Pakistan BioMedical Journal <p>Title of Journal: <strong>Pakistan Biomedical Journal (ISSN Online: 2709-2798, Print: 2709-278X)</strong></p> <p>Frequency: <strong>Monthly</strong></p> <p>Affiliated with: <strong>Lahore Medical Research Center</strong></p> <p><strong>Website: (</strong><a href=""></a>)</p> <p><strong>Address:</strong> 746-A, Kashmir Block, Allama Iqbal Town, Lahore, Pakistan</p> <p>Published By: <strong>CrossLinks International Publishers (CLIP), Lahore, Pakistan</strong></p> <p><strong>Website: (</strong><a href=""></a>)</p> <p><strong>Address:</strong> 590-Karim Block, Allama Iqbal Town, Lahore, Pakistan</p> <p><strong>Description:</strong></p> <p><strong>Pakistan BioMedical Journal (PBMJ)</strong> is an Official Journal of "<strong>Lahore Medical Research Center LLP" (LMRC)</strong> and is being funded and supported by Lahore Medical Research Center LLP (LMRC). Pakistan Biomedical Journal (PBMJ) is an open access, peer-reviewed international journal that publishes in all fields of health, allied health and biomedical sciences for an internationally diverse authorship. Clinical studies, clinical trials, population studies, public health, discovery medicine, study of microbes, molecular and cellular biology, basic mechanisms of biology, genetics, cancer biology, molecular medicine, pharmacology, virology, chemical biology, immunobiology, chemical biology, physiological and pathological studies are within the scope of journal.<br />A highly-cited, multi-disciplinary, international editorial board assures timely publication of manuscripts. Reviews on latest advancements in biomedical sciences</p> <p><strong><u>Approved &amp; recommended by HEC</u></strong></p> <p>Our Journal is approved and recommended by Higher Education Commission of Pakistan. (HRJS journal recognition system).</p> <p><strong>Schedule for Articles Submission:</strong></p> <p>Submissions are welcome and may be submitted here. <a href=""></a></p> <p><strong>Fee &amp; Subscription Charges</strong></p> <p>Publication Fee (National) Rs 35000 / Article</p> <p>Publication Fee (International ) 200 USD / Article</p> <p>Annual Subscription 115 USD</p> <p> </p> CrossLinks International Publishers en-US Pakistan BioMedical Journal 2709-278X <p>This is an open-access journal and all the published articles / items are distributed under the terms of the <a href="">Creative Commons Attribution License</a>, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments <a href=""></a></p> <p> </p> <p> </p> <p> </p> Ashwagandha And Its Pharmacological Activity Against Immunity <p>As pandemic hit the globe, stress in people increased drastically. Some people were losing their jobs while others were restricted to their homes due to precautionary measures against COVID-19 infection. Some were stressed about their living while others concerned about their families being affected. Many lost their dear ones. But one thing we learnt in this phase was fighting immunity and how immunity plays a vital role in prevention of disease.</p> <p>Ashwagandha <em>(</em>roots of<em> Withania somnifera, fam. Solanaceae)</em> is named generally as "Indian Winter cherry" or "Indian Ginseng" has been in use for medicinal purposes since more than 3000 years [1]. This herb is one of the main spices of Ayurveda (the customary arrangement of medication in India) consumed since centuries as a Rasayana (rejuvenator) for its larger spectrum of medical advantages. &nbsp;By increasing cell-mediated immunity, Ashwagandha boosts the body's resistance against disease. It also has powerful antioxidant properties, which help to protect cells from free radical damage.</p> <p>The bitter leaves are used to treat fevers and uncomfortable swellings. Aphrodisiac, astringent, depurative, diuretic and aphrodisiac are all properties of the flowers. It can also help eliminate white spots from the cornea when combined with rock salt and an astringent. Hysteria, anxiety, memory loss, syncope, and other conditions are treated with Ashwagandharishta, which is made from it. It is also consumed for nervous exhaustion, insomnia, neurodegenerative diseases, memory loss [2]. It is also used as anti-inflammation, anti-cancerous, general weakness, impotency and respiratory disorders [3]. A randomized controlled trial has suggested its role in the treatment of anxiety and depression in schizophrenia [4]. Its role in health and healing has also been observed [5]. As studies show its role on immunity so we should consume it in our daily lives for variety of benefits.</p> Nazia Koser Hooria Mubashar Amber Hassan Copyright (c) 2022 Pakistan BioMedical Journal 2022-05-31 2022-05-31 02 02 10.54393/pbmj.v5i5.507 Anatomical Sites OF Superficial Basal Cell Cancers Demonstrate Higher Rates of Mixed Histology <p>Historically, "aggressive" histologic subsets (HSs) of basal cell carcinoma (BCC) seem to be more likely to statistically exhibit Subclinical extension and require more phases during Mohs micrographic surgery (MMS) and consequently larger margins upon excision. The "Mohs Suitable Use Criteria (MAUC)" for the most appropriate therapy of superficial basal cell carcinoma. <strong>Objective:</strong> To evaluate if aggressive subtypes of superficial Basal Cell Carcinoma are common among healthy, immunocompromised patients and high-risk anatomical sites. <strong>Methods:</strong> The study was carried out in Khyber Teaching Hospital Peshawar, from November 2021-march to 2022, A total of 100 Mohs surgeries on superficial basal cell carcinoma were performed. Under light microscope slides were examined for any pattern of histology besides superficial basal cell carcinoma for statistical analysis MAU anatomical site healthy individuals and immunocompromised patients were grouped accordingly <strong>Results</strong>: Among health and immunocompromised individuals’ zone H and zone L were significantly increased in mixed histology. While in healthy individuals’ the association between L Zone and M zone was incredibly significant but in immunocompromised was not significant <strong>Conclusions:</strong> The mixed histology of SBCC was higher in the head and neck region. Researchers say that the MAUC scoring technique for SBCC is supported by a high incidence in SBCC of the head and neck.</p> Zahid Sarfaraz Khan Asim Muhammad Muhammad Ataullah Syeda Gulrukh Saba Shah Tehmina Naushin Hina Mir Nabiha Naeem Ziyad Ahmad Sudhair Abbas Bangash Irfan Ullah Copyright (c) 2022 Pakistan BioMedical Journal 2022-05-31 2022-05-31 44 48 10.54393/pbmj.v5i5.451 Association Between Foot Pain and High Heeled Shoes in Working Women <p>Women have been wearing high heels for decades and they remain a must-have for females going out on the town or to the workplace every day. It causes prolonged pressure on the muscles, bones, and tissues of the feet and ankles, on the other hand, may cause chronic foot discomfort or abrupt injuries that need surgical intervention in the feet and ankle. <strong>Objective: </strong>To determine an association between foot pain and high-heeled shoes in working women. <a name="_Toc27934404"></a><strong>Methods:</strong> A cross-sectional study was conducted to measure the prevalence of foot pain among females wearing heeled footwear, focusing only working women. A sample size of 285 was taken. Foot Health Status Questionnaire was used to collect data from the respondents from different areas of Lahore. The data was collected from office workers and school teachers. Considering inclusion and exclusion criteria. females were requested to participate. The questionnaire consisted of 13 questions that were used in this survey. The questionnaire had multiple options out of which only one option was to be selected which was nearest to representing their condition of foot. All the data was analyzed on SPSS (version 25) software. A scoring of 0-100 was used to calculate the results. <a name="_Toc27934405"></a><strong>Results:</strong><a name="_Toc27748292"></a><a name="_Toc27910821"></a><a name="_Toc27934406"></a><a name="_Toc27067785"></a><a name="_Toc27609898"></a> According to this study, a majority of 162 females had mild to moderate foot pain, 84.4% of females had foot pain and 15.6% of females had no pain. Foot pain had a statistically significant association with walking, climbing stairs, and doing work or activities, (P-value 0.000). Respondents having foot pain couldn’t do all the above activities normally. Restrictions and limitations were found among the respondents with foot pain.<a name="_Toc27934407"></a> A P-value of less than 0.05 indicates that there is a significant association between the severity of foot pain and difficulties during work or activities of daily life <strong>Conclusions</strong>: The study concluded that there is very high prevalence of foot pain (96%) among females wearing high heels. Long term use of high heels significantly affects the foot health and activities of respondents.<a name="_Toc27934408"></a></p> Saba Fatima Usman Riaz Ayma Sadia Maham Khalid Ahmed Jamal Tamknat Ilyas Copyright (c) 2022 Pakistan BioMedical Journal 2022-05-31 2022-05-31 49 53 10.54393/pbmj.v5i5.419 Awareness and Knowledge of Human Immunodeficiency Virus Transmission and Prevention from Mother to Child: A Cross-Sectional Study among Female Sex Workers <p>Human Immunodeficiency Virus (HIV) can be transferred during pregnancy from the infected mother to the fetus through the placenta or to her infant during delivery or breastfeeding. <strong>Objective: </strong>To evaluate awareness and understanding of HIV transmission and prevention from mother to child among female sex workers having and expecting pregnancy.<strong> Methods: </strong>It is a cross-sectional survey conducted in three cities: Lahore, Faisalabad and Islamabad, Pakistan. A sample size of 150 was considered as per convenience and collected using the snowball sampling technique. The data was collected using a specially designed questionnaire which was pilot tested by 10 health experts. The female sex workers of fertile age group 15-49 years who were pregnant or expecting pregnancy in the future were included. The female sex worker who was infertile or was on birth control was excluded from the study. Data were analysed with the help of the SPSS version 22. <strong>Results:</strong> The minimum and maximum age of female sex workers was 15 and 49 years respectively, with a mean age of 31.7±7.76 years. The female sex workers responded that 63(42%) know the mother-to-child transmission while the majority 87(58%) do not know that HIV infected mothers can transmit HIV to their children. The responses regarding mother-to-child transmission show that 61(21.3%) know about the trans-placental route, 100(35%) vaginal delivery, 58(20.3%) cesarean section, and 25(8.7%) breastfeeding. The response regarding the prevention of HIV from mother to a child shows that only 59(25.8%) prefer cesarean section, 29(12.7%) prefer no breastfeeding and very few 21(9.2%) prefer the use of antiretroviral therapies among infected women and children. <strong>Conclusions: </strong>In conclusion, the female sex workers were unaware of the prevention of HIV from breastfeeding and vaginal delivery. Moreover, they were unaware of precautions such as cesarean section and the usage of anti-retroviral therapies for infected mothers before delivery.</p> Akash John Tallat Anwar Faridi Copyright (c) 2022 Pakistan BioMedical Journal 2022-05-31 2022-05-31 54 58 10.54393/pbmj.v5i5.422 Cauda Equina Syndrome Outcome: Early V/S Late Surgery <p>There is no reservation that the superlative result for Cauda Equina Syndrome (CES) requires decompression by surgery. <strong>Objective: </strong>The goal of our study was to determine the effect of surgical procedure, with relation to time, on bladder and bowel symptoms. <strong>Methods:</strong> A retrospective analysis of patients undergoing surgical decompression by CES was done. The subjects with persistent symptoms were surveyed for at least two-years. BASS criteria were applied to classify CES: painless urinary retention (CESR), incomplete (CESI) and CES suspicious (CESS). The resolution of presenting autonomic symptoms was assessed following surgery.<strong> Results: </strong>A total of 120 patients were confirmed with CES and referred for surgery. Surgical treatment included all cases of laminectomy or lumbar discectomy. 60 patients reported CESR, 24cases of CESI and 36 cases of CESS. No statistical alteration in sex, age, alcohol comorbidities score and smoking by the time of surgery was noted. All patients with CESR and CESI showed a positive response in bladder and bowel dysfunction following surgery. There was no substantial change in the recovery of autonomic dysfunction associated with the time of surgery. <strong>Conclusions:</strong> Surgical decompression is an operative method of treatment that suggestively alleviates the symptoms of CES involved autonomic system. Early decompression by surgery 24 hours after start of symptoms does not seems to improve resolving of bladder or bowel dysfunction significantly</p> Ramesh Kumar Muhammad Faaiq Ali Shiraz Ahmed Ghouri Farrukh Zulfiqar Qazi Muhammad Zeeshan Muhammad Asim Khan Rehmani Copyright (c) 2022 Pakistan BioMedical Journal 2022-05-31 2022-05-31 59 62 10.54393/pbmj.v5i5.430 Correlation Between Mobility Restriction, Body Image Perception and Prosthesis Satisfaction Among Lower Limb Amputee Prosthesis Users <p>Amputation is known as the surgical removal of the body part. Amputation occurs as a result of many conditions. The most common reason is poor blood circulation which results in a result of narrowing or damage of arteries. <strong>Objective: </strong>To determine the correlation between mobility restriction, body image perception and prosthesis satisfaction among lower-limb amputee prosthesis users. <strong>Methods: </strong>This cross-sectional study was conducted on 63 participants after taking consent from IRB from University of Lahore. The data was collected from PSRD, Ghurki Trust Teaching Hospital of Lahore. Both males and female amputees were included with 18 to 60 years. Data was collected by using TAPES, Amputee body image scale and amputee mobility predictor assessment scale. <strong>Results:</strong> The results showed that the average age out of 63 amputees were 39.37. Female were 21 (33.3%) and male were 42 (66.7%). According to result people with below the knee amputation had more mobility (20.00), more satisfaction level (62.04) and less disruption of body image (18.15) in comparison with people who had above the knee level amputation (15.50, 68.50 and 16.50). The result showed that satisfaction level and mobility were directly correlated with one another but on the other hand inverse correlated relationship was seen of body image disruption with mobility and satisfaction level (P&lt;0.05). <strong>Conclusions:</strong> Based on these results, it was concluded that body image perception, mobility and prosthesis satisfaction are correlated to one another in people with lower limb amputation who uses a prosthesis<strong>. </strong></p> Farah Javaid Fareeha Amjad Syed Asadullah Arslan Ashfaq ` Ahmad Adnan Hashim Seemab Javaid Khadija Irfan Copyright (c) 2022 Pakistan BioMedical Journal 2022-05-31 2022-05-31 63 67 10.54393/pbmj.v5i5.363 Effects Of Physiotherapy on Strength, Range and Function in Children with Erb’s Palsy; An Experimental Study <p>Children who sustain brachial plexus injuries after birth face significant functional limitations due to a variety of sequelae affecting the shoulder, elbow, or forearm. These effects could be permanent or temporary. It is critical for proper joint development to maintain complete passive mobility while neurological function is being restored. Children with Erb’s palsy are more likely to have weak muscles, which can be found by ultrasonography <strong>Objective: </strong>To determine the effects of physiotherapy on strength, range and function in children with Erb’s palsy. <strong>Methods: </strong>It was a clinical trial conducted at physiotherapy department outpatient at General hospital Lahore. A sample of 46 children aged between 0-10 years, with the C5 and C6 lesion and with limited range of motion were included while children with any history of previous or recent trauma or surgery to upper limb and to the other roots of brachial plexuses was excluded. Modified Mallet scale and active movement scale was used as outcome measures. The coin toss technique of randomization was adopted, with 'Heads' assigned to strengthening exercises and 'Tails' assigned to general treatment. Independent sample test was employed to assess pre and post differences. Physiotherapy treatments included neurodevelopmental approaches to improve proprioception input, orthosis, and electrical current stimulation. Free weights, resistance bands and manual resistance were used in the strength training. The active range of motion was evaluated using goniometry, and a baseline measurement was generated using a modified mallet scale. The treatment was given every day for six months. Post-intervention measures were implemented two, four, and six months following the intervention. SPSS 25.0 was used for data analysis. <strong>Results: </strong>The finding showed that pre-interventional oxford scale muscle strength for experimental group showed the mean and standard deviation (1.434± 0.5068), control group (1.65± 0.48) while Oxford scale muscle strength post intervention showed the results with the mean and standard deviation for the experimental group 3.13± 0.54 and control group 2.65± 0.48 and showed significant <em>p value</em> less than 0.005. <strong>Conclusions:</strong> The study concluded that physiotherapy integrated approach improved upper limb strength, ranges and functional abilities in patients with Erb’s Palsy.