A native of Danzig, he studied chemistry at the University of Kiel and obtained his PhD in 1957 at the Max Planck Institute for Biochemistry in Munich, under Nobel laureate Adolf Butenandt, the discoverer of estrone and other female hormones. In the same year he moved to the Sloan Kettering Institute in New York City and almost immediately began a 40-year collaboration with the founder of this Journal, epidemiologist and cancer prevention pioneer Ernst Wynder, in a partnership that would prove to be one of the most durable and productive in cancer research. Wynder, who had already won widespread recognition

ATM/ATR inhibitor clinical trial as author of the first American study demonstrating the link between cigarette smoking and lung cancer (Wynder and Graham, 1950), understood that for all its strengths, the epidemiology of tobacco-related diseases required a strong biological

and mechanistic foundation as the basis for policy recommendations that could lead to prevention of cancer at the population level. Hoffmann provided the laboratory side of the dyad, elucidating the structure and carcinogenic potential of dozens of chemical compounds Sirolimus order isolated from tobacco smoke in an approach that combined state-of-the art analytic chemistry with in vitro experimentation and in vivo bioassays. When Wynder left Memorial Sloan-Kettering in 1969 (Sloan-Kettering had merged with Memorial Hospital in 1960) to found the American Health Foundation (AHF), (Stellman, 2006a) Hoffmann came with him and eventually became Chief of the Division of Environmental Carcinogenesis as well as Associate Director at AHF’s Naylor Dana Institute for Disease Prevention

in Valhalla, NY, until its closing in 2004. He published over 300 papers in peer-reviewed journals, including 81 co-authored ADP ribosylation factor with Wynder (Stellman, 2006b), and contributed his expertise to numerous other publications as editor or reviewer. He continued to work and publish after Wynder’s 1999 death; his most recent paper appeared in 2010 (Schwartz et al., 2010). His formidable accomplishments in the field of carcinogenesis include the discovery, with Stephen S. Hecht, of the presence and importance of an entire class of carcinogens—nitrosamines—in tobacco smoke, which they published in Science ( Hoffmann et al., 1974), and later on the identification of 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) as the pre-eminent tobacco-specific nitrosamine. ( Hecht et al., 1978). He published extensively on polycyclic aromatic hydrocarbons, starting with a 1961 publication with Wynder in Nature. ( Wynder and Hoffmann, 1961). He also studied the carcinogenicity of gasoline and diesel engine exhaust and numerous other environmental pollutants. His laboratory provided many researchers with opportunities to advance their careers.

Soluble proteins were purified from bacterial lysates by glutathione-affinity chromatography

as previously described [29], then analysed by sodium-dodecyl-sulphate (SDS) polyacrylamide gel electrophoresis (PAGE). GST-fused proteins from inclusion bodies (insoluble fraction) were dissolved in a CAPS buffer (CAPS 50 mM, DTT 1 mM and Sarkosyl 0.3%), hence denaturing the proteins [30]. The dissolved and denatured protein was dialyzed overnight against 20 mM Tris–HCl pH 8.5. Insoluble proteins dissolved in CAPS buffer/dialysed are referred check details to as ‘CAPS-denatured proteins’ throughout the text. Purified proteins were quantified by two different methods: (i) a Bradford assay at 595 nm and (ii) UV spectrophotometry at 280 nm (extinction coefficient determined from aa sequences of each fusion protein). Concentration measurements were consistent using both methods. Relative amounts of proteins to be injected were based on copy number considerations in a BTV particle, as determined by X-ray crystallography (780 copies for VP7, 360 copies for VP5 and 180 copies for VP2 [1]). Seven

groups of six Balb/c mice were injected subcutaneously at days 0, 14 and 28 with 100 μl of soluble protein/Montanide ISA 50V emulsion (Table 1). Three groups of six Balb/c mice were injected subcutaneously at days 0, 14 and 28 with 100 μl of CAPS-denatured protein/Montanide ISA 50V emulsion (Table 1). A group of six Balb/c mice were injected subcutaneously at days 0, 14 and 28 each with 100 μl of Zulvac-4® Bovis. Sera were used for normalisation of ELISA results. A group of six control Balb/c mice which were not immunised with any of the antigens was PD0332991 also included. Six groups of six IFNAR−/− mice were injected subcutaneously at days 0, 14 and 28 with: a mixture of VP2 SB-3CT domain 1 (VP2D1) and VP2 domain 2 (VP2D2) in Montanide, then challenged with (i) BTV-4 or (ii)

