Rehman Journal of Health Sciences

BODY-WEIGHT SUPPORTED TREADMILL TRAINING COMBINED WITH ELECTRICAL MUSCLE STIMULATION EFFECTIVE IN IMPROVING LOCOMOTION AFTER INCOMPLETE SPINAL CORD INJURY: A CASE STUDY

Amir Zeb — 2024-12-31

Introduction: Although body weight supported treadmill training (BWSTT) and electrical muscle stimulation (EMS) have demonstrated substantial efficacy as standalone interventions, their combined therapeutic potential remains underexplored. This study investigates the synergistic effects of BWSTT and EMS on locomotor and functional recovery in a patient with incomplete spinal cord injury (SCI).

Material & Methods: A 47-year-old male with an L2 ASIA C SCI from a T12 fracture presented with significant lower limb weakness. Initial assessments showed a WISCI-II score of 9, 6MWT distance of 30 meters, 10MWT speed of 0.074 m/s, and a SCIM score of 43/100. Rehabilitation included 12 weeks of BWSTT (three 60-minute sessions/week) and EMS (twice daily on alternate days), targeting lower limb muscles.

Results: At the 6th-week of reassessment, the patient's neurological level improved to L3 ASIA C, with increases in WISCI-II (12), 6MWT (50 meters) and improved 10MWT speed (0.15 meter/seconds). By the 12-week mark, the WISCI-II increased to 18, 6MWT to 125 meters, and 10MWT increased to 0.58 m/s. The SCIM score increased significantly to 91/100.

Conclusion: The combination of BWSTT and EMS in rehabilitation improved locomotion, endurance, and independence in an incomplete SCI patient, highlighting the need for further research.

FACTORS RELATED TO PURSUING HIGHER EDUCATION AMONG NURSES IN A DEVELOPING CONTEXT

Hamid Ali — 2024-12-31

Introduction: Higher education plays a vital role in nursing education, nursing care, nursing practice, and administration. This research examines the factors that facilitate the pursuit of higher education, including personal and professional factors such as promotion, better job positions, and job satisfaction. It also discusses the challenges faced, which include both personal and institutional factors, such as financial constraints and a busy work schedule during studies.

Material & Methods: In this literature review, existing studies on the inhibiting and facilitating factors were retrieved through a literature search in PubMed, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Google Scholar.

Results: Preliminary evidence suggests that inhibiting factors for higher education include financial issues, work schedules, and organizational policies. On the other hand, facilitating factors are associated with the acquisition of knowledge and skills, high job positions, and personal satisfaction. Therefore, pursuing higher education presents several challenges, and there is a need for research in developing countries to identify context-specific inhibiting and facilitating factors. This research would help overcome these challenges and enhance facilitating factors to increase the number of nurses and address the shortage of highly qualified professionals.

Conclusion: Nurses face both facilitating factors and challenges in higher education, including institutional, personal, and professional factors. Higher education students can significantly overcome these challenges through access to scholarships, flexible work schedules, and a sense of unity among nurses.

BIOFILM DISRUPTION STRATEGIES IN CLINICAL SETTINGS

Syed Sohail Ahmad — 2024-12-31

Biofilms are structured microbial communities surrounded by an extracellular polymeric matrix produced by the microorganisms themselves. They account for nearly 80% of clinical infections. These biofilms exhibit resistance not only to antibiotics but also to the human immune response, highlighting the need for efficient countermeasures. The clinical relevance of biofilms is further supported by their strong association with healthcare-associated infections, particularly involving medical devices, which result in increased mortality, morbidity, and healthcare expenditures.¹

Numerous strategies have been developed to address the challenges posed by biofilms. Prospective prophylactic strategies include incorporating antimicrobial coatings and surface modifications into medical devices. The introduction of liquid reservoir silicone-based urinary catheters as an alternative to conventional antimicrobial treatments represents another step in this direction. The biofilm biology of notorious pathogens, such as Pseudomonas aeruginosa, has been extensively studied at the molecular level, enabling the development of tailored therapeutic strategies based on insights into their molecular composition.²

