Linguistic Theories Essay - 1626 Words

In the past, the study of grammar has been investigated for centuries, it was also significantly role in language teaching and learning. The reasons for teaching and learning are different in each period. In some eras, a major aim of teaching and learning was making learners to be able to communicate. In others, it was essentially taught for the purposes of reading and writing. For these reasons, the studies of two linguistic theories, the traditional grammar and the structuralism were created. They can be viewed differences by views on language, language learning and teaching as well as strengths and weaknesses as follows. Traditional grammar is one of the most significant grammar teaching, this kind of grammar was influenced by the†¦show more content†¦Traditional grammar was dissatisfied by the early modern linguists by reason of its inconsistency. Analyzing feature of language as parts of speech cannot clarify by their meaning. For example, in a sentence He runs home. Not only home is the name of a place, but it also modifies runs. Confusion occurs when the two classification of noun and adverb overlap. Hence, structural linguistics were constructed. It analyzes language by dividing a sentence into the smallest part, called immediate constituents (IC analysis) or slot and filler. This process analyzes the sentence in paradigmatic way. In order to find the beginning of structuralism, this kind of grammar came from the work of Ferdinand de Saussure. He was the first linguist who perceived that each language should be analyzed its own structure. The early modern linguists observed that linguistics ought to be an empirical science. It can be proved not from sentiment or attitude. For instance, it might be judge from score or performance. Due to the notion of structural linguistics all of languages have different structure and system. They observed that language is unique. Then, contrastive analysis was explored to this opinion. Anyway, analyzing lan guage ought to be examined spoken language rather than written language. They explained that we should investigate the actually use of language which was closed andShow MoreRelatedThe, And Corpus Linguistics Theories And Gender Studies1798 Words   |  8 PagesBased on the CDA and corpus linguistics theories and gender studies, this study conducts an analysis of how the descriptions and representations of rape incidents and the offenders and victims in the discourse of rape cases have influence in the determination of rape cases in terms of the court appeal decision. In particular, this study focuses on the discourse of appeal decisions on rape cases â€Å"on processes of education, surveillance, control and discipline of social and sexual gender behaviors†Read MoreSaussure And Saussure s Linguistic Theory Essay1751 Words   |  8 PagesIntroduction In the history of linguistics, the Swiss Linguist and Semiotician, Ferdinand de Saussure (26 November 1857 – 22 February 1913) (â€Å"Ferdinand de Saussure†, 2016, para.1), and the American Linguist, Philosopher and Politician, Noam Chomsky (7 December 1928–) (â€Å"Noam Chomsky†, 2016, para.1) have had a great influence on methodology of linguistics. Saussure’s linguistic theory has influenced modern linguists and their theories to the extent that positioned them by reference to Saussure: theyRead MoreThe Opposing Theory Of Halliday s Systemic Functional Linguistics1744 Words   |  7 PagesThe opposing theory of Halliday’s Systemic Functional Linguistics is Chomsky’s Innate Language Theory. Chomsky describes his theory as language unfolding through natural cognitive ability (Torr, 2015). Instead of the idea of learning language from social interactions and other people, language is something already in the mind that is unlocked (Gr ammar before meaning, nativist’s perspective). This innate ability is called â€Å"Language Acquisition Device (LAD)† (Chomsky 1987, Cited in Harris, 2009, ppRead MoreLanguage Acquisition Theories : Behaviorism, Linguistic Nativism, Social Interactionism, And Neurobiological Perspective1580 Words   |  7 PagesIntroduction Within the field of education, according to Christie and Enz (2011), there are four different language acquisition theories: behaviorism, linguistic nativism, social interactionism, and the neurobiological perspective. According to Christie and Enz (2011), behaviorist insinuates that nurturing, which is the way a child is taught or sculpted by parents and the surroundings, plays a principal position in children’s language advancement. The nativist perspective is the opposite of theRead MoreReflections of Saussures Theory of Linguistics585 Words   |  2 PagesReflections of Saussures Theory of Linguistics Ferdinand de Saussure is a linguist from the 19th century whose ideas, writing and influence are still felt today in many areas of the social sciences. He is