BTV-8; or a mixture of VP2D1 + VP2D2 + VP5Δ1–100/Montanide, then challenged with (iii) BTV-4 or (iv) BTV-8; or a mixture VP2D1 + VP2D2 + VP5Δ1–100 + VP7/Montanide, then challenged with (v) BTV-4 or (vi) BTV-8 (Table 1). Blood samples were collected at day 0 and day 28. The mice received an intravenous lethal [31] challenge on day 40, with 103 pfu of BTV-4-italy03 (homologous-challenge), or 10 pfu of BTV-8-28 (heterologous-challenge). Blood was collected on the day of challenge (day 40), then at days 2, 3, 4, 5, 7, 10 and 12 p.i. Sera were tested for anti-VP2, anti-VP5 and anti-VP7 antibodies by ELISA and immunofluorescence and for NAbs by PRNT. Two groups of six IFNAR−/− mice were injected subcutaneously with VP5Δ1–100 on days 0, 14 and 28. These groups were not challenged with BTV-4 or BTV-8. Two additional groups of six IFNAR−/− mice were immunised with VP7 on days 0, 14 and 28, then challenged at day 40 with either BTV-4 or BTV-8. Two groups of non-immunised mice were used as positive controls, to confirm lethality of BTV-4 or BTV-8 challenge-strains.

Study participants over estimated the sero-prevalence of WNv in Saskatchewan at 20%. Recently completed sero-prevalence studies from 2003 to 2007 estimate the sero-prevalence NVP-AUY922 order in Saskatchewan at 3.3% (range: 2:0–5.3% depending on geographic area) (unpublished data, J. Tataryn and P. Curry), with one specific geographic area of Saskatchewan as high as 8.5% [2]. Risk perceptions of the

public are likely influenced by media coverage and personal knowledge of individuals directly affected by WNv. The main concern for public health is the burden of illness to WNv patients and their families as well as the impact on the health care system. For example, in 2007, the Saskatoon Health Region reported

358 cases, including 32 neurological cases and 2 deaths; 15% of all cases were hospitalized. In that year, WNv was a leading cause of human encephalitis and aseptic meningitis in the region (Saskatoon Health Region Health Status Report, 2008; http://www.saskatoonhealthregion.ca/your_health/documents/PHO/shr_health_status_report_2008_full.pdf). Adults, seniors, and individuals who have chronic illnesses or who are immunosuppressed were perceived by study participants Roxadustat to be at greater risk of WNv disease and complications. Literature from across North America suggests that certain co-morbidity groups are at higher risk of prolonged recovery due to WNv, even the more mild form of West Nile fever [10]. Other factors, identified by study participants, believed to increase the risk of contracting WNv included living TCL in the southern part of the province, living

in a rural setting, working primarily outdoors, or participating in outdoor recreational activities. Again, these risk factors are reported in other studies from across North America [2] and [10]. Nearly all public health practitioners personally recommended preventive strategies against contracting WNv. The methods most commonly suggested by study participants included using mosquito repellent with DEET, wearing covering clothing such as long sleeves and pants, and avoiding exposure to mosquitoes during peak mosquito activity time periods. The 2004 sero-prevalence study conducted in southern Saskatchewan reported that study participants were highly knowledgeable about personal protective measures with over 95% of participants believing the protective measures prevent WNv; however, less than 50% reported practicing the behaviours all of most of the time [2]. This disconnect between knowledge and action for the personal prevention of WNv makes the introduction of a vaccine an extremely tangible method to prevent all forms of WNv disease which does not have to be applied on a daily basis. The majority of health care professionals felt confident in the potential efficacy of vaccination for prevention of WNv.

