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VISCERAL MOBILIZATION: STATE OF ART FOR SYSTEMIC PATHOLOGIES MANAGEMENT
No full textThe global disease burden has evident about significant increase in many systemic diseases such as central obesity, diabetes mellitus and atherosclerosis. The concept of invasive and pharmacological management of various systemic diseases has seen a paradigm shift towards conservative management techniques like physical therapy in the last two decades for multiple conditions like type II Diabetes Mellitus, Complex Regional Pain Syndrome Type I, Atherosclerosis, Hypertension and Peripheral Arterial Disease.
Multiple exercise guidelines have been created and customized and implemented worldwide to address discussed pathologies. However, it has been observed that the effects of exercises are short term requiring a life time commitment to continue the exercise regimen. Henceforth, the idea of visceral mobilization which is a hands-on treatment method implemented to mobilize the organs brought forward with pronounced systemic effects including angiogenesis and healing of aged or injured tissue along with symptomatic management1.
A wide range of systemic effects have been observed with the spinal manipulation and soft tissue mobilization leading to the confirmation of physiological effectiveness of visceral mobilization. Spinal control produces changes in muscle shaft reaction, nocifensive reflex reaction and neuronal movement, electromyography, and immunologic reaction. Further, it is seen to deliver physiological changes including autonomic, circulatory, lymphatic and immunologic capacities, instinctive reaction, quality articulation, neuroanatomy, capacity and pathology, and cell reaction to in vitro recreated massage
HEALTH PROFESSIONAL’S PERCEPTION OF DOMINANT PERSONALITY TRAITS OF STAMMERERS
No full textBackground and Aim: Allied health professionals play an important role in therapy of stammering. So, this study was to assess the perception of health professionals regarding different dominant personality traits of stammerers as they devise the therapy and counselling techniques accordingly.
Methodology: This observational study was conducted at the department of Developmental and Behavioral Pediatrics; Children Hospital Lahore. The 25 bipolar semantic differential scales developed by Woods and William, was used in this study. A total of 100 health professionals were given the questionnaire. The health professionals involved in this study were Speech and Language Pathologists, Dev. Pediatricians, Occupational Therapists, Physiotherapists, Clinical Psychologists, Special Educationist and Nurses.
Results: Sample size of this study was 100. Percentage of females was greater than males (88% vs 12%). Results showed that majority of the participants perceive stammerers as nervous, shy, cooperative, friendly, talkative, sensitive, anxious, fearful, perfectionist, intelligent, emotional, aggressive, self-conscious, self-pitying, guarded, introvert.
Conclusion: In this study many health professionals considered that there are many negative personality traits that are dominant among stammerers that had to be addressed seriously. Along with negative traits, there are some positive dominant traits of stammerers according health professionals’ perception
Progress in Regenerative Dentistry Approaches: An Update
No full textAdvanced research in biomedical engineering, together with rising treatment standards and the demand for non-conventional methods, have contributed to the explosive growth of the field of dentistry known as regenerative dentistry. Stem cells, scaffolds, and bioactive substances are the three main elements of tissue engineering, the field that forms the basis of regenerative dentistry. Because of these remarkable properties, stem cells produced from dental tissue are very relevant in this field. In a wide spectrum of dental specializations, regenerative techniques have brought novel options to many established treatment protocols. Consider the alternative to conventional root canal therapy provided by pulp revascularization and other regenerative endodontic procedures. Thanks to 3-D bioprinting and computer-aided design, which have revolutionized oral and maxillofacial tissue engineering, modified guided tissue regeneration procedures are gradually replacing standard surgical and nonsurgical periodontal therapy. This paper provides an overview of the most current therapeutic approaches that have been used in clinical settings and highlights the importance of dental tissue-derived stem cells for regenerative dentistry
Post-operative Analgesia with Intraperitoneal Bupivacaine Alone and with Dexmedetomidine Following Laparoscopic Cholecystectomy
No full textBackground: Laparoscopic cholecystectomy (LC) is a customary treatment for patients with symptomatic cholelithiasis. This study aimed to compare the mean duration of analgesia (DOA) of intraperitoneal bupivacaine (BPV) with dexmedetomidine (DEX) to intraperitoneal BPV alone in patients undergoing LC.