</p> Sarwat Anees Hafiz Syed Ijaz Ahmed Burq Muniba Afzal Muhammad Asrar Yousaf Tooba Amin Muhammad Rizwan Copyright (c) 2022 Pakistan BioMedical Journal 2022-05-31 2022-05-31 68 72 10.54393/pbmj.v5i5.462 Evaluation of Attitude and Emotions towards Sudden Closure of Educational Institution during Covid-19 among Medical Student: A Cross-Sectional Survey <p>In reaction to an alarming increase in the number of infected cases and fatalities due to new coronavirus infections in 2019, all academic institutions, including primary and secondary schools, were closed. Objective: To assess medical students' attitudes and emotions concerning a sudden shutdown of an educational institution during COVID-19. Methods: After meeting the requirements for 139 patients, data was collected from medical students at The University of Lahore and medical students at Allama Iqbal Medical College in Lahore, and a Performa was affixed for this purpose. Convenient sampling was employed by employing a different questionnaire to collect data from public and private patients in order to obtain consent to proceed with this data Results: The mean and standard deviation for the achievement feelings questionnaire total score were found to be 80.76±4.128 on the histogram with a normal curve. The mean and standard deviation for achievement emotions questionnaire categorization were determined to be 67.30±3.44 on the histogram with a normal curve. The mean and standard deviation for the achievement emotions questionnaire good emotions were determined to be 79.47±6.039 on the histogram with a normal curve. The mean and standard deviation for achievement feelings questionnaire negative emotions were determined to be 55.88±3.801 on the histogram with a normal curve. Conclusions: In conclusion, children scored higher on positive emotions (31/40 versus 25/55, respectively). Students are typically delighted with the return of school activities, according to the study. This could be viewed as an indication of the student's future curiosity and drive to study. According to the findings of this study, aging has both an inverse and direct association with good and negative emotions.</p> Saniea Qaiser Hira Riaz Asadullah Arslan Ashfaq Ahmed Rabia Sana Copyright (c) 2022 Pakistan BioMedical Journal 2022-05-31 2022-05-31 73 78 10.54393/pbmj.v5i5.434 Evaluation of the Causal Factors of Complications Following Ileostomy Closure <p>To estimate the causative factors of complications in ileostomy reversal. This study was conducted at the Department of Surgery Khairpur Medical College Khairpur Mirs from January 2021 to December 2021. <strong>Methods: </strong>This analysis comprised 52 patients selected consecutively who underwent ileostomy reversal within one year. The study excluded patients under 12 years of age. All patients were followed weekly for three months. The main measure of outcome was the occurrence of surgical complications within 30 days of resolution. <strong>Results:</strong> 52 total patients of ileostomy closures were analyzed to evaluate features contributory to mortality and morbidity. There was no death in this study, but the complication ratio was 15.4% (8 patients), the most common complications were leakage of anastomosis 4 (7.7%), infection of wound 2 (3.8%) and intestinal obstruction 2 (3.8%). The anastomotic site closure technique, primary stoma closure, surgeon's experience and stoma type were important contributing factors. <strong>Conclusions:</strong> We determined that ileostomy closure is related with several problems but not cause any death. The techniques of closure of the anastomotic site, the surgeon's experience, the type of stoma and the technique of closure of skin were forecasters of complications</p> Zulfiqar Ali Shar Zahoor Hussain Siraj ud Din Iftikhar Ahmed Farman Ali Aijaz Hussain Memon Copyright (c) 2022 Pakistan BioMedical Journal 2020-05-31 2020-05-31 79 83 10.54393/pbmj.v5i5.444 Evaluation of Tumor Markers Among Patients with Hepatitis C Infection <p>Tumor markers are biomolecules found in blood, urine and tissue of individuals and, with particularly high concentration in most cancers, therefore, their concentration has diagnostic value. These markers may be used for screening, identification (type and stage), monitoring, and predicting prognosis. Increases in tumor markers are sometimes seen in patients with chronic liver disease without hepatocellular carcinoma (HCC). <strong>Objective: </strong>To determine the tumor markers, present among patients with Hepatitis C infection. <strong>Methods: </strong>From April 2021 to March 2022, serum samples from 700 HCV patients who presented to the Department of Pathology at the Pir Syed Abdul Qadir Shah Jeelani Institute of Medical Sciences, Gambat Khairpur Mirs, were used in this descriptive, cross-sectional study. Using the ACCESS-2 system, serum samples were analyzed for the presence of the specified tumor markers. <strong>Results: </strong>There was a significant increase in CA125 (P = 0.03) and AFP levels (P = 0.03). CA19-9, CEA, and CA15-3 levels in the blood were unremarkable (P &gt; 0.05). It is too early to say if the increase in CA125 or AFP will lead to eventual carcinoma based on this study, but it deserves further exploration using a longitudinal research methodology.<strong> Conclusion: </strong>CA125 and AF (P were the most common tumor markers found in HCV patients. Given the association of the aforementioned indicators with hepatic cancer, HCV patients with CA125 and AFP levels over normal should be considered high-risk.</p> Shameem Bhatti Ahmed Saeed Kanta Ahuja Khaleeque Memon Naseem Khatoon Bhatti Ghulam Qasim Ujjan Copyright (c) 2022 Pakistan BioMedical Journal 2022-05-31 2022-05-31 84 87 10.54393/pbmj.v5i5.475 Assessment of Microbiological Quality of Raw Milk and Identification of Pathogenic Bacteria <p>Milk contains important nutrients such as minerals, vitamins, proteins and lipids and are consumed by all age group of humans around the world. It is impossible to avoid contamination of milk with micro-organisms because presence of nutrients therefore quality of milk can be determined by the microbial content in milk. <strong>Objective:</strong> To investigate the microbiological quality of raw milk. <strong>Methods:</strong> In the present study, there were 30 cow milk samples collected from different dairy farms of Lahore. Firstly, a surf field mastitis test was performed for detection of clinical and sub-clinical mastitis. The microbial isolation was performed by microbial culturing and biochemical tests and antibiotic sensitivity test was performed for isolated bacteria. These isolated bacterial DNA was extracted and amplified by <em>16S rRNA</em> PCR. The precipitated amplicon was sequenced by <em>16S rRNA</em> sequencing. The results were evaluated statistically to check the level of significance among them. <strong>Results:</strong> The <em>Chi-square</em> values of catalase test, oxidase test, indole test, methyl red test, Voges Proskauer test and triple sugar iron were 12.42, 13.77, 8.77, 9.02, 10.67 and 4.29 respectively and the <em>p-values</em> were 0.034, 0.031, 0.042, 0.039, 0.044 and 0.056 respectively on MacConkey Agar. The <em>Chi-square</em> values of catalase test, oxidase test, indole test, methyl red test, Voges Proskauer test and triple sugar iron were 12.44, 11.98, 9.38, 7.02, 14.22 and 10.43 respectively and p-values were 0.034, 0.045, 0.039, 0.012, 0.022 and 0.053 receptively on Mannitol salt Agar. The <em>Chi-square</em> and <em>p-values</em> of gram staining bacteria were 13.99 and 0.034 respectively and showed the significant relationship among them. Mastitis test were presented the value of <em>Chi-square</em> 17.86 and <em>p-value</em> 0.029. The <em>ANOVA</em> table on DNA isolation method were exposed the highly significant relationship among the variables. <strong>Conclusions:</strong> There was a significant association between different treatments. Different pathogens can grow in milk and milk products and produce toxic metabolites. Products that are contaminated by these toxic metabolites when consumed may results in food poisoning</p> Anum Afreen Aqeela Ashraf Afeefa Chaudhry Copyright (c) 2022 Pakistan BioMedical Journal 2022-05-31 2022-05-31 88 93 10.54393/pbmj.v5i5.469 Effect Of Stress on Quality of Life in Patients with Chronic Rheumatoid Arthritis <p>Stress symptoms affect one’s body, thoughts and feelings. Stress may decrease an individual’s self-esteem, increasing anxiety and sadness, and adversely affecting the general quality of life (QoL) in rheumatoid arthritis (RA) patients. Objective: To determine the effect of stress on quality of life in patients with chronic rheumatoid arthritis. Methods: This cross-sectional study was conducted on 196 participants at The University of Lahore Teaching Hospital. Stress in RA patients was measured using a perceived stress score (PSS). PSS scores were calculated by inverting replies to the four positively stated items (items 4, 5, 7, and 8) and then accumulating all scale items (<em>e.g.,</em> 0 = 4, 1 = 3, 2 = 2, 3 = 1 &amp; 4 = 0). The SF-36 questionnaire was used to measure QoL. The lower the score, the greater the degree of impairment; for example, a score of zero equals maximum disability and a score of 100 equals no disability. A non-probability convenient sampling strategy was used to compute sample size. Results: The results showed that the average value of age was 44.14± 6.842 years with a lowest value of 32.00 and a highest value of 58.00 years. Male had a frequency of 13 (6.6%) and patients with a frequency of 183 (93.4%). According to the results, the average value of physical health component scoring was 37.12± 9.96 and the average value of mental health component scoring was 44.00± 5.738. The results showed that the average value of perceived stress score was 25.32± 7.47. The significant value of 0.000 was smaller than the <em>p-value</em> in the study, indicating that there is a link between stress and quality of life. Conclusion: These findings led to the conclusion that stress had an impact on RA Patient's quality of life.</p> Sumia Ahmed Ali Hira Riaz Asadullah Arslan Ashfaq Ahmad Maryam Iqbal Copyright (c) 2022 Pakistan BioMedical Journal 2022-05-31 2022-05-31 94 98 10.54393/pbmj.v5i5.452 Impact of Maternal Nutrition Education on Dietary Practices of School Going Children (3-6 years of age) <p>Nutrition (Nutritional) education is a kind of education that is important to improve the health status of people. School children are undergoing rapid mental and physical development. Therefore, an appropriate diet is critical throughout this stage of life to ensure normal and healthy growth. As a result, nutrition education should begin at a young age for children <strong>Objective: </strong>To evaluate the impact of nutrition education of mothers on the dietary habits of school-going children aged 3-6 years <strong>Methods: </strong>A Quasi-Experimental study was executed on 77 children of class playgroup to class 1 studying in the Government girl’s school of Garhi Shahu, Lahore. Firstly, anthropometric data were collected through the children and secondly socio-demographic and dietary knowledge of mothers of selected children were noted through pre-designed questionnaires and interview method. The mothers were then given 45 minutes of nutrition education and a dietary change course, and some informative dietary guidelines leaflets and a weekly healthy kid’s school lunch planner were given to the mothers which they were requested to implement in the daily routine of children. After three months again the anthropometrics and questionnaires were assessed and compared with the initial findings <strong>Results: </strong>After nutrition education, the percentage of children who followed the servings of healthy food groups and avoided consumption of harmful meals (fast, fried, processed foods), unhealthy beverages (carbonated drinks), and intake of fruits and vegetables increased dramatically. After the intervention, the percentage of children who followed recommended nutritional, lifestyle, and physical activity guidelines, as well as healthy school lunch practices, improved statistically significantly (P&lt;0.005). The percentage of children who skipped meals on daily basis was 20% decreased to 8%. Before the intervention, 63% of mothers say that their children consumed breakfast regularly and after the intervention, it increases to 75%. The children's anthropometric status improved significantly, with a P&lt;0.005 significance level <strong>Conclusions: </strong>In this study, nutrition education had a significant impact on the school-going children in their anthropometry measurements, healthy school lunch boxes, and awareness of their mothers about healthy eating practices. Seminars and camps should be arranged in schools to educate the mothers and the students at a young age regarding their health and healthy eating to reduce the nutritional deficiencies and diseases</p> Mamoona Zahid Shaista Jabeen Sidra Khalid Habib-ur- Rehman Maria Aslam Copyright (c) 2022 Pakistan BioMedical Journal 2022-05-31 2022-05-31 99 103 10.54393/pbmj.v5i5.290 Impact of Premenstrual syndrome on quality of life of working women <p>The premenstrual disorder is a typical psychosomatic disorder for women of reproductive age. It is an array of emotional, behavioral, and physical signs that happen all through the late luteal phase of the menstrual cycle and vanishes by it’s beginning <strong>Objective:</strong> To investigate the effect of premenstrual syndrome on the life of working women and their experience of tiredness and insight about the causes, effect and controlling of symptoms. <strong>Methods:</strong> This cross-sectional study included 170 working females and was completed in 6 months from July 2021-December 2021. Inclusion Criteria included the age of 20 to 40years. Exclusion Criteria included housewives and females having a systematic illness and autoimmune disorders. Premenstrual Syndrome (PMS) Scale and SF-36 were used. All patients were chosen using the purposive sampling technique. <strong>Results: </strong>Working women with PMS have decreased levels of work-related quality of life in their professional lives. The PMS score in working women 7.82% mild symptoms, 22.32% moderate, 16.13% severe symptoms, 3.17% very severe symptoms. <strong>Conclusions: </strong>PMS significantly influenced daily activities related to professional and personal lives. Valid conclusions were drawn that PMS had a great impact on working women with behavioral and psychological symptoms.</p> Anam Mahmood Noor Fatima Zunaira Rafaqat Atif Raza Arifa Shehzadi Copyright (c) 2022 Pakistan BioMedical Journal 2022-05-31 2022-05-31 104 107 10.54393/pbmj.v5i5.312 Methicillin-Resistant Staphylococcus Aureus (MRSA) Epidemiology and Antibiotics Susceptibility Profile Isolated from Different Clinical Samples in Tertiary Care Hospital <p><em>Staphylococcus aureus</em> is a versatile bacterium that causes a wide range of diseases in humans and animals. <strong>Objective:</strong> To determine the occurrence and antibiotic sensitivity profiles of Methicillin-Resistant <em>Staphylococcus aureus</em> (MRSA) isolates directly from the clinical samples. <strong>Methods:</strong> Individuals from various subgroups of the District Peshawar provided three different clinical specimens that are pus, body fluids and blood. Plasma, Macconkey and Cysteine Lactose Electrolyte Deficient agar (CLED) agar were used to prepare each specimen in the usual method. Gram staining test, catalase, and coagulase were used to identify and confirm <em>S. aureus.</em> The conventional "Kirby-Bauer disc" diffusion method was used to confirm MRSA antibiotic resistance patterns to several antibiotics. <strong>Results:</strong> A maximum of 750 diagnostic samples were evaluated and 50 (6.37%) were found to be positive for MRSA, with 33 (72%) coming from pus samples, 9 (19%) from fluid samples, and 6 (12%) from blood samples. Males had a higher prevalence of MRSA strains (69%) than females (31%). Most MRSA strains were completely resistant to different type of antibiotics <em>e.g.</em> penicillin, oxacillin, and ampicillin, while remaining completely susceptible to linezolid, teicoplanin, &amp; vancomycin. Other anti-microbials to which MRSA strains were resistant are ceftriaxone (78.88%), cefoxitin (65.55%), erythromycin (83.33%), clindamycin (72.22%), co-amoxiclav (76.66%), fusidic acid (67.77%), and gentamycin (83.33%) (74.4%). <strong>Conclusions:</strong> This study found that the frequency of MRSA in Pakhtunkhwa is lower in comparison to that reported in other regions of Pakistan. Moreover, because MRSA is multi-drug-resistant, culture sensitivity testing should be conducted to determine the best antibiotic to use to treat MRSA infection</p> Wajid Ali Shah Zaman Zakia Subhan Abdur Razaq Muhammad Nabi Maria Khattak Nabiha Naeem Dua-E-Jamila Khurrum Sudhair Abbas Bangash Irfan Ullah Copyright (c) 2022 Pakistan BioMedical Journal 2022-05-31 2022-05-31 108 112 10.54393/pbmj.v5i5.455 Occurrence and Distribution of Diabetes Mellitus in Mardan, KPK Pakistan <p>Diabetes Mellitus (DM) is a metabolic disorder which is described by chronic hyperglycemia due to faulty insulin secretion. Metabolism of lipids, carbohydrates and proteins are disturbed in DM <strong>Objective:</strong> To assess the occurrence and distribution of diabetes mellitus in Mardan, Pakistan <strong>Methods:</strong> It is a cross-sectional, survery-based study conducted at District Headquarter Hospital Mardan, Khyber Pakhtunkhwa. The detailed information about age and gender of the patients was collected. Blood glucose level was detected by Glucose oxidase test. <strong>Results:</strong> The overall prevalence of DM was found as 50.4%. DM was found dominant in females (52%) as compared to males (48%). Moreover, the age groups of 30-40 years were most affected. Fasting blood sugar (FBS) range was high in the age of 10-20 years and Random blood sugar (RBS) range was high in the age of 40 years and above.