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EFFECTIVENESS OF LUMBAR STABILIZATION EXERCISES IN NON-SPECIFIC LOW BACK PAIN AMONG OCCUPATIONAL THERAPISTS
No full textBACKGROUND AND AIMSLow Back Pain (LBP) is considered as the second leading source of musculoskeletal disorders, affecting 85% individuals worldwide atsome point in their life time. Numerous studies estimated Occupational Therapists have predominant risk of developing LBPdue to nature of their daily activities therefore the aim of this study is to evaluate the effectiveness of lumbar stabilizing exercises amongOccupational Therapists with non-specific LBP.METHODOLOGYA single blind, RCT was conducted at Dr. Ziauddin Hospital included 30 Occupational Therapists divided in to Group A and B thatreceived lumbar stabilization and general extension exercises respectively. Both the groups received 4 weeks of intervention on 6days/week. Data was collected Pre and Post the treatment on Numeric Rating Scale and Oswestry LBP Disability Questionnaire.RESULTSBoth the groups showed significant results (p<0.05), however Group A showed marked reduction in pain and disability in comparison toGroup B that showed moderate decrease in both outcome measures.CONCLUSIONLumbar stabilization exercises are more effective to reduce LBP as compared to general extension exercises. Multi-center trials arerecommended in the management of LBP in healthcare professionals to prevent musculoskeletal disorders.
KEYWORDSLow Back Pain, Mechanical, Postural, Occupational Therapist, Spinal Column, Disorders
Efficacy Of Zinc Supplementation In Maintaining Sustained Remission In Children With Steroid-Sensitive Nephrotic Syndrome
No full textBackground: Nephrotic syndrome (NS) is one of the most prevalent primary glomerular diseases affecting children, causing significant morbidity. This study was performed to determine the efficacy of zinc supplementation in maintaining sustained remission (SR) in children with steroid sensitive nephrotic syndrome (SSNS).
Methods: This randomized controlled trial was conducted at the Pediatric Medicine Outpatient Department, Nishtar Hospital, Multan, from July 2024 to May 2025. A total of 192 children aged 2–12 years with frequently relapsing were enrolled through random sampling, and randomly assigned to receive either zinc supplementation plus standard therapy or standard therapy alone for six months. Zinc was given as 5 mg (<4 years) or 10 mg (>4 years) daily, and SR was assessed. Data were analyzed using SPSS v26.0, with chi-square, and independent sample t-test applied, taking p<0.05 was considered significant.
Results: In a total of 192 children, 117 (60.9%) were male. The mean age, and duration of disease was 7.36 ± 2.02 years, and 2.03±0.61 years, respectively. The mean number of relapses was 2.15±0.41. Overall, the efficacy was noted in 74 (38.5%) children. The efficacy was seen in 46 (47.9%) children in Zinc group while no Zinc group showed efficacy in 28 (29.2%) children (p = 0.011). Efficacy was found to have significant association with socio-economic status in zinc treated group (p=0.044).
Conclusion; This study support the use of Zinc supplementation in pediatric SSNS, exhibiting significant efficacy in imparting remission of relapses.
Keywords: Nephrotic syndrome, prednisolone, proteinuria, relapse, zinc.
Trial Registration: NCT06860620 (clinicaltrials.gov
Comparative In Vitro Assessment of Marginal Microleakage and Caries-Like Lesions Around Common Restorative Materials
No full textBackground: Secondary caries formation is still one of the main reasons of restorations fail, mostly caused by the material\u27s resistance to microleakage and marginal sealing ability. The objective of this research was to assess compare the degree of secondary caries development next to restorations made of Glass Ionomer Cement (GIC), Composite Resin, and Amalgam.
Methods: The in-vitro study was conducted (March 2024 to August 2024) at Dentistry department at with randomly selected groups (n = 30 each) created from 90 extracted human premolars: Group A (Composite Resin), Group B (Amalgam), and Group C (GIC). In accordance with the guidelines provided by the manufacturers, standardized Class I and II cavities were prepared and restored. The samples were subjected to artificial demineralization (pH cycling) and thermocycling in order to replicate oral conditions that are favorable for the development of marginal caries. In SPSS version 26.0, one-way ANOVA and chi-square tests were used to analyze the data(p < 0.05 as significant).