most well known for his piece (published by his students) Course in General Linguistics published after his death in 1916. Saussures theories were bold, innovative, and inspirational to many philosophers, linguistics, and thinkers around the world. This paper will briefly reflect upon someRead MoreThe Effects Of Linguistic Effects On The Developmental Bases Of Theory Of Brain1288 Words   |  6 PagesResearchers Kobayashi, Glover and Temple were interested in studying the linguistic effects on the developmental bases of Theory of Mind (ToM). Their main goal was to uncover both the language dependent and independent neural bases that are important for ToM development. To do this, hemodynamic responses were recorded with the fMRI while the bilingual (Japanese and English speaking) participants of two different age groups (early bilingual children and late bilingual adults) preformed various falseRead MoreLinguistic Nativism: There’s Something Between the Ears Language is something that humans use and1300 Words   |  6 PagesLinguistic Nativism: There’s Something Between the Ears Language is something that humans use and encounter every day. Whether it be writing a paper, reading an email, talking to your best friend on the phone, or asking someone for directions, the use of language is broad and heavily intertwined with experiencing the world in the human condition. But the question of how humans come from being silent babies to speaking children is still unanswered. Linguistic nativism is one theory that addressesRead MoreA Second Or Foreign Language Learner Needs For Gain Knowledge1703 Words   |  7 Pages2.0 Introduction A second or foreign language learner needs to gain knowledge in and about the target language. In order to do that , one needs to know how to build morphemes into words and words into sentences (linguistic or grammatical competence). Yet, this knowledge is not the end of learning a language. While grammatical competence may be the essence of learning a new language; on its own, it is not enough. A learner also needs to know how to use that knowledge appropriately in a social contextRead MoreChomsky s Theory Of Human Language1362 Words   |  6 Pageslanguage, adopting a rationalistic influence, proposing his Cognitive Development Theory, and including essentialist aspects in his philosophy, Chomsky gives linguistics a respectable place in the greater sphere of epistemology. Noam Chomsky creates a narrow scope of linguistics, reducing the focus of its study. Chomsky believes studying the meaning, reference, and use of language should be excluded from the field of linguistics. He insists the study must be focused toward the capacity of humans to acquireRead MoreThe Behaviorist Theory of Learning1081 Words   |  4 PagesThe cornerstone of the theory of learning underlying Situational language teaching is a type of behaviorist habit-learning theory. It addresses the primacy of the processes rather than the conditions of learning. As pointed out by Overton (2013), the behaviorist theory of learning is rooted in the principle of habit formation. Mistakes are prohibited so as to escape bad habit formation. In line with the character of behaviorism, the teacher is supposed to present the language orally rather than in

How Do We Manage Groups And Teams - 1335 Words

There are various ways to manage groups and teams in our society, workplace, families or whether it is everywhere in the world. One way to manage a group is to have a vision of what you are working with. Teamwork is one of the most important a competent an individual could be committed to. When working in groups you have to be dependable to do the job and committed to do your best. There is a saying that says, â€Å"There is no I’s in team†, it all about working together. Being independent a person is responsible for his/or her own work area and that is alright, but not a good thing to accomplish in a work ethic surrounding. There is an interdependent work group which everyone relies on each member to get his or her job done. It is good†¦show more content†¦(Using six leadership styles for effective team performance, 2016). As a leader over cheerleader squad, you may have young ladies from Mexico or any other foreign country. One of the hardest things i s learning the languages from each other’s country. So the young ladies learn the cheer and work together as a group, not just a few girls learning. Working together this is teams think style. Then the squad goes to the football game and cheers in front of all the people this is a group think style. Some companies have different kinds of leadership styles in their workplace. A Laissez-Faire leader is a person who has high experience and has to train employee under his supervision, this leader fails to provide information or ideas to the ones under his supervision which leads to poor production in the