<strong> Conclusions:</strong> It is concluded that DM is most commonly found in females and the age group of 30-40 years is more affected. FBS range was high in the age group of 10-20 years and RBS range was high in the age of 40 years and above</p> Huma Fatima Ayesha Bibi Asma Ashraf Nargis Shaheen Miss Laiba Fawad Ali Copyright (c) 2022 Pakistan BioMedical Journal 2022-05-31 2022-05-31 113 117 10.54393/pbmj.v5i5.313 Patient Satisfaction Referred to Physical Therapy After One Week Management of Mechanical Low Back Pain <p>The degree to which a patient is content with the health treatment he or she receives is characterized by patient satisfaction with health care. Patient satisfaction necessitates a match between expectations and outcomes. <strong>Objective:</strong> To determine the satisfaction level of patients with treatment of physiotherapy for mechanical back pain patients. <strong>Methods:</strong> This study was a cross-sectional survey that was conducted on a sample of 100 patients with chronic low back pain (LBP). Non-probability convenient sampling technique was used using predefined inclusion and exclusion criteria. A patient satisfaction questionnaire was used to assess the level of satisfaction among these patients with the therapy they received for their LBP after they signed an informed consent form. <strong>Results:</strong> Patients with acute LBP were satisfied with the communication, technical quality, and overall satisfaction with their therapy, but not so much with the financial element or interpersonal style. Communication and overall satisfaction were high among patients with persistent low back pain, but the financial and technical quality was low. Male patients were satisfied in terms of communication, time spent with a physical therapist, and general satisfaction and were relatively less satisfied with financial aspects and accessibility and convenience in terms of treatment. Female patients were satisfied in terms of accessibility and convenience, communication, and general satisfaction and were relatively less satisfied with the financial aspect and technical quality in terms of the treatment they received for LBP <strong>Conclusions:</strong> Overall patients were satisfied in terms of communication, time spent with physical therapists. However, patients were relatively less satisfied with the financial aspect and interpersonal manner in terms of the treatment they received for LBP.</p> Amirah Zafar Umar Sadiq Sobia . Hafeez Bibi Shakeela Rasheed Saad Kamal Akhtar Copyright (c) 2022 Pakistan BioMedical Journal 2022-05-31 2022-05-31 118 121 10.54393/pbmj.v5i5.428 Pattern and Outcomes of Traumatic Brain Injury (TBI) In Pediatric Patients <p>Traumatic brain injury (TBI) is the leading cause of mortality and permanent impairment in children. <strong>Objective:</strong> To investigate the pattern and outcomes of TBI in pediatric patients. <strong>Methods: </strong>A descriptive cross-sectional study was conducted at Holy family Hospital Rawalpindi from June 2021 to February 2022 in the Department of Emergency. We included 141 children with no prior history of neurological deficits, who had a CT scan immediately following their presentation. All children were monitored throughout their hospital stay to determine the in-hospital mortality and any neurological deficits. SPSS Version 24 was used for data analysis. <strong>Results: </strong>Male patients were 86 (61%). The majority of patients were between the ages of 5 and 10 years. There were 35 male patients and four female patients who were involved in a road traffic accident. Only 20 of the patients who had hypotension on admission showed recovery. The p-value was significant in 46 hypotensive patients out of which 23 died. The hospital had to treat 11 patients who had been hospitalized for more than a month. Only 31 of the 96 patients with depressed mentation had surgery, compared to other patients with no neurological deficit. <strong>Conclusions: </strong>TBI in pediatric patients was affected by gender, age, time of arrival after injury, and presenting conditions in our study. More needs to be done in the area of public health. The hospital and perhaps the country would benefit from a trauma registry system.</p> Iqra Saghir Iftikhar Hussain Bilal Jahangir Syed Zohaib Raza Mohammad Hasan Ume Farwa Bukhari Hamza Amin Copyright (c) 2022 Pakistan BioMedical Journal 2022-05-31 2022-05-31 122 126 10.54393/pbmj.v5i5.429 Quality of Parent-Child Relationship, Emotional Regulation and Interpersonal Difficulties in University Students <p>Studies considered parent-child attachment a significant relationship that can have a great impact an adult’s life. However, despite the parent-child attachment, the quality of the parent-child relationship is important, which has a significant impact on children’s emotional, physical, and mental health. <strong>Objective</strong>: To find the relationship between the quality of the parent-child relationship and interpersonal difficulties with emotional regulation in university students. <strong>Methods: </strong>The Correlation research design was used for the quantitative method in the study. The study was carried out on 300 university students (males and females) with the age range of 18 to 25 years selected through stratified random sampling from private and government universities. <strong>Results:</strong> The quality of the parent-child relationship was observed to be a positive sign of emotional regulation and interpersonal difficulties in students. The current research also reveal that a negative or less satisfying relationship with their parents result in more issues regarding their emotions and relationships. <strong>Conclusions:</strong> Less satisfying parental relationships leads to various problems of psychological and social health of individuals.</p> Asma Rafiq Aasma Yousaf Taiba Afzal Kianat Imdad Asma Hameed Iqra Batool Copyright (c) 2022 Pakistan BioMedical Journal 2022-05-31 2022-05-31 127 132 10.54393/pbmj.v5i5.453 Results Of Anterior Fixation for Subaxial Cervical Injuries in A Tertiary Care Centre <p>Sub-axial injuries of cervical spine involving posterior ligaments, articular facets and pillars are communal, and surgical treatment is debatable, and studies describe variable consequences from combined access of anterior and posterior approach or separately <strong>Objective:</strong> To assess the outcome of early (&lt;72 hours) anterior cervical discectomy and fusion with plating for injuries of the sub-axial cervical spine. <strong>Methods:</strong> A retrospective analysis, from January 2018 to December 2020 was conducted in a tertiary care referral center. 110 patients (67 male, 43 females; mean age 51.1 years; range 19-80 years) who endured anterior cervical discectomy (ACD) at single-level and fusion (ACDF using a polyetheretherketone, (PEEK, cage) with plate fixation for injuries of sub-axial cervical spine were evaluated. Radiological evaluation was done considering fusion, segmental height (SH), advancement of adjacent segment disease (ASD) and lordosis (Cobb Angle). Clinical results were evaluated by means of visual analogue scale (VAS) for neck pain and Frankel Grading for neurological function <strong>Results:</strong> The cervical trauma was instigated by road traffic accident (RTA) in 69 cases, slip down in 16 cases and a fall from a height in 25 cases. Simple lateral cervical X-rays and CT with reconstruction were taken in all subjects and showed dislocation or subluxation of C3 to C4 in 15 patients, 39 patients with C4 to C5 dislocation, 32 patients with C5 to C6 dislocation and C6 to C7 in 24 patients. The preoperative mean Cobb angle was -3.9 ± 8.01 °. 4.1 ± 6.6 ° was the mean Cobb angle instantly later to treatment and 1.8 ± 4.7 ° at the final visit. The operation brings a substantial decrease in the regional kyphotic angle (p &lt;0.05). The SH mean before surgery was 37.01 ± 1.9 mm. The SH mean was 41.2 ± 1.9 mm instantly after operation and 37.9 ± 1.9 mm at the final visit. The mean rise in height at the end of observation was 0.9 mm. The variance between pre-operative SH measurements and final SH was significant (p &lt;0.05). An improvement of VAS from 8.4±1.01 to 2.8±1.6 at 12 months was statistically significant. There was also an improvement in 19.1% of cases for at least one Frenkel grade at 12 months follow-up. <strong>Conclusions:</strong> The fusion with a PEEK cage and the fixation with anterior cervical plate resulted in satisfactory clinical results and high fusion rates deprived of any morbidity at the donor-site. This procedure is effective and safe for single-level sub-axial injuries of the cervical spine</p> Shiraz Ahmed Ghouri Farrukh Zulfiqar Muhammad Asim Khan Rehmani Ramesh Kumar Muhammad Faaiq Ali Qazi Muhammad Zeeshan Copyright (c) 2022 Pakistan BioMedical Journal 2022-05-31 2022-05-31 133 137 10.54393/pbmj.v5i5.431 Role of Computed Tomography in The Evaluation of Focal Liver Lesions <p>The liver lesions have marked differences across geographic regions and ethnic groups. In order to avoid inappropriate diagnosis and unnecessary surgery, Computed Tomography (CT) being a non-invasive imaging modality and with high sensitivity, provides better detection and distinguishing benign from malignant focal liver tumor lesions. <strong>Objective: </strong>To determine the role of Computed Tomography in the evaluation of focal liver lesions. <strong>Methods: </strong>A descriptive study was conducted at Government Kot Khawaja Saeed Teaching Hospital, Lahore, Pakistan. A sample size of 124 patients of both genders, age ranging from 22-90 years were enrolled in this study with a convenient sampling technique. Pregnant females and patients having renal insufficiency were excluded. The variables used to obtain data were: Age, Gender, Presenting complex clinical risk factors, CT findings, and other diagnoses. Toshiba Aquilion 16 CT scanner with KV 80-135 and MAs 500 was used. Injections of 1.5ml/kg IV contrast were given to patients, with a total dosage of 80-100ml at 4.5ml/sec through an 18G intravenous catheter. After contrast injection liver was scanned at 3 different time points or phases. All of the factors mentioned above were documented and kept in each patient's individual case record form (CRF). Data was gathered during the time frame specified. To examine the acquired data and arrange and compile the results, the statistical tool SPSS version 24 was used. Descriptive statistics and a <em>Chi-square</em> test was applied to check the comparison. <strong>Results: </strong>Among 124 individuals, 77 (62.1%) individuals were males, and 47 (37.9%) individuals were female. Average age of patients was 53.85±13.50 years. Multiple lesions were observed in 79 (63.7%) individuals had multiple lesions while 45 (36.3%) individuals had a single lesion. 94 (75.8%) individuals had malignant lesions while 30 (24.2%) had benign lesions. Lesions were more common in males than in females. The most common presenting complex clinic risk factor was hepatitis C virus with 45 individuals (36.3%) with Hepatitis C +ve. The most common CT finding was Hepatocellular Carcinoma with 41(33.1%). <strong>Conclusions: </strong>The study concluded that Computed Tomography being a non-invasive imaging modality and with high sensitivity, provides better detection and differentiation between benign and malignant focal liver lesions.</p> Amina Arif Aruj Latif Asif Ishaq Mehreen Fatima Syed Muhammad Yousaf Farooq Awon Abbas Malik Manahil Saleem Rifat Abbas Umair Farooq Bhatti Copyright (c) 2022 Pakistan BioMedical Journal 2022-05-31 2022-05-31 138 142 10.54393/pbmj.v5i5.454 The Effects of Resistance Training For 12 Weeks on Serum Calcium, Phosphorous and Parathyroid Hormone Levels of Urban and Rural Children <p>Resistance Training (RT) is considered as an integral component of a comprehensive physical activity program for children and healthy adults and has shown to be an important component for the development of bone strength by improving their muscular power, nerve conduction, and deposition of minerals and maintenance of body balance. <strong>Objective: </strong>To determine the effects of resistance training on the mineral content of bone in children aged 11-14 years boys. <strong>Methods: </strong>Volunteer young boys between the ages of 11 to 14 years, 30 each from rural and urban setting of district Peshawar were recruited. Calcium, phosphorus, parathyroid hormone (PTH) and anthropometric parameters were measured before and after three months of resistance training. <em>Paired sample </em><em>t-test</em> was used for changes over time. <strong>Results: </strong>The study found that there was a significant effect of resistance exercise on participant’s serum calcium level (8.44± 0.582 <em>vs.</em> 10.24± 0.786, <em>p value&lt;0.001),</em> phosphorous (3.82± 0.265 <em>vs. </em>4.59± 0.271, <em>p value&lt;0.001)</em> and PTH (20.37± 4.620 <em>vs</em>. 29.20± 6.099, <em>p value&lt;0.001)</em> in experimental group. <strong>Conclusions:</strong> Resistance training has an effective role in the increase of calcium, phosphorus and PTH and anthropometric measurements</p> Ghulam Mustafa Abdul Waheed Mughal Inayat Shah Tasleem Arif Maryum Mustafa Abbasi Copyright (c) 2022 Pakistan BioMedical Journal 2022-05-31 2022-05-31 143 147 10.54393/pbmj.v5i5.465 The Morbidity Patterns of Children with Severe Malnutrition <p>Malnutrition is a widespread problem worldwide <strong>Objective:</strong> To identify the morbidity patterns of children with severe acute malnutrition <strong>Methods:</strong> A cross-sectional study was conducted in the Pediatric Unit-II of Abbasi Shaheed Hospital for a six-month duration from July 2021 to December 2021. Children aged 1 to 60 months with severe acute malnutrition (WHZ score &lt;-3 SD) were selected. All patients were assessed for clinical symptoms, various disease states such as metabolic abnormalities, infections, congenital/hereditary anomalies, and outcomes such as left against medical advice (LAMA), stabilization, or death on discharge. Data was analyzed and collected using descriptive statistics in SPSS version 17. <strong>Results:</strong> A total of 150 children were admitted according to the admission criteria. The number of males was 85 (56.7%) and females 65 (43.3%), and the male to female ratio was 1.4: 1. 120 (80%) had severe wasting without edema and 30 (20%) had malnutrition with edema. The average length of stay was 10 + 3.6 days. The main incidence in children with MAS are diarrhea (46.7%), pneumonia (18.7%), sepsis (15.3%), and other diseases such as meningitis 5(3.3 %), severe skin infections, 7(4.7%), urinary tract infections 9(6%), and eye lesions due to vitamin A deficiency 2(1.3%). 13 (8.7%) patients had measles with diarrhea and pneumonia. Acute watery diarrhea was observed in 68(45.3%) of diarrhea cases. 21 (14%) children had congenital or hereditary defects. 9 (6%) had central nervous system disorders. <strong>Conclusions:</strong> The spectrum of incidence in hospitalized children with severe malnutrition includes both congenital or hereditary defects and infections. The sepsis and diarrhea with metabolic disturbances mainly contributed to the mortality.</p> Riffat Farrukh Shaheen Masood Qamar Rizvi Ibrahim Shakoor Sarwat Sultana Sultan Mustafa Copyright (c) 2022 Pakistan BioMedical Journal 2022-05-31 2022-05-31 148 152 10.54393/pbmj.v5i5.433 The Splenic Artery and Segmental Branches Morphometric Study in Humanoid Cadaver Spleens by Method of Dissection <p>Human spleen has various functions including immune system regulation and haematopoisis. The spleen is an extremely vascularized and fragile organ. It is the second major lymphatic organ, containing 25% of lymphoid tissue in the body, and has haematologic and immunologic roles. <strong>Objective: </strong>To understand the segmental branches morphometry of the polar and splenic arteries. <strong>Methods:</strong> The analysis was performed on 86 spleens collected from adult human cadavers of not known gender, stored in 10% formalin solution. In the Department of Anatomy, Mohi-ud-Din Islamic Medical College (MIMC), Mirpur, Azad Jammu &amp; Kashmir and Women Medical and Dental College Hospitals, Abbottabad for six- months duration from July-December 2021 <strong>Results:</strong> In 59 (68.6%) spleen samples; there were 2 primary branches, 23 (26.7%) samples had three primary branches, and 4 (4.7%) specimens had four primary branches. 20 (23.3%) samples had superior polar arteries, 34 (39.5%) had inferior polar arteries, and both inferior and superior polar arteries in 7 (8.1%) samples. The inferior polar artery length ranged from 0.9-5.90 cm, with 3.17 cm of average length and 3.30 cm median length. The superior PB diameter ranged from 0.8-4.12 mm, with 2.20 mm average length and 2.4 mm median length. The mean diameter of middle PB ranged from 0.8 mm to 3.6 mm, with an average of 2.10 mm and 2.4 mm median length. The superior polar artery diameter ranged from 0.5-3.1 mm, with 1.40 mm average length and 1.4 mm of median. The inferior polar artery diameter varies from 0.5-2.9 mm, with 1.3 mm of an average diameter with 1.4 mm median. <strong>Conclusions:</strong> As various splenic sparing surgeries depend on a better information of the vascular anatomy of the spleen, this analysis enhances the current information about the segmental branches’ morphometry of the splenic artery.