The predicted probability of infection leading to death was under 0.001% in children under eleven years of age, rising to approximately 0.07% in fifty to sixty-four year olds. The corresponding risk of death increased considerably in the over sixty-four year olds, to approximately 9%, although

the greater part of this risk is likely to be concentrated in the oldest individuals. Paediatric vaccination of two to eighteen year olds, at coverage rates of 10%, 50% and 80%, reduced the simulated click here mean annual number of general practice consultations resulting from influenza A and B infections in the entire population by 310,000 (37%), 690,000 (84%) and 790,000 (95%) respectively. Corresponding figures for hospitalisations were 8000 (34%), 19,000 (78%) selleck chemicals and 23,000 (94%) and for deaths were 6000 (33%), 15,000 (76%) and 18,000 (94%). An 80% coverage of 2–4 year olds reduced the mean annual number of consultations, hospitalisations and deaths in the entire population by 360,000 (44%), 10,000 (40%) and 7000 (36%). Vaccinating 10% of two to eighteen year olds is predicted to

avert an annual mean of 140,000 general practice consultations in this age group and a further 160,000 in the wider population, as a result of indirect protection (<2 years: 25,000; 19–49 years: 75,000; 50–64 years: 25,000; 65+ years: 36,000) (Fig. 5b). Increasing coverage of 2–18 year olds to 50% significantly increases the mean annual number of consultations averted, with 310,000 prevented by vaccination in the target age group and herd immunity preventing 390,000 more (<2 years: 56,000; 19–49 years: 187,000;

50–64 years: 60,000; 65+ years: 82,000). Further increasing the coverage to 80% of 2–18 year olds results in diminishing returns reflecting the pattern of infection, annually preventing a mean of 330,000 consultations in those age groups receiving the vaccine and herd immunity averting 463,000 additional consultations (<2 years: 63,000; 19–49 years: 223,000; 50–64 years: 74,000; 65+ years: 103,000). The corresponding figures for 10% coverage of 2–4 year olds were 185,000 consultations prevented in the targeted age groups, with Rolziracetam indirect protection averting a further 180,000 (<2 years: 32,000; 19–49 years: 80,000; 50–64 years: 28,000; 65+ years: 39,000). The skewed nature of the probability of hospitalisation or death with age, once infected with influenza, is apparent in the number of these outcomes averted by paediatric vaccination. Within those age groups targeted, vaccination of 10% of 2–18 year olds is estimated to prevent an annual mean of approximately 1000 hospitalisations (Fig. 5c) and fewer than 20 deaths (Fig. 5d). Herd immunity in the remaining population would prevent 7300 hospitalisations and 6500 deaths, of whom 5400 (74%) and 6100 (95%) respectively are in the elderly over 64 years of age.

PBMC were plated in duplicate wells at 0.4 million

per well on MultiScreen 96-well HPVDF filtration plates (MAIPS4510, Millipore) after coating overnight at 4 °C with 10 μg/mL of anti-IFNγ (1-D1K, Mabtech) and blocking with the supplemented medium described above. Cells were incubated (37 °C, 5% CO2) for 18–20 h with positive (phytohaemagglutinin 10 μg/mL, Sigma) or negative (supplemented medium) controls or peptide pools consisting of up to 32 peptides (each 20mers overlapping by 10, final concentration 10 μg/mL/peptide). Plates were developed using biotin–streptavidin–ALP (Mabtech) with the addition of a chromogenic substrate (BioRad). Spots were counted using an ELISPOT reader and associated software (both Autoimmun Diagnostika). Final counts were expressed as sfu/million RO4929097 PBMC after averaging duplicate well counts and subtracting background. For larger proteins, responses from multiple peptide pools were summed to give the response against the whole protein. Data analysis

was carried out using Microsoft Excel®, GraphPad Prism® and STATACorp STATA® with Kaplan-Meier analysis in SPSS®. A total of 34 volunteers passed screening and were enrolled into study groups 1–7 between April and November 2006. Volunteer demographics are shown in Table 1. Fifteen volunteers received learn more one vaccination each in the dose-escalation groups 1–5 (n = 3 per group). Nineteen volunteers

were enrolled into the prime-boost vaccination groups 6 (or ‘FFM’ receiving the vaccine sequence FP9-PP/FP9-PP/MVA-PP, n = 9) and 7 (‘MMF’, n = 10). Idoxuridine Three volunteers subsequently withdrew (one from the FFM group due to a pre-existing condition not revealed at screening and two from the MMF group due to unforeseen changes to work and travel plans). All available data has been included in the analysis for these volunteers. Fifteen of the 16 volunteers completing the prime-boost vaccination study subsequently volunteered to enter the separate but linked challenge study. They were joined by six newly-recruited unvaccinated malaria-naïve challenge control volunteers. No serious adverse events (SAEs) occurred during the study. Of 717 adverse events (AEs) recorded during the entire vaccination phase, 577 (81%) were judged probably or definitely related to vaccination (termed ‘vaccine-related’ from here on). Of these, 562 (97%) were AEs anticipated from previous studies of these vaccine vectors about which volunteers were specifically asked at each visit (solicited AEs, Fig. 1). The majority of all AEs reported during the vaccination phase were mild, with only 1 (0.1%) graded severe and 8% moderate in severity. The severe AE was local swelling at the vaccine site.

