Sania Maqbool, Muntaha Irshad, Mehr Un Nisa, Rashida Munir, Muhammad Farooqi, Muazzem Nasir, Muhammad Ahmad, Sana Gohar, Jaazba Asif, Suman Akram, Hina Arshad, Karam Idrees, Maryam Khan, Rimsha Rasheed, Farzand Ali
Background: Diabetic peripheral neuropathy (DPN) is a common complication of diabetes that can lead to significant balance issues, increasing the risk of falls and associated morbidity. Exercise is known to mitigate these complications, yet the comparative effectiveness of different exercise modalities remains underexplored. Objective: The study aimed to evaluate the effectiveness of aerobic exercise training compared to balance training and traditional balance exercises in improving balance among patients with DPN. Methods: A randomized controlled trial was conducted at Mayo Hospital, Lahore, with 60 patients diagnosed with DPN, divided equally into three groups: Group A (aerobic exercise), Group B (balance training), and Group C (traditional balance exercises). Each group received interventions three times weekly for four weeks. Balance was assessed using the Berg Balance Scale (BBS) pre- and post-intervention. Data were analyzed using SPSS version 25, with paired t-tests and one-way ANOVA to evaluate treatment effects. Results: Post-treatment BBS scores showed significant improvement across all groups (p < 0.001). Group A exhibited the greatest improvement, with mean scores increasing from 47.20 to 52.65. Group B's scores increased from 43.95 to 48.25, while Group C showed the least improvement, from 43.95 to 46.80. Conclusion: Aerobic exercise significantly enhances balance in DPN patients compared to balance training and traditional exercises, highlighting its potential as a primary intervention strategy.
{"title":"A Randomized Control Study of Effectiveness of Aerobic Exercise Training and Balance Training on Balance in Patients with Diabetic Peripheral Neuropathy","authors":"Sania Maqbool, Muntaha Irshad, Mehr Un Nisa, Rashida Munir, Muhammad Farooqi, Muazzem Nasir, Muhammad Ahmad, Sana Gohar, Jaazba Asif, Suman Akram, Hina Arshad, Karam Idrees, Maryam Khan, Rimsha Rasheed, Farzand Ali","doi":"10.61919/jhrr.v4i3.1215","DOIUrl":"https://doi.org/10.61919/jhrr.v4i3.1215","url":null,"abstract":"Background: Diabetic peripheral neuropathy (DPN) is a common complication of diabetes that can lead to significant balance issues, increasing the risk of falls and associated morbidity. Exercise is known to mitigate these complications, yet the comparative effectiveness of different exercise modalities remains underexplored.\u0000Objective: The study aimed to evaluate the effectiveness of aerobic exercise training compared to balance training and traditional balance exercises in improving balance among patients with DPN.\u0000Methods: A randomized controlled trial was conducted at Mayo Hospital, Lahore, with 60 patients diagnosed with DPN, divided equally into three groups: Group A (aerobic exercise), Group B (balance training), and Group C (traditional balance exercises). Each group received interventions three times weekly for four weeks. Balance was assessed using the Berg Balance Scale (BBS) pre- and post-intervention. Data were analyzed using SPSS version 25, with paired t-tests and one-way ANOVA to evaluate treatment effects.\u0000Results: Post-treatment BBS scores showed significant improvement across all groups (p < 0.001). Group A exhibited the greatest improvement, with mean scores increasing from 47.20 to 52.65. Group B's scores increased from 43.95 to 48.25, while Group C showed the least improvement, from 43.95 to 46.80.\u0000Conclusion: Aerobic exercise significantly enhances balance in DPN patients compared to balance training and traditional exercises, highlighting its potential as a primary intervention strategy.","PeriodicalId":507812,"journal":{"name":"Journal of Health and Rehabilitation Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141921841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Liaqat Hussain, Chandar Parkash, Yusra, Muntaha Irshad, Ashraf Abdul Qahir, Aslam Zardari, A. Basit
Background: Improved prophylaxis has shifted valvular heart disease (VHD) from rheumatic to non-rheumatic causes globally, with rheumatic VHD nearly eradicated in high-income countries. However, non-rheumatic VHD remains a major health issue in low-to-middle-income countries like those in South Asia. This study examines non-rheumatic VHD trends in Pakistan compared to South Asia and global figures. Objective: To evaluate non-rheumatic VHD trends in Pakistan from 1990 to 2019 using Global Burden of Disease (GBD) data. Methods: The study extracted data on prevalence, deaths, disability-adjusted life years (DALYs), and age-standardized death rate (ASDR) from the GBD study. An ecological design analyzed data using Excel and R-Studio. Poisson regression assessed the 30-year ASDR trend at global, South Asian, and national levels, calculating percentage changes with incidence rate ratios (IRR) and 95% confidence intervals. Results: From 1990 to 2019, Pakistan's non-rheumatic VHD prevalence increased by 14.1% (6.4 to 7.3 per 100,000), and ASDR rose by 12.9% (1.32 to 1.49), with an IRR of 1.102 (95% CI: 1.002-1.198). Global ASDR slightly decreased (IRR: 0.997, 95% CI: 0.971-1.024), and South Asia’s IRR was 0.996 (95% CI: 0.959-1.034). Deaths in Pakistan rose by 1.1% (0.59 to 0.60 per 100,000), and DALYs increased by 17% (14.1 to 16.5 per 100,000), with significant rises in Sindh (30.3%), Baluchistan (23.7%), and Azad Jammu & Kashmir (23.9%). Conclusion: GBD data show a significant increase in non-rheumatic VHD burden in Pakistan over 30 years, necessitating policy and interventions to address this growing health issue.