</p> Atif Hussain Sarah Yunus Nida Qasim Hayat Abdul Hafeez Baloch Abdul Rashid Copyright (c) 2022 Pakistan BioMedical Journal 2022-05-31 2022-05-31 153 156 10.54393/pbmj.v5i5.461 Frequency Of Abnormal Pap’s Smears in Patients with Vaginal Discharge <p>Cervix malignancy is one of the common types of cancer all across the globe. Among all the types of cancers in females, cervical cancers are the major cause of mortality. The detection and management of these types of cancers are necessary. One of the easiest tests is Pap’s smear which is a rapid and painless screening test for detection of cervical dysplasia or cervical malignancy. <strong>Objective:</strong> To calculate the current magnitude and most frequent abnormal Pap’s smear in the female population of Sindh, Pakistan, and to determine the frequency of abnormal Pap’s smears in patients with vaginal discharge. <strong>Methods: </strong>It was descriptive cross-sectional research conducted for six months in department of Obstetrics &amp; Gynecology Unit, Civil Hospital Karachi from November, 2017 to May, 2018. A total of 214 women with vaginal discharge were included in this study. Demographic variables and history of previous pelvic or abdominal surgery was recorded. All enrolled women underwent examination of cervix and cell sample was obtained with Ayr’s spatula for pap’s smear and evaluated <strong>Results: </strong>The average age of the women was 34.86 years, frequency of abnormal pap’s smears in patients with the vaginal discharge was observed in 4.67% (10/214) cases. Out of 10 cases, infection was observed in 8 women and 2 patients exhibited dysplasia. The frequency of abnormal Pap’s smears in patients with vaginal discharge was found to be low but the complaint of vaginal discharge was very common. <strong>Conclusions:</strong> It was concluded that factor such as increasing age, low socioeconomic status and high parity were the contributory factors for the vaginal discharge. So, there must be raised awareness among females about their reproductive system and self-concern for their own health</p> Najm Us Sehar Sana khan Ana Mehreen Rajput Ume Farwa Nusrat Shah Saba Naz Copyright (c) 2022 Pakistan BioMedical Journal 2022-05-31 2022-05-31 157 161 10.54393/pbmj.v5i5.448 Hepatoprotective and Anti-inflammatory Potential of Crude methanolic extract of Euphorbia pilulifera via NF-KB/Nrf2/Akt/TGF-β1 pathway <p>Liver fibrosis is a natural process that initiates after liver injury to repair the damaged tissue. The liver has a significant capacity for self-repair of the damaged tissue. To a great extent, the miscellaneous interactions of immune cell subtypes manage these repair procedures like fibrosis and wound healing. <strong>Objectives:</strong> To assess the hepatoprotective and anti-inflammatory potential of <em>Euphorbia pilulifera</em> through modulating the NF-KB/Nrf2/AKT/TGF-β1 pathway.<strong> Methods:</strong><em> Euphorbia pilulifera </em>methanolic extract was primarily assessed for its cytotoxic potential against HepG2 cells. Methanolic extract of<em> E. pilulifera</em> showed 90% hepatoprotective activity against CCl<sub>4</sub>- induced toxicity in HepG2 cells. The methanolic extract downregulated the NF-κB gene by 90%; the AKT, gene by 14%, and the TGF-β1 gene expression by 69% at the concentration of 50µg/ml at the mRNA level. On the other hand, methanolic extract of <em>E. pilulifera </em>increased the expression of the Nrf2 gene by 44% at 50µg/ml concentration. Furthermore, the antioxidant activity of leaves extract through DPPH radical scavenging assay was estimated. <strong>Results:</strong> Methanolic extract showed 50.83± 0.39% inhibition against DPPH radicals at 200µg/ml concentration. In addition, the anti-inflammatory potential of the crude extract was assessed. The methanolic extract at 25µg/ml concentration revealed the maximum percentage of hemolysis protection. The methanolic extract was found highly effective against inflammation and hepatotoxicity. <strong>Conclusions:</strong> <em>Euphorbia pilulifera</em> leaf extract has the potential to ameliorate hepatic injury and inflammation in HepG2 cells.</p> Ammara Shams Koloko Brice Landry Faiza Shams Somayya Tariq Ayesha Azeem Hamza Anjum Noreen Latief Kausar Malik Bushra Ijaz Copyright (c) 2022 Pakistan BioMedical Journal 2022-05-31 2022-05-31 162 167 10.54393/pbmj.v5i5.487 Factors Affecting Contraceptive Behavior Among Young Married Couples <p>Improving reproductive health is central to achieving the Millennium Development Goals on improving maternal health, reducing child mortality and eradicating extreme poverty. This requires that married couples should understand and adopt safe and effective methods of fertility control. <strong>Objective: </strong>To study the contraceptive behavior of young married couples presenting to fertility and contraceptive clinic – Dept. of Obstetrics &amp; Gynecology, Liaquat University Hospital, Hyderabad. <strong>Methods:</strong> 100 young married couples with age in between 18 to 25 years were enrolled (chosen via non-probability - consecutive sampling) for this cross-sectional analysis. After taking written informed consent, data was collected using an anonymous, self-structured, interview based questionnaire comprising of inquiring regarding basic biodata and sociodemographic details. Detailed history of marital relations, contraceptive knowledge and behavior along with complaints regarding self-perceived barriers to contraceptive use were noted. The data obtained was analyzed using SPSS version.21 &amp; Microsoft Excel 360. <strong>Results:</strong> Active contraceptive practice at the time of survey was 31.5% and the only known contraceptive behavior among the couples were either oral contraceptive pills, condoms or abstinence method. Contraceptive practice was more common among more educated individuals, with higher socioeconomic status and those living in a nuclear family and already having at least 1 male child. Contraceptive use was less reported in couples early after their marriage and use was more frequent in later years. <strong>Conclusions: </strong>There is a dearth of knowledge among young married couples regarding more modern methods of contraception and the contraceptive practice is rather limited. The perception towards contraceptive too can be improved through proper education.</p> Muhammad Ilyas Siddiqui Farah Liaquat Nazia Memon Khalil Kazi Samreen Aijaz Saba Bashir Copyright (c) 2022 Pakistan BioMedical Journal 2022-05-31 2022-05-31 168 171 10.54393/pbmj.v5i5.491 Determination of Human Stature from Foot Dimensions in Peshawar <p>One of the accepted methods for identifying unknown individuals is estimating their Stature from the body components and remnants. <strong>Objective:</strong> To establish regression formulas for determining stature from foot dimensions in Peshawar. <strong>Methods: </strong> The study was carried out in Jinnah medical college Peshawar from March 2021 to August 2021 consisting of 62 males and 72 females a total number of individuals was 135, and the age range was between 17 to 55 years. Age, Stature, Foot length, and the width was measured. <strong>Results:</strong> The stature, foot width, mean age, and foot length were 30.23, 1835.248.11 mm, FL=272.553.20 mm, FW = 85.00 1.0 mm for males and for females 28.05, 1734.556.52 mm, FL = 234.67 2.08 mm, FW = 77.11 0.64 mm. Males stature (r = 0.70, p 0.01) had the highest correlation with foot length (r = 0.61, p 0.01) than females (r = 0.61, p 0.01). The female’s regression formula for stature is St =3.428 FL+1120 and Stature =3.538+1522.2 while for male it was St = Stature = 4.2129 FL +100.52 and Stature 5.2106 FW +1686.4. <strong>Conclusions:</strong> For determining stature, the foot length is more reliable. in Peshawar Pakistan.</p> Zahid Sarfaraz Khan Fatima Daud Syed Abdul Basit Syeda Gulrukh Saba Shah Wajahat Hassan Hina Mir Sudhair Abbas Bangash Muhammad Sohail Afzal Irfan Ullah Copyright (c) 2022 Pakistan BioMedical Journal 2022-05-31 2022-05-31 172 175 10.54393/pbmj.v5i5.450 Glycated Albumin's Clinical Effectiveness in The Diabetes Diagnosis <p>In places like Asia, the use of Glycated Albumin (GA) as a diabetes diagnostic marker has increased in recent years. Glucophage (GA) has been shown to be effective in the diagnosis of diabetes in asymptomatic people who have medical records and rising blood glucose levels that indicate a high risk of acquiring diabetes. <strong>Objective: </strong>To find out the impact of glycated albumin in the diagnosis of diabetes mellitus. <strong>Methods: </strong>This study included a total of 250 participants including one or even more diabetes risk factors or Fasting Plasma Glucose (FPG) varying from 5.6 molar ratio to 6.9 molar ratio but no symptoms of diabetes. The lab Taurus device was used to assess plasma GA using an enzymatic technique. <strong>Results</strong>: Among the patients, 20(6.9%) had <em>HbA1c</em> greater than 49 molar ratio. As per the outcomes, GA's diagnosed diabetic participants with a sensitivity of 73.6% (95% confidence interval: 44.4 – 92.4) and a specificity of 74.5% (95 % confidence interval: 44.4 – 92.4) at a cut-off of 15% (Area under the <em>ROC curve</em>: 0.79; 96%, CI: 0.79-0.99; <em>P≤ 0.01</em>), which corresponds to the better diagnostic performance. At different cut-offs for diabetes diagnosis, the specificity and sensitivity of GA are examined. The 14.2% cut-offs were linked with greater sensitivity (89.5%; 96%, CI: 59.2 – 89.5) and adequate specificity (63.6%; 95%, CI: 52.9 – 66.5), making it more appropriate for screening at-risk individuals. <strong>Conclusions: </strong>This research proves the clinical efficacy of GA for diabetes diagnosis participants at risk for the disease. Further investigation is required to evaluate the relative relevance of GA in relation to the other diabetes screening indicators</p> Summeira Jabeen Shah Hajira Ishaq Hina Hakeem Saima Shaheen Sikandar Ali Khan Sosan Rauf Hina Mir Sudhair Abbas Bangash Muhammad Ali Irfan Ullah Copyright (c) 2022 Pakistan BioMedical Journal 2022-05-31 2022-05-31 176 181 10.54393/pbmj.v5i5.449 The Significance of Hematologic Indices in Patients with Heart Failure <p>The leading cause of death worldwide is coronary heart disease (CHD). In patients with chronic heart failure, hemographic markers have been associated with clinical outcomes. Hemographic indices, or measures of white blood cells, are easy and useful, clear and simple predictors of both subclinical and systemic inflammation. <strong>Methods:</strong>A retrospective study was conducted on the hospitalized patient for HF from April 2019- May 2020. Total 170 patients were enrolled in current study. The inclusion criteria of the study was patients above 18 years, hospitalized patient for HF, having an EF&lt; 40% and having two or more symptoms of HF as well as be discharged alive from the hospital. The hemograhic indices were taken for each patient at the time of admission. The hemographic indices were defined as WBC count, neutrophil count, RL, NLR, and PLR. The neutrophil-platelet ratio (NLR) and the platelet-lymphocyte ratio (PLR) were derived as the ratios of neutrophil and platelet counts to lymphocyte counts, respectively. The entire test was performed by the hospital biochemistry lab under standard protocol. Patients were followed till six months. At the time of admission complete medical history and hemographic indices was recorded. Data was entered and analyzed using SPSS 25.0. The quantitative variables were presented by mean and standard deviation and qualitative with frequency/percentages. All the qualitative variables were compared among both by using Chi-square test and all quantitative variables by independent sample t test. The p-value less than 5% were considered as significant. <strong>Results:</strong>Total 170 patients were enrolled in current study among which 123(72.3%) survived and 47(27.64%) were died during 6 month follow up. The mean age among survived were 57.55<u>+</u>7.5 and dead was 59.96<u>+</u>7.9 (P-value= 0.06). According to gender male have dominance, in survived patients there were 98(79.7%) and in dead 38(80.9%) males (P-value= 0.86). 53(43.1%) patients were smokers in survived patients and 27(57.4%) in dead (P-value= 0.09). Status of comorbidities showed that the diabetes mellitus showed quite common among groups. The neutrophil count, WBC, lymphocyte count and NLR were elevated in deceased patients. The Platelet counts and hemoglobin levels were low in deceased. <strong>Conclusion: </strong>It was concluded from current study that the increased neutrophil count, WBC, lymphocyte count and NLR were associated with the mortality of HF patients</p> Mohsin Shabir Ikram ul Haq Humaira Achakzai Ahsan Shabir Muhammad Kashif Iltaf Naseer Ahmed Copyright (c) 2022 Pakistan BioMedical Journal 2022-05-31 2022-05-31 182 185 10.54393/pbmj.v5i5.421 Sonographic evaluation, prevalence and differential diagnosis of renal cyst <p>Renal cysts are a common finding on routine ultrasound scans. Renal cysts are easily detected with ultrasound, with its low cost, non-invasiveness and no exposure to radiation, ultrasound is an exceptional method for primary evaluation of patients with cystic lesions. Most cysts detected by chance and are benign, but they can become complex if infection, bleeding, or ischemia occur. <strong>Objective:</strong> To assess the prevalence of renal cysts and find relationship with age and sex in the study group and to outline the differential diagnosis of renal cyst by ultrasonography. <strong>Methods: </strong>This was a cross-sectional descriptive study. An ultrasound examination was performed on 109 patients who were diagnosed with renal cysts. Cystic wall thickness, form, number of cysts, and acoustic enhancement were employed as sonographic criteria for evaluating renal cysts. <strong>Results:</strong> The incidence of renal cysts were more in females than in male s(52.3% <em>vs</em>. 47.7%). The majority of the cysts were solitary than multiple (69.7% vs. 30.3%). Most of the cysts were at lower pole cortical cysts (22.9%). Simple cyst was the most common type (90.8%), autosomal-dominant polycystic kidney disease (ADPKD) was 6.4%. 59 patients were asymptomatic and 50 patients were symptomatic with flank pain as the most common symptom. <strong>Conclusions: </strong>Simple cysts are the most frequently found kidney cysts on ultrasound. Aging and hypertension were common risk factors related with renal cysts. End-stage renal failure is caused by ADPKD, which is the most prevalent genetic cause. Diagnosis and early detection of renal cyst is important, routine ultrasound scans for adults is advisable prior to getting any serious complication.</p> Sunaina Ali Maniha Nauman Minahil Saleem Ms. Iqra Manzoor Dr. Iqra Ramzan Dr. Mehreen Fatima Copyright (c) 2022 Pakistan BioMedical Journal 2022-05-31 2022-05-31 186 189 10.54393/pbmj.v5i5.426 Comparison between Static Stretching Exercises and Eccentric Muscle Energy Techniques in Upper Cross Syndrome: Randomized control trial <p>Neck pain is the most common complaint and Cervical pain is more common in middle-aged women than in males. The most prevalent reason for patients to seek medical attention is neck pain. <strong>Objective:</strong> To identify the effectiveness of stretching and muscle energy techniques along with mobilization of cervical segment in the management of upper cross syndrome.<strong>Methods:</strong> The randomized controlled experiment took place from August 2018 to January 2019 at Benazir Bhutto Orthopedic and Rehabilitation Centre in Pakistan (Rawalpindi) and included patients with upper cross syndrome that were randomly consigned to two equal groups using a lottery system. The Group-A patients management is eccentric muscular energy therapy with cervical segmental mobilization, although Group-B patients treatment protocol is static stretching exercises accompanied by segmental mobilization of cervical spine . Each patient received two sessions each week for three weeks, during which their visual analogue scale, and neck disability index were measured. An inclinometer was used to measure the cervical passive range of motion. Data was collected at the commencement of the study and again after three weeks of treatment. SPSS 21 was used to analyze the data. <strong>Results:</strong> Twenty (20%) of the 40 individuals were in each of the two groups. The average age in Group-A was 42.7511.13 years. It remained 40.509.14 years in Group-B. On all metrics, the eccentric muscular energy technique and static stretching approach equally demonstrated substantial results that is P Value is less than 0.05.<strong>Conclusion:</strong> Both approaches were shown to be equally successful in lowering neck impairment, enhancing cervical range of motion, and decreasing pain</p> Asima Irshad Muhammad Fahad Khan Mehwish Khan Kaniz Rabia Javeria Aslam Ibraheem Zafar Ramsha Masood Iqra Naz Maimoona Aslam Ammanullah Nazir Copyright (c) 2022 Pakistan BioMedical Journal 2022-05-31 2022-05-31 190 194 10.54393/pbmj.v5i5.490 Comparative Effect of Muscle Energy Techniques and Mulligan Mobilization on Pain & Range of Motion in patients with Mechanical Neck Pain <p>Mechanical cervical pain starts at the back of the head and moves down the neck to the lower cervical spine and shoulders. Vertebral arrangements are interrupted with this condition, and the joints of the cervical spine and ribs perform abnormal biomechanical movements, resulting in diminished mobility and pain. <strong>Objective:</strong> To compare the effectiveness of Muscle Energy Techniques (METs, Post-isometric relaxation) with Mulligan Mobilization (Natural Apophyseal Glides, NAGs) in subjects with Mechanical Neck Pain <strong>Methods</strong>: It was a Randomized Controlled Clinical Trial. Sixty patients are allocated in 2 groups: A and B with 30 patients in each group with age limit from 25-50 years treated for 4 weeks on alternate days with METs and Mulligan mobilization with baseline exercise plan respectively. Intervention plan was divided into 2 phases. Outcome measures used in this study are Numeric Pain Rating Scale (NPRS), Neck Disability Index (NDI) and Goniometer for Neck range of motions.<strong> Results:</strong> Patients in group B showed marked improvement as compared to group A. <em>p-value </em>less than 0.05 is considered significant. Mean age of patients for Group A was 39.91±8.14 and in Group B was 42.39±8.01 respectively.