The polyherbal extract was mixed with the required excipients and compressed into tablets. HPTLC study of extract and formulation was carried out to ensure the correlation between them by comparing the HPTLC chromatogram

of the extract and formulation. The phytochemical constituents present in the extract as well as in the formulation were identified by GC–MS method. Spotting device: Linomat IV automatic sample spotter; CAMAG (Muttenz, Swizerland) Stationary Phase: Silica gel 60 F254 For HPTLC, 2 g of extract and formulation were extracted with 25 ml of methanol on a boiling water bath for 25 min consecutively three times using fresh portion of 25 ml methanol, filtered and concentrated. Chromatography was performed by spotting extract and formulation on precoated silica gel aluminium plate 60 F254 (10 cm × 10 cm with 250 μm thickness) using Camag Linomat selleck inhibitor IV sample applicator and 100 μl Hamilton syringe. The samples, in the form of bands of length 5 mm, were spotted 15 mm from the bottom, 10 mm apart, at a constant application rate of 15 nl/s using nitrogen aspirator. Plates were developed see more using mobile phase consisting of Methanol:Chloroform:Water:Acetic acid (2:7:0.5:0.5).

Subsequent to the development, TLC studies were carried out. 25 μl of the test solution was applied on aluminium plate precoated with silica gel 60 F254 of 0.2 mm thickness and the plate was developed in Methanol: Chloroform:Water:Acetic acid in the ratio 2:7:0.5:0.5. The plate was dried and scanned at 366 nm, then the plate dipped in vanillin-sulphuric of acid reagent and heated to 105 °C till the colour of the spots appeared.

Densitometric scanning was performed on Camag TLC scanner III in the absorbance/reflectance mode. The HPTLC fingerprinting profile of the polyherbal formulation was developed using silica gel 60 F254 as stationary phase and methanol:chloroform:water:acetic acid in the ratio of 2:7:0.5:0.5 as mobile phase. The fingerprint provided a means of a convenient identity check for the finished product. The HPTLC fingerprint can be used efficiently for the identification and quality assessment of the formulation. GC–MS analysis was performed using THERMO GC-TRACE ULTRA VER: 5.0 interfaced to a Mass Spectrometer (THERMO MS DSQ II) equipped with DB-5-MS capillary standard nonpolar column (Length: 30.0 m, Diameter: 0.25 mm, Film thickness: 0.25 μm) composed of 100% Dimethyl poly siloxane. For GC–MS detection, an electron ionization energy system with ionization energy of 70 eV was used. Helium gas (99.999%) was used as the carrier gas at a constant flow rate of 1.0 ml/min and an injection volume of 1 μl was employed. Injector temperature was set at 200 °C and the ion-source temperature was at 200 °C. The oven temperature was programmed from 70 °C (isothermal for 2 min), with an increase of 300 °C for 10 min. Mass spectra were taken at 70 eV with scan interval of 0.5 s with scan range of 40–1000 m/z.

These conditions certainly contributed to the rapid loss of the contaminating viruses. Only viruses that are present at very high titers and which grow very rapidly without adaptation would be able to survive such passaging. In a second series of

passages we also monitored more than 50 specimens that did not contain an influenza virus but were positive for other respiratory viruses. In these specimens interference by competing influenza virus growth was excluded. The culture conditions differed, as lower inoculum dilutions were used. Each sample/harvest was diluted 1:100 into the culture, which is the lowest standard dilution applied to recover very low-titred influenza virus. Also under these conditions 54 positive results for 8 different viruses became Veliparib in vitro negative after only 2 or 3 passages and SNS-032 research buy after a total dilution of the original specimen by a factor of 2 × 10−4 to 2 × 10−5. When similar passages were conducted with adherent Vero cells (“Vero WHO seed”), several positive samples (adenovirus, rhinovirus, enterovirus, metapneumovirus, and bocavirus) remained positive after 2 passages. However, except for adenovirus, the counts did not increase but dropped

(data not shown). These results demonstrate that, under practical conditions as applied to grow influenza viruses, contaminating viruses can be effectively removed by passaging in MDCK 33016PF cells. In combination with their superior isolation efficiency [7] and [28], MDCK cells appear highly suitable to be used as an alternative to embryonated eggs to isolate and propagate candidate vaccine viruses.