Methods: This randomized controlled trial was done at the Department of Anesthesiology, Bahawalpur Victoria Hospital, Bahawalpur, Pakistan, from October 2023 to March 2024. A simple random sampling technique was adopted. A total of 68 cases undergoing LC were enrolled and randomly allocated to either Group-B (n=34) who received intraperitoneal BPV 50 ml 0.25%+5 ml normal saline and Group-BD (n=34) who were served intraperitoneal BPV 50 ml 0.25%+ DEX 1 μg/kg with normal saline 5 ml. The postoperative pain intensity for both groups was recorded and compared using a 10-point visual analogue score (VAS) at 0, 30 minutes, 1 hour, 2, 4, 6, 8, 12, and 24 hours. Independent sample t-test and chi-square test were used to compare data between groups taking p<0.05 as significant.
Results: The mean DOA in the patients in group B was 4.42±3.95 hours, and in group BD, it was 7.63±2.65 hours (p=0.0002). It was noted that pain scores were significantly low in Group BD at 1 hour (2.63±0.53 vs. 2.26±0.64, p=0.0116), 2 hours (2.81±0.56 vs. 2.43±0.73, p=0.0188), 4-hours (3.70±0.73 vs. 3.32±0.52, p=0.0160), and 6-hours (3.93±0.48 vs. 3.50±0.46, p=0.0003). BD group offered a significantly longer DOA (p=0.0002), an extended spell for rescue analgesia (p=0.0001), and a lesser dose of diclofenac (p=0.0137).
Conclusion: Intraperitoneal instillation of DEX 1 μg/kg with local anesthetic 0.25% BPV 50 ml at the end of surgery in patients undergoing LC significantly reduced the postoperative pain, especially up to six hours postoperatively
Etiological Spectrum and Clinical Outcomes of Patients Admitted with Acute Viral Hepatitis: A Retrospective Study
No full textBackground: Acute viral hepatitis poses a significant health burden in urban Pakistan, especially Karachi, due to poor sanitation and limited healthcare infrastructure, highlighting the need to understand its causes, clinical features, and outcomes.
Methods: A retrospective observational study was conducted at Hamdard University Hospital, Karachi, Pakistan, from January 2020 to July 2023. Patients of all ages with a confirmed diagnosis of acute viral hepatitis were included using non-probability consecutive sampling. Data were collected from medical records, including demographics, clinical symptoms, laboratory parameters such as Alanine Aminotransferase (ALT), Aspartate Aminotransferase (AST), and bilirubin level, along with the outcomes. Patients were categorized based on the etiologies of hepatitis A, B, and E. Data were analyzed using SPSS v25, with appropriate statistical tests applied based on variable type and distribution. A p-value <0.05 was considered statistically significant.
Results: Out of 276 patients, hepatitis A accounted for 173 (62.9%) cases, followed by hepatitis E 93 (33.8%) and hepatitis B 9 (3.3%). The mean age of patients was 19.14 ±3.18 years, with a significant male predominance in hepatitis A 72 (70.6%) and a higher female prevalence in hepatitis E 72 (41.1%). The mean ALT, AST, and bilirubin levels were 1562.15 ±744.49 U/L, 1358.42 ±682.41 U/L, and 7.21 ±3.85 mg/dL, respectively, with no significant differences across etiologies. Liver failure occurred in 17 (6.2%) of cases, and 28 (10.2%) required intensive care unit admission. The majority of the hepatitis cases were reported in August (53, 19.27%), September (37, 13.45%), and July (36, 13.09%), corresponding to the monsoon periods.
Conclusion: Hepatitis A and E were the leading causes of acute viral hepatitis among hospitalized patients
A Cross-Sectional Analysis for Generalized Assessment of Hernia Recovery and Complications in Tertiary Healthcare Settings
No full textBackground: A hernia is the protrusion of an organ or tissue through a weakened area in the muscle or connective tissue and is usually associated with a bulge and discomfort. The objective of this study was to conduct a generalized assessment of Hernia patients-based recovery and complications in tertiary healthcare settings.
Methods: This retrospective cross-sectional observational study (April 2023 to Oct 2023) was conducted at Shaikh Zayed Hospital and Akhtar Saeed Hospital in Lahore. A consecutive sampling technique was used and the sample size was calculated (n=80) with a 95% confidence interval using OpenEpi software version 3.0.1. The patients (n=80) who underwent any kind of hernias surgery procedures were included in this study. Data about demographics, surgery procedures, postoperative complications (wound infection, seroma, hematoma, recurrence), hospital stay complications (prolonged stay due to infection or delayed recovery), recovery time, and serum albumin levels were collected and analyzed using SPSS version 25 and %age with recovery rate was calculated.
Results: Out of 80 patients, A total of 27 patients (33.8%) had postoperative complications. The overall wound infection rate of 11.3% (n= 9) was seen. As for serum albumin levels, patients with serum albumin <3.5 g/dL were more prone to complications (45.8%, n=37 vs. 18.2%, n=14, p=0.009) together with a longer stay in hospital (6.7 ± 1.8 vs. 4.5 ± 1.1 days, p=0.034).