{"title":"Thirty-year Trend of Non-rheumatic Valvular Heart Disease: A Comparison of Pakistan with South Asia and Global Scenario","authors":"Liaqat Hussain, Chandar Parkash, Yusra, Muntaha Irshad, Ashraf Abdul Qahir, Aslam Zardari, A. Basit","doi":"10.61919/jhrr.v4i3.1255","DOIUrl":"https://doi.org/10.61919/jhrr.v4i3.1255","url":null,"abstract":"Background: Improved prophylaxis has shifted valvular heart disease (VHD) from rheumatic to non-rheumatic causes globally, with rheumatic VHD nearly eradicated in high-income countries. However, non-rheumatic VHD remains a major health issue in low-to-middle-income countries like those in South Asia. This study examines non-rheumatic VHD trends in Pakistan compared to South Asia and global figures.\u0000Objective: To evaluate non-rheumatic VHD trends in Pakistan from 1990 to 2019 using Global Burden of Disease (GBD) data.\u0000Methods: The study extracted data on prevalence, deaths, disability-adjusted life years (DALYs), and age-standardized death rate (ASDR) from the GBD study. An ecological design analyzed data using Excel and R-Studio. Poisson regression assessed the 30-year ASDR trend at global, South Asian, and national levels, calculating percentage changes with incidence rate ratios (IRR) and 95% confidence intervals.\u0000Results: From 1990 to 2019, Pakistan's non-rheumatic VHD prevalence increased by 14.1% (6.4 to 7.3 per 100,000), and ASDR rose by 12.9% (1.32 to 1.49), with an IRR of 1.102 (95% CI: 1.002-1.198). Global ASDR slightly decreased (IRR: 0.997, 95% CI: 0.971-1.024), and South Asia’s IRR was 0.996 (95% CI: 0.959-1.034). Deaths in Pakistan rose by 1.1% (0.59 to 0.60 per 100,000), and DALYs increased by 17% (14.1 to 16.5 per 100,000), with significant rises in Sindh (30.3%), Baluchistan (23.7%), and Azad Jammu & Kashmir (23.9%).\u0000Conclusion: GBD data show a significant increase in non-rheumatic VHD burden in Pakistan over 30 years, necessitating policy and interventions to address this growing health issue.","PeriodicalId":507812,"journal":{"name":"Journal of Health and Rehabilitation Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141921719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ihsan Ullah, Ali Raza, Shafi Ullah, Sultan Hikmat Yar, Shah sawar Khan, Tahir Munir, Abid Ullah, Shah Zeb, H. Zeb, Muhammad Wali Saleem
Background: Timely management of acute ST-elevation myocardial infarction (STEMI) is crucial, as prolonged door-to-device (DTD) time is directly related to worse cardiac outcomes. Institutions aim to achieve optimal DTD times as a measure of quality improvement. Objective: This study aimed to evaluate the impact of a higher number of routine cases on the DTD time of acute STEMI patients presenting to a tertiary care cardiac center. Methods: This retrospective observational study was conducted at the Peshawar Institute of Cardiology (PIC) in Peshawar. A total of 371 patients presented with acute STEMI over a three-month period, of whom 258 were included in the detailed analysis. Patient data, including baseline characteristics, arrival time, and device time, were obtained from the hospital database. Patients were divided into three groups based on their presentation timing: Morning (08:00 am to 02:00 pm), Evening (02:00 pm to 08:00 pm), and Night (08:00 pm to 08:00 am). The primary endpoint was to calculate and compare DTD time between these groups and evaluate the impact of routine case volume, especially during daytime hours. Results: Out of the 258 patients studied, 194 (75.4%) were male, with a mean age of 58.2 ± 11.2 years. Hypertension was the most common risk factor, affecting 131 patients (50.7%). A higher number of cases presented during the night shift (n=99), followed by the evening (n=81) and morning shifts (n=78). The use of conventional right radial artery access (RRAA) was prevalent (n=239, 92.6%, p=0.032). The total mean DTD time was 90.78 ± 39.9 minutes, with shift-wise DTD times of 74.0 ± 29.6 minutes for the night shift, 98.97 ± 40.0 minutes for the evening shift, and 103.5 ± 44.0 minutes for the morning shift. Post-procedural TIMI-III flow was achieved in 90.9% of night shift patients, 86.4% of evening shift patients, and 82.0% of morning shift patients. Conclusion: A higher number of routine cases resulted in prolonged DTD time. Establishing a designated catheterization lab exclusively for primary PCIs could improve DTD times and patient outcomes.