company. Autocratic leadership style is one make decisions on their own and do not wants inputs from others. This style of leadership requires close working relationship with their employees. Transactional leadership style rewardsShow MoreRelatedHow to Become a Great Leader1510 Words   |  7 Pagesand Lineback explained their views / ideas on how they believe a manager can become a great boss using the 3 main imperatives on becoming a great boss; manage yourself, manage your network and manage your team. The research highlighted below suggests most companies have managers which would fall into different levels of competencies. I would contend with this article and agree with the points outlined. Capabilities of an organisation’s management team Great Capable Mediocre Poor Awful Read MoreSummarize Different Tools and Techniques Project Managers Can Use to Help Them Manage Project Teams. What Can They Do to Manage Virtual Team Members?936 Words   |  4 PagesSystems Project Management Week 4 Summarize different tools and techniques project managers can use to help them manage project teams. What can they do to manage virtual team members? Answer: For a while companies and individuals have stated that people are our biggest assets of an organization (Schwalbe, 2013). And therefore by extension so are the teams on our projects. However effective team and resource management is probably the most challenging task for most project managers. Many project managersRead MoreChoosing Your Battles1341 Words   |  6 Pagesconditions, we can see the conflict among people, groups, organizations, and nations. World War I and II are best examples. Many organizations see the conflict as wasting of time and money, and should be avoid it. On the other hand, other organizations translate the conflict as important factor to great constrictive and high performance teams, by transforming the differences to functional conflict. There are many ways to manage the conflict between team members, according to Kinne (2000), we can ensureRead MoreAdvantages And Disadvantages Of Group Diversity1453 Words   |  6 Pagessuch, and all you have to do is walk down the street to see the meaning of this concept right in front of you. The main reason for this has been because of immigration over many years. The environment in American society, whether it is in the workforce, schools, churches, or anywhere you go, can be said to be unique and made up of the characteristics of a given group that are unlike any other. Our country is highly complex, and the diversity amongst all the different groups of people can create aRead MoreOrganization Is An Entity That Has Internal Environment757 Words   |  4 Pagesincrease the number of patients we need to handle o Reduce the cost: DRG, Bundled payments†¦ o Increase quality: o Eliminate healthcare disparities These changes in indirect environment led healthcare organization to change their internal environments to adapt to these major changes. When we look at organizational change impact we look at three levels individuals groups and teams and the organization as a whole In part one of this series, we discussed how individuals respond to changeRead MoreOrganizational Effectiveness1507 Words   |  7 Pagestask, team and individual. It delivered the idea that the content leaders or managers should have ability to obligate all three main aspects of the Action-Centered Leadership model. The accentuation on each circle can be various and depends much on the given situation (Adair, 1973). This essay critically discuses and analyzes several number of events relating team performance during camp at Fairthorne Manor within the framework of John Adair diagram and illustrates the development of team membersRead More4 MAT Review Wheelan1339 Words   |  6 PagesCitation) Creating Effective Teams: A Guide for Members and Leaders Liberty University Student Date Professor Abstract Wheelan (2013) identifies the four stages of team development and provides detailed explanation of how a group transforms itself from a stage one group of uncertainty into a successful, highly productive stage four team. This requires work and a thorough understanding of the many internal/external influences that can occur during each stage. A team member or leader who is wellRead MoreThe Myers Briggs Type Indicator996 Words   |  4 Pagesunderstandable and useful in people’s lives. The essence of the theory is most people do have consistent behavioral patterns† (The Myers Briggs Foundation, 2015). The theory was introduced in the 1920’s by Carl G. Jung and the MBTI tool was developed in the 1940’s by Isabel Briggs Myers and her mother Katharine Briggs. In the first phase, our team was to take the MBTI assessment. Based on our findings, our group presents essentially an almost perfect match of the opposites, an evenly mix of fourRead MoreDifference Between Management And Leadership1738 Words   |  7 Pages Then progressing onto a style of management and leadership, discussing the impact it can have on the staff team, parents and other stakeholders. Management style and leadership style. Managers and leaders are very similar as they both lead staff teams by motivation but they do this in different ways. Managers have more authority with the team and plan, organise and co-ordinate their team to most productivity. A leader has â€Å"the ability of a superior to influence the behaviour of subordinates and