Recent patents indicate a shift in biofilm inhibition strategies. For example, the University of Sydney has obtained a patent for a topically applied formulation containing surfactants and biocides.³ Additionally, recent studies suggest that plant-derived compounds have the potential to significantly disrupt bacterial biofilms.⁴

To effectively combat persistent infections caused by biofilms, it is essential to adopt a multi-faceted approach that combines scientific advancements with clinical interventions. For instance, bacterial adaptation to biocides like benzalkonium chloride may enhance biofilm formation, underscoring the importance of prudent antimicrobial use and innovative biofilm disruption methods.⁵

The fight against biofilm-associated infections requires a multifaceted approach that fosters collaboration among advanced materials scientists, microbiologists, and clinical practitioners. Stakeholders must work together to address the challenges of the biofilm paradigm, emphasizing opportunities for innovation and collective action.

EVALUATION OF COLOUR VISION DEFECTS USING D-15 IN RELATION WITH IRIS COLOUR AND PUPIL SIZE; A CROSS-SECTIONAL STUDY

Muhammad Rashid — 2024-12-31

Introduction: Colour of iris is associated with race and may show hereditary patterns. In this context it may be associated with colour vision defects and size of pupil. This study was conducted to determine whether variations in iris colour and pupil size were correlated with colour vision defects as measured by the D-15 test.

Material & Methods: A proforma based cross-sectional study was conducted at College of Ophthalmology and Allied Vision Sciences in Mayo Hospital, Lahore. Data was collected from September 2023 to December 2023. The study was approved by the Ethical review board of the College of Ophthalmology and Allied Vision Sciences. The sample size was 70 subjects, with the inclusion criteria being individuals aged 18 or older, having normal colour vision or colour vision deficiency, and able to read and understand D15 instructions. Exclusion criteria included those with a history of eye disease or injury, taking medication that could affect colour vision, or those unable to complete the D15 due to physical or cognitive limitations. Statistical significance was calculated using Chi-square test. P value<0.05 was considered significant.

Results: Brown iris colour was common (51.47%) with predominance in females. Pupil size in the range of 6.6-7.0mm was higher in females. Two patients had colour blindness with iris colour of brown and amber (P=0.613) and their pupil size was between 6.6mm to 7.5mm (0.047) depicting positive correlation.

Conclusion: Colour vision defects were not significantly influenced by iris colour; however, larger pupil sizes (6.6-7.5mm) showed a noteworthy correlation with these vision problems.

KNOWLEDGE, ATTITUDE AND PRACTICES REGARDING COVID-19 AMONG THE GENERAL POPULATION OF PESHAWAR DISTRICT; AN ANALYTICAL CROSS-SECTIONAL STUDY

Hazrat Bilal — 2024-12-31

Introduction: Knowledge, Attitude and Practices (KAP) regarding COVID-19 play a very vital role in assessing whether the population have accepted the behavioral changes to COVID-19 or still, the population is unaware or has a negative attitude towards preventive measures to COVID-19.

Material & Methods: A KAP study was carried out in Peshawar, Pakistan. Residents of the Peshawar district, both genders, aged 18 years and older, were included in the study. An online questionnaire consisting of questions related to demographic information, knowledge, attitude and practice of COVID-19 was shared with the participants. Informed consent was taken from all participants. Chi-square and correlational tests were used to check the associations and correlations between different variables.

Results: A total of 262 participants took part in the study. The mean age of the participants was 27.66 ± 8.706 years. Most of the participants were males (76.3%), graduated (49.5%), students (51.5%), single (66%), and were living in the urban area (54.6%). The mean knowledge score was 9.14 ± 2.44 out of a total of 12. There was a significant association (P-value <0.05) between knowledge and the field of education. 88.8% of participants believed that the situation of COVID-19 would be controlled and 86.6% agreed that Pakistan will win the battle against COVID-19. 81.7% were visiting crowded places, 52.7% were wearing masks and 91.6% were washing their hands with soap.

Conclusion: The population demonstrated a generally strong level of knowledge. Most of the participants had a positive attitude towards COVID-19. There was malpractice of different preventive measures except washing hands with soaps. Attitude towards COVID-19 was significantly associated with occupation and field of education.