<strong> Conclusion:</strong> It is concluded from the study that Mulligan Mobilization was more effective as compared to METs in progressing NPRS and NDI scales.</p> Usama Jamil Iram Aslam Sania Maqbool Saddiqa Qamar Hafiz Muhammad Uzair Asghar Aliza Tauqeer Arifa Mobeen Mudassar Iqbal Copyright (c) 2022 Pakistan BioMedical Journal 2022-05-31 2022-05-31 195 199 10.54393/pbmj.v5i5.470 Factors Responsible for Non Participation in Sports Among Transgender. A Cross Sectional Approach <p>Transgenders are not actively participating in sports in Pakistan. There may be many factors and barriers involved for their non-participation<strong> Objective: </strong>To investigate the factors responsible for the non -participation of transgender in sports. <strong>Methods:</strong> Cross-sectional approach was applied for the collection of required data. Snowball sampling technique for the selection of purposive sampling was applied. Appropriate questionnaire was prepared and used for data collection from a sample of (n=118) individuals with mean age 16 years. Feasibility of the questionnaire was obtained with the help of pilot testing by selecting 30 individuals. <strong>Results</strong>: The analyzed data have shown that almost all transgender have agreed upon the importance of sports in their lives. At the same time, the results have shown that different factors such as governmental, societal and personal significantly contributing for their non-participation in sports (0.024 &lt; 0.05, 007 &lt; 0.05 &amp; 0.009 &lt; 0.05).<strong> Conclusion:</strong> The results of the study indicated a viewpoint of the transgender that describes sports as one of the important means for getting recreation and satisfaction. Given this stance, one might expect that transgender would experience discomfort while participation in sports. However, the research findings do not reveal any deleterious effect of sports participation in light of the views of transgender.</p> Muhammad Jamil Alamgir Qureshi Muhammad Zafar Iqbal Shireen Bhatti Muhammad Waqas Soniha Aslam Muhammad Rafiq Qambrani Muhammad Akram Ansari Javed Ali Soomro Copyright (c) 2022 Pakistan BioMedical Journal 2022-05-31 2022-05-31 200 204 10.54393/pbmj.v5i5.409 Diabetes Mellitus and its impact on Quality of life <p>To narrate the characteristic of life of patients having type II Diabetes mellitus (DM2) &amp; the factors influencing it. <strong>Methods: </strong>This was a cross-sectional study. Patients with diabetes mellitus type 2 (DM2) who were over the age of 18 were chosen. Age, gender, profession, matrimonial status, time of type two diabetes development, other diseases, depressive status were all evaluated as factors that affect quality of life (Beck Depression Inventory). A (HRQOL) scale was utilised to assess the quality of life by using the thirty-six-item short-form survey (SF-36). Based on their SF-36 patients were separated into three groups. <strong>Results: O</strong>ne thousand three hundred and ninty four sample had a middle phase of 62 years. An average score of 50.1 was assigned to the global HRQOL. According to bivariate analysis, phase, matrimonial status, gender, employment, comorbidities, DM2 duration, and other diseases all had an effect on HRQOL. In the regression model (logistic), age (OR 1.04) and depression (OR 4.4) were identified as independent factors that influenced overall quality of life. <strong>Conclusion: </strong>The HRQoL of DM2 patients is lower, which is associated to a higher risk of depression. The presence of depression and advanced age have a negative impact on the patient's HRQoL.</p> Shomaila Irim Khurram Munir Asma Hussain Saima Mir Moazzma Ahmed Jais Kumar Karmani Amanullah Nazir Iqra Naz Faisal Basheer Copyright (c) 2022 Pakistan BioMedical Journal 2022-05-31 2022-05-31 205 210 10.54393/pbmj.v5i5.404 Assessment of the Correlation between hand grip strength test and seated medicine ball throw test at 45° angle among physiotherapy students: An Observational Study <p>Seated Medicine Ball Throw (SMBT)test at 45 degrees throw angle is used to measure the Upper body power. Measurement of grip strength, is an important component in body strength evaluation and can provide us with a quick assessment of an individual’s upper limb strength<strong>. Objective</strong> To assess the relationship between handgrip strength and upper body power among physiotherapy students via Digital Handgrip Dynamometer and Seated Medicine Ball throw test respectively. <strong>Methods: </strong>A cross-sectional study was carried out at Shalamar School of Allied Health Sciences, Lahore. This study recruited 45 participants of both gender, age between 18 to 24 years. Peak grip strength of both hands was taken using digital handheld dynamometer in kg. Seated Medicine Ball Throw, also called the medicine ball chest pass was performed by the participants using 2 kg medicine ball. SPSS was used to calculate the correlation of all variables. When the ball is released at 45 degrees, this study found a high association between handgrip strength and Seated Medicine Ball throw distance. SMBT has a mean of 149.7837.14, Right Handgrip Strength has a mean of 21.26kg5.3, and Left Handgrip Strength has a mean of 20.53kg4.69. <strong>Results: </strong>Grip strength left (r=.0.899) and right (r=.871) were found to have a significant link with Seated Medicine Ball throw (SMBT) performance in Pearson product-moment analysis. The dependent variable, SMBT, and the independent variables, HGS and Height, had a strong positive linear association (r=0.908). <strong>Conclusion:</strong> A higher Handgrip strength leads to a longer Throw distance, implying that a stronger Handgrip signifies a stronger Upper body.</p> Ramsha Akbar Masooma Gull Javeria Aslam Kaniz Rabia Sufian Ahmed Nadia Anwer Abdul Rahman Arsalan Saleem Chugtai Copyright (c) 2022 Pakistan BioMedical Journal 2022-05-31 2022-05-31 211 215 10.54393/pbmj.v5i5.488 Comparison of Effectiveness of Movement with Mobilization and Muscle Energy Technique in reducing Pain and improving Functional Status in patients with Frozen Shoulder <p>Adhesive capsulitis, “popularly is a condition with an unclear etiology known as Frozen Shoulder (FS)". This disorder limits the range of motion of the shoulder joint. <strong>Objective:</strong> To compare the effectiveness of movement with mobilization and muscle energy technique (METs) in reducing pain and improving functional status in patients with frozen shoulder <strong>Methods: </strong>Study was conducted at Department of Physiotherapy, Mayo Hospital Lahore after obtaining the consent from 36 patients. Patients were divided into Two groups. For two weeks, Group 1 received Movement with Mobilization Protest movements (MMM) while Group 2 received METs. The data was processed into SPSS and evaluated using the <em>Independent Sample t test and Paired Sample t test</em><em>.</em> <strong>Results: </strong>The outcome assessment instruments, “goniometer for ROM” and “shoulder pain, and disability index,” revealed that “Motion by Mobility is more effective than Muscle Energy Technique in increasing ROM and operational condition” of the patient having frozen shoulder. <strong>Conclusions: </strong>There was a considerable improvement in pain and ROM from pre-treatment levels in both the study groups. Whereas “Movement with Mobilization is more effective than Muscle Energy Technique” in alleviating pain, enhancing range of motion, and enhancing functional capacity in “patients with shoulder pain.”</p> Noman Ghaffar Awan Faizan ur Rehman . Asma Hamza Bilal Hanan Azfar Rimsha Arif Hafiz Rana Muhammad Arslan Copyright (c) 2022 Pakistan BioMedical Journal 2022-05-31 2022-05-31 216 219 10.54393/pbmj.v5i5.474 Effects Of Myofascial Release Versus Pelvic Floor Muscle Exercises in Women with Primary Dysmenorrhea <p>Primary dysmenorrhea is also associated with significantly high economic burdens due to absenteeism, and 2-to-3-fold increased healthcare costs. <strong>Objective:</strong> To determine the effects of myofascial release versus pelvic floor muscle exercises in women with primary dysmenorrhea<strong>. Methods:</strong> The study design was Randomized Clinical Trial. The study was conducted at Gynae Department of Hamza Hospital Lahore and completed ten months after the approval of synopsis. Sample size is 22, calculated by Epitool. Nonprobability convenient sampling technique was used. Females with 17-30 years of age and who fulfilled five criteria to be considered for primary dysmenorrhea were included in the study. Visual Analogue Scale (VAS) and working ability, location, intensity, days of pain, dysmenorrhea (WaLIDD) Score was used as a tool. <strong>Results: </strong>Twenty-four participants with mean age of the participants was 21 ± 2.75 years while Body Mass Index (BMI) of participants was 26.23 ± 1.631. Normality of data was checked by <em>Shapiro wilk test</em> that showed that data was normally distributed with <em>p value ≤ 0.05.</em> <em>Parametric test, paired sample t test and an independent samples t-test</em> was conducted to compare the effects of Myofascial release and Pelvic floor muscle exercises group in between and within group. Total score of VAS and WaLIDD was measured before and after 12 weeks of intervention in between two groups. The mean difference was 5.82 in Myofascial release group and 4.3 in Pelvic floor muscle exercises group. Although there was a significant reduction in WaLIDD score in both groups after treatment, but the myofascial release group was superior to pelvic floor exercise group<strong>. Conclusions:</strong> It was concluded that myofascial release and Pelvic floor muscle exercises are effective for treatment for primary dysmenorrhea, but Myofascial release has greater effects on relieving primary dysmenorrhea Symptoms than the pelvic floor muscle Exercises after the treatment sessions</p> Sadia Khan Sundas Ihsan Shazia Sehgal Ayma Hashmi Hafiza Neelam Muneeb Nahrat Kumar Alias Akash Muhammad Faizan Hamid Copyright (c) 2022 Pakistan BioMedical Journal 2022-05-31 2022-05-31 220 225 10.54393/pbmj.v5i5.471 The Economic Burden of Viral hepatitis C infection at various stages of the disease in District Mardan, Pakistan <p>Hepatitis C is a blood-borne, infectious disease caused by the Hepatitis C virus (HCV). It attacks hepatic cells, causing infection and inflammation in the liver, eventually leading to cirrhosis and hepatocellular cancer (HCC). Globally, around 200M people carry HCV with mortality rate of 350,000 due to chronic complications of the liver triggered by HCV. <strong>Objective: </strong>To assess the overall annual cost borne by chronic HCV patients at various stages of the disease in District Mardan, Pakistan. <strong>Methods: </strong>Out of total 160 patients, 135, 19 and 6 patients had non-cirrhotic, compensated cirrhosis, decompensated cirrhosis and other complications respectively, Data were obtained from these identified patients’ trough well designed questions based on their social and economic burden in 2019. Descriptive and inferential statistical techniques were applied to estimate the direct and indirect medical costs of HCV in District Mardan. <strong>Results:</strong> This research discovered a significant link between direct and indirect costs and various phases of viral hepatitis C. The per patient annual indirect costs non-medical costs at different stage of HCV infection was found Rs. 10000 (66.57 $), Rs. 25700 (171.10 $) and Rs. 83200 (553.92 $) for non- cirrhotic, compensated cirrhosis and decompensated cirrhosis patients where non-medical costs were estimated Rs. 2000 (13.31 $), Rs. 3235 (66.57 $), and Rs. 7540 (50.19 $), for non- cirrhotic, compensated cirrhosis and decompensated cirrhosis patients and their average were estimated as Rs.51533 (343.09 $), and 4258.33 (28.35. whereas The estimated per patient direct cost for non-cirrhotic, compensated cirrhosis and decompensated cirrhosis are Rs.51060 (339.94 $), 108650 (723.36 $) and 224370(1493.80 $). <strong>Conclusions: </strong>It was concluded that indirect medical costs grew up with the progression of disease as productivity loss due to absenteeism increases and traveling expenses increases with increased in number of hospital visits.</p> Misbah Nosheen Sajjad Khan Copyright (c) 2022 Pakistan BioMedical Journal 2022-05-31 2022-05-31 226 230 10.54393/pbmj.v5i5.482 Assessment of Resting Heart Rate and Body Composition among Exercise Performers <p>Obesity is a global health issue and millions of people around the globe have obesity. <strong>Objective: </strong>To examine the effect of aerobic exercise on resting heart rate and various parameters of body composition. <strong>Methods: </strong>It was a randomized controlled trial. The participants of the study included forty (40) volunteer inter collegiate females of Punjab Pakistan. They were randomly categorized into two groups <em>i.e.</em> control group (CG) and experimental group (EG). It was conducted by following the prescribed exercise protocols of eight (08) weeks. A written informed consent was taken from each subject before participation in the study. After completion of the exercise protocols, the pre and post test data were processed through statistical package for social sciences (SPSS, version,25) <strong>Results:</strong> The RHR of the 40 participants in pretest was (76.37± 5.63) and in posttest was (73.55± 5.51). The HRR of the 40 participants in pretest was (116.70± 4.46) and in posttest was (110.77± 10.00). In respect of resting heart score of EGs in pretest and posttest the data indicate that the score of pretest of RHR (76.35± 3.85) and post of RHR (71.55± 3.45) were significantly different. In respect of resting heart score of control group in pretest and posttest the data indicate that the score of pretest of RHR (76.40± 7.09) and post of RHR (75.55± 6.48) were not significantly different. In the same way, significantly the pretest measurement of HRR (117.30± 5.74), of control group was not different from the posttest measurement of HRR (119.51± 4.65) <em>t</em><sub>19</sub>= -1.714, <em>p</em>≤ <em>0.05</em>. However, the researcher concluded that before the treatment the EG and CG were balanced in body composition, RHR and HRR. Hence the researcher found that there is significant difference between EG and CG in body composition, RHR and HRR after the treatment.<strong>Conclusion: </strong>Based on analysis, the researcher concluded that aerobic exercise has significant impact on resting heart rate and various parameters of body composition among female exercise performers.</p> Fozia Nawaz Alamgir Khan Muhammad Zafar Iqbal Shireen Bhatti Muhammad Jamil Zeliha Selamoglu Samiullah Khan Soniha Aslam Javed Ali Soomro Copyright (c) 2022 Pakistan BioMedical Journal 2022-05-31 2022-05-31 231 236 10.54393/pbmj.v5i5.415 Prevalence of shoulder pain and disability in adult using manual wheelchair, a cross sectional study <p>The objective of this study is to find out prevalence of shoulder pain and disability in adults using manual wheelchair in Pakistan. <strong>Study Design: </strong>Cross sectional study.<strong>Setting: </strong>Data was collected from Ghurki Trust Teaching Hospital, Pakistan Society for the Rehabilitation of the Disabled and Mayo hospital of Lahore. <strong>Methods: </strong>This is a cross-sectional study. After taking consent and IRB from UOL, this study was conducted on manual wheel chair use from at least three months of Lahore. It included both males and females of 25 above age. (SPADI) Shoulder pain disability index (SPADI) and the Wheelchair User's Shoulder Pain Index (WUSPI) will be used to collect data. The questionnaire was filled at the spot. <strong>Results:</strong> Out of total 127 participants 48.8% were female and 51.2% were male. The mean age of the study subjects was 32.32±4.719 years. The prevalence of shoulder pain was documented in 127 participants is 78% with moderate pain 27.6% and severe pain in 38.0%. There was mild disability in 29.9% health care provider and moderate disability in 31.5% wheelchair users. <strong>Conclusion: </strong>The finding of this study concluded that 78.7% prevalence of shoulder pain in manual wheelchair users and 69.3% shoulder disability in manual wheelchair users. As the duration of wheelchair usage increases the shoulder pain and disability also increases</p> Affifa Sher Muhammad Fareeha Amjad Syed Asadullah Arslan Adnan Hashim Maryam Hameed Rana Hamza Habib Khadija Irfan Copyright (c) 2022 Pakistan BioMedical Journal 2022-05-31 2022-05-31 237 240 10.54393/pbmj.v5i5.362 Association of learning styles with academic performance of final year MBBS students <p>The research paradigm of this enquiry is post positivism. It reflects a deterministic philosophy in which causes probably determine effects or outcome. The knowledge that develops through a post positivist lens is based on careful observation and measurement of objective reality that exist “out there” in the world. Thus, developing numeric measures of observations and studying the behavior of individual become paramount for a post positivist, close ended question are used in research. This method of inquiry may be carried out in, test or verifies theories or explanation, identifies variable to study, relates variable in question, observe and measures information in numbers. <strong>Setting and duration of study: </strong>This observational study was conducted at Bolan Medical College, Quetta, Balochistan, from 1<sup>st</sup> March 2017 to 30 March 2018. <strong>Result: </strong>The results were concluded from a total of 200 candidates from different medical universities that became part of the study. In the earlier section of the results, descriptive statistics were presented. The three main determinants of the study were activist, reflector, the rest where the mean values were illustrated as 6.82, 8.04, and 7.47 respectively the highest number of candidates were 35 in total with percentage as 17.5%. This was followed by 33 individuals that accounted for 16.5%.