Should Animal Testing Be Banned - 1665 Words

Testing Cosmetics on Animals Companies around the world use animals to test cosmetics. Animals, such as rabbits, guinea pigs, hamsters, rats, and mice, are used to test the effects of chemicals on the eyes and skin. While animal testing is not mandatory, many companies use it. About Cosmetics Animal Testing by the Humane Society International talks about the different options companies have that do not require the cruel use and eventual death of animals. The article also talks about the overall reasoning behind animal testing and why companies choose to use animal testing. Why The US Won t Ban Cosmetics Animal Testing Anytime Soon by Cheryl Wischhover talks about why the United States still allows animal testing when there are many alternative options available. Today, companies are more aware of their public image and how cosmetic animal testing can affect how the public views them. Companies are looking for alternative ways to test the effects of chemicals that do not require the use of animals. â€Å"About Cosmetics Animal Testing† is an article written by the Humane Society International. In the article, they cover the reasons behind animal testing and why companies still use animal testing even though cruelty-free methods have been developed. Each year, 100,000-200,000 animals die around the world for cosmetic research. During these tests, â€Å"chemicals are rubbed onto the shaved skin or dripped into the eyes of rabbits; repeated oral force feeding studies lasting weeksShow MoreRelatedShould Animal Testing Be Banned?844 Words   |  3 PagesShould animal testing be banned? Nowadays, a lot of animals has been tested on a range of experiments over the world. You could be supporting animal teasing cruelty without knowing it. Have you ever check if there’s animal testing on the cosmetics before you buy it? Today, a lot of cosmetics has been testing on helpless animals and there are about 1.4 million animals die each year from animal testing ( CatalanoJ, 1994). Most of the experiments that are completed in the laboratories are very cruelRead MoreAnimal Testing Should Be Banned880 Words   |  4 Pagesdepending on animals testing. Therefore, if people talk about laboratories, they should remember animal experiments. Those animals have the right to live, according to people who dislike the idea of doing testing on animals; the other opinion, supports the idea of animal testing as the important part of the source of what has reached medicine of the results and solutions for diseases prevalent in every time and place. Each year huge numbers of animals a re sacrificed for the science all these animals, whetherRead MoreAnimal Testing Should Be Banned776 Words   |  4 PagesAnimal Testing Should be Banned  ¨Over 100 million animals are burned, crippled, poisioned and abused in US labs every year ¨ ( ¨11 Facts About Animal Testing ¨). Imagine if that was someones animal getting tortured in labs just to test things such as beauty products and perfume. Animal testing was first suggested when,  ¨Charles Darwin evolutionary theory in the mid 1850s also served to suggest that animals could serve as effective models to facilitate biological understanding in humans ¨ (Murnaghan)Read MoreAnimal Testing Should Not Be Banned940 Words   |  4 Pages1). Over 100 million animals are burned, crippled, poisoned, and abused in US labs every year. 2). 92% of experimental drugs that are safe and effective in animals fail in human clinical trials. (DoSomething â€Å"11 Facts About Animal Testing†). There are currently no laws combating the testing of cosmetics on animals, but the practice is harmful and must be ended. As evidenced by the statistics above, millions of animals are tortured and murdered in the United States every year for virtually no reasonRead MoreAnimal Testing Should Not Be Banned1572 Words   |  7 PagesAnimal Testing Every year, over two hundred million innocent animals are injured or killed in scientific experiments across the world. Of those animals, between seventeen and twenty million are used in the United States alone. It is said that an animal dies in a laboratory every three seconds (Animal Testing 101). Those in favor of animal experimentation say they are taking animals’ lives to save humans. It is not necessary to subject animals to torturous conditions or painful