ASSOCIATION BETWEEN SMARTPHONE ADDICTION AND NECK PAIN AND DISABILITY AMONG UNIVERSITY STUDENTS; A CROSS-SECTIONAL STUDY

Somiya Naz — 2024-12-31

Introduction: The smartphone has become an important necessity in our daily life. It has many positive impacts; communication has made easy, daily utilities and health care services may be accessible through online services and mobile apps. On the other hand, it has negatively affected individuals as addiction to smartphones causes physical and mental health problems. Smartphone addiction leads to prolonged forward head posture, straining neck muscles and compressing spinal discs, which can cause chronic pain and musculoskeletal issues.

Material & Methods: This was a cross-sectional study and data was collected from 907 students from the universities of Rawalpindi/ Islamabad and Lahore. The study was conducted from February 2022 to June 2022. Visual Analogue Scale (VAS pain), Neck Disability Index Urdu version (NDI-U), and short version of the Smartphone Addiction scale (SAS-S) were used to analyze neck pain intensity, neck pain & disability and smartphone addiction respectively. Data were analyzed using SSPS version IBM- 21. Descriptive statistics were used in terms of mean, frequency, and percentages and the Pearson correlation coefficient was used to assess the relationship between smartphone addiction and neck pain & disability.

Results: Out of 907 participants, 38.7% were male and 61.3% were female, 21.25% were medical students, and 78.7% were non-medical students. The result of this study shows that a significant moderate association was found between SAS-SV and NDI-U (r= 0.59, p<0.01), SAS-SV and VAS pain (r= 0.63, p<0.01).

Conclusion: There is a moderate association between smartphone addiction and neck pain in university students. These results highlight the importance of awareness and preventative strategies among young smartphone users.

UTILITY OF SMARTPHONE IN CAPTURING LAPAROSCOPIC CHOLECYSTECTOMY: A COST-EFFECTIVE TECHNIQUE

Sidra Dil Muhammad — 2024-12-31

Introduction: These days the use of multimedia recording is prevalent in healthcare systems. Surgical procedures are being recorded all over the world for coaching purpose and it also aid in assessing surgeons performance to improve patient care quality, sharing rare operative finding with colleagues so providing better way of communication among surgeons and above all, this act of video recording is also a stress reliever for the operating surgeon too by rewinding the video in order to search for any lost gauze piece during surgery to avoid medical negligence.

Material & Methods: This retrospective study was conducted at Government Tehsil Headquarter (THQ) Hospital Sabzazar, Lahore from May 2021 to September 2023. The study included 226 patients who underwent laparoscopic cholecystectomy. All laparoscopic cholecystectomies were captured by smartphone camera, mounted on a tripod stand. Time required for video recording apparatus setting was recorded. Additional equipment and staff needed for recording was noted. Utility in terms of video image quality, zoom capability, resolution and recorded videos sufficient for coaching purposes was assessed by independent respondent by using 5-point Likert scale.

Results: Time required for video recording apparatus setting was 3.62±1.01 minutes. 5-point Likert scale score of video image quality, zoom capability and resolution were 5, 5 and 5, respectively. Recorded videos sufficient for coaching purposes had a score of 4. No additional equipment and staff were needed for recording in the operating room. Overall utility of smartphone cameras in capturing laparoscopic cholecystectomy was 4.75.

Conclusion: A remarkable video of laparoscopic cholecystectomy can be captured by using smartphone camera which can later be availed for teaching and training purposes of medical students.

THE PREVALENCE OF BENIGN PAROXYSMAL POSITIONAL VERTIGO AND ITS ASSOCIATION WITH QUALITY OF LIFE

Mehwish Raza — 2024-12-31

Introduction: Benign Paroxysmal Positional Vertigo (BPPV) is an inner ear mechanical disorder caused by dislodged otoconial debris from the utricle entering one or more semicircular canals.

Material & Methods: A cross-sectional survey was conducted in UMT Lahore. 219 participants were included in the study through convenient sampling determined asymptomatic healthy adults aged 18-40 years, including those at high risk of falling. Individuals with conditions that hinder BPPV diagnosis or those with existing vestibular or musculoskeletal disorders were excluded. Data was collected through a structured questionnaire. Participants were recruited from University of Management and Technology, School of Health Sciences campus students and workers, with informed consent obtained prior to data collection. Data was analyzed using SPSS version 22.

