A SINGLE-BLIND, PLACEBO-CONTROLLED CLINICAL TRIAL OF LOCAL APPLICATION OF KOHL-CHIKNI DAWA-A UNANI COMPOUND FORMULATION IN THE PATIENTS WITH CORNEAL OPACITY

Objective: The present clinical trial was undertaken to evaluate the safety, preventive/curative efficacy of the local application of Kohl-Chikni Dawa (KCD) in patients with corneal opacity (CO), to provide an economic, safe, and effective alternative treatment for it. Methods: The present prospective single-blind, placebo-controlled trial was undertaken at Majeedia Hospital, Hamdard University, New Delhi. Ninety-two diagnosed patients of CO were randomly allocated to three groups for local application of KCD/placebo two sticks BID. Results: Forty patients completed the 6-month duration of the study. KCD was found effective in the general amelioration of the signs and symptoms of CO. There was a statistically significant reduction in the CO score and improvement in vision on the reading of the Snellen chart in the test drug group in comparison to the placebo group in Grade-I (Nebular type) CO (p>0.05). Conclusion: KCD was found very much effective to reduce the CO score, with clinical improvement of vision in the nebular type of CO. The dose of KCD in two sticks BID was found safe and tolerable with no side effects. A multicentric trial of the test drug on larger sample size for a longer duration is required to establish the efficacy of the formulation on CO

Formalizing Mobile Ad Hoc and Sensor Networks Using VDM-SL

AbstractMobile ad hoc and sensor networks (MAHSNs) are expected to become the fabric of modern societies. Despite considerable advancements, these networks are yet unable to surmount many operational challenges especially in safety-critical large-scale applications. Most of the published research focused on performance analysis of nonfunctional properties and ignore correctness of the approach which is vital in large and complex systems. This paper investigates an alternative formal specification and analysis technique for MAHSNs. We model MAHSNs as dynamic graph and employ VDM-SL for formal specification and verification of LASCNN algorithm. Constraints are put on the data where required to support validation of the formal algorithm. Pre and post conditions are defined for correct operation of communication in terms of messages. VDM-SL is used because it is a formal specification language to describe detailed examination of the system. The specification is analyzed and validated using VDM-SL toolbox

Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial

Background Post-partum haemorrhage is the leading cause of maternal death worldwide. Early administration of tranexamic acid reduces deaths due to bleeding in trauma patients. We aimed to assess the effects of early administration of tranexamic acid on death, hysterectomy, and other relevant outcomes in women with post-partum haemorrhage. Methods In this randomised, double-blind, placebo-controlled trial, we recruited women aged 16 years and older with a clinical diagnosis of post-partum haemorrhage after a vaginal birth or caesarean section from 193 hospitals in 21 countries. We randomly assigned women to receive either 1 g intravenous tranexamic acid or matching placebo in addition to usual care. If bleeding continued after 30 min, or stopped and restarted within 24 h of the first dose, a second dose of 1 g of tranexamic acid or placebo could be given. Patients were assigned by selection of a numbered treatment pack from a box containing eight numbered packs that were identical apart from the pack number. Participants, care givers, and those assessing outcomes were masked to allocation. We originally planned to enrol 15 000 women with a composite primary endpoint of death from all-causes or hysterectomy within 42 days of giving birth. However, during the trial it became apparent that the decision to conduct a hysterectomy was often made at the same time as randomisation. Although tranexamic acid could influence the risk of death in these cases, it could not affect the risk of hysterectomy. We therefore increased the sample size from 15 000 to 20 000 women in order to estimate the effect of tranexamic acid on the risk of death from post-partum haemorrhage. All analyses were done on an intention-to-treat basis. This trial is registered with ISRCTN76912190 (Dec 8, 2008); ClinicalTrials.gov, number NCT00872469; and PACTR201007000192283. Findings Between March, 2010, and April, 2016, 20 060 women were enrolled and randomly assigned to receive tranexamic acid (n=10 051) or placebo (n=10 009), of whom 10 036 and 9985, respectively, were included in the analysis. Death due to bleeding was significantly reduced in women given tranexamic acid (155 [1·5%] of 10 036 patients vs 191 [1·9%] of 9985 in the placebo group, risk ratio [RR] 0·81, 95% CI 0·65–1·00; p=0·045), especially in women given treatment within 3 h of giving birth (89 [1·2%] in the tranexamic acid group vs 127 [1·7%] in the placebo group, RR 0·69, 95% CI 0·52–0·91; p=0·008). All other causes of death did not differ significantly by group. Hysterectomy was not reduced with tranexamic acid (358 [3·6%] patients in the tranexamic acid group vs 351 [3·5%] in the placebo group, RR 1·02, 95% CI 0·88–1·07; p=0·84). The composite primary endpoint of death from all causes or hysterectomy was not reduced with tranexamic acid (534 [5·3%] deaths or hysterectomies in the tranexamic acid group vs 546 [5·5%] in the placebo group, RR 0·97, 95% CI 0·87-1·09; p=0·65). Adverse events (including thromboembolic events) did not differ significantly in the tranexamic acid versus placebo group. Interpretation Tranexamic acid reduces death due to bleeding in women with post-partum haemorrhage with no adverse effects. When used as a treatment for postpartum haemorrhage, tranexamic acid should be given as soon as possible after bleeding onset. Funding London School of Hygiene & Tropical Medicine, Pfizer, UK Department of Health, Wellcome Trust, and Bill & Melinda Gates Foundation

The Effect of Neuropathic Pain on Psychological Well-Being of An Individual

This comprehensive study delves into the intricate relationship between neuropathic pain and psychological well-being among individuals while exploring the multifaceted influences of pain severity, gender, socio-economic class, and potential gender-based disparities. Employing a cross-sectional design, data were meticulously gathered from a sample of 110 participants within a medical facility. To assess neuropathic pain and psychological well-being, the study thoughtfully employed self-report measures, notably the DN4 Questionnaire for pain assessment and the Satisfaction with Life Scale for evaluating psychological well-being. The findings of this study unveiled a robust and statistically significant negative correlation between neuropathic pain and psychological well-being (r = -0.87, p = 0.02). This compelling correlation indicates that as the severity of neuropathic pain escalates, psychological well-being tends to markedly diminish. This relationship was further corroborated through linear regression analysis, demonstrating that for each incremental unit increase in neuropathic pain, there is a corresponding decrease of 0.87 units in psychological well-being (p = 0.001). Furthermore, this study unearthed noteworthy negative correlations between neuropathic pain and distinct domains of life, encompassing general activity, mood, normal work, relationships, sleep and enjoyment in life. These correlations illuminate that as the severity of neuropathic pain intensifies, individuals encounter impediments in various facets of their lives, including their daily activities, emotional states, work performance, social interactions, sleep quality, and overall life satisfaction. Notably, the socio-economic class emerged as a salient factor influencing well-being, with individuals in the middle class exhibiting significantly higher well-being scores when compared to their counterparts in the lower socioeconomic class (F = 5.770, p = 0.004). Intriguingly, gender did not wield a substantial impact on either well-being or pain levels in this study's context. The profound implications of these findings underscore the imperative necessity for the development and implementation of comprehensive pain management strategies, as well as robust psychosocial support systems tailored to individuals grappling with neuropathic pain. Future avenues of research should consider adopting longitudinal study designs to gain insights into the evolution of these relationships over time and should also explore nuanced cultural and gender-related factors that might further elucidate the complex interplay between pain experiences and psychological well-being