Results: The findings showed that Amalgam restorations had the most severe lesions and the highest leakage (0.87 ± 0.21 mm), while Composite Resin restorations had the lowest microleakage (0.58 ± 0.16 mm) and the lowest caries incidence. GIC exhibited results that were in between (0.72 ± 0.19). The groups differed significantly (p = 0.01 for caries severity and p = 0.002 for leakage).
Conclusion: In comparison to Amalgam and GIC, Composite Resin demonstrated better marginal adaptation and resistance to secondary caries. These results highlight the significance of choosing restorative materials to reduce restoration failures
Histomorphometric Evaluation of Myocardial Tissue Zones in Patients With Persistent Hypokalaemia
No full textBackground: Persistent hypokalaemia influences cardiac structure and function, but its zonal effect on myocardial remodeling is not definite. This study quantitatively examined myocardial tissue zones in chronic hypokalaemia, to build a schematic model of myocardial remodeling.
Methods: This a cross-sectional analytical study (March to September 2022) was carried out in Department of Histopathology including Sixty postmortem myocardial samples from patients with chronic hypokalemia (serum K+ <3.0 mmol/L) were examined. Tissue samples from the endocardial, mid-myocardial and epicardial areas were stained and histomorphometric parameters were determined. Zonal comparisons were done by the method of repeated measures analysis of variance, correlation was determined between serum levels of potassium by Pearson correlation (p < 0.05 is considered as significant).
Results: Zonal differences were found to be significant in myocyte diameter (F = 6.42, p = 0.002), nuclear density (F = 5.91, p = 0.004), interstitial fibrosis (F = 5.87, p = 0.004) and vascular density (F = 4.72, p = 0.011). The endocardial zone had the highest interstitial fibrosis (28.6 ± 6.2%), smallest diameter of myocytes (12.6 ± 2.1 um), lowest nuclear density (185 ± 22 nuclei/mm2) and vascular density (9.8 ± 2.1 vessels/mm2) compared to the mid-myocardial and epicardial zones. Lower serum potassium levels correlated with increased fibrosis (r = -0.52, p < 0.001), decreased myocyte diameter (r = +0.46, p = 0.003), decreased nuclear density (r = +0.39, p = 0.007) and decreased vascular density (r = +0.41, p = 0.005).
Conclusion: Chronic hypokalaemia results in zone-specific histomorphometric remodeling of myocardial tissue, which is mainly manifested as endocardial fibrosis, decreased vascularity, and depletion of nuclei
Impact of Solid Organ Injury Severity on Critical Care Resource Use and Clinical Outcomes in Blunt Abdominal Trauma Patients:A Schematic Assessment
No full textBackground: Solid organ injuries during blunt abdominal trauma (BAT) have a major effect on patient outcomes. This systematic review and meta-analysis aimed to evaluate the impact of solid organ injury severity on critical-care resource use, non-operative management failure, and mortality in patients with blunt abdominal trauma.
Methodology: Research was conducted in PubMed, Scopus, Web of Science, and Google Scholar until November 2025, and included any of the studies involving adult patients and reporting blunt liver, spleen, or kidney injuries. Articles that presented odds ratios (ORs) or adequate information on ICU admission, NOM failure, or mortality were incorporated. A random-effects model was employed for the meta-analyses, using inverse-variance weighting. ORs with 95% confidence interval (CI) were pooled, and I2 measured the heterogeneity. The Newcastle-Ottawa scale was used to assess the risk of bias, and the certainty of evidence was estimated with GRADE. Sensitivity and subgroup analysis have been conducted to examine the soundness of results.
Results: 12 articles were included. Solid organ injuries of high grade were linked to augmented ICU admission/critical-care use (OR 2.95, 95% CI = 1.09-7.99, I2 =92%). There were no statistically significant differences in NOM failure (OR 0.53, 95% CI = 0.06-4.58, I2 =89%) and mortality (OR 1.48, 95% CI = 0.67-3.28, I2 =78%). The overall level of evidence was moderate.
Conclusion: Solid organ injury severity is a predictor of critical-care resource use, whereas there is a less predictable effect on NOM failure and mortality. Individual management according to the grade of an injury, and patients are advised
Histological Evaluation of Fallopian Tubes in Tubal Factor Infertility with Past Pelvic Inflammatory Disease
No full textBackground: A Persistent history of pelvic inflammatory disease (PID) causes mucosal damage and fibrosis, as well as hydrosalpinx, which eventually results in tubal patency and fertility. The present study aimed to determine the histopathological features of fallopian tubes of women with tubal factor infertility with a history of PID.