{"title":"Impact of Routine Case Volume on Door-to-Device Time for Primary PCI Patients: The Concept of a Designated Primary PCI Cath Lab at a Large Volume Cardiac Center","authors":"Ihsan Ullah, Ali Raza, Shafi Ullah, Sultan Hikmat Yar, Shah sawar Khan, Tahir Munir, Abid Ullah, Shah Zeb, H. Zeb, Muhammad Wali Saleem","doi":"10.61919/jhrr.v4i3.972","DOIUrl":"https://doi.org/10.61919/jhrr.v4i3.972","url":null,"abstract":"Background: Timely management of acute ST-elevation myocardial infarction (STEMI) is crucial, as prolonged door-to-device (DTD) time is directly related to worse cardiac outcomes. Institutions aim to achieve optimal DTD times as a measure of quality improvement.\u0000Objective: This study aimed to evaluate the impact of a higher number of routine cases on the DTD time of acute STEMI patients presenting to a tertiary care cardiac center.\u0000Methods: This retrospective observational study was conducted at the Peshawar Institute of Cardiology (PIC) in Peshawar. A total of 371 patients presented with acute STEMI over a three-month period, of whom 258 were included in the detailed analysis. Patient data, including baseline characteristics, arrival time, and device time, were obtained from the hospital database. Patients were divided into three groups based on their presentation timing: Morning (08:00 am to 02:00 pm), Evening (02:00 pm to 08:00 pm), and Night (08:00 pm to 08:00 am). The primary endpoint was to calculate and compare DTD time between these groups and evaluate the impact of routine case volume, especially during daytime hours.\u0000Results: Out of the 258 patients studied, 194 (75.4%) were male, with a mean age of 58.2 ± 11.2 years. Hypertension was the most common risk factor, affecting 131 patients (50.7%). A higher number of cases presented during the night shift (n=99), followed by the evening (n=81) and morning shifts (n=78). The use of conventional right radial artery access (RRAA) was prevalent (n=239, 92.6%, p=0.032). The total mean DTD time was 90.78 ± 39.9 minutes, with shift-wise DTD times of 74.0 ± 29.6 minutes for the night shift, 98.97 ± 40.0 minutes for the evening shift, and 103.5 ± 44.0 minutes for the morning shift. Post-procedural TIMI-III flow was achieved in 90.9% of night shift patients, 86.4% of evening shift patients, and 82.0% of morning shift patients.\u0000Conclusion: A higher number of routine cases resulted in prolonged DTD time. Establishing a designated catheterization lab exclusively for primary PCIs could improve DTD times and patient outcomes.","PeriodicalId":507812,"journal":{"name":"Journal of Health and Rehabilitation Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141921863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Areeba Mahmood, Syed Muhammad Yousaf Farooq, Ume Kalsoom Attique, Hamna Areej, Haq Nawaz Khan, M. Usama Tahir
Background: Carotid artery disease is prevalent in individuals with hypertension and renal failure, often characterized by the thickening of the fibromuscular layers of the intima and media, and narrowing of the lumens in smaller arteries and arterioles. This condition increases the risk of atherosclerotic vascular diseases affecting the coronary and cerebral vessels, which can lead to myocardial infarction and stroke. Hypertension is a major contributing factor to these structural changes, increasing the susceptibility to carotid artery disease. Objective: This study aimed to compare the Color Doppler results for evaluating carotid artery disease in patients with and without hypertension, focusing on differences in intima-media thickness (IMT) and other Doppler indices between these two groups. Methods: A cross-sectional study was conducted on 120 patients at the ultrasound clinic of the University of Lahore. The study included 72 hypertensive and 48 non-hypertensive individuals with clinical indications of carotid artery disease. The sample size was calculated based on the prevalence of hypertension in Pakistan. Doppler ultrasonography was performed using a Toshiba XARIO XG machine equipped with a linear probe operating at 5-7.5 MHz. Patients were selected based on clinical indications, and both male and female participants were included, while those who were unwilling or uncooperative were excluded. Data analysis was conducted using SPSS version 25.0, and parameters such as age, presence of hypertension and diabetes, gender, and intima-media thickness were recorded. The study analyzed the mean ± standard deviation of Resistive Index, Pulsatility Index, End Diastolic Velocity, and Peak Systolic Velocity. An independent t-test was used to compare Doppler indices between hypertensive and non-hypertensive participants, with a significance level set at p < 0.05. Results: The study revealed significant differences in intima-media thickness (IMT) between hypertensive and non-hypertensive groups. In non-hypertensive patients, the mean ± standard deviation of IMT was 0.56 ± 0.14 mm for the right carotid artery and 0.57 ± 0.14 mm for the left. In hypertensive patients, these values were 0.63 ± 0.16 mm for the right and 0.62 ± 0.14 mm for the left carotid artery. The differences were statistically significant with p-values of 0.013 and 0.048 for the right and left carotid arteries, respectively. No significant differences were observed in other Doppler indices, such as RI, PI, PSV, and EDV, between the two groups. Conclusion: Hypertension is a major risk factor significantly associated with increased carotid intima-media thickness and plaque formation. Monitoring blood pressure and using Doppler ultrasound for early detection of increased IMT can help prevent carotid artery plaque formation and improve the prognosis of cardiovascular and cerebrovascular diseases. Pakistan.
