Stroke-related upper limb dysfunction and spasticity are main causes of long-term disability which affect functional independence and quality of life notably among patients. Segmental muscle vibration (SMV) has arisen as a promising rehabilitation approach to improve motor recovery and reducing spasticity in poststroke patients. This study aimed to compare the effects of the SMV on upper limb function and spasticity in subacute poststroke patients treated with two vibration frequencies (i.e., 60 Hz and 120 Hz) with those of patients treated with traditional therapy alone. Twenty-eight participants (N = 28) were randomized into three groups including two experimental groups that received extra SMV at 60 Hz and 120 Hz, and a control group that received conventional physiotherapy. The interventions were provided twice a week for eight weeks. The study employed Fugl-Meyer Assessment for Upper Extremes (FMA-UE), Modified Ashworth Scale (MAS) and Motor Assessment Scale were used to measure the outcomes. Upper limb function showed significant improvements across all groups and a decrease in spasticity at baseline (p < 0.05). Nevertheless, the postintervention between-group results were not significantly different between two SMV and control groups (p > 0.05). SMV in combination with traditional therapy is effective, but there was no difference in the benefits of 60 Hz versus 120 Hz in patients with subacute stroke treated with conventional therapy alone.

Cardiovascular diseases (CVDs) are major causes of increased mortality and disability across the globe. Effective management of diabetes mellitus (DM) in CVD patients requires the integration of monitoring of glycemic status (HbA1c) and lipid metabolism. This cross-sectional analytical study included 121 patients and 80 control subjects to analyze the association of HbA1c levels with lipid profiles. Serum biochemical analyses of the lipid profile [total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and triglycerides] were performed with an Agilent 8453 UV‑Visible spectrophotometer (Agilent Technologies, USA), and HbA1c was measured on an A1C EZ 2.0 glycohemoglobin analyzer. Comparisons of characteristics between the groups were performed using chi square or Fisher's exact tests and unpaired Student’s t‑tests, and the relationships between HbA1c and other variables were determined by correlation and linear regression analyses. The cohort exhibited evidence of poor glycemic control (mean HbA1c of 8.23%) and was associated with increasing age (mean 50.7 years) and weight (mean 70.61 kg). Low levels of HDL-C and a positive family history are associated with disease. Increased age and high body weight, systolic blood pressure (SBP), diastolic blood pressure (DBP) and fasting blood glucose levels were associated with high HbA1c levels (≥ 6.5 %), whereas HDL-C levels were inversely associated with HbA1c. Key correlations included significant positive associations of age, weight, SBP, and DBP with HbA1c (all p < 0.05). HDL-C was negatively correlated with HbA1c (p = 0.04). The association of HbA1c with dyslipidemia confirms interlinked nature of risk factors for CVD and glycemic control. Our findings support integrated clinical management that addresses blood pressure alongside glycemic and lipid targets to help mitigate long-term cardiovascular risk in diabetic patients.

The prevalence of type 2 diabetes mellitus (T2DM) is rising steeply across South Asia, and day-to-day self-management largely determines whether patients avoid complications. However, local evidence on which patients struggle most remains limited. This exploratory study examined the pattern and determinants of self-management among adults with T2DM visiting physicians in Sargodha, Punjab, Pakistan. Between July and August 2025, 483 eligible patients were recruited by consecutive sampling across five outpatient clinics and hospital-linked pharmacies. A structured, interviewer-administered questionnaire adapted from a previously published regional instrument captured nine recommended self-care practices and sociodemographic and clinical characteristics; each interview lasted approximately ten minutes. The proportion of patients reporting each practice was summarized with Wilson confidence intervals (CIs), and a practice-count index (0–9) was derived. Because the internal consistency of the nine items was low (Kuder–Richardson 20 = −0.11; mean interitem φ = 0.08; Kaiser–Meyer–Olkin [KMO] = 0.56), practices were analyzed individually, and adequate self-management was defined a priori as adherence to at least five of nine practices. Associations were tested using chi-square tests, t tests and multivariable binary logistic regression, with Poisson regression as a sensitivity analysis. Adherence was highest for home and periodic blood glucose monitoring (68.1% and 67.3%, respectively) and lowest for three-monthly glycated hemoglobin (HbA1c) testing (26.5%) and stress-management techniques (45.5%). Overall, 70.8% achieved adequate self-management. In the adjusted analysis, younger age (adjusted odds ratio [aOR] 0.96 per year; 95% CI 0.94–0.98) and being married rather than unmarried (unmarried aOR 0.37; 95% CI 0.20–0.67) independently predicted adequate self-management (likelihood ratio χ² = 28.8, p = 0.001; area under the curve 0.66). Education, income, family system, disease duration, family history and smoking status were not independent predictors. Diabetes self-care in this setting is uneven, with striking underuse of laboratory monitoring and stress management. Older and unmarried patients warrant targeted support.