Results: The mean age of the 219 participants was 23.06 years (SD = 4.63). Female participants significantly outnumbered males, with 82.2% (180 individuals) being female and 17.8% (39 individuals) male. Regarding symptoms, 43.4% of the participants reported feeling dizzy, while 56.6% did not. The prevalence of BPPV, assessed using the Dix-Hallpike maneuver, was found to be 13.2%, while 86.8% tested negative for BPPV. Despite vertigo symptoms being present in a notable portion of participants, the statistical analysis did not reveal a significant association between vertigo test results and quality of life scores, as indicated by a p-value of 0.414.

Conclusion: BPPV is most likely the most prevalent cause of vestibular vertigo, accounting for 20 to 30% of cases diagnosed in specialized clinics. This study aims to highlight the importance of early diagnosis and intervention for BPPV, particularly in individuals with low quality of life, to improve overall well-being and reduce psychological distress.

FREQUENCY OF NECK MYOFASCIAL PAIN SYNDROME AND ITS ASSOCIATION WITH SEVERITY OF PAIN AND DISABILITY IN PATIENTS WITH CERVICAL RADICULOPATHY; A CROSS-SECTIONAL STUDY

Sahib Rehman — 2024-12-31

Introduction: Vertebral nerve root malfunction-related disease is called cervical radiculopathy (CR), the clinical picture of which is pain spreading from the neck to the affected root. Myofascial pain syndrome (MPS) is the main cause of pain and disability in the working population. The aim of the study was to find the frequency of myofascial trigger points and their association with the degree of pain and disability in persons with cervical radiculopathy.

Material & Methods: A cross-sectional study was conducted. The sample size was 148 patients, recruited from physiotherapy departments of 2 hospitals in Peshawar, population size of 240, using non-probability convenience sampling technique. Data was collected from CR patients between the ages of 18 to 65. After meeting the eligibility criteria, participants were evaluated by using the numeric pain rating scale (NPRS) and neck disability index (NDI) to determine the level of pain and disability respectively. A 4-point criterion was used for the identification of myofascial trigger points.

Results: The study included 148 participants. Out of which 90 were males and 58 were females. The patient's mean age was 39.27 ± 13.59 years. There were 60.8% males and 39.2% females with a mean weight of 71.973 ± 11.77 kg and a mean height of 169.46 ± 8.59 cm. The mean score of MTrPs, NDI, and NPRS was 15.15 ± 3.28, 22.74 ± 6.34, and 5.80 ± 1.38 respectively. The correlation coefficients of NDI & MTrPs, NPRS & MTrPs, and NDI & NPRS were .868, .822, and .807 respectively.

Conclusion: There was a high prevalence of Myofascial Trigger Points in cervical radiculopathy patients, and Myofascial Trigger Points also had a strong correlation with the severity of pain and disability.

PRACTICE TRENDS OF LEARNING STYLES AMONG UNDERGRADUATE HEALTH CARE STUDENTS

Muti Ur Rahman — 2024-12-31

Introduction: Understanding and addressing diverse learning styles in education is becoming more important, particularly in the context of healthcare training. As medical knowledge becomes more complicated and healthcare delivery develops, educational institutions acknowledge the need to adapt their teaching techniques in order to better educate undergraduate students for their future roles

Material & Methods: It was a cross-sectional study, a total of 100 students were selected through Random sampling technique. Kolb’s Learning Style Questionnaire was used to evaluate Practice trends of learning style in different undergraduate healthcare students.

Results: This study found that 79.6% of undergraduate healthcare students had a very strong preference for activist learning style, 42.9% for reflector learning style, 67.3% for theorist learning style, and 65.3% for pragmatist learning style.

Conclusion: This study concluded that undergraduate healthcare students use several learning styles (activist, reflector, theorist, and pragmatist). Kolb's Learning Style Questionnaire revealed a substantial preference (79.6) for the activist learning style.