</p> Fazal Dad Sirajul Haque Shaikh Copyright (c) 2022 Pakistan BioMedical Journal 2022-05-31 2022-05-31 241 247 10.54393/pbmj.v5i5.309 Effects Of Functional Therapy Program on Elbow Arthropathy of Hemophilia Patient <p>Hemophilia is an X-linked genetic progressive hemorrhage condition that is characterized by a clotting factor VIII (classic hemophilia, or hemophilia A) or IX (hemophilia B) deficiencies. <strong>Objective: </strong>To determine the comparative effects of functional therapy program and manual therapy program on elbow arthropathy of haemophilia patients. <strong>Methods: </strong>It was a single blinded randomized controlled trial in which assessor was kept blind. In this study non-probability purposive technique was applied. The study was conducted in the Sundas foundation Lahore taking into account consort guidelines. Thirty participants suffering from hemophilia were enrolled in study in 2 groups while considering inclusion and exclusion criteria. Randomization was done through lottery method and concealment was done. Group A (n=15) was treated with manual therapy Grade 1, 2 or 3 mobilization techniques according to patient condition program and Group B (n=15) were treated with functional therapy. Hot pack was used as a baseline treatment for 10 min. For data collection Goniometer was used to measured elbow flexion and extension and Stanford HAQ 20 item Disability for assessing disability.<strong> Results: </strong><em>P-value</em> was &lt;0.01which shows that both groups were effective for managing the patient of hemophilia, but manual therapy show more significant result as compared to functional therapy program.<strong> Conclusion: </strong>In manual therapy treatment group, there was significant improvement in range of movement of elbow joint which enhanced functional activity of arm in haemophilic patients with chronic elbow arthropathy.</p> Hafiz Muneeb Ur Rehman Azfar Khurshid Shazia Rafiq Hunza Zulfiqar Ayesha Razzaq Copyright (c) 2022 Pakistan BioMedical Journal 2022-05-31 2022-05-31 248 252 10.54393/pbmj.v5i5.391 Effect Of Speech Therapy in Children with Cochlar Implant <p>Hearing loss is the absence or difficulty in hearing. And its levels range from mild severe to profound while the term deafness is used for the person who cannot hear it. <strong>Objective:</strong> To determine the effect of speech therapy in children with cochlear implant. <strong>Methods:</strong> This descriptive study was carried out at Fatima Memorial College Medicine and Dentistry, from 1<sup>st</sup> October 2021 to December 2021 to determine the effect of speech therapy in children with cochlear implant. For this purpose a total of 30 children who were implanted and receiving speech therapy were evaluated. Effect of speech therapy was determined by collecting data from the parents of cochlear implant children by using a questionnaire. The questionnaire constituted the receptive and expressive language measures that determine the effect of speech therapy. Questionnaire which was used as data collecting instrument that was designed by expert opinion and literature review. <strong>Results:</strong> Result indicated that out of 30 children who were implanted and receiving speech therapy, 30 (100%) were communicating verbally using word phrase and sentence. These findings suggested that children with cochlear implant were communicating verbally instead of sign language or gestural mode of communication and improved intelligibility. <strong>Conclusions:</strong> It is concluded that speech therapy is effective in children with cochlear implant</p> Muhammad Ahmed Muhammad Azzam Khan Daniel Akhter Ultamish Ahmed Maria Mehboob Idrees Farooq Ayesha Badar Tallat Anwar Faridi Copyright (c) 2022 Pakistan BioMedical Journal 2022-05-31 2022-05-31 253 256 10.54393/pbmj.v5i5.463 Effects Of Neurodynamics on Spasticity in Upper Extremity of Stroke Patients <p>Stroke leads to long term disability and spasticity is one of them. Neurodynamic is a movement which aimed to restore the electrical signal directed to the nerve and the spinal cord. The neural mobilization is used to restore the movement and improve elasticity of nervous system to improve the arm function and regain the motor ability in patients with stroke. <strong> Objective:</strong> To assess the effects of neurodynamics on spasticity in upper extremities of stroke patients. <strong>Methods:</strong> It is a Randomized controlled trial. Data was collected from 46 stroke Patients. Simple Random Sampling was done and data was collected from District headquarters hospital (DHQ) Jhelum. Patients with chronic stroke, age 40-60 years, Modified Ashworth Scale (MAS) ≥1 to 3 and both male and female were included in this study. For 6 weeks, the experimental group received conventional therapy with neurodynamics (10 reps/ set, 1 set/ day, 3 days/week), whereas the control group received conventional treatment (12 reps/ set, 1 set/ day, 3 days/week). The MAS, Fugl Meyer Upper Extremity Scale (FMUE), goniometry and Action Research Arm Test were used to examine the participants at zero, three, and six weeks (ARAT). The <em>Shapiro-Wilk test</em> was used to ensure that the data was normal, and statistical analysis was performed using SPSS 21. <strong>Results:</strong> Statistically significant improvement was found in between group analyses in MAS, FM-UE motor score and AROM as the <em>p-value</em> was &lt;0.05. There was no significant difference in ARAT, FM-UE sensation, joint pain, passive joint motion, coordination and PROM as <em>p-value was &gt;0.05</em>. Statistically significant improvement was found in within group analyses in MAS, FM-UE motor score, sensation, joint pain, AROM and PROM as the <em>p-value was &lt;0.05</em> except in ARAT and FM-UE coordination. <strong>Conclusion: </strong>The result shows that neurodynamic combined with conventional treatment was more effective than conventional treatment alone to reduce spasticity, improve upper extremity function and AROM. The result also shows that there was significant improvement in upper extremity joint pain, sensation and PROM and no improvement occurred in coordination and fine task performance within groups. The study concludes that neurodynamic is effective for spasticity and has additional benefit in improving UE functional performance and active range of motion but the effects of neurodynamic combined with conventional treatment are no different than conventional treatment alone on passive range of motion, joint pain, coordination, fine task performance and sensation.</p> Nafeesa Zamurd Mirza Obaid Baig Aamir Gul Memon Muhammad Khan Bugti Mazhar Ali Butto Maryam Sulaiman Umar Shakoor Amber Shakoor Muhammad Adnan Saman Jahangir Copyright (c) 2022 Pakistan BioMedical Journal 2022-05-31 2022-05-31 257 262 10.54393/pbmj.v5i5.443 Frequency Of Peripheral Neuropathy in Chronic Hepatitis C Patients Presenting at Liaquat University Hospital, Hyderabad <p>Hepatitis C virus (HCV) and its infective pathogenic role leads to the psychiatric and neurological signs and symptoms. Therefore, close monitoring and regular follow-up is warranted. <strong>Objective:</strong> To find out the frequency of peripheral neuropathy among patients presenting at Liaquat University Hospital, Hyderabad, having Chronic Hepatitis C.<strong> Methods: </strong>The cross-sectional study included 359 patients with chronic HCV, aged 20 to 70 years, who presented to the Liaquat University Hospital's Hepatitis Clinic and Outpatient Department of General Medicine and Neurology. Non-probability - sequential sampling was used to choose patients. Patients were asked about demographic information and the duration of chronic HCV after giving informed written consent. The clinical examination was performed to see if there were any reduced tendon reflexes in all of the patient's extremities. To diagnose peripheral neuropathy based on nerve conduction velocity, all patients had an electrophysiological test using a simplified nerve conduction study (NCS) methodology (NCV). The research lasted six months, from June 2021 to December 2021. The information was examined via SPSS version 25.0. <strong>Results: </strong>There were 219 Men (61%) And 140 Females (39%) among the 359 Patients. The average age (SD) of the participants was 42.3 (8.7) years (range 22–70). HCV infection lasted 36 months on average (range 1–156). Out of 359 patients, 61 had clinical peripheral neuropathy (PN) (17%). Electrophysiological evidence of PN was present in all of these patients, electrophysiological investigation revealed subclinical PN in 19 more patients (5.3%). <strong>Conclusion: </strong>On the basis of the findings from this study, it can be concluded that a high prevalence of peripheral neuropathy is present among the patients with HCV in our locality. However, an electrophysiological examination should always be done to avoid underestimating PN, particularly in older HCV patients.</p> Syed Yasir Abbas Hafsa Auroj Arshad Sattar Lakho Akbar Gohar Abro Ghulam Shahar Bano Tahir Hanif Rajput Copyright (c) 2022 Pakistan BioMedical Journal 2022-05-31 2022-05-31 263 266 10.54393/pbmj.v5i5.473 Cyclopeptide Kalata B12 as HCV-NS5A potent Inhibitor <p>Hepatitis C Virus (HCV) is the leading cause of liver diseases globally, causing severe complications such as liver fibrosis, cirrhosis, and hepatocellular carcinoma (HCC). Despite the advent of successful regimens, still, 71 million individuals are chronically infected every year. Therefore, more accessible novel therapies are needed to fight the challenges such as adverse effects, genotype selectivity, and resistance to these regimens due to viral mutations. HCV NS5A is a non-structural phosphoprotein, with its pivotal role in viral replication assembly, and has been the target of continuous research. Cyclopeptides are an emerging class of peptides reported to have antiviral, anticancer, and antimicrobial properties. These cyclopeptides have exceptional resistance to thermal, chemical, or enzymatic degradation. Herein, we present the inhibitory potential of cyclopeptide Kalata B12 against the HCV NS5A gene. <strong>Objective: </strong>To investigate the antiviral potential of Kalata B2, Kalata B12, and cycloviolacin O14 against HCV NS5A <strong>Methods</strong>: We investigated thirty cyclopeptides through molecular docking analysis for their anti-HCV-NS5A inhibition potential. Three cyclopeptides, Kalata B2, Kalata B12, and cycloviolacin O14 showed minimum binding energies, for their antiviral potential. The defense-related, circular mini-protein Kalata B12 showed an impressive docking score of -9.80 Kcal/mol. Further, it was synthesized and went through cytotoxicity analysis via MTT assay on HepG2 cell line, which showed more than 85% cell viability at submicromolar concentrations. <strong>Results:</strong> The peptide Kalata B12 showed significant<em> (***P&lt;0.0001) </em>inhibition of NS5A gene (approx. 75%) at 100nM in <em>I</em><em>n vitro </em>trials, confirmed by real-Time PCR analysis. <strong>Conclusions: </strong>Kalata B12 cyclopeptide was found to be a potential HCV NS5A inhibitor</p> Faiza Shams Nazia Kanwal Somayya Tariq Ayesha Malik Kausar Malik Bushra Ijaz Copyright (c) 2022 Pakistan BioMedical Journal 2022-05-31 2022-05-31 267 271 10.54393/pbmj.v5i5.483 Efficacy And Surgical Outcome of Trabeculectomy with Mitomycin-C In Congenital Glaucoma with Hazy Cornea <p>Glaucoma is characterized by an optic neuropathy associated with raised intraocular pressure (IOP) and visual field defect <strong>Objective: </strong>To determine the efficacy and outcome of trabeculectomy augmented with anti-metabolite mitomycin-C in children with childhood glaucoma. <strong>Methods: </strong>A total of 40 eyes of 22 diagnosed cases of congenital glaucoma were studied. All these children underwent mitomycin-C augmented trabeculectomy from July 2017 to August 2020. The primary outcome was control of postoperative intraocular pressure (IOP) at the end of one year. A target pressure of &lt;15mmHg was set as target pressure to label a successful surgical outcome. <strong>Results: </strong>The mean age of the patients enrolled in the study was 26.8± 12.2 years (range: 8 – 32 months) with a male to female ratio of 7:4. The mean ± SD IOP before trabeculectomy surgery was (31.5± 8.6) (range: 21 – 53) mmHg. At the one-year follow-up, the mean postoperative IOP was (19.4± 7.9) (range: 9 – 48) mmHg. Target IOP &lt; 15 mmHg was successfully achieved in 27 (67.5%), 24 (60.0%) and 22 (55.0%) eyes at postoperative 1, 6 and 12 months respectively. Repeat trabeculectomy was required in 5 (12.5%) eyes, while 5 (12.5%) eyes developed corneal perforations and 3 (7.5%) eyes developed phthisis bulbi. <strong>Conclusion: </strong>Trabeculectomy with mitomycin C can be a primary surgical intervention in congenital glaucoma. However, repeat surgery may be required and other related surgical complications can occur after this surgery in patients with uncontrolled IOP.</p> Muhammad Hassaan Ali Syed Raza Ali Shah Ayeza Nadeem Butt Samreen Jamal Uzma Hamza Nadeem Hafeez Butt Copyright (c) 2022 Pakistan BioMedical Journal 2022-05-31 2022-05-31 272 275 10.54393/pbmj.v5i5.458 SERUM IRON, COPPER and ZINC LEVELS IN PREECLAMPSIA AND NORMOTENSIVE PRIMIGRAVIDA FEMALES <p>Hypertensive ailments of pregnancy are major health problems for women and their babies around the world. Among the hypertensive disorders, preeclampsia and eclampsia are the major risk factors for maternal and neonatal morbidity and mortality. <strong> </strong>Now preeclampsia is considered a state of oxidative stress, in which over utilization of antioxidants may proceed into worst form of this disease<strong>. </strong>So, this study was planned to assess the role of serum iron, copper and zinc as co factors for antioxidant system, and compare their levels within primigravida normotensive pregnant women and preeclampsia women. <strong>Methods: </strong>It was a cross-sectional comparative study conducted in Biochemistry department, University of health Sciences, Lahore. The study was carried out on 90 women which were divided into two equal groups of 45 each, preeclampsia and controls respectively. Serum levels of iron, copper and zinc were estimated by atomic absorption spectrometer. Data analyses were performed by utilizing SPSS version 20.0. <strong>Results: </strong>Serum levels of Fe and Cu were raised in preeclampsia patients, 151.85±61.22 (μg/dl), 130.83±48.29 (μg/dl) and serum Zn levels were decreased 77.94±23.55 (μg/dl) when compared with normotensive controls 104.39±55.36 (μg/dl), 116.64±26.56 (μg/dl), and 92.77±22.91 (μg/dl) respectively. A positive correlation between copper and systolic blood pressure (r= 0.440), BMI and weight (r = 0.543), while negative correlation of iron with zinc (r = -0.285) was observed in preeclamptic women. A negative correlation between copper and zinc (r = -0.440) was also observed in normal pregnant women but no such correlation was observed within Preeclampsia group. <strong>Conclusion: </strong>It is apparent from this study that increased levels of iron and copper and decreased levels of zinc during pregnancy is associated with the pathogenesis of preeclampsia.</p> Arshia Mobeen Rana Mahwish Shahzad Bushra Iftikhar Zia Ullah Bushra Shaheen Shabbir Hussain Copyright (c) 2022 Pakistan BioMedical Journal 2022-05-31 2022-05-31 276 281 10.54393/pbmj.v5i5.440 Efficacy of Spinal Epidural Anesthesia and Sub Diaphragmatic Lidocaine with Spinal Anesthesia in reduction of shoulder pain: Randomized Clinical trial <p>To determine the efficacy of spinal anesthesia with sub diaphragmatic lidocaine for gynecological laparoscopic surgery at the commencement of the procedure to spinal anesthesia for get pain relief <strong>Methods:</strong> It was a randomized clinical trial conducted at Ali Medical Hospital in Islamabad. A total of 84 patients were given sub diaphragmatic lidocaine spinal anesthesia, only spinal epidural anesthesia and general anesthesia. During procedure, 2, 4, 6 and 12 hours after surgery, and before discharge, patients' pain perception was measured using Visual Analogue Scale (VAS) <strong>Results: </strong>Outcomes showed no significant difference in perception of pain at different time intervals in all three groups. (F 4, 77 = 0.38, <em>p = 0.81</em>). At all-time intervals following surgery, patients' pain levels were similar between groups (F 2, 77 = 0.53, <em>p = 0.57)</em>. <strong>Conclusions:</strong> The use of sub diaphragmatic lidocaine at the onset of surgery together with the spinal anesthesia did not result in a prominent statistical difference in patients' postoperative VAS scores when compared to general anesthesia and spinal epidural anesthesia after and prenatal invasive techniques.</p> Din Muhammad Jamali Tayyab Ali Bilal Liaqat Chaudhry Syed Rameez Hassan Nahin Akhtar Malik Muhammad Saifullah Awan Copyright (c) 2022 Pakistan BioMedical Journal 2022-05-31 2022-05-31 282 287 10.54393/pbmj.v5i5.468 Effect Of Forward Head Posture with Neck Disability and Quality of Life in Freelancer <p>Freelancer is an independent person who earns money from clients on a task basis. Freelancers are often known to work on a computer or a laptop. They spend the majority of the time on the computer due to which they are more likely to develop bad posture Objective: To determine the effect of forward head posture with neck disability and quality of life in Freelancers. Methods: This cross-sectional study was conducted on 133 participants. The data was collected from freelancer teachers and students from The University of Lahore. Goniometer was used to assess the people with forward head posture. The neck disability was assessed by using neck disability index questionnaire. Quality of life was assessed by using SF-36 questionnaire. History of the symptoms including pain and tenderness clicking was noted. Results: The results showed that the frequency of posture, no forward head cases out of 133 were 24 (18.0%) and forward head cases out of 133 were 109 (82.0%). The results show the comparative relationship between posture and hours for which people use laptop. About 21 people without forward head posture use laptop for 4 to 6 hours and around 46 people with forward neck posture use laptop for 12 to 14 hours. The results show the comparative relationship between posture and time at which people use laptop. About 9 people (37.5%) without forward head posture use laptop at late night and around 38 people (34.9%) with forward neck posture use laptop at night time Conclusions: Based on the result, it was concluded that forward head posture has a strong effect on neck functional disability and quality of life in freelancers.