{"title":"Comparative Study of Carotid Artery Disease in Hypertensive Versus Non-Hypertensive Patients Using Color Doppler Flow Imaging","authors":"Areeba Mahmood, Syed Muhammad Yousaf Farooq, Ume Kalsoom Attique, Hamna Areej, Haq Nawaz Khan, M. Usama Tahir","doi":"10.61919/jhrr.v4i3.1254","DOIUrl":"https://doi.org/10.61919/jhrr.v4i3.1254","url":null,"abstract":"Background: Carotid artery disease is prevalent in individuals with hypertension and renal failure, often characterized by the thickening of the fibromuscular layers of the intima and media, and narrowing of the lumens in smaller arteries and arterioles. This condition increases the risk of atherosclerotic vascular diseases affecting the coronary and cerebral vessels, which can lead to myocardial infarction and stroke. Hypertension is a major contributing factor to these structural changes, increasing the susceptibility to carotid artery disease.\u0000Objective: This study aimed to compare the Color Doppler results for evaluating carotid artery disease in patients with and without hypertension, focusing on differences in intima-media thickness (IMT) and other Doppler indices between these two groups.\u0000Methods: A cross-sectional study was conducted on 120 patients at the ultrasound clinic of the University of Lahore. The study included 72 hypertensive and 48 non-hypertensive individuals with clinical indications of carotid artery disease. The sample size was calculated based on the prevalence of hypertension in Pakistan. Doppler ultrasonography was performed using a Toshiba XARIO XG machine equipped with a linear probe operating at 5-7.5 MHz. Patients were selected based on clinical indications, and both male and female participants were included, while those who were unwilling or uncooperative were excluded. Data analysis was conducted using SPSS version 25.0, and parameters such as age, presence of hypertension and diabetes, gender, and intima-media thickness were recorded. The study analyzed the mean ± standard deviation of Resistive Index, Pulsatility Index, End Diastolic Velocity, and Peak Systolic Velocity. An independent t-test was used to compare Doppler indices between hypertensive and non-hypertensive participants, with a significance level set at p < 0.05.\u0000Results: The study revealed significant differences in intima-media thickness (IMT) between hypertensive and non-hypertensive groups. In non-hypertensive patients, the mean ± standard deviation of IMT was 0.56 ± 0.14 mm for the right carotid artery and 0.57 ± 0.14 mm for the left. In hypertensive patients, these values were 0.63 ± 0.16 mm for the right and 0.62 ± 0.14 mm for the left carotid artery. The differences were statistically significant with p-values of 0.013 and 0.048 for the right and left carotid arteries, respectively. No significant differences were observed in other Doppler indices, such as RI, PI, PSV, and EDV, between the two groups.\u0000Conclusion: Hypertension is a major risk factor significantly associated with increased carotid intima-media thickness and plaque formation. Monitoring blood pressure and using Doppler ultrasound for early detection of increased IMT can help prevent carotid artery plaque formation and improve the prognosis of cardiovascular and cerebrovascular diseases. Pakistan.","PeriodicalId":507812,"journal":{"name":"Journal of Health and Rehabilitation Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141924964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Malaria is a significant public health and socio-economic issue, affecting over 300 million people annually across more than 90 countries. Pregnant women are particularly vulnerable to malaria due to their decreased immunity, which increases the risk of adverse pregnancy outcomes, including low birth weight, preterm delivery, and infant mortality. Objective: This study aimed to investigate the role of trace elements in pregnant women with vivax malaria by comparing their serum concentrations with those of healthy pregnant women. Methods: This hospital-based case-control study was conducted at Liaquat University of Medical & Health Sciences and City Hospital, Hyderabad, Sindh, Pakistan. A total of 120 participants were enrolled, comprising 60 pregnant women diagnosed with gestational vivax malaria and 60 age- and gestational age-matched healthy pregnant women. Blood samples were collected and analyzed using Atomic Absorption Spectroscopy to measure serum levels of magnesium (Mg), iron (Fe), copper (Cu), and zinc (Zn). Data were statistically analyzed using SPSS version 25, with significance set at p < 0.05. Results: The study found significantly lower concentrations of copper, magnesium, zinc, and iron in the serum of pregnant women with vivax malaria compared to healthy controls. The mean serum levels for copper were 1.50 ± 0.59 mg/L in the malaria group versus 2.01 ± 0.41 mg/L in controls, magnesium was 1.60 ± 0.72 mg/L versus 2.09 ± 0.87 mg/L, zinc was 0.93 ± 0.63 mg/L versus 1.40 ± 0.57 mg/L, and iron was 0.97 ± 0.82 mg/L versus 1.40 ± 0.77 mg/L (p < 0.001 for all comparisons). Conclusion: The findings suggest that pregnant women with vivax malaria have significant deficiencies in essential trace elements, which may contribute to compromised immune function and adverse pregnancy outcomes. Addressing these deficiencies through targeted nutritional interventions could enhance immunity and improve maternal and neonatal health outcomes in malaria-endemic regions.