PREVALENCE OF POST TONSIL BLEEDING IN CHILDREN SCHEDULE FOR TONSILLECTOMY AND ADENOIDECTOMY; A CROSS-SECTIONAL STUDY

Salman Malik — 2024-12-31

Introduction: Tonsillectomy and adenoidectomy are among the most common surgical procedures performed in children to address recurrent tonsillitis and obstructive sleep-disordered breathing (SDB).

Material & Methods: A cross-sectional study was conducted on 246 children scheduled for tonsillectomy and adenoidectomy. Data were collected on various demographic and clinical variables, including age, gender, weight, pre-existing conditions (such as asthma, allergies, and sleep apnea), ASA classification, and primary diagnosis. Post-tonsil bleeding was categorized as primary (within the first 24 hours post-surgery) or secondary (after 24 hours).

Results: In a study of 246 children undergoing tonsillectomy and adenoidectomy, 36 (14.6%) experienced post-tonsil bleeding. The highest incidence was in middle childhood (6-11 years) with a significant p-value of 0.01. Males had a higher incidence of bleeding (15.9%) compared to females (13.0%) with P=0.05. Children weighing less than 15 kg were more prone to bleeding (22.2%, p=0.01). Pre-existing conditions such as sleep apnea significantly increased bleeding risk (25%, p=0.01). General anesthesia was associated with a bleeding rate of 14.7% (p=0.05). Higher ASA classifications correlated with increased bleeding, particularly ASA III (37.5%, p=0.01). Obstructive sleep-disordered breathing (SDB) was also a significant risk factor (18.2%, p=0.01). Primary bleeding was characterized by 40% minimal, 30% moderate, 20% severe, and 10% life-threatening cases, with no significant difference in severity compared to secondary bleeding. The hemorrhage location was primarily in the right tonsil bed (50%) for both primary and secondary bleeding, with no significant positional differences.

Conclusion: In conclusion, this study identifies key risk factors for post-tonsil bleeding in children undergoing tonsillectomy and adenoidectomy, including age, weight, pre-existing conditions, ASA classification, and type of anesthesia used.

PLANT EXTRACTS AS A PROBABLE BIORESOURCE TO FORMULATE GROWTH MEDIA FOR CANDIDA ALBICANS

Sadiah Saleem — 2024-12-31

Introduction: Heavy price of microbiological culture media is a major financial challenge for diagnostic laboratories that require accurate and swift pathogen identification for infectious disease diagnosis. Therefore, the present study is aimed at evaluating growth parameters of Candida albicans on plant extract-based, economical media.

Material & Methods: Native edible/medicinal plants were used to prepare extracts which served as major component of medium. Results of extract media combinations (EMCs) were compared to that of reference medium potato dextrose broth (PDB).

Results: Growth kinetics presented short lag phase followed by log phase; lasted for 3 days in PDB and 2 days in EMCs. Biomass values on EMCs were statistically not significant (P= > 0.05) with values of PDB on day 2. Media pH was acidic, reducing sugars were present on day 2 in PDB, neem bark + sugarcane peel extract; (SPEX); NBS, date bark + SPEX + yeast extract; DBSY and undetectable in coconut bark + SPEX; CBS. Dry cell weight results in EMCs (excluding CBS) on day 2-10 were at par with PDB whereas: protein content in PDB /EMCs was low. Electron microscopy showed elongated budding cells with extracellular matrix in PDB/EMCs however, cellular elongation was more prominent in EMCs. Productivity ratio was higher in DBSY followed by NBS whereas, absolute growth index score on NBS was equivalent to that of potato dextrose agar.

Conclusion: Above results indicate efficacy of these EMCs as growth medium plus a tool for rapid differentiation between Candida albicans and non- albicans species based on morphology.

PERCUTANEOUS FIXATION FOR DISPLACED COLLES FRACTURES; A PRACTICAL INSIGHT FROM A PUBLIC HOSPITAL

Shahzeb Solangi — 2024-12-31

Introduction: Displaced Colles fractures are common injuries affecting patient functionality and quality of life. Percutaneous treatment efficacy requires a thorough evaluation, especially in postgraduate trainees managing it.