</p> Rabia Tasmeer Syed Asad Ullah Arslan Ashfaq Ahmad Fareeha Amjad Copyright (c) 2022 Pakistan BioMedical Journal 2022-05-31 2022-05-31 288 292 10.54393/pbmj.v5i5.472 Perception Of Physical Therapist Of Lahore Regarding Ethical Issues In Clinical Practice; A Cross Sectional Study <p>Ethics are broad range of thinking about expressional interdependence behaviors of human being and about situational balance between right and wrong as moral duty. <strong>Objective: </strong>The purpose of this study was to figure out ethical issues in clinical practice of physical therapy practice. <strong>Methods: </strong>A cross sectional study was conducted at various clinical setups in Lahore enrolling practicing physical therapists via non-probability convenience sampling technique. A sample of 249 physical therapists was extracted using sample size calculator (Confidence interval 95%). Participants were selected on the basis of inclusion criteria and responses were recorded using self-structured questionnaire whose content validity was assessed using Lynn, M.R (1986) method. The questionnaire consisted of set of opinions regarding multidimensional aspects of ethics in patient care. The data was analyzed by SPSS version 20. The analysis was based on descriptive statistics such as frequency percentages and measures of central tendency and standard deviation. The multiple responses were calculated regarding collective opinions. <strong>Results: </strong>Demographics of the participants were expressed in frequency and percentages. The results showed that professional ethics were learned by 174(70.7%) respondents during physical therapy course, by 38 (15.4%) via internet and by 34(13.8%) by other sources. On average, most of the responses regarding awareness, obligation and inter-professional relationship were reported as moderate to minimum. <strong>Conclusions: </strong>The study concluded that perception and opinions of physical therapists regarding ethical issues garnered only moderate to minimum concern about clinical practice. However, they identified a huge gap and lack of coordination with other health professional in clinical facility.</p> Abdullah Khalid Khan Saima Jabbar Iqra Ashraf Momina Najeeb Navera Fatima Romaisa Javed Umer Khalid Khan Arslan Anwar Copyright (c) 2022 Pakistan BioMedical Journal 2022-05-31 2022-05-31 293 297 10.54393/pbmj.v5i5.436 Effects of Neurodevelopmental Therapy on Gross Motor Function and Postural Control in Children with Spastic Cerebral Palsy: A Randomized Controlled Trial <p>Cerebral palsy (CP) is one of the most prevalent childhood-onset causes of permanent disability affecting gross motor functioning and postural control ability. <strong>Objective:</strong> To determine the effects of neurodevelopmental treatment on the gross motor function postural control among children with spastic CP. <strong>Methods:</strong> A single-blinded randomized controlled trial was carried out at Sher e Rabbani Hospital, Department of Pediatric Rehabilitation, Sheikhupura. 66 children fulfilling the inclusion criteria were recruited using the non-probability sampling technique. Participants were divided into two groups, Group A which received beuro developmental techniques along with routine physical therapy while Group B received only routine physical therapy treatment. To collect data, Gross motor function measure scale (GMFM-88) and posture and postural ability scale (PPAS) were employed as outcome measures. <strong>Results:</strong> Repeated measure <em>ANOVA</em> and an <em>independent t-test</em> were executed for parametric data after assuming normality. Pairwise comparison of both groups demonstrated that gross motor function was significantly improved from baseline to 4th, 8<sup>th</sup>, and 12th week after applying NDT treatment <em>(p-value≤ 0.05).</em> Pairwise comparison of both groups revealed that postural ability post NDT treatment and significant improvement was observed after 12 weeks in comparison to baseline. While within-group comparison at different follows up for gross motor function measure and postural control also expressed <em>p≤ 0.05 </em>as significant. <strong>Conclusions:</strong> Children with spastic CP who received Neurodevelopmental Therapy along with conventional physical therapy treatment showed significant improvements in gross motor function and postural control as compared to the control group.</p> Abdullah Khalid Khan Syed Asadullah Arslan Fahad Tanveer Saima Jabbar Iqra Ashraf Arslan Anwar Muhammad Sufyan Karamat Umar Khalid khan Copyright (c) 2022 Pakistan BioMedical Journal 2022-05-31 2022-05-31 298 304 10.54393/pbmj.v5i5.418 Awareness, Knowledge, and Satisfaction of physiotherapy treatment in cerebral palsy children's parents. <p>Cerebral palsy (CP) is a neurological ailment that includes a variety of signs and symptoms, some of which might be associated with neurodegenerative or metabolic problems, especially those that begin in the first two years of life. It can be caused by a variety of factors. Children with disabilities' families have grown increasingly active in their care and have taken on the role of primary caregiver. Early detection and intervention of problems to minimize developmental delays. <strong>Objectives:</strong> To assess the awareness, knowledge and satisfaction about physical therapy in parents of cerebral palsy children visiting hospitals in Lahore <strong>Methods: </strong>Cross-sectional study was conducted at visiting hospitals in Lahore from November 2021 to April 2022 through a non-probability convenient sampling technique. A total of 81 parents were selected for this study. The data was assembled by using a self-made questionnaire.<strong> Results: </strong>Parents of 35<strong> (</strong>43.2%) children were aware of physiotherapy while 46 (56.8%) came to know about physical therapy treatment after coming to the hospital setting. The majority, 51(63%) parents were aware of physiotherapy treatment because of child specialist referral. 64(79%) children were taking physiotherapy treatment on daily basis. 45.7% of parents were extremely satisfied, 38.3% were very satisfied and 0% were not satisfied with physiotherapy treatment.<strong> Conclusions: </strong>It was concluded that the majority of parents were not aware of physical therapy before visiting the respective setting or having a session with a physiotherapist and the majority of parents were satisfied by the physiotherapy treatment given to their children.</p> Shahzaib Anwer aqsa Naveed Saba Riaz Rabia Jawa Muhammad Ahmad Naseer Aamir Gul Memon Hareem Nazir Muhammad Mubarak Janjua Copyright (c) 2022 Pakistan BioMedical Journal 2022-05-31 2022-05-31 305 308 10.54393/pbmj.v5i5.417 Prevalence Of Psychosocial Issues Among Internally Displaced Children by Military Wars in District Khyber <p>Internally Displaced Persons (IDPs) are those who have been forced to leave their homes to avoid the impacts of armed war, violence, and other forms of violence. Human rights violations or natural or man-made calamities have occurred, but they have not passed an internationally recognized state border. <strong>Objective: </strong>To identify the psychosocial effects created by military wars on the internally displaced children of District Khyber, Khyber Pakhtunkhwa, Pakistan <strong>Methods:</strong> For this purpose, 300 children were selected randomly, out of which 150 were males and 150 were females. These 300 children belonged to the middle and the secondary school of the same District and were internally displaced because of military wars. Data was collected using PTSD Checklist-Civilian Version (PCL-C) questionnaire and demographic information sheet and responses were recorded and analyzed using a SPSS version 24 software. <strong>Results: </strong>The <em>p-value</em> of less than 0.001 indicated that children belonging to year 2002 were victimized of war the most and had severe psychosocial effects. The factors such as loss of housing, family, finances, employment and the lack of accessibility to health care services had direct correlation with the increase in psychosocial impacts. <strong>Conclusion: </strong>It is concluded that females and children of middle and secondary schools were most affected</p> Alam Zeb Misbah Rehman Maria Rafique Copyright (c) 2022 Pakistan BioMedical Journal 2022-05-31 2022-05-31 309 313 10.54393/pbmj.v5i5.512 Stability of Iodine in Differently Iodised Salts <p>Iodine deficiency is a public health problem worldwide. Iodization of salt is a valuable technique to overcome iodine insufficiency. There are, however, problems in uniform iodization of salt. The study was conducted to investigate comparative stability and uniformity of mixing of iodine in iodized salt fortified with aqueous solution of KIO<sub>3 </sub>(powder grade salt) or the same compound added additionally in dry form (granular grade salt). The research study was conducted in the laboratory of Nutrition, Section of the Food science Division of Nuclear institute for Food and Agriculture (NIFA), Peshawar. Salt samples were prepared in a medium sized salt crushing facility at Lahore. These samples were transported in bulk packing to Nuclear Institute for Food and Agriculture (NIFA), Peshawar. Following 3 types of samples will be prepared; powder grade salt fortified with 50 ppm of iodine as KIO<sub>3</sub> solution using drip system, granular grade salt iodized with the same system without additional KIO<sub>3 </sub>(this grade of iodized salt always lacks complete and homogeneous iodization and needs addition of more iodine to attain the 50 ppm level) and granular grade salt iodized with additional KIO<sub>3</sub> to make up the total to 50 ppm. the salt samples were packed in high density polyethylene (HDPE) and low density polyethylene (LDPE) packing separately. Analysis was carried out at the initial stage (0day) and subsequently at monthly interval up to fourth month. By standard iodometric titration all collected salt samples were tested for their iodine levels. Data were statistically analyzed using Statistix version 8.0. ANOVA were worked out by completely randomized design with factorial arrangement. Means were separated using Tucky HSD test. The mean moisture contents of salt packed in LDPE and HDPE varied significantly (P &lt; 0.05), salt packed in LDPE showed higher average moisture contents than the salts packed in HDPE. Effect of iodization type was also significant (P&lt;0.05) on the moisture contents of the salts. Granular salt iodized with drip and additional dry KIO<sub>3</sub> had the highest moisture contents followed by granular salt iodized with drip system and the lowest moisture content was exhibited by powdered salt iodized with drip system only. The mean moisture contents of salt during different storage intervals were significantly (P &lt; 0.05) different from each other, except during third and four month, With the salt showing higher average moisture contents during the last month and lowest in the first month. Effect of iodization type was also significant (P&lt;0.05) on the moisture contents of the salt. Granular salt iodized with drip and additional dry KIO<sub>3</sub> had the highest moisture contents followed by granular salt iodized with drip system and the lowest moisture content was exhibited by powdered salt iodized with drip system only. The mean moisture contents of salt during different storage periods were significantly (P &lt; 0.05) different from each other, except during third and four month. The salt showed higher average moisture contents during the last month and lowest in the first month. Effect of packing material type was also significant (P&lt;0.05) on the moisture contents of the salt. The mean moisture contents of salt packed in LDPE and HDPE varied significantly (P &lt; 0.05).However, salt packed in LDPE showed higher average moisture contents than that of salts packed in HDPE. The powder salt retained iodine better than the other two salts types used. The iodine retention gradually decreased during storage periods. Among the packaging material used the salt in low density polyethylene showed higher moisture content. During storage intervals the average moisture content increased. The granular salt (grade II) showed maximum moisture content among the three salt types</p> Kalsoom Siddiq Muhammad Samiullah Yamin Rashid Muhammad Ihsan Muhammad Yasir Fawad Ali Copyright (c) 2022 Pakistan BioMedical Journal 2022-05-31 2022-05-31 314 320 10.54393/pbmj.v5i5.361 Association of Patellofemoral Syndrome with Prolonged Duration of Sitting among Teachers; A Cross-Sectional Survey <p>Although there are several etiologies for patellofemoral pain syndrome, prolonged sitting is one of the less well-understood causes. Recently, there has been some discussion about the alignment problems. The purpose of the present research is to investigate the alignment issues that may arise because of extended sitting. Teachers are among the members of the population who may be forced to such long periods of sitting. In this manner, it may benefit teachers and the whole community. <strong>OBJECTIVE:</strong> The objective of the study was to determine the association of patellofemoral syndrome with duration of sitting among teachers. <strong>METHODS:</strong> This was a Cross-Sectional Study conducted among 278 male 104 (37.4%) and female 174 ( university teachers having an age range of 25 to 50 years, spending an average of 4 hours in sitting 62.6%) position and having pain were included in the study, based on convenience sampling technique. Data was collected after taking ethical approval from The University of Lahore by using the SNAPPS (survey instrument for natural history, etiology, and prevalence of patellofemoral pain studies) Questionnaire. SPSS 25 was used to analyze data. <strong>RESULTS:</strong> The descriptive statistics showed a mean and standard deviation to be 30.81±4.08 for age, 5.39±1.09 for the sitting duration, 5.233±2.81 for teaching experience, and 22.28±11.48 for patellofemoral pain syndrome. The results showed that there were 12.6% of teachers with no chances of patellofemoral pain syndrome at the time of data collection, 11.5% with minimal chances, 73% had borderline and 2.9% having early symptoms of PFPS. The results regarding association of PFPS and sitting duration per day showed a significant direction association as shown by p-value 0.01. <strong>CONCLUSION:</strong> The study concluded that there was a significant association between number of sitting hours and patellofemoral pain syndrome among teachers. Most prolonged sitters are at more risk for developing patellofemoral pain syndrome. There were no teachers in the advance stage of patellofemoral pain syndrome.</p> Shabina Arshad Bhatti Iqra Waseem Muhammad Akhtar Syed Asadullah Arslan Farwah Batool Ashfaq Ahmed Copyright (c) 2022 Pakistan BioMedical Journal 2022-05-31 2022-05-31 321 324 10.54393/pbmj.v5i5.439 Frequency of Gastrointestinal Diseases Diagnosed on Barium Contrast Studies <p>Barium is a non-invasive, low-cost imaging technology. Gastrointestinal (GIT) symptoms are common and have significant economic and social implications. <strong>Objective: </strong>To determine the frequency of gastrointestinal diseases diagnosed on barium contrast studies. <strong>Methods:</strong>This research includes 125 participants suffering from Gastrointestinal Diseases. The research was carried out at a secondary care private sector hospital in Gujranwala, Pakistan. The information was gathered between January and April of 2022. All patients who were recommended for barium examinations and those who had never surgery before were included in the study. Images were obtained for research objectives immediately after barium was taken orally. SPSS version 20 was used to enter and evaluate data. <strong>Results: </strong>Out of 125 Patients about 62(49.6%) were male and 63(50.4%) were female. The age ranges from (13-88 years) with a mean age of 48 years. The patients diagnose on barium study shows 11(8.8%) gastric ulcer, 7(5.6%) patients Achalasia, 19(15.2%) Diverticula, 10(8.0%) esophageal stricture, 13(10.4%) esophagitis, 5(4.0%) GERD, 7(5.6%) pyloric stenosis, 5(4.0%) SMA syndrome, 2(1.6%) others, and 46(36.8%) patients had normal radiological findings. <strong>Conclusion: </strong>Barium studies are a sensitive and reliable approach to identifying gastrointestinal problems. The barium studies should reclaim their place as a primary diagnostic tool by complementing endoscopy to provide physicians with information regarding the nature of the lesion</p> Aneeqa Khalid Akash John Abid Ali Narjis Batool Areej Zamir Copyright (c) 2022 Pakistan BioMedical Journal 2022-05-31 2022-05-31 325 329 10.54393/pbmj.v5i5.511 Cholera: A Recent Epidemic <p>Cholera in an intestinal infection caused by Vibrio cholerae. Its symptoms include profuse secretory diarrhea. Cholera can be endemic, epidemic or pandemic. This disease still remains a challenge to the modern world. Although it can be asymptomatic or mild but in severe complications it can cause death within hours due to dehydration. About one in 20 infected people have severe water diarrhea along with vomiting, leading to dehydration. Even the asymptomatic people can spread the infection. Other symptoms include rapid heart rate, loss of skin elasticity, dry mucous membranes, low blood pressure, thirst and muscle cramps.