{"title":"Role of Trace Elements in Pregnant Women with Malaria: A Case-Control Study","authors":"Dr. Saira Baloch","doi":"10.61919/jhrr.v4i3.1205","DOIUrl":"https://doi.org/10.61919/jhrr.v4i3.1205","url":null,"abstract":"Background: Malaria is a significant public health and socio-economic issue, affecting over 300 million people annually across more than 90 countries. Pregnant women are particularly vulnerable to malaria due to their decreased immunity, which increases the risk of adverse pregnancy outcomes, including low birth weight, preterm delivery, and infant mortality.\u0000Objective: This study aimed to investigate the role of trace elements in pregnant women with vivax malaria by comparing their serum concentrations with those of healthy pregnant women.\u0000Methods: This hospital-based case-control study was conducted at Liaquat University of Medical & Health Sciences and City Hospital, Hyderabad, Sindh, Pakistan. A total of 120 participants were enrolled, comprising 60 pregnant women diagnosed with gestational vivax malaria and 60 age- and gestational age-matched healthy pregnant women. Blood samples were collected and analyzed using Atomic Absorption Spectroscopy to measure serum levels of magnesium (Mg), iron (Fe), copper (Cu), and zinc (Zn). Data were statistically analyzed using SPSS version 25, with significance set at p < 0.05.\u0000Results: The study found significantly lower concentrations of copper, magnesium, zinc, and iron in the serum of pregnant women with vivax malaria compared to healthy controls. The mean serum levels for copper were 1.50 ± 0.59 mg/L in the malaria group versus 2.01 ± 0.41 mg/L in controls, magnesium was 1.60 ± 0.72 mg/L versus 2.09 ± 0.87 mg/L, zinc was 0.93 ± 0.63 mg/L versus 1.40 ± 0.57 mg/L, and iron was 0.97 ± 0.82 mg/L versus 1.40 ± 0.77 mg/L (p < 0.001 for all comparisons).\u0000Conclusion: The findings suggest that pregnant women with vivax malaria have significant deficiencies in essential trace elements, which may contribute to compromised immune function and adverse pregnancy outcomes. Addressing these deficiencies through targeted nutritional interventions could enhance immunity and improve maternal and neonatal health outcomes in malaria-endemic regions.","PeriodicalId":507812,"journal":{"name":"Journal of Health and Rehabilitation Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141921518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Muhammad Hafeez, Muhammad Zia Ul Haq, Shabana Rahim
Background: Low back pain (LBP) is a prevalent condition with significant socio-economic impacts. Among its multifactorial causes, calf muscle tightness is a key mechanical contributor. This study evaluates the impact of a calf stretching intervention on LBP. Objective: To assess the effectiveness of calf stretching using an inclined board in reducing pain and disability and improving physical health in individuals with chronic LBP and calf tightness. Methods: A single-group intervention design was utilized with 22 participants aged 18-65 years, clinically diagnosed with chronic LBP and calf tightness. The intervention involved a one-minute standing stretch on a 45-degree inclined wedge, performed three times daily for four weeks. Assessments were conducted at baseline and post-intervention using the Numerical Pain Rating Scale (NPRS), Oswestry Disability Index (ODI), and SF-12 questionnaire. Participants’ compliance was monitored through daily logs, and weekly follow-up sessions ensured correct performance of the stretches. Data were analyzed using paired samples t-tests with SPSS version 25. Results: The paired samples t-test showed significant improvements across all measures. The mean NPRS score decreased by 4.40 points (p < 0.001), indicating reduced pain. The Physical Component Summary (PCS) of the SF-12 improved by 12.96 points (p < 0.001), reflecting enhanced physical health. The ODI score reduced by 4.40 points (p < 0.001), suggesting decreased disability. Conclusion: The study demonstrates that a structured calf stretching program significantly reduces pain and disability while improving physical health in individuals with LBP and calf tightness. Incorporating calf flexibility assessments and interventions can be crucial in LBP management.
{"title":"The Impact of Calf Stretching Using Inclined Board Standing on Low Back Pain: An Interventional Study","authors":"Muhammad Hafeez, Muhammad Zia Ul Haq, Shabana Rahim","doi":"10.61919/jhrr.v4i3.1265","DOIUrl":"https://doi.org/10.61919/jhrr.v4i3.1265","url":null,"abstract":"Background: Low back pain (LBP) is a prevalent condition with significant socio-economic impacts. Among its multifactorial causes, calf muscle tightness is a key mechanical contributor. This study evaluates the impact of a calf stretching intervention on LBP.\u0000Objective: To assess the effectiveness of calf stretching using an inclined board in reducing pain and disability and improving physical health in individuals with chronic LBP and calf tightness.\u0000Methods: A single-group intervention design was utilized with 22 participants aged 18-65 years, clinically diagnosed with chronic LBP and calf tightness. The intervention involved a one-minute standing stretch on a 45-degree inclined wedge, performed three times daily for four weeks. Assessments were conducted at baseline and post-intervention using the Numerical Pain Rating Scale (NPRS), Oswestry Disability Index (ODI), and SF-12 questionnaire. Participants’ compliance was monitored through daily logs, and weekly follow-up sessions ensured correct performance of the stretches. Data were analyzed using paired samples t-tests with SPSS version 25.\u0000Results: The paired samples t-test showed significant improvements across all measures. The mean NPRS score decreased by 4.40 points (p < 0.001), indicating reduced pain. The Physical Component Summary (PCS) of the SF-12 improved by 12.96 points (p < 0.001), reflecting enhanced physical health. The ODI score reduced by 4.40 points (p < 0.001), suggesting decreased disability.\u0000Conclusion: The study demonstrates that a structured calf stretching program significantly reduces pain and disability while improving physical health in individuals with LBP and calf tightness. Incorporating calf flexibility assessments and interventions can be crucial in LBP management.","PeriodicalId":507812,"journal":{"name":"Journal of Health and Rehabilitation Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141922109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ayesha Aleem, Iram Amanullah, Muhammad Abubakar Ali, Muhammad Hamza Masud Ghumman, Iqra Tahir, Rida Tahir, Aqsa Yaqoob, Momina Tariq Qureshi, Mobasher Ahmad Butt
Background: The prevalence of depression and anxiety among university students worldwide is a growing concern. Concurrently, caffeine consumption has increased, attributed to perceived benefits. While moderate caffeine intake might offer protective effects, excessive consumption has been linked to anxiety and depression. Although studies have explored this relationship globally, research specific to Pakistan remains limited. Objective: This study aimed to evaluate the impact of excessive caffeine consumption on the levels of anxiety and depression among university students in Lahore, Pakistan. Methods: A cross-sectional observational study was conducted over eight weeks from June 20th to August 15th, 2023, among 324 university students in Lahore, Pakistan. Participants were selected through convenient sampling from both medical and non-medical universities. Data were collected using a validated questionnaire, which included sections on socio-demographic information, academic history, mental health history, and caffeine intake. The Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder-7 (GAD-7) scales were used to assess depression and anxiety, respectively. Ethical approval was obtained from the Research and Ethics Committee of Gulab Devi Institute of Pharmacy (REC/GDIP/23/DCP/16). Statistical analysis was performed using SPSS Version 25, with Pearson's correlation coefficient employed to evaluate the relationship between caffeine consumption and mental health outcomes. Results: Of the 324 participants, 238 were female (73.5%) and 86 were male (26.5%). The majority were in their fifth year or higher (52.5%). Tea was the primary source of caffeine (75.9%), followed by coffee (22.8%) and energy drinks (17.9%). Significant positive correlations were found between caffeine consumption and PHQ-9 scores (r = .216, p < .001) as well as GAD-7 scores (r = .258, p < .001). Conclusion: Excessive consumption of caffeine-containing beverages is significantly associated with higher levels of depression and anxiety among university students in Lahore. These findings highlight the need for awareness and preventive measures to mitigate the mental health risks associated with high caffeine intake in this population.