Cigarette smoking is a leading preventable cause of death in Pakistan, yet adults’ knowledge of its specific harms and attitudes toward pack warning labels are incompletely characterized. We conducted a comparative cross-sectional survey of 406 adults (260 smokers and 146 nonsmokers) in Ichhra, a densely populated locality of Lahore, Punjab. An interviewer-administered questionnaire adapted from a validated instrument captured sociodemographic characteristics, smoking behavior, a 14-item health-risk knowledge battery, and warning-label attitudes. Knowledge scores were classified by the modified Bloom cutoff, and internal consistency was assessed using the Kuder–Richardson 20 (KR-20) and Cronbach’s alpha coefficients. Categorical characteristics were compared with the chi-square test, weight with the t test, and the knowledge score with the Mann–Whitney U test, applying a Bonferroni correction across the 14 item comparisons. Independent predictors were modeled with binary and ordinal logistic regression, and dimensionality (whether each scale measures one or more distinct constructs) was examined by exploratory factor analysis. The sample was predominantly male (97.8%); smokers consumed 7.6 (SD 3.9) cigarettes daily for 6.2 (SD 4.8) years, and 52.7% had attempted to quit. The knowledge and warning-label scales showed acceptable reliability (KR-20 = 0.71 and 0.72), and the quit-barrier scale had good reliability (Cronbach’s alpha = 0.84). Nonsmokers knew more than smokers did; six items remained significant after the Bonferroni correction, all favoring nonsmokers. Good knowledge was more common among nonsmokers (72.6% versus 53.1%; p = 0.001). After adjustment, smoking (adjusted odds ratio [aOR] 0.42, 95% confidence interval 0.26 to 0.68), a rural background (0.45, 0.28 to 0.71) and lower personal income independently predicted poorer knowledge, whereas a graduate education level predicted being a smoker (3.48, 2.13 to 5.68). Among smokers, feeling concerned about smoking predicted quitting attempts (2.13, 1.26 to 3.60). Health messaging should prioritize smokers and people with a rural background and should address sex-specific harms.

Sacroiliac joint (SIJ) dysfunction is a common but frequently overlooked source of low back and pelvic pain, and the comparative value of the available conservative treatments remains uncertain. This study examined whether the muscle energy technique (MET) and core stability exercises reduce pain and disability in adults with SIJ dysfunction and whether the two differ. A quasiexperimental, nonrandomized, two-group design with assessments before and after treatment was used. Seventy-two adults with clinically diagnosed SIJ dysfunction were recruited from a private hospital in Lahore, Pakistan, by purposive sampling and allocated by an odd/even identifier system to the MET (n = 36) or core stability exercise (n = 36) group; both groups additionally received a baseline program of hot pack and transcutaneous electrical nerve stimulation over three weeks. Pain was measured with a visual analog scale (VAS, 0 to 10), and disability was measured with the modified Oswestry Disability Index (ODI, 0 to 100). Within-group changes were tested with paired t tests, corroborated by the Wilcoxon signed-rank test, and posttreatment scores were compared by analysis of covariance (ANCOVA) with adjustment for baseline. Both groups improved significantly: the modified ODI decreased from 70.67 to 17.00 in the MET group and from 56.00 to 17.67 in the core stability group, and the VAS score decreased from 6.54 to 3.38 and from 5.88 to 3.83, respectively (all p < 0.001). After adjustment for baseline, the groups did not differ in terms of disability (p = 0.607), whereas the MET group experienced significantly less pain than the core stability group did (adjusted VAS score 3.31 vs 3.89, p < 0.001). Both techniques reduced pain and disability in SIJ dysfunction; MET was superior for pain but equivalent for disability. Because allocation was nonrandom and the groups differed at baseline, adequately powered randomized trials with longer follow-up periods are needed.