Conclusion: In conclusion, postoperative complications were seen particularly in patients with low serum albumin levels and prolonged hospital stays
Short-Term Effects of Mobilization with Movement Vs. Sham Techniques in Patients with Rotator Cuff Impingement: A Randomized Controlled Trial
No full textBackground of the Study: Shoulder Impingement Syndrome (SIS) is a clinical condition in which soft tissues surrounding the space of the shoulder joint cause pain and inflammation. This study aimed to compare the effects of mobilization with movement and sham technique on patients with rotator cuff impingement syndrome and their outcomes in terms of range of motion, pain, and disability.
Methodology: A randomized controlled trial based on six-month duration was conducted on 44 participants. Group A received the Movement with Mobilization while Group B Sham technique only. The shoulder pain and disability index (SPADI) was used for disability, the numerical pain rating scale (NPRS) was used for pain, and a goniometer was used for ROM.
Results: Mean differences in pain, disability index, and range of motion measures were significantly higher in the MWM group compared to the sham group, with values such as pain at 8.35 vs. 6.04, SPADI at 108.55 vs. 78.14, and internal rotation at 129.9 vs. 20.5, respectively. MWM was statistically and clinically more effective than the sham intervention in reducing pain, improving range of motion, and decreasing disability.
Conclusion: It is concluded that MWM is more effective as compared to sham treatment on patients with rotator cuff impingement syndrome in decreasing pain and increasing mobility
Study Habits, Learning Styles, And Preferences Among Medical Students: A Cross-Sectional Survey
No full textBackground of the study: Medical education’s rigorous academic and emotional demands significantly impact students’ learning experiences. Understanding medical students’ learning styles and study habits is crucial for informing evidence-based teaching practices and promoting student success.
Methodology: This cross-sectional study was conducted in Karachi, Pakistan among 366 medical students from United College of Physical Therapy (UCPT), United Medical and Dental College (UMDC), Dow University of Health Sciences (DUHS), Jinnah Medical and Dental College (JMDC) and Ziauddin University (ZU) using a non-probability convenient sampling technique. Study tools include The VARK Questionaire Version 8.01 and The Study Habits Inventory Questionaire. Data was collected through face-to-face conversations.
Results: The study revealed predominant preferences for unimodal learning (63.6%), particularly kinesthetic methods (21.1%). Bimodal (24.2%), trimodal (8%), and quadrimodal (4%) preferences were also observed. While students demonstrated proficiency in note-taking, reading comprehension, and test anxiety management, challenges emerged in time management and concentration.
Conclusion: This study underscores the diverse learning styles prevalent among medical students, with a notable preference for kinesthetic learning. Despite proficiency in certain study habits, time management and concentration challenges persist among a considerable portion of the student population. Addressing these challenges through targeted interventions is essential for enhancing educational outcomes and student success.
Eccentric Load Exercise in the Prevention of Hamstring Injuries in Athletes: A Perspective
No full textnot require
Frequency of Musculoskeletal Symptoms Among the Club Cricketers of Rawalpindi/Islamabad
No full textBackground of the study: The concept of playing and watching cricket in Pakistan is very common among youth; being considered a leisurely gentleman\u27s game. However, the possible injuries that occur involving the musculoskeletal (MSK) system can be due to several causes such as improper training schedule, sudden involuntary movements, or the lack of proper warm-up/cool-down session. To contribute for betterment, our study aimed to determine the frequency of musculoskeletal symptoms among club cricketers.
Methodology: This was a descriptive cross-sectional study with a sample size of 344 male participants. The data collection tools which were used involves a self-structured Questionnaire for demographics and a modified Nordic Musculoskeletal Questionnaire for musculoskeletal symptoms. Data was analyzed on SPSS version 21.
Results: The frequency of MSK symptoms reported in the previous 12 months was highest for lower back pain (n=98, 28.5%) followed by shoulder pain (n=98, 28.5%)
while during the last 7 days upper back n=20 (54.1%) was reported as the highest one followed by knees n=28 (49.1%). During past 12 months, cricketers were unable to perform daily tasks due to discomfort, seen in knees n=35 (61.4%) followed by upper back n=19 (51.4%) and shoulder n=44 (44.9%). The maximum number of players who had hurt their body regions in accidents were highest with wrist n=22 (36.1%), ankle/foot n=23 (33.3%) and knees n=15 (26.3%).
Conclusion: Musculoskeletal symptoms in club cricketers were most commonly found in the shoulder and lower back region, however, they were least common in upper back