{"title":"Association of Depression and Anxiety with Consumption of Caffeine-Containing Beverages in University Students of Lahore, Pakistan","authors":"Ayesha Aleem, Iram Amanullah, Muhammad Abubakar Ali, Muhammad Hamza Masud Ghumman, Iqra Tahir, Rida Tahir, Aqsa Yaqoob, Momina Tariq Qureshi, Mobasher Ahmad Butt","doi":"10.61919/jhrr.v4i3.1256","DOIUrl":"https://doi.org/10.61919/jhrr.v4i3.1256","url":null,"abstract":"Background: The prevalence of depression and anxiety among university students worldwide is a growing concern. Concurrently, caffeine consumption has increased, attributed to perceived benefits. While moderate caffeine intake might offer protective effects, excessive consumption has been linked to anxiety and depression. Although studies have explored this relationship globally, research specific to Pakistan remains limited.\u0000Objective: This study aimed to evaluate the impact of excessive caffeine consumption on the levels of anxiety and depression among university students in Lahore, Pakistan.\u0000Methods: A cross-sectional observational study was conducted over eight weeks from June 20th to August 15th, 2023, among 324 university students in Lahore, Pakistan. Participants were selected through convenient sampling from both medical and non-medical universities. Data were collected using a validated questionnaire, which included sections on socio-demographic information, academic history, mental health history, and caffeine intake. The Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder-7 (GAD-7) scales were used to assess depression and anxiety, respectively. Ethical approval was obtained from the Research and Ethics Committee of Gulab Devi Institute of Pharmacy (REC/GDIP/23/DCP/16). Statistical analysis was performed using SPSS Version 25, with Pearson's correlation coefficient employed to evaluate the relationship between caffeine consumption and mental health outcomes.\u0000Results: Of the 324 participants, 238 were female (73.5%) and 86 were male (26.5%). The majority were in their fifth year or higher (52.5%). Tea was the primary source of caffeine (75.9%), followed by coffee (22.8%) and energy drinks (17.9%). Significant positive correlations were found between caffeine consumption and PHQ-9 scores (r = .216, p < .001) as well as GAD-7 scores (r = .258, p < .001).\u0000Conclusion: Excessive consumption of caffeine-containing beverages is significantly associated with higher levels of depression and anxiety among university students in Lahore. These findings highlight the need for awareness and preventive measures to mitigate the mental health risks associated with high caffeine intake in this population.","PeriodicalId":507812,"journal":{"name":"Journal of Health and Rehabilitation Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141924915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Lasers have recently been discovered as effective treatment modalities in dentistry, offering benefits such as reduced bleeding, infection, treatment and healing durations, and significantly improving patient convenience. They have found a wide range of applications in dentistry, from periodontal therapy to post-extraction healing, allowing for surgical procedures without sutures and minimizing post-operative bleeding by sealing blood vessels. Objective: To evaluate the efficacy of diode laser treatment for tissue ablation in the oral cavity, particularly focusing on cases of excessive gingival growth (gummy smile) and peri-implantitis. Methods: This case series involved two patients: a 19-year-old female undergoing orthodontic treatment with excessive gingival growth and a gummy smile, and a 50-year-old female with peri-implantitis. Both patients were treated using a 980 nm diode laser. Laser parameters included a pulsed operational mode with a frequency of 5 kHz, peak power of 3 W, average power of 1.5 W, and a fiber diameter of 200 µm, with a 50% duty cycle. Data collection involved pre-operative and post-operative clinical examinations, including intraoral photographs, to document gingival overgrowth and treatment outcomes. Post-operative assessments were conducted at regular intervals to evaluate healing, erythema, swelling, and signs of infection. Statistical analysis was performed using SPSS version 25. Results: In the first case, laser treatment reduced gingival overgrowth from 6-7 mm to 0 mm, with no erythema or swelling and minimal pain (VAS score from 4/10 to 1/10). Esthetic improvement was rated as excellent. In the second case, laser treatment resolved gingival overgrowth, eliminated bleeding on probing, and reduced pain (VAS score from 5/10 to 1/10). Implant abutments were clean, with no inflammation. Conclusion: Diode laser therapy is effective for tissue ablation in the oral cavity, ensuring the restoration of esthetics and function. It offers precise tissue removal, reduced post-operative bleeding, and accelerated healing, making it a valuable tool in modern dental practice.
