulcer-free time) during the first year after randomization, and patient-reported health-related quality of life. RESULTS Patient and clinical characteristics at baseline were similar in the two treatment groups. The time to ulcer healing was shorter in the early-intervention group than in the deferred-intervention group; more patients had healed ulcers with early intervention (hazard ratio for ulcer healing, 1.38; 95% confidence interval [CI], 1.13 to 1.68; P=0.001). The median time to ulcer healing was 56 days (95% CI, 49 to 66) in the early-intervention group and 82 days (95% CI, 69 to 92) in the deferred-intervention group. The rate of ulcer healing at 24 weeks was 85.6% in the early-intervention group and 76.3% in the deferred-intervention group. The median ulcer-free time during the first year after trial enrollment was 306 days (interquartile range, 240 to 328) in the early-intervention group and 278 days (interquartile range, 175 to 324) in the deferred-intervention group (P=0.002). The most common procedural complications of endovenous ablation were pain and deep-vein thrombosis. CONCLUSIONS Early endovenous ablation of superficial venous reflux resulted in faster healing of venous leg ulcers and more time free from ulcers than deferred endovenous ablation

STANDARDISATION AND HPTLC METHOD DEVELOPMENT OF MARKETED AYURVEDIC FORMULATION – BALARISHTA

Objective: The present study aims to standardize four marketed brands of Balarishta, an Ayurvedic formulation viz. Baidyanath-Balarishta (BB), Dabur-Balarishta (DB), Zandu-Balarishta (ZB) and Nagarjuna-Balarishta (NB) with respect to their physicochemical (organoleptic properties, pH, specific gravity, total solid content, ethanol content, reducing and non-reducing sugar content), phytochemical and microbial parameters (total bacterial count, total fungal count and test for specific pathogens viz. P. aeruginosa, E. coli and S. aureus). It also aims to develop and validate a new highperformance thin layer chromatography (HPTLC) method for simultaneous determination of three major phytoconstituents present in Balarishta viz. withaferin A, gallic acid and ephedrine.Methods: ‘Protocol for testing Ayurveda, Siddha and Unani medicines' was used as a reference for conducting standardization experiments. HPTLC method was developed on Camag Linomat-5 using silica gel 60 GF254 as the stationary phase and Toluene: Chloroform: n-propanol: Ethanol: Formic acid (6: 3: 1: 2: 1, v/v/v/v/v) as the mobile phase. The analytical method validation studies were performed as per International Conference on Harmonization-Quality (ICH-Q2 (R1)) guidelines.Results: The results of standardisation tests obtained were compared with specifications mentioned in ‘Ayurvedic Pharmacopoeia of India 2008 Volume 2, Part 2' and a comparative data of each Balarishta formulation was generated for all the quality control parameters performed. A new, accurate, precise and robust HPTLC method was successfully developed with Retardation factor (Rf) of 0.17±0.02, 0.35±0.01 and 0.54±0.02 for ephedrine, gallic acid and withaferin A respectively.Conclusion: The results of this research work will serve as a valuable quality tool for routine quality control analysis of Balarishta formulations.Keywords: Balarishta, Standardisation, Withaferin A, Gallic acid, Ephedrine and HPTLC

Anti-corruption Strategies in Afghanistan: An Alternative Approach

© 2016, © 2016 SAGE Publications. Afghanistan is one of the most corrupt countries in the world. This article provides a critical examination of Afghan anticorruption strategies based on formal anticorruption strategy, bureaucratic reform, and counter-narcotics. This article includes reference to some of the opinions of 70 semi-structured interviews conducted by the author in Kabul during May–June 2010 with anticorruption experts, rights-based organizations, civil society groups, ministries, and international and national organizations. The findings are that political interference from Afghan elites preserves corruption and deep roots of patron–client corruption—patronage networks and illicit drug trafficking interests with criminal groups for profitable gain—are difficult to combat with the existing anticorruption strategy. Hence, new approaches need to be attempted, such as, incorporating religion and ethics and empowering local leaders to combat corruption within a sixfold approach which involves (i) raising awareness, (ii) prevention, (iii) prosecution and sanctions, (iv) detection, (v) a collaborative counter-narcotics strategy, and (vi) linking religion

Production and partial characterization of chitinase from a halotolerant Planococcus rifitoensis strain M2-26

peer reviewedThis paper is the first to investigate the production and partial characterization of the chitinase enzyme from a moderately halophilic bacterium Planococcus rifitoensis strain M2-26, earlier isolated from a shallow salt lake in Tunisia. The impact of salt, salinity concentration, pH, carbon and nitrogen sources on chitinase production and activity have been determined. This is the first report on a high salt-tolerant chitinase from P. rifitoensis, since it was active at high salinity (from 5 to 30% NaCl) as well as in the absence of salt. This enzyme showed optimal activity at 70 C and retained up to 82 and 66% of its original activity at 80 or 90 C, respectively. The activity of the enzyme was also shown over a wide pH range (from 5 to 11). For characterization of the enzyme activity, the chitinase secreted in the culture supernatant was partially purified. The preliminary study of the concentrated dialysed supernatant on native PAGE showed at least three chitinases produced by strain M2-26, with highest activity approximately at 65 kDa. Thus, the thermo-tolerant and high salt-tolerant chitinases produced by P. rifitoensis strain M2-26 could be useful for application in diverse areas such as biotechnology and agro-industry

BIOACTIVITY GUIDED FRACTIONATION AND ANTI-INFLAMMATORY ACTIVITY OF ACACIA NILOTICA PODS

Objective: The present study aims at screening the methanol extract and the tannin fraction of the pods of Acacia nilotica for anti-inflammatory activity. Methods: The methanol extract and its tannin fraction were evaluated for acute toxicity using rats as per the Organization for Economic Co-operation and Development (OECD) guidelines. They were found to be safe up to a dose of 2000 mg/kg. The anti-inflammatory activity of the extract and its fraction was evaluated using the carrageenan-induced rat paw edema method for determining the acute phase of inflammation. The activity against sub-acute inflammation was evaluated using the cotton pellet granuloma pouch method. Diclofenac sodium was used as the reference drug.Results: The results of pharmacological screening indicated the methanol extract to possess statistically significant anti-inflammatory activity at 100 mg/kg dose. The tannin fraction of methanol extract was found to be more potent than the methanol extract with maximum response at 25 mg/kg dose.Conclusion: The methanol extract and tannin fraction of pods of Acacia nilotica possess significant anti-inflammatory activity the latter one being more potent.Â