</p> <p>Precautionary measures include increased water intake and use of boiled water for drinking, washing face, teeth, washing vegetable and fruits, washing utensils. Avoid raw or unpeeled fruits and vegetables, unpasteurized milk, uncooked meat. It is highly treatable disease but hydration is &nbsp;must and maintained. Antibiotics are not used for emergency treatment but it can only reduce the span of disease by half and thus help in further spread of disease [1].</p> <p>Director General of ‘Global Task Force; on cholera control side event in observance of WHA, held of 25<sup>th</sup> May, 2022 stated that, ‘Although cholera was eliminated from the globe north more than 150 years ago, it continues to plague the global south. Cholera is a disease of inequity. Almost exclusively, it affects the communities without adequate water, sanitation and hygiene and those who have been displaced. Despite pandemic, humanitarian crises and natural disasters, the Democratic Republic of Congo, Malawi, Tanzania, Uganda, Yemen, Zambia all conducted preventive campaigns with oral cholera vaccine. Cases and deaths have declined in the recent years but preliminary data for 2021 shows a massive increase in the number of cholera-related death, with an average case fatality rate of 3%. The trend in 2022 remains very concerning, with at least 14 countries experiencing new cholera outbreaks. This is why the work of Global Task Force on Cholera Control is so important’ [2].</p> Anna Maria Lavezzi Copyright (c) 2022 Pakistan BioMedical Journal 2022-05-31 2022-05-31 01 01 10.54393/pbmj.v5i5.498 Diabetes Mellitus: Life Style, Obesity and Insulin Resistance <p>In millennia, 40 million people were died with non-communicable diseases and diabetes is one of them. In diabetes, insulin secretions are not produced properly or resist to body and if it is not treated, it might cause death of all the organs. Researchers now seek the other therapies apart from medicinal, to manage diabetes with minimal side-effects and more efficacy. They are experimenting on herbs and therapeutic food that play role in disease or delay the progression of disease. Drugs in these days are very costly and may also have side effects. Different herbs may have a beneficial role in diabetes due to the active components involved in insulin resistance such as ‘myoinsoitol’.</p> <p>Researchers are more interested in lifestyle in recent decades because it is importance for health [1]. People that follow an unhealthy lifestyle are in million. The dominant form of lifestyle that affects the unhealthy lifestyle is alcohol, drug abuse, malnutrition, stress, and unhealthy diet [2]. Unhealthy lifestyle may cause death, illness, disabilities, metabolic disease, cardiovascular diseases (CVD), skeletal diseases, diabetes, and hypertension [3]. The oldest disease known by man is probably diabetes which dates back to 3000 years ago, first reported in Egyptian [4,5]. Type 1 and type 2 diabetes differentiation was made in 1936 [6]. In 1988 type 2 was defined as metabolic syndrome [7]. Defects in insulin secretion or action cause hyperglycemia and this group may cause metabolic disease and form diabetes mellitus. Failure of organs and body dysfunction may be caused by prolonged chronic hyperglycemia. Diabetes may be developed by several pathogenic processes [8]. Insulin resistance may be due to insulin deficiency or abnormalities and the destruction of the cells of the pancreas by an autoimmune disorder. Deficient action of insulin on target tissues may affect the fat carbohydrate and protein metabolism [9].</p> <p>Deficiency of insulin may cause hyperglycemia by affecting the complex hormonal pathways by unknown mechanisms [10]. Beta cells in the islets of Langerhans of the pancreas produces a hormone ‘insulin’ which regulates carbohydrate, fats and protein metabolism. Insulin is secreted from beta cells by glucagon but commonly by glucose. Hyperglycemia is caused when the balance of insulin and glucagon is disturbed [11]. In 5-10% subjects diagnosed with type 1 diabetes [12]. &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;The β cells in the pancreas are destructed [13,14].</p> <p>&nbsp;In most patients, β-cell destruction varies as it may be increasing in some patients while slow in others. In children and adolescent’s ketoacidosis is the first stage of this disease. In other patients fasting hyperglycemia converts into a severe stage and in the presence of stress, the ketoacidosis is occurred [15,16]. Most of the patients depend on insulin for survival to prevent ketoacidosis because in these patients β-cell function is sufficient for the prevention of ketoacidosis [17].</p> <p>In type 1 diabetes the pathogenesis is still unclear, there is no data on why the auto antibodies against work on islets cells hallmark [18,19]. Type 1 diabetes is most common in children or adolescents. Several environmental factors also cause diabetes apart from genetic predisposition [20,21], including Ljungan virus, viral infection, herpes virus, enterovirus, congenital rubella [22,23]. The autoimmune disease also occurs by different pollutants, low level of vitamin D, childhood infection, prenatal exposure to viruses [24]. These things may be controversial because in recent studies viral infection may cause the type 1 diabetes [25].</p> <p>In type 2 diabetes, hyperglycemia causes the insulin deficiency and is also known as non-insulin diabetes mellitus. It may be due to genetic, behavioral or environmental risk factors [26-28]. In poor developing countries like Africa, type 2 diabetes increased the morbidity and mortality due to the commonness and late diagnosis of this type of disease [29]. Type 2 diabetes is also associated with genetics and lifestyle. Type 2 diabetes mostly occur genetically as compared to type 1 diabetes [30]. Approximately, there are 90% chances of diabetes occurrence, if in monozygotic twins, one is affected with diabetes. In type 2 diabetes, Maturity Onset Diabetes of the Young (MODY) is also identified in type 2 diabetes, it is not like autoantibodies in &nbsp;&nbsp;type 1 diabetes&nbsp; &nbsp;and it occurs in 25 years of age [31,32]. The genetics of this disease are still unclear as some patients have mutations but never develop the disease, and others will develop clinical symptoms of MODY but have no identifiable mutation [33].</p> <p>Diabetes may be devasting in the next years due to the obesity because obesity is more prevalent globally and due to this insulin resistance may occur. A lot of medicines are prescribed for the hyperglycemia but it also has so many side effects. There are a lot of nutraceuticals that are helpful in diabetes management and &nbsp;most of the herbs have potential to lower the hyperglycemia and treat diabetes insulin resistance.</p> Minal Butt Huma Bader Ul Ain Tabussam Tufail Shahnai Basharat Zeenat Islam Baila Ahmad Sahar Imran Rabia Hussain Muhammad Imran Copyright (c) 2022 Pakistan BioMedical Journal 2022-05-31 2022-05-31 03 05 10.54393/pbmj.v5i5.496 Bioactive Profile and Health Claims of Ginkgo biloba <p><em>Ginkgo biloba</em> also known as ‘maidenhair tree’ is a therapeutic herbal medicine consumed by people around the globe and is commonly used to treat neurological and cardiovascular disorders as well as neurological illnesses such as Alzheimer’s disease, dementia, and cognitive impairment. As it is rich in vitamins and has a number of bioactive compounds which are helpful in treating many health-related issues. This review aims to cover the beneficial side of <em>Ginkgo biloba</em> like its pharmacological effects, antidiabetic effects, anti-inflammatory effects, and its role in treating diseases</p> Muhammad Aqib Saeed Huma Bader Ul Ain Hafiza Nazia Koser Bahisht Rizwan Tabussam Tufail Muhammad Abdullah Farrukh Jawad Alvi Asifa Saleem Sahar Imran Fatima Zahra Copyright (c) 2022 Pakistan BioMedical Journal 2022-05-31 2022-05-31 06 11 10.54393/pbmj.v5i5.460 Gestational Diabetes and its Therapeutic Nutritional Care <p>Gestational Diabetes mellitus (GDM) is another type of diabetes that is hyperglycemia that is recognized during pregnancy. It encloses non-diagnosed type 2 diabetes hyperglycemia which appears in pregnancy later. The major aim of this review paper study was to probe that how nutritional intake can be beneficial to overcome a leading community problem for gravid females termed as gestational diabetes. Insulin level management along with healthy eating habits were studied from more than 20 researches to conclude the healthy eating patterns of women in pregnancy suffering with gestational diabetes. Mediterranean diets have a superior role in effect of onset of diabetes mellitus in gravid women. Intake of some seeds like <em>Picralima nitida,</em> root and stems like <em>Nauclea latifolia</em> and leaves like <em>Oxytenanthera abyssinica</em> along with ginger plays a pivotal role as nutritional treatments in gestational diabetes. A number of studies have shown that history of diabetes, nutritional care and adequate insulin management declines the onset of gestational diabetes.</p> Maryam Maqsood Huma Bader Ul Ain Ayesha Naqoosh Rida Naqoosh Tabussam Tufail Ayesha Amjad Muhammad Imran Sahar Imran Asifa Saleem Habib-ur- Rehman Copyright (c) 2022 Pakistan BioMedical Journal 2022-05-31 2022-05-31 12 17 10.54393/pbmj.v5i5.445 Health Promoting Properties and Extraction of Specific Bioactive Compounds in Blueberries <p>In addition to possessing well-known flavor attributes, blueberries are an exceptional source of health-promoting bioactive compounds. Blueberries have been developing in ubiquity over the world for decades. Blueberries are high in flavonoids (for the most part anthocyanidins), polyphenols (procyanidin), phenolic acids, pyruvic acid, chlorogenic acid, and other compounds that have anticancer, anti-obesity, anti-inflammation, defensive properties for vision and liver, avoid heart maladies, anti-diabetes, boost brain work, muscular bones, improve insusceptibility, anticipate cardiovascular maladies, and boost cognitive decay. Blueberry extraction procedures have progressed essentially in later a long time. Modern extraction technologies include Ultrasound-Assisted Extraction, Microwave Assisted Extraction, Pulsed Electric Field Extraction, and Supercritical Liquid extraction. This strategy strikes a stability between the fruit's dietary value and its occurrence. This improvement within the food division is due to customer expectations that are getting to be more health-conscious, prompting the industry to look for ways to dodge ailment</p> Nabia Ijaz Huma Bader Ul Ain Shahid Bashir Tabussam Tufail Kashif Ameer Sahar Imran Kainat Abid Fatima Zahra Asifa Saleem Copyright (c) 2022 Pakistan BioMedical Journal 2022-05-31 2022-05-31 18 20 10.54393/pbmj.v5i5.492 Undernutrition with Special Reference to Iron-deficiency Anemia in Reproductive Age Group Females in Pakistan <p>Undernutrition, especially micronutrient deficiency is one of the major but least addressed Global health issues. Globally 22% of maternal deaths and 24% of perinatal deaths account for Iron deficiency Anemia. One-fifth of females in Pakistan are suffering from anemia. It accounts for 19.3% of births of newborns that are small for their gestational age and 25% of babies born with low birth weight in Pakistan. Reproductive age group females’ especially pregnant females of the underprivileged rural populations are more prone to develop iron deficiency due to increased physiological requirements or administration of substances acting as inhibitors. But increased usage of substances that act as adjutants can fulfill the physiological requirements of pregnancy. This review aims to explain the roles of different Nutraceuticals in the prevention of iron deficiency anemia, especially in reproductive age group pregnant females.</p> <p>&nbsp;</p> Rozina Shahadat Khan Huma Bader Ul Ain Tabussam Tufail Muhammad Imran Sahar Imran Sunair Siddique khan Romaisa Siddique Faiz Rasool Saira Ahmad Habib-Ur Rehman Copyright (c) 2022 Pakistan BioMedical Journal 2022-05-31 2022-05-31 21 28 10.54393/pbmj.v5i5.412 A Review of Oral Lichen Planus and its Management with Herbal Treatment <p>Oral lichen planus is an inflammatory disorder that affects the mouth. Oral mucosa primarily affects women in their forties and fifties. OLP is a localised autoimmune disorder caused by T-cell malfunction, according to previous research. The tongue, buccal mucosa, and gingiva are the most prevalent sites for OLP. The distribution of oral lesions is always symmetrical and bilateral. Oral leukoplakia and oral erythro leukoplakia might be mistaken for plaque-like and atrophic/erosive OLP, respectively. Because OLP is an immunologically mediated condition, corticosteroids are the most effective treatment. Herbal medicine, which has anti-inflammatory and antioxidant qualities, appears to be a viable alternative therapy. As a result, the goal of this research was to describe the efficacy of different OLP treatments.</p> Madiha khan niazi Kinza Jalal Huma Amjad Sana Jamshed Sahar Imran Wajeeha Arooj Nizwa Choudhary Farooq Hassan Copyright (c) 2022 Pakistan BioMedical Journal 2022-05-31 2022-05-31 29 32 10.54393/pbmj.v5i5.287 Emerging trends in Diagnosis and Treatment of Brain Tumor <p>Brain tumors are rare but have high mortality rate among children and young adults. The purpose of this report is to portray the situation of imaging strategies and advancements for distinguishing reaction of cerebrum tumors to remedy within the placing of multicenter medical trials. Inside as of now utilized advances, usage of institutionalized image procurement and the usage of volumetric appraisals and subtraction maps are likely going to decorate tumor notion, depiction, and dimension. Throughout the subsequent couple of years, new innovations, for instance, 23Na MRI and CEST imaging improvements may be investigated for their usage in growing the ability to quantitatively photo tumor response in order to provide remedies in a scientific trial placing. The combination of poor visualization and absence of remedial choices urge the need to enhance clinical results for patients experiencing CNS malignancies</p> Rashida Perveen Muhammad Naveed Babur Noor Ul Ain Shah Adnan Hafeez Sadia Sabir Tahreem Fatima Rai Shahzad Ali Aiman Faizan Copyright (c) 2022 Pakistan BioMedical Journal 2022-05-31 2022-05-31 33 37 10.54393/pbmj.v5i5.478 The Association of Covid-19 Outbreak with Cancer Patients <p>SARS-CoV-2 was perceived in China which forms a pandemic within weeks and affected the whole world population. Unfortunately, some people who were already suffering from cancer were affected severely and had more disease severity. COVID-19 badly affected cancer diagnosis and treatment resulting in increased mortality rate. A major issue that cancer patients had to face was a lack of access to necessary health care. The “Renin-angiotensin-aldosterone system (RAAS)” plays a role in cancer development, it was observed that COVID-19 affects the functioning of RAAS by affecting the Angiotensin-Converting Enzyme -2 (ACE-2) receptor with the assistance of spike proteins to gain entrance into the cells. It was proved that the ACE 2 receptor is a major link between cancer and COVID-19. Cancer patients are very sensitive to COVID-19 due to “macrophages”. Macrophages induce inflammatory responses in both cancer and COVID-19 patients. It was also observed that COVID-19 may create a microenvironment for cancer development by increasing the activation of macrophages, and neutrophils as well as causing the overproduction of proinflammatory cytokines.</p> Wardha Ghaffar Maha Noor Parsikla Akram shehla javaid Copyright (c) 2022 Pakistan BioMedical Journal 2022-05-31 2022-05-31 38 43 10.54393/pbmj.v5i5.438 Knee osteoarthritis: A systematic Review on different Exercise therapy Interventions on K.A.M <p>Exercise therapy can be part of a conservative treatment plan for knee osteoarthritis. Knee adduction moments (KAMs) are thought to be reduced with exercise therapy. A large study looked at exercise therapy's effect on KAM and other physical factors in persons with knee osteoarthritis. <strong>Methods:</strong> Searches were performed on the following electronic databases: MEDLINE, Google Scholar, Cochrane Central, EMBASE, and OpenGrey. Study participants with knee osteoarthritis undergoing structured exercise therapy were randomized controlled trials. For every study, we conducted independent analyses to extract data and analyze the bias risks. We calculated the mean differences and 95% confidence intervals for each outcome. <strong>Results:</strong> In the three studies that involved 233 participants, there were no significant differences in KAMs between intervention and control groups. Two of the studies observed improvements in physical function after exercise therapy and one of them demonstrated significant reductions in pain. All three trials favor the intervention group in terms of muscle strength and torque. <strong>Conclusions: </strong>A change in knee adduction time was not associated with the therapeutic benefits of exercise therapy. Exercise therapy for knee osteoarthritis may not be effective if there is no momentary adduction. Dynamic joint loading may result from a shift in neuromuscular control after exercise therapy</p> Muhammada Mahnoor Muhammad Waseem Akhtar Quratulain Maqsood Arslan Saeed Mahmood Alam Durrani Danish Hassan Muhammad Ramzan Wajeeha Zia Copyright (c) 2022 Pakistan BioMedical Journal 2022-05-31 2022-05-31 330 335 10.54393/pbmj.v5i5.416