{"title":"Tissue Ablation Using Lasers: A Case Series","authors":"Nauman rauf Khan, Hira Khosa, Asma Shakoor, Sameen Zohra, Mariam Jabbar, Hira Butt","doi":"10.61919/jhrr.v4i3.1220","DOIUrl":"https://doi.org/10.61919/jhrr.v4i3.1220","url":null,"abstract":"Background: Lasers have recently been discovered as effective treatment modalities in dentistry, offering benefits such as reduced bleeding, infection, treatment and healing durations, and significantly improving patient convenience. They have found a wide range of applications in dentistry, from periodontal therapy to post-extraction healing, allowing for surgical procedures without sutures and minimizing post-operative bleeding by sealing blood vessels.\u0000Objective: To evaluate the efficacy of diode laser treatment for tissue ablation in the oral cavity, particularly focusing on cases of excessive gingival growth (gummy smile) and peri-implantitis.\u0000Methods: This case series involved two patients: a 19-year-old female undergoing orthodontic treatment with excessive gingival growth and a gummy smile, and a 50-year-old female with peri-implantitis. Both patients were treated using a 980 nm diode laser. Laser parameters included a pulsed operational mode with a frequency of 5 kHz, peak power of 3 W, average power of 1.5 W, and a fiber diameter of 200 µm, with a 50% duty cycle. Data collection involved pre-operative and post-operative clinical examinations, including intraoral photographs, to document gingival overgrowth and treatment outcomes. Post-operative assessments were conducted at regular intervals to evaluate healing, erythema, swelling, and signs of infection. Statistical analysis was performed using SPSS version 25.\u0000Results: In the first case, laser treatment reduced gingival overgrowth from 6-7 mm to 0 mm, with no erythema or swelling and minimal pain (VAS score from 4/10 to 1/10). Esthetic improvement was rated as excellent. In the second case, laser treatment resolved gingival overgrowth, eliminated bleeding on probing, and reduced pain (VAS score from 5/10 to 1/10). Implant abutments were clean, with no inflammation.\u0000Conclusion: Diode laser therapy is effective for tissue ablation in the oral cavity, ensuring the restoration of esthetics and function. It offers precise tissue removal, reduced post-operative bleeding, and accelerated healing, making it a valuable tool in modern dental practice.","PeriodicalId":507812,"journal":{"name":"Journal of Health and Rehabilitation Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141921563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Stroke, a leading cause of death and disability, is characterized by a sudden disruption of blood flow to the brain, resulting in motor weakness and hemiparesis. Rehabilitation aims to improve functional outcomes, with Proprioceptive Neuromuscular Facilitation (PNF) and Electrical Muscle Stimulation (EMS) being promising interventions. Objective: This study aimed to determine the effects of PNF with and without EMS on spasticity, gait, and lower limb function in chronic stroke patients. Methods: A randomized controlled trial was conducted with 22 participants recruited from the physiotherapy department of District Headquarters Sheikhupura from October 2022 to May 2023. Participants were randomly divided into a control group, receiving PNF techniques alone, and an experimental group, receiving PNF combined with EMS. The PNF techniques included rhythmic initiation, stabilizing reversals, and dynamic reversals, while EMS was applied at a frequency of 25 to 50 Hz for 10 seconds, three times a week for six weeks. Outcome measures included the Modified Ashworth Scale, Modified Barthel Index, Dynamic Gait Index, and Tinetti Performance Oriented Mobility Assessment. Data were analyzed using SPSS version 25. Results: Post-intervention, the experimental group showed significant improvements over the control group in the Modified Ashworth Scale (p=0.022), Modified Barthel Index (p=0.028), Dynamic Gait Index (p=0.042), and Tinetti Assessment (p=0.004). Conclusion: The study concluded that combining PNF with EMS yields better outcomes in managing spasticity, gait, and lower limb functions in chronic stroke patients than PNF alone.