The authors would like to thank Knut Schwarz, Marion Wellnitz, from Veronika Horn and Inge Lettermann for their skillful technical assistance with these studies. We gratefully acknowledge confirmatory PCR test results by independent methods that were partly provided by Marcus Panning, of the Virology Department of the University Clinic in Freiburg, Germany. “
“Dendritic cells (DCs) are key components of the immune system which function by binding and collecting antigens. Following recognition, DCs present the antigen of interest through selective surface markers to T-cells in order to activate a specified immune response [1]. Antigen presentation also stimulates the differentiation of T-cells to B cells which release antibodies specific for the antigen of interest. It is these functions that researchers aim to exploit in the production of vaccines. Non-viral gene delivery to DCs is an attractive approach for DNA vaccination to elicit immune responses towards encoded antigenic sequences [2]. Non-viral techniques often entail delivery of nucleic acids that are bound to a cationic polymer (polycations) resulting in plasmid DNA (pDNA) – polymer products, known as polyplexes [3]. Polycations operate by binding and condensing pDNA into smaller structures thereby facilitating uptake.

Furthermore, these VLPs induced broad sero- and HI-reactivity. Based on this data we speculate that the vaccine could also protect against other,

divergent H7 strains. We have previously shown that the presence of active baculovirus in insect cell-derived VLP preparation is able to substantially increase immunogenicity and protection due to its immune-stimulatory capability [16]. We would assume that they play a substantial role in the efficacy and potent immunogenicity of the H7 VLP vaccine tested here. VLP vaccines that contain baculoviruses might prove to be useful in pandemic situations where large quantities of highly effective PD0332991 in vitro vaccines are needed. However, bioactive, live viruses in vaccine formulations might induce strong reactogenicity and safety concerns might prevent their application in humans. Importantly, a bioactive baculovirus component of a vaccine

would need to be standardised and tested for stability under different storage conditions. In addition it would be necessary to assess the minimum effective concentration of baculovirus in a vaccine dose and to establish an acceptable HA or VLP to active baculovirus ratio. Assessment of the latter ratio might be difficult due to the presence of baculovirus–VLP hybrids – baculovirus particles selleck compound that incorporate HA and VLPs that incorporate baculovirus capsid and envelope however proteins [45] and [46]. As a large body of research is currently focusing on baculovirus-based expression systems in vaccine manufacturing, more safety data will accumulate and more analytical methods will become available for this system in the near future [46] and [47] and might possibly spur its establishment in human applications. We thank Stefan Gross and Chen Wang for technical assistance. MK and MW are funded by the PhD programme “BioToP – Biomolecular Technology of Proteins” (Austrian Science Funds, FWF Project W1224). DP was supported

by the Austrian Science Fund (25092-B13). FK was supported by an Erwin Schrödinger fellowship (J 3232) from the Austrian Science Fund. This work was partially supported by CEIRS (Centers for Excellence for Influenza Research and Surveillance grant (HHSN26620070010C), NIH program project grant 1P01AI097092-01A1 and a PATH grant to the Palese and García-Sastre laboratories. Conflict of interest statement: The authors declare that they have no conflict of interest. “
“Influenza is an important cause of death and serious illness, particularly among adults aged ≥65 years and those with certain underlying chronic conditions. In the United States, approximately 226,000 hospital admissions are attributed to influenza each year [1].

two-dose boys = $256 million over 70 years of vaccination in a population of 10 million, results not shown). Compared to no vaccination, all two- and three-dose girls-only and girls & boys HPV vaccination strategies investigated produce cost-effectiveness ratios below the $40,000/QALY-gained cost-effectiveness threshold ( Fig. 2, and see Supplementary Table 3 for detailed results). In the base-case, two-dose girls-only vaccination (vs. no vaccination) consistently produces the lowest incremental cost-effectiveness ratio with cost/QALY-gained varying between $7900 [IQR: 7000;9700] and $10,400 [IQR: 8800;13,400] ( Fig. 2b–f). The only