Material & Methods: This was a descriptive retrospective study that was conducted at the Department of Orthopedics, Civil Hospital Karachi, from 15 June 2022 to 15 August 2023. Non-probability consecutive sampling was used to select 96 patients who underwent percutaneous fixation for displaced Colles fractures. Data was collected through clinical examinations and radiographs, using a pre-designed protocol. The surgical procedures utilized two divergent 1.8 mm smooth K-wires. Follow-up evaluations were conducted to assess both radiological union and functional outcomes.

Results: The radiological assessment showed an 88.54% union rate, and the functional outcomes at six months post-treatment were excellent 69.79%, good 16.67%, fair 8.33%, and poor 5.21%. No significant differences were found based on age, gender, residence, employment status, BMI, fracture duration, or injury mechanism.

Conclusion: Percutaneous fixation successfully restored structural integrity and functional capacity for displaced Colles fractures, with a radiological union rate of 88.54% and 86.46%, despite the limitations due to a single-center design. Further research should explore individualized treatment strategies.

FREQUENCY OF OBESITY AND ASSOCIATION OF DIETARY DIVERSITY AMONG CHILDREN IN RAWALPINDI; A CROSS-SECTIONAL STUDY

Khadija Sharif — 2024-12-31

Introduction: The prevalence of childhood obesity has increased dramatically in recent decades leading to morbidity and an increased risk of non-communicable diseases later in life. In Pakistan childhood obesity has become a concerning issues yet limited data exists on its prevalence. Previously, it was thought that only children living in the developed countries were at the risk of being overweight and obese, however the new incoming data suggests otherwise. The vast majority of overweight or obese children live in developing countries, where the rate of increase has been more than 30% higher than that of developed countries.

Material & Methods: A cross-sectional study was conducted at two private schools of Rawalpindi from January 2023 to June 2023. A total of 139 Children between 5 to 12 years of age were recruited in the study through Stratified Random Sampling technique. The study was approved by the Ethical Review Committee (FUSH). Data was collected through a customized questionnaire. Body Mass Index (BMI) z-score was used to screen for overweight and obesity. Data was analyzed using SPSS.

Results: 4 out of 139 children were obese and hence the prevalence of obesity was 2% among the observed children. The children who consumed more than the recommended amounts of daily fruits (p=0.111), vegetables (p=0.018), dairy products (p=0.262), meat products (p=0.136), wheat products (p=0.094), water intake (p=0.247), fried food (p=0.024), sweets/sugar (p=0.009), and processed food (p=0.08) were more likely to be obese. Children with 60 minutes of daily physical activity were less likely to be obese. (p=0.021).

Conclusion: Childhood obesity remains relatively underrecognized in Pakistan, with approximately 2% of children aged 5-12 affected. There is a need for promoting healthy dietary habits, encouraging balanced consumption of fruits, vegetables, and water, while discouraging the intake of fried food, sweets/sugar, and processed food. Targeted and culturally appropriate interventions are necessary to foster a healthier lifestyle among children.

RELATIONSHIP OF ROUNDED SHOULDER POSTURE WITH PEAK EXPIRATORY FLOW RATE IN UNDERGRADUATE MEDICAL STUDENTS HAVING MECHANICAL NECK PAIN

Mahnoor Khan — 2024-12-31

Introduction: Undergraduate medical and allied health sciences students spend a large part of their day studying in numerous wrong positions for a prolonged time. This leads to the development of back discomfort and may affect the structural development of the spine. Lack of focus on posture, giving too little time to physical activity and mental stress have been reported to cause musculoskeletal problems such as Rounded Shoulder Posture (RSP) and Mechanical Neck Pain (MNP). RSP causes a decrease in lung compliance, affecting Peak Expiratory Flow Rate (PEFR).

Material & Methods: A cross-sectional study was conducted on undergraduate medical students with a sample size of 218 where 113 were females and 105 were male. Two questionnaires were used, Northwick Park Neck pain questionnaire (NPQ), for checking the level of neck disability and pain, and a self-structured questionnaire where general questions were asked and values of RSP and PEFR were noted. The degree of RSP was checked through the vernier caliper manually whereas PEFR was calculated by taking the meaning of three values taken from each participant through flow meter. Ethical approval for the study was granted by Institutional Review Board and Ethical Committee of Alliance Healthcare, under approval number IRB&EC/2023-HIS/057.