experiments in theRead MoreAnimal Testing Should Not Be Banned1581 Words   |  7 PagesAnimal testing is being used by different organizations all over the world to prevent specific diseases, especially cancer. Americans see animal testing having a harmful effect but it is one of the main reasons why society has most cures for some illnesses. This topic is important because people need to know what goes on during animal testing and why it is very beneficial. Animal testing needs to be used to find all cures. Some ani mals such as chimps/ monkeys have 90% of the same DNA humans haveRead MoreAnimal Testing Should Not Be Banned1721 Words   |  7 Pages † Today, more animals are being used in experiments than ever before: around 100 million in the United States alone† (3). Animal testing is now an international issue, and it is becoming a major story. Currently, animals are often used in medical testing, make-up testing, and other consumer product testing. Animals used in such product testing are often abused and suffer from serious side-effects. Animal testing can be painful for the animals, testing results are usually not even useable forRead MoreAnimal Testing Should Be Banned1364 Words   |  6 Pagesbenefit. Using animals for these experimentations usually does not come to mind. Animals are often abused, suffer, and even die during laboratory testing for the benefits of people to make sure medications, household products, newest procedures, and cosmetics are safe and effective for human use. Humans have benefited from animal testing for years while these animals suffer consequences with no positive outcomes for themselves. Even if a product or procedure is deemed successful, these animals are frequentlyRead MoreAnimal Testing Should Be Banned Essay1632 Words   |  7 Pages Animal Testing Should Be Banned Throughout the decades, animals have been used in medical research to test the safety of cosmetics including makeup, hair products, soaps, perfume, and countless of other products. Animals have also been used to test antibiotics and other medicines to eliminate any potential risks that they could cause to humans. The number of animals worldwide that are used in laboratory experiments yearly exceeds 115 million animals. Unfortunately, only a small percentage ofRead MoreAnimal Testing Should Be Banned2391 Words   |  10 Pageseasier for consumers. These are only mild examples of the animal testing that goes on every single day around the world, and right here in the United States of America. Animals are kept in lonely, cold, dirty kennels, and some never see the light of day. They are tested on, force fed, and often mistreated even when the tests are over. Every day innocent animals are shocked, injected, poisoned, restrained, and endure excruciating pain testing chemicals in most, i f not all, of the products everyday Americans

Current Perspectives on Combination Therapy

Question: Discuss about the Current Perspectives on Combination Therapy. Answer: Introduction: Goal of antihypertensive therapy should eliminate blood pressure rise without adversely affecting quality of life. Maintenance of normal blood pressure (BP) is central to the homeostasis. BP is controlled by different factors like renal sodium excretion, fluid volume in the body and cardiac performance. Hence, different mechanisms are responsible for rise in blood pressure. Drugs acting on the single target would not be able to act on multiple targets. In such case, there would be requirement of drugs acting on multiple targets. Drugs used for hypertension should control intravascular volume, cardiac output and systemic vascular resistance. Use of combination therapy for hypertension as a first line therapy is more helpful in achieving effective blood pressure control as compared to the single drug treatment1. In case, if two physiologic mechanisms are disrupted, there would be possibility of neutralizing counter regulatory mechanisms. This would result in more reduction in the blood pressure. Hence, diuretic drugs acting on the rennin angiotensisn system should be combined with the angiotensin-converting-enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs). Diauretics can also be given in combination with -blockers, as it inhibits release of rennin. Dihydropyridine calcium channel blockers (CCBs) used to increase level of circulating catecholamines which leads to the stimulation of renin-angiotensin system. Hence, these CCBs can be combined with ACE inhibitors. ACE inhibitors and beta blockers act on the same target like renin-angiotensin system. Hence, combining these two drugs would not be beneficial2. Effective control of hypertension is required in the hypertensive patients especially in patients with co morbidity like diabetes mellitus. In such patients more aggressive blood pressure control is very much required. It is evident that in most of the