Methods: A descriptive cross-sectional study was conducted on 180 women who had tubal factor infertility and previous documented PID after having undergone surgical tubal sampling. A non-probability consecutive sampling technique was used. Clinical and demographic information was recorded, and the surgical specimens of the fallopian tubes were processed for histological examination on hematoxylin & eosin and special stains. Histopathologic parameters of interest were assessed, including mucosal integrity, inflammatory infiltrate, fibrosis, hydrosalpinx, granulomatous inflammation, and vascular changes. Associations were examined between clinical indicators and the severity of tubal damage using chi-square tests, t tests and logistic regression.
Results: In 30.0% of specimens, there was a complete loss of the mucosal surface, while moderate/severe fibrosis occurred in 67.7% of specimens. Chronic inflammatory infiltrates were seen in 71.1%, while hydrosalpinx was observed in 40.6% of the specimens. Women with ≥2 PID episodes had significantly greater plasma cell counts (p = 0.001) and 3 times greater risk of having severe tubal damage (p = 0.002).
Conclusion: Repeated PID, long-term infertility, and hydrosalpinx constitute important indicators of severe tubal histopathology, further confirming the need for early management of PID and timely tubal assessment to optimize fertility potential
Impact of Antenatal Lumbopelvic Pain on Fear of Childbirth, Pregnancy-Related Quality of Life, and Kinesiophobia: Antenatal Lumbopelvic Pain and its Outcomes
No full textBackground: Antenatal lumbopelvic pain is one of the most common musculoskeletal discomforts that affects women during pregnancy. There are numerous reasons for the pain, commonly it arises due to biomechanical, hormonal, and postural changes and can significantly restrict daily activities of functional living. In addition, it may contribute to the psychological disturbances including fear of childbirth. Therefore, understanding the relationship between lumbopelvic pain and the fear of childbirth, quality of life, and kinesiophobia in pregnant women is essential for developing targeted interventions to improve maternal well-being.
Methodology: The data was collected from 105 pregnant women aged 18 to 40 years, diagnosed with lumbopelvic pain and the positive posterior pelvic pain provocation test. The level of pain intensity, fear of childbirth, quality of life, and kinesiophobia were outcome variables that were measured using the numeric pain rating scale (NPRS), tokophobia severity scale (TSS), quality of life gravidarum questionnaire (QoL-GRAV), and Tampa scale of kinesiophobia, respectively.
Results: Pearson correlation test was used to assess the correlation between the study variables and p < 0.05 was considered significant. Higher lumbopelvic pain weakly correlates with fear of childbirth (r=0.374) and kinesiophobia (r=0.013). However, a weak negative correlation was observed between lumbopelvic and pregnancy-related quality of life (r=-0.159).
Conclusion: The antenatal LPP pain is associated with fear of childbirth and pregnancy-related QOL. However, the relationship between LLP and kinesiophobia was found to be non-significant.
Keywords: Fear, Kinesiophobia, Low Back Pain, Lumbopelvic pain, Pregnancy, Quality of life
To cite this article: Abbas H, Jamil A, Arshad K. Impact of Antenatal Lumbopelvic Pain on Fear of Childbirth, Pregnancy-Related Quality of Life, and Kinesiophobia. Pakistan Journal of Rehabilitation. 2026; 15(1):31-34.
Predictors of Foot Care Practices among Patients with Type 2 Diabetes Mellitus: A Cross-Sectional Study: Predictors of Diabetic Foot Care Practices
No full textBackground: Foot complications are a major cause of morbidity in Type 2 Diabetes Mellitus (T2DM), which often leads to ulcers, infections, and amputations. Despite the fact that most of the diabetic foot complications are preventable, gaps in patient understanding, awareness and education lead to suboptimal practices in foot care. This study investigated the knowledge and education-related predictors of foot care practices among patients with T2DM.
Methodology: A multi-center cross-sectional study was conducted on 328 individuals with T2DM, attending tertiary care hospitals in Karachi. The data collection involved a self-administered structured questionnaire, aimed at assessing demographics, educational exposure, diabetes knowledge, foot care knowledge and self-reported foot care practices. Random Forest algorithms were employed to select variables for ordinal regression to assess predictors for foot care practices.