Results: In the study, Pearson correlation test showed that the RSP is associated with PEFR in participants having MNP. Mean and standard deviation of Rounded Shoulder Posture was 8.33±1.75 cm and PEFR was 265.11 ±112.11 L/min. The test showed that the P-value was <0.01 and R-value was 0.239. The significance is <0.01 which showed that there was correlation between RSP and PEFR. whereas when we applied the same test on participants having only MNP with PEFR, no significance (<0.426) was seen.

Conclusion: The study concluded that there is a relationship of RSP with PEFR, as the severity of abnormal posture and the degree of rounded shoulders increase, there is a significant decrease in expiratory flow levels.

EFFECTS OF MUSCLE ENERGY TECHNIQUE AND POSTURAL CORRECTION EXERCISES IN LORDOTIC FEMALES WEARING HIGH HEELS; A QUASI EXPERIMENTAL TRIAL

Nosheen Manzoor — 2024-12-31

Introduction: Low back pain is one of the most common ailments for which patients seek physiotherapy treatment. Pelvic tilting becomes evident when the mechanical causes of low back pain are identified. In such cases, the iliopsoas muscle plays a crucial role in managing LBP. Since it is often contracted, stretching the muscle can help alleviate the condition. There is a correlation between lumbar lordosis and pelvic inclination in females who wear high-heeled shoes. The purpose of this study was to determine the effects of Muscle Energy Technique (MET) and Postural Correction Exercises on low back pain in females wearing high heels.

Material & Methods: A total of 28 females, aged 18–45 years, who wore high-heeled shoes for six hours per day and presented with low back pain and an increased lumbosacral angle without radiating symptoms, were randomly divided into two groups. Patients in the treatment group received Muscle Energy Techniques (METs), while those in the control group performed posture correction exercises. Functional disability and pain were assessed using the Modified Oswestry Low Back Pain Disability Questionnaire and the Pain Numeric Rating Scale. Data analysis was conducted using SPSS version 16.0. An independent t-test was used to compare changes between groups, while a paired t-test was used to assess changes within each group.

Results: There was no significant difference at baseline (p > 0.05), indicating that both groups were homogeneous at the time of recruitment. However, the post-treatment p-value (p < 0.05) showed a significant reduction in pain and disability levels in patients treated with MET. Additionally, lumbar range of motion (ROM) demonstrated statistically significant improvement in pelvic tilt angle, flexion, and extension in the MET group (p < 0.05), while both groups showed significant improvements in side-flexion and rotation ROM (p < 0.05).

Conclusion: MET is more effective in treating lordotic posture. Patients in the MET group experienced greater reductions in pain and disability, along with improved range of motion, compared to those performing postural correction exercises.

THE FREQUENCY OF SPLENIC INJURY IN PATIENTS PRESENTING WITH BLUNT ABDOMINAL TRAUMA AT A TERTIARY CARE HOSPITAL PESHAWAR

Muhaddis Ahmad — 2024-12-31

Introduction: Blunt abdominal trauma poses significant morbidity and mortality risks without prompt diagnosis. Its occurrence varies by region, age, and gender, with rapid deceleration or compression causing injuries to adjacent abdominal organs or vessels. This study aimed to determine the frequency of splenic injury in blunt abdominal trauma patients at a tertiary care hospital in Peshawar.

Material & Methods: A cross-sectional study was conducted at Lady Reading Hospital's trauma department from July 1st to December 31st, 2022. Patients with severe head injuries were excluded. Splenic injuries were diagnosed via CT abdomen with IV contrast or exploratory laparotomy. Patients underwent conservative treatment until diagnosis, with monitoring for hemodynamic instability.

Results: During the study period, 137 patients presented to the trauma department, comprising 74.5% males and 25.5% females, with a mean age of 32.5 ± 9.1 years. Falls (35.8%), assaults (26.3%), road traffic accidents (23.4%), and other causes (14.6%) were common modes of injury. Splenic injury was documented in 29.2% of patients.

Conclusion: Splenic injury is prevalent among patients presenting with blunt abdominal trauma. Further research is warranted to identify additional factors contributing to spleen injury, facilitating preventive strategies in the future.