{"title":"Effects of Proprioceptive Neuromuscular Facilitation with and without Electrical Muscle Stimulation on spasticity, gait and lower limb function in chronic stroke patients","authors":"Shanza Khan, Wajiha Shahid, Raheema Khalid, Maira Pervez, Rahma Hameed, Sidra Khaliq","doi":"10.61919/jhrr.v4i3.1204","DOIUrl":"https://doi.org/10.61919/jhrr.v4i3.1204","url":null,"abstract":"Background: Stroke, a leading cause of death and disability, is characterized by a sudden disruption of blood flow to the brain, resulting in motor weakness and hemiparesis. Rehabilitation aims to improve functional outcomes, with Proprioceptive Neuromuscular Facilitation (PNF) and Electrical Muscle Stimulation (EMS) being promising interventions.\u0000Objective: This study aimed to determine the effects of PNF with and without EMS on spasticity, gait, and lower limb function in chronic stroke patients.\u0000Methods: A randomized controlled trial was conducted with 22 participants recruited from the physiotherapy department of District Headquarters Sheikhupura from October 2022 to May 2023. Participants were randomly divided into a control group, receiving PNF techniques alone, and an experimental group, receiving PNF combined with EMS. The PNF techniques included rhythmic initiation, stabilizing reversals, and dynamic reversals, while EMS was applied at a frequency of 25 to 50 Hz for 10 seconds, three times a week for six weeks. Outcome measures included the Modified Ashworth Scale, Modified Barthel Index, Dynamic Gait Index, and Tinetti Performance Oriented Mobility Assessment. Data were analyzed using SPSS version 25.\u0000Results: Post-intervention, the experimental group showed significant improvements over the control group in the Modified Ashworth Scale (p=0.022), Modified Barthel Index (p=0.028), Dynamic Gait Index (p=0.042), and Tinetti Assessment (p=0.004).\u0000Conclusion: The study concluded that combining PNF with EMS yields better outcomes in managing spasticity, gait, and lower limb functions in chronic stroke patients than PNF alone.","PeriodicalId":507812,"journal":{"name":"Journal of Health and Rehabilitation Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141923456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gulaly Ayub Khan, Maryam, Chandnee Rehman, Asia Rubab
Background: Gestational diabetes mellitus (GDM) is a common pregnancy complication associated with adverse maternal and fetal outcomes, particularly among obese women. Understanding the prevalence and risk factors for GDM in this population is crucial for effective clinical management and prevention strategies. Objective: This study aimed to determine the frequency of GDM among obese pregnant women and assess its association with body mass index (BMI) categories, as well as to investigate obstetric outcomes associated with GDM in this cohort. Methods: This was a cross-sectional study conducted at Khyber Teaching Hospital, Peshawar, from February 2021 to July 2022. The sample size was calculated to be 152 participants. Inclusion criteria included pregnant women with a BMI of 30 or greater. Exclusion criteria were women with pre-existing diabetes mellitus and multiple pregnancies. Data collection involved direct interviews and medical record reviews, capturing demographic information, medical history, BMI measurements, and glucose tolerance test results. GDM was diagnosed according to the American Diabetes Association criteria. Statistical analysis was performed using SPSS version 25.0, with a significance level set at p ≤ 0.05. Results: Among the 152 participants, the mean age was 28.6±4.8 years. The prevalence of GDM was found to be 29.6%. Of the participants, 46% had a period of gestation (POG) of less than 37 weeks, and 54% had a POG of 37 weeks or more. BMI distribution showed that 47% of women had a BMI of 30-34.9 kg/m², and 53% had a BMI of 35 kg/m² or greater. Gravida distribution indicated that 35% were primigravida, and 65% were multigravida. The prevalence of GDM was significantly higher in women with a BMI of 35 or greater (38.5%) compared to those with a BMI of 30-34.9 (22.9%) (p = 0.031). Women with GDM had higher incidences of preeclampsia (31.1% vs. 12.1%, p = 0.008) and cesarean delivery (53.3% vs. 29.0%, p = 0.015). Conclusion: The study highlights a high frequency of GDM among obese pregnant women, emphasizing the importance of addressing obesity as a modifiable risk factor for GDM. Effective strategies for GDM screening and management in obese populations are essential to improve maternal and fetal outcomes.
{"title":"Frequency of Intrauterine Growth Restriction Associated with Hypertensive Disorders of Pregnancy","authors":"Gulaly Ayub Khan, Maryam, Chandnee Rehman, Asia Rubab","doi":"10.61919/jhrr.v4i3.1175","DOIUrl":"https://doi.org/10.61919/jhrr.v4i3.1175","url":null,"abstract":"Background: Gestational diabetes mellitus (GDM) is a common pregnancy complication associated with adverse maternal and fetal outcomes, particularly among obese women. Understanding the prevalence and risk factors for GDM in this population is crucial for effective clinical management and prevention strategies.\u0000Objective: This study aimed to determine the frequency of GDM among obese pregnant women and assess its association with body mass index (BMI) categories, as well as to investigate obstetric outcomes associated with GDM in this cohort.\u0000Methods: This was a cross-sectional study conducted at Khyber Teaching Hospital, Peshawar, from February 2021 to July 2022. The sample size was calculated to be 152 participants. Inclusion criteria included pregnant women with a BMI of 30 or greater. Exclusion criteria were women with pre-existing diabetes mellitus and multiple pregnancies. Data collection involved direct interviews and medical record reviews, capturing demographic information, medical history, BMI measurements, and glucose tolerance test results. GDM was diagnosed according to the American Diabetes Association criteria. Statistical analysis was performed using SPSS version 25.0, with a significance level set at p ≤ 0.05.\u0000Results: Among the 152 participants, the mean age was 28.6±4.8 years. The prevalence of GDM was found to be 29.6%. Of the participants, 46% had a period of gestation (POG) of less than 37 weeks, and 54% had a POG of 37 weeks or more. BMI distribution showed that 47% of women had a BMI of 30-34.9 kg/m², and 53% had a BMI of 35 kg/m² or greater. Gravida distribution indicated that 35% were primigravida, and 65% were multigravida. The prevalence of GDM was significantly higher in women with a BMI of 35 or greater (38.5%) compared to those with a BMI of 30-34.9 (22.9%) (p = 0.031). Women with GDM had higher incidences of preeclampsia (31.1% vs. 12.1%, p = 0.008) and cesarean delivery (53.3% vs. 29.0%, p = 0.015).\u0000Conclusion: The study highlights a high frequency of GDM among obese pregnant women, emphasizing the importance of addressing obesity as a modifiable risk factor for GDM. Effective strategies for GDM screening and management in obese populations are essential to improve maternal and fetal outcomes.","PeriodicalId":507812,"journal":{"name":"Journal of Health and Rehabilitation Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141922079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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