patients control of blood pressure using monotherapy is as difficult task. Achieving blood pressure in 140/90 mmHg range in hypertensive patients and 130/80 mmHg range in diabetes is not possible in most of the patients. Effective control of blood pressure is required for the reducing the cardiovascular complications3,4. In a study it was proved that 2 mm Hg reduction in blood pressure can reduce stroke and transient ischemic attacks by 15 % and coronary artery disease by 6 5%. Monotherapy for hypertension is beneficial in most of the patients, however more than 50 % patients require combination therapy for effective control of blood pressure. It is recommended that combination therapy is required in patients with systolic blood pres sure (SBP) 20 mm Hg above goal and/or diastolic blood pressure (DBP) above 10 mm Hg. Many factors are responsible for the occurrence of hypertension. In such scenario, control of blood pressure using single drug acting on one target is unrealistic. Drugs used in the combination therapy can act on different targets and can act as complimentary to each other to control blood pressure. Methodology required for the preparation of combination therapy requires two or more drugs to be combined together. Methodology and Results: In this review studies of only randomized clinical trials are considered. Studies were incorporated with patients comprising of essential hypertension and patients with secondary hypertension were excluded from the study. Studies with patients above 18 years were considered for this review. All the studies considered in this review comprised of one arm with combination of two or more antihypertensive drugs and another arm was antihypertensive monotherapy. Results were considered in terms of efficacy of combination therapy in controlling blood pressure and rapidity of controlling blood pressure. Other outcome measures considered were adherence to the combination therapy, occurrence of morbidities and adverse events. Articles were searched form the databases like Cochrane Central Register of Controlled Trials (Central), MEDLINE, and EMBASE. Data was extracted from the selected articles and this data comprised of study design, population characteristic, components of combination therapy , comparator drugs and outcomes of the clinical trial. Articles with bias towards participants blinding, selection bias, data collection and data analysis were not considered for this review. Studies incorporated in this review were group design, randomized trial, controlled trial and cross over design. Pecherina et al., (2014). conducted a randomized study with parallel groups. In this 124 participants were incorporated with 60 % male and 40 % female. Nebivolol and Amlodipine were given in combination with 2.5/2.5 and 5/5 ratio. 24 hours ambulatory blood pressure monitoring was performed for three months. Along with this heart rate, compliance and quality of life were also evaluated. It was observed that these drug combinations produced effective blood pressure control as compared to the individual drugs8. McLay et al., (2000) conducted double blind, placebo controlled randomized multicentre study. In this study 26 participants were incorporated. Felodipine and Metoprolol each at 50mg were administered to the participants. Mean BP prior to initiation of the study were 172 15/ 102 6 mmHg. In this study, 26 hours ambulatory blood pressure monitoring was performed for 12 weeks. Compliance and adverse events were also monitored in the study. Felodipine and Metoprolol combination effectively reduced blood pressure in these participants9. In Hypertension Optimal Trial (HOT), 33 % patients achieved their target BP using monotherapy and 45 % patients achieved their target BP using combination of two drugs. In Strategies in Treatment of Hypertension (STRATHE) study it was observed that combination of -blocker and ACE inhibitor and CCB exhibited more effect as compared to the administration of the same drugs sequentially. This study was conducted for 9 months and it was observed that 62 % patients in the combination therapy and 49 % in the sequential monotherapy exhibited attainment of target BP. Thiazide-diuretics and -blockers were studied in different studies like STOP, MRC, ALLHAT. These combination drugs are well-known drugs for uncomplicated hypertension. Combination of thiazide-diuretics are ACE-inhibitors are more useful in patients with hypertension with congestive heart failure. This combination therapy is very potent therapy and rapid reduction in the hypertension should be monitored in this therapy. Diuretics and AT (angiotensin) 1-blockers (ARB) would be more useful in hypertension with left ventricular hypertrophy as compared to the -blockers and diuretics combination11. Di uretics and calcium antagonist (dihydropyridines) are helpful in treating isolated systolic hypertension (ISH) patients. -blockers and ACE-inhibitors in combination can be used in hypertensive patients post myocardial infarction and in patients with coronary heart disease chromic heart failure. Calcium antagonists (dihydropyridine-type) and -blockers combination drugs are helpful in patients with coronary artery disease. Calcium antagonists and ACE-inhibitors combination drugs are helpful hypertensive patients with nephropathy, coronary artery disease and atherosclerosis. Efficacy and safety of these combinations were established in the ELSA, PREVENT, SECURE and INSIGHT studies. ACE-inhibitors and AT1-blockers are useful in hypertensive patients with diabetic nephropathy and glomerulonephritis. These drugs in combination reduced proteinuria more as compared to the individual drugs12. Advantages : Combination of drugs can reduce doses of all the drugs in the combination. This would be helpful in reducing adverse effects of drugs in combination. It can improve compliance by administering drugs once a day. Synergistic effect can be achieved using combination therapy. These combination therapies are helpful in achieving normal blood pressure, even in patients with difficulty in controlling blood pressure. Hence, combination therapy can be useful in all the subgroups of hypertension patients. As faster blood pressure can be controlled in patients using combination therapy, patients would be willing to stick to the combination therapy for long term use. Response rate is much higher in combination therapy (75%-95%) as compared to the monotherapy (30%-50%). Convenience of consumption is the most prominent advantage of single pill combination therapy6. Disadvantages : Patients consuming combination therapy reported more dizziness as compared to the patients treated with monotherapy. There is possibility of side effects due to side effects due to drug interactions in combination therapy. Combination therapy may increase cost for the patient7. Discussion: In combination therapy, drugs should be selected based on the efficacy of the combination in reducing blood pressure and treating cardiovascular complications like stroke, myocardial infraction and heart failure. However, more emphasis should be given on reducing blood pressure because reduction in blood pressure is the primary determinant of reducing cardiovascular complications. These combination therapies are proved to be useful in reducing blood pressure in patients with diabetes, renal disease and cardiovascular disease13. Elevation in the blood pressure occurs due to multiple factors. Hence, treating blood pressure with monotherapy, may evoke compensatory response and there would be rise in blood pressure due to other mechanism. In such case, combination of drugs acting on different targets of hypertension would be more beneficial in treating hypertension. Keeping this thing in mind, different combinations are developed for treating hypertension. These combinations include reni n angiotensin aldosterone system (RAAS) inhibitor and diuretic, RAAS inhibitor and CCB, renin inhibitor and ARBS, CCBs and diuretics, b-blockers + diuretics, thiazide diuretics and potassium-sparing diuretics, and CCBs and -blockers. In clinical trials it was observed that patients receiving combination exhibited more effect as compared to the administration of same drugs sequentially. On an average, 75 % of patients require combination therapy for achieving target BP. Selection of combination drug and dose of drugs is very important in developing combination therapy because there may be individual differences for response of combination therapy. In hypertensive patients, insufficient BP control itself is risk factor for diabetes. In combination therapy, more emphasis should be given to drugs which are more effective in long term as compared to the short term effects. This would be helpful in reducing long term cardiovascular effects. Combination drugs should act either on different target or it should block counter regulatory mechanism15. In clinical trials it was observed that dose of drugs in monotherapy are approximately 5 times more as compared to the dose of drugs in combination. Pharmcokinetic properties of drugs in combination should be compatible to each other. In combination therapy, target blood pressure should be reached within 4 6 months of the initia tion of the treatment. It would be helpful in maintaining this BP level for long duration irrespective of the follow-up treatment. In recent times, it is recommended that 2 drugs combination should be used if there is BP more than 160/100 mm Hg in patients with uncomplicated hypertension and 150/90 mm Hg in patients with diabetes and other cardiovascular complications. Monotherapy is first choice for first stage hypertension, however recently recommendation was given for combination therapy in stage 1 hypertensive patients. Adverse effect can be