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

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

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

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

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

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

Molecular diversity and Biotechnological Potential of Halo-tolerant and Haloalkaliphilic Actionomycetes from Saline Habitats along the coastal Gujarat

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Studies on Some Compounds of Medicinal Interest

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Reliability of resting brain networks using FMRI

Resting state FMRI studies on human subjects are primarily focused on elaborating effects of resting state brain networks on task induced paradigm and to check consistency of these networks between different groups of populations. Recent studies have shown consistency of RSFC networks within same subjects with intra-site and intra-session variation. The primary objective of this study was to check consistency of resting state networks between sites and between different groups of people in spite of change in scanning parameters and population. A total of 437 subjects resting state FMRI data from six different sites were collected varying in age group from 21 to 40 years, with scanning parameters varying from site to site. All the data was pre-processed in exactly similar fashion to reduce effects of site variation and to make group comparison feasible. It was hypothesized that in spite of variation in scanning parameters and population differences, cross-correlation values of time series between 97 ROIs chosen in the brain, should be consistent. To compare resting state connectivity measures, scatter plots of cross-correlation co-efficient between ROIs across sites were used. The investigation demonstrated a strong correlation between cross correlation values for pair of ROIS between sites. These findings suggest reliability and consistency of resting state brain networks between sites

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