exception is when two-dose duration of protection is assumed to be 10 years ( Fig. 2a). In the sensitivity analysis, two-dose girls-only vaccination Doxorubicin cell line cost-effectiveness ratios remained below $40,000/QALY-gained ( Fig. 3a). The maximum cost per dose for two-dose girls-only vaccination to remain cost-effective (vs. no vaccination) is predicted to be $128, $218 and $252 assuming two-dose vaccine protection lasts 10, 20 and 30 years, AUY-922 concentration respectively (see Supplementary Fig. 4 and Table 4). The incremental cost-effectiveness ratio of

giving the third dose of vaccine to girls (i.e., of three-dose girls-only vs. two-dose girls-only) is estimated to be below $40,000/QALY-gained if: (i) three doses provide longer protection than two doses (i.e., more than 5 years), and ii) two-dose protection is less than 30 years ( Fig. 2 and Fig. 3). Under most scenarios, two-dose girls & boys vaccination (vs. two-dose girls-only) provides fewer or similar QALYs-gained and is more expensive than three-dose girls-only vaccination (i.e., is dominated; Fig. 2 and Fig. 3). The almost only exceptions are: (i) if the third dose provides little or no additional protection to two doses, (ii) when extreme scenarios for burden of HPV-disease among MSM are assumed (e.g., 7% males are MSM, the relative risk of disease among

MSM vs. male heterosexuals is 17, and girls-only vaccination is assumed to have no effect on HPV-related disease incidence in MSM) or (iii) when vaccine cost for boys is 10–40% of the cost for girls ( Fig. 3b, Supplementary Fig. 3). Finally, the incremental cost-effectiveness ratio of three-dose girls & boys vaccination (vs. three-dose girls-only) is greater than $100,000/QALY-gained under all base-case scenarios and most scenarios investigated in sensitivity analysis ( Fig. 2 and Fig. 3). In the sensitivity analysis, three-dose girls & boys vaccination is estimated to be less than $40,000/QALY-gained if the cost per dose for girls and boys is substantially reduced (Supplementary Fig. 4c).

Randomised controlled trials are needed that combine activity/exercise approaches with other interventions such as psychological approaches, educational approaches and medication. The optimal combination and dosage of such approaches will need to be determined. WAD, whether acute or chronic, is a challenging and complex condition. With clear evidence emerging of a myriad of physical and psychological factors occurring to varying degrees in individual patients, it is also clear that practitioners

involved in the management of WAD need specific skills in this area. Physiotherapists are the health care providers who likely see the greatest number of patients http://www.selleckchem.com/products/sch-900776.html with WAD, and by virtue of the health system set-up, spend the most time with these patients. Physiotherapists are well placed to take on a coordination or ‘gatekeeper’ role in the management of WAD and research into health services models that include physiotherapists in such a role is also needed. Competing interests: Nil. Acknowledgement: Michele Sterling received a fellowship from the National Health and Medical Research Council of Australia. Correspondence: Michele Sterling, Centre of National Research on Disability

and Rehabilitation Medicine (CONROD), The University of Queensland and Griffith University, Australia. Email: [email protected] Ceritinib supplier “
“Primary dysmenorrhoea is defined as cramping pain GPX6 in the lower

abdomen that occurs just before or during menstruation without identifiable pelvic pathology.1 Secondary associated symptoms include nausea, vomiting, fatigue, back pain, headaches, dizziness, and diarrhoea.2 Primary dysmenorrhoea has been reported as the leading cause of recurrent absenteeism from school or work in adolescent girls and young women, and is considered to be a common disorder among women of reproductive age.3 A survey of 1266 female university students found the total prevalence of primary dysmenorrhoea to be 88%, with 45% of females having painful menstruation in each menstrual period and 43% of females having some painful menstrual periods.4 Excessive production and release of prostaglandins during menstruation by the endometrium causes hyper-contractility of the uterus, leading to uterine hypoxia and ischaemia, which are believed to cause the pain and cramps in primary dysmenorrhoea.3 Based on this understanding, pharmacological therapies for primary dysmenorrhoea focus on alleviating menstrual pain and relaxing the uterine muscles by using non-steroidal anti-inflammatory drugs (NSAIDs) or oral contraceptive pills.5 A survey of 560 female students from three medical colleges in India reported that 87% of those with dysmenorrhea also sought treatment.6 Among the women who sought treatment, 73% took analgesics and 58% had physiotherapy management, primarily heat treatment.