problem in both monotherapy and combination therapy. In monotherapy, adverse effect may be due high doses of drugs as compared to the combination therapy. However, in combination therapy adverse effect can be due to drug interactions. Developments of a combination require knowledge of full pharmacology of both the drugs in the combination. There should be rationale for development of combination therapy. Conclusion: Combination therapy for hypertension is widely accepted. Few patients can be effectively treated for hypertension with the combination therapy only. Combination therapy should be efficacious, with high response rate, work in all the subgroups of hypertensive patients, no metabolic side effects and affordable to patients. These combinations comprises of 2 or 3 drugs in a single pill. Antihypertensive drugs with 2 drugs are well established, however enough clinical evidence is not available for combination of 3 drugs. Selection of the drugs for antihypertensive combination therapy is mainly depends on the hemodynamic and metabolic criteria. Combination drugs should be used in a single pill rather than sequential administration. Advantages of combination therapy indicates that characteristics of combination therapy are similar to the ideal drug. In summary, patients should use combination therapy for achieving target BP. References: Coleman TG, Hall JE. Systemic Hemodynamics and Regional Blood Flow Regulation. In: Izzo JL Jr, Black HR, Sica DA, eds. Hypertension Primer. 4th ed. Philadelphia, PA: Lippincott, Williams and Wilkins; 2008. Kettani FZ, Dragomir A, Cote R, Roy L, Berard A, Blais L, et al. Impact of a better adherence to antihypertensive agents on cerebrovascular disease for primary prevention. Stroke; a journal of cerebral circulation. 2009; 40(1):21320. American Diabetes Association: Standards of medical care in diabetes. Diabetes Care 2010, 33(Suppl 1):11-61. Ong KL, Cheung BM, Man YB, Lau CP, Lam KS: Prevalence, awareness, treatment, and control of hypertension among United States adults 1999-2004. Hypertension 2007, 49:69-75. Alan H. Gradman, Jan N. Basile, Barry L. Carter, George L. Bakris. Combination Therapy in Hypertension. Journal Of Clinical Hypertension. 2010;4:4250 Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A, Bohm M, et al. ESH/ESC Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Journal of hypertension. 2013; 31(7):1281357. Scotti L, Baio G, Merlino L, Cesana G, Mancia G, Corrao G. Cost-effectiveness of enhancing adherence to therapy with blood pressure-lowering drugs in the setting of primary cardiovascular prevention. Value in health: the journal of the International Society for Pharmacoeconomics and Outcomes Research. 2013; 16(2):31824. Pecherina TB, Vedernikova AG, Evdokimov DO, Klimenkova AV, Barbarash OL. Postregistration study of comparative assessment efficacy of the use of fixed combination of nebivolol and amlodipine for the treatment of patients with moderate and high degree of arterial hypertension. Kardiologiia. 2014; 54(6):218. McLay JS, MacDonald TM, Hosie J, Elliott HL. The pharmacodynamic and pharmacokinetic profiles of controlled-release formulations of felodipine and metoprolol in free and fixed combinations in elderly hypertensive patients. European journal of clinical pharmacology. 2000; 56(8):[52935 pp.]. Hansson L, Zanchetti A, Carruthers SG, et al. Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: principal results of the Hypertension Optimal Treatment (HOT) randomized trial. Lancet. 1998;351:17551762. Mallat SG, Tanios BY, Itani HS, Lotfi T, Akl EA. Free versus Fixed Combination Antihypertensive Therapy for Essential Arterial Hypertension: A Systematic Review and Meta-Analysis. PLoS One. 2016 22;11(8):e0161285. doi: 10.1371/journal.pone.0161285. eCollection 2016. Mallat SG, Itani HS, Tanios BY. Current perspectives on combination therapy in the management of hypertension. Integrated blood pressure control. 2013; 6:6978. James PA, Oparil S, Carter BL, Cushman WC, Dennison-Himmelfarb C, Handler J, et al. Evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014; 311(5):50720. Weber MA, Schiffrin EL, White WB, Mann S, Lindholm LH, Kenerson JG, et al. Clinical practice guidelines for the management of hypertension in the community: a statement by the American Society of Hypertension and the International Society of Hypertension. Journal of clinical hypertension. 2014; 16(1):1426. Nowak E, Happe A, Bouget J, Paillard F, Vigneau C, Scarabin PY, et al. Safety of Fixed Dose of Antihypertensive Drug Combinations Compared to (Single Pill) Free-Combinations: A Nested Matched Case-Control Analysis. Medicine. 2015; 94(49):e2229. Sherrill B, Halpern M, Khan S, Zhang J, Panjabi S. Single-pill vs free-equivalent combination therapies for hypertension: a meta-analysis of health care costs and adherence. Journal of clinical hypertension . 2011; 13(12):898909.