Ijaz Hussain, Political and Legal Dimensions of Indus Water Treaty (Book Reviews)

Of the many issues that the partition of India in 1947 did not address in time, and were left to worsen the relations between India and Pakistan, the issue of riparian rights was only next in importance to the issue of Kashmir. In many respects the two issues have direct bearing on each other as well, as some important rivers emanate from Indian-held Kashmir. As the time passes more and more historians are coming to the conclusion that the massacre at the time of partition, the uprooting of more than 12 million people from their native homes, horrendous violence against women, burning and looting, etc, all owe mainly to the colonial administration that failed to ensure peaceful transition to two independent countries. No less than a person than a former Prime Minister of Great Britain, Winston Churchill, described the attitude of the then British government as the ‘biggest escape of human history’. In its urge to get rid of Indian responsibility, the government of Prime Minister Clement Atlee, showed extraordinary haste in relinquishing its responsibilities without ascertaining that the partition of a country of a subcontinental size would involve a huge amount of work. It required taking into consideration all administrative and security aspects so that the two countries could move along their independent journey as good neighbours. Unfortunately, the failure of the British government, both in London and, through its viceroy, in Delhi, left a number of issues unsettled, which the two independent countries have been trying to resolve for the last seven decades. Moreover, with the passage of time, new factors emerged which further complicated the original issues.

Association Between Female Sexual Dysfunction and Fertility Among Women of Reproductive Age at the Aga Khan University Hospital, Nairobi.

Introduction: Sexual function plays an essential role in the bio-psychosocial wellbeing and quality of life of women and disturbances in sexual functioning often result in significant stress. Sexual dysfunction in women is a highly prevalent condition affecting up to 43% of women. Subfertility being a common problem affecting up to 20% of the population, causes significant psychosocial distress which might adversely affect sexual functioning and vice versa. However, despite the high prevalence of both conditions, little has been studied on the effects of subfertility on sexual functioning especially in sub-Saharan Africa. Objectives: This study primarily compared the prevalence of female sexual dysfunction in patients on assessment for subfertility and those seeking fertility control services at the Aga Khan University Hospital, Nairobi. We secondarily sought to determine the factors associated with female sexual dysfunction in the sub-fertile patients and those seeking fertility control services. Methods: This was an analytical cross sectional study. Eligible women of reproductive age (15-49 years), attending the gynaecological clinics with complaints of subfertility and those seeking fertility control services were requested to fill a general demographic tool containing personal data and the Female Sexual Function Index (FSFI) questionnaire after informed consent. Prevalence of sexual dysfunction was calculated as a percentage of patients not achieving an overall FSFI score of 26.55. Univariate and multivariate analysis were done to compare clinical variables to delineate the potential association. Results: The prevalence of female sexual dysfunction was 31.2% in the subfertile group and 22.6% in fertility control group. The difference was not statistically significant (p=0.187). The mean domain and overall female sexual function scores were lower in the subfertile group than the fertility control group though this was not statistically significant. The most prevalent sexual domain dysfunctions in both the subfertility and fertility control groups were desire and arousal while the least in both groups was satisfaction dysfunction. Subfertility type was not associated with sexual dysfunction. Higher education attainment was protective of female sexual dysfunction in the subfertile group while use of hormonal contraception was associated with greater sexual impairment in the fertility control group. Higher maternal age and alcohol use appeared to be protective against sexual dysfunction in the combined study population. Conclusion: The present study demonstrated no association between the fertility status and the prevalence female sexual dysfunction. Subfertility type was not associated with sexual dysfunction. Education level and hormonal contraception use were associated with female sexual dysfunction in