Results: A total of 328 participants were included in the study. Better practices were predicted by older age (OR = 1.03; 95% CI: 1.01-1.05). Participants who had a monthly income of PKR 100,000 - 250,000 were less likely to have better practices as opposed to those with monthly income of PKR <100,000 (OR = 0.43; 95% CI: 0.20-0.93). Received formal foot care education was significantly associated with improved foot care practices (OR = 3.73; 95% CI: 1.24-11.13), as was community foot care education (OR = 2.90; 95% CI: 1.29-6.50). The knowledge of diabetes (OR = 4.51; 95% CI: 2.09-9.74), and foot care knowledge (OR = 7.54; 95% CI: 3.47-16.39) were the strongest predictors of improved foot care practices.
Conclusion: This study demonstrates that diabetes and foot care knowledge along with formal and community-based education are highly significant predictors of foot care practices in patients with T2DM showing the significance of targeted educational interventions to enhance preventive practices.
Keywords: Attitudes, Self-Care, Foot Care, Health Knowledge, Practice, Type 2 Diabetes Mellitus
To cite this article: Hussain S, Tajwar H, Khan R, Akber FA, Wasim S. Predictors of Foot Care Practices Among Patients with Type 2 Diabetes Mellitus: A Cross-Sectional Study. Pakistan Journal of Rehabilitation. 2026; 15(1):35-40.
A Meta-Analytical Correlation Between Salivary pH, Buffer Capacity, and Microbiome Composition in Caries-Free and Caries-Active Individuals
No full textBackground: Salivary composition, including pH, buffer capacity, and microbial profile, which are important in oral health and susceptibility to caries. This systematic review and meta-analysis aimed to provide an aggregate of available information on salivary pH, buffer capacity, and levels of S. mutans in caries-active and caries-free individuals.
Methods: PubMed, Scopus, Web of Science, and Google Scholar (2010-2025) were searched according to PRISMA 2020. Studies included examined salivary pH, buffer capacity, and the level of Streptococcus mutans of human populations in correlation with dental caries. RoB 2 and NOS determined the risk of bias, and quality of evidence was assessed using the GRADE. Pooled standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated by a random-effects meta-analysis based on the inverse-variance technique. Subgroup and sensitivity analyses were also conducted.
Results: A total of 12 studies were incorporated, of which 09 studies were used for meta-analysis. There was no statistically significant difference in salivary pH in cohorts of experiments and controls (SMD = 1.68; I2 = 94%). Experimental cohorts had much better scores in salivary buffer capacity (SMD = 0.55; I2 = 82%). There were no significant changes in Streptococcus mutans (SMD = 1.79; I2 = 97%). Risk of bias was low to moderate, and the quality of the evidence was moderate, as per GRADE.
Conclusion: Salivary buffer capacity seems to be a major protective variable related to caries in dentistry, whereas salivary pH and S. mutans alone do not seem to be reliable predictors of caries.
To Compare The Effects Of Empagliflozin And Metformin On Serum Vitamin D Levels In Patients With Metabolic Syndrome.
No full textBackground: Metabolic Syndrome (MetS) is a cluster of metabolic conditions with increased risk to cardiovascular disease and type 2 diabetes mellitus T2DM. Recent researches have also proposed a relationship between MetS and vitamin D insufficiency. Empagliflozin and Metformin are commonly prescribed for treating MetS; however, their comparative impact on serum vitamin D level remains unclear. The aim of the study was to assess and compare the impact of empagliflozin and metformin on serum vitamin D levels in patients with MetS.
Methods: A comparative study was carried out involving 100 patients diagnosed with T2DM, who were assigned to receive Empagliflozin (Group A) & Metformin (Group B). The variables, including weight, BMI, waist-hip ratio (WHR), blood pressure, fasting blood sugar (FBS), lipid profile and Serum Vitamin D, were recorded, before and after treatment. Statistical analysis was performed using SPSS v23 to assess group differences.
Results: After treatment, the Metformin group showed significant reduction in weight and BMI (p < 0.05), while Empagliflozin group had greater reduction in WHR and Blood pressure (p < 0.05). glycemic control improved significantly in both groups, with a slightly greater FBS reduction in the metformin group (p < 0.05). Empagliflozin significantly increased Vitamin D levels (p < 0.001), whereas Metformin reduced them.
Conclusion: both drugs improved glycemic control, but Empagliflozin had added benefits on central obesity, blood pressure, lipid profile, and Vitamin D levels, highlighting its potential extra-metabolic effects and the need for further long-term research