Volume 1
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2022
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Volume 1

Letter

Faiza Javaid Tariq
Published online: 31 December 2022
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Climate change has affected all living beings and has become a global issue. Over the years, environmental pollution has increased drastically. Air pollution is one of the leading causes of many health issues, specifically respiratory problems. The disease spectrum, from allergies to cancers, is the cause of the economic burden that impacts the countries' welfare. Unhealthy living and ineffective pollution control policies need to be addressed. The role of the government and public health sector is to change their approach to ensure a healthy, clean environment and reduce carbon and other pollutants, thus improving the air quality for better living.

Original Articles

Alishah Malik
Published online: 26 December 2022
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Surgeries were considered the only effective treatment method for patients suffering from chronic low back pain with lumbar radiculopathy for a while. However, in the contemporary world, it is not regarded as the primary treatment method until other conventional pharmacological and physical therapy interventions have not proven effective. Therefore, this study compares the outcomes in terms of pain relief and perceived level of mobility in patients with chronic low back pain with lumbar radiculopathy, regardless of whether the butler neural mobilization technique or manual therapy is used. This comparative cross-sectional study was conducted in Lahore, recruiting 100 patients by rendering a purposive sampling technique undergoing any treatment method mentioned above. Observations were recorded pre- and postintervention with a follow-up of 7 days to assess the response to both techniques using a questionnaire. Face-to-face interviews were conducted to assess pain levels using the Numeric Pain Rating Scale (NPRS) and Modified Oswestry Disability Questionnaire (MODQ). Descriptive statistics, chi-square test, Mann‒Whitney U test, independent t test, and the Wilcoxon signed-rank test were used to analyze the data. The medical characteristics of patients who had opted for manual therapy and butler neural mobilization were not different (p > 0.05), except for the quality of pain (p < 0.05). However, pre- and postintervention NPRS scores, pain intensity during the last 24 hours using NPRS scores, and MODQ scores were significantly different among the groups, indicating postintervention pain reduction for both groups comprising patients who had opted for manual therapy (p = 0.001) and butler neural mobilization technique (p = 0.001). Moreover, patients who had opted for either technique had improved their disability levels compared with the preintervention disability levels (p = 0.001). The study concluded that both techniques significantly reduce pain and disability levels, including butler neural mobilization and manual therapy, among patients suffering from chronic low back pain with lumbar radiculopathy.

Javeria Saeed
Published online: 26 December 2022
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Many countries are focusing on antenatal programs and developing strategies to ensure the availability of basic needs to pregnant women and prevent complications concerning childbirth. During the antenatal period, pelvic floor muscle exercises (PFMEs) reduce complications during labor or puerperium, benefiting the mother and the child. Therefore, the current study was designed to identify the gaps in knowledge, attitudes, and practices of PFMEs among pregnant women. This descriptive cross-sectional study recruited 385 pregnant women using a purposive sampling technique aged 18 to 40 who visited major tertiary care public hospitals in their second and third trimesters. Face-to-face interviews were conducted using a semistructured questionnaire consisting of four sections: sociodemographics, knowledge, attitude, and practices. The overall knowledge of the pregnant women was determined using the modified Bloom's cutoff point. Descriptive statistics were calculated for the collected data. Pregnant women's education levels varied widely, ranging from no formal education to graduate. Most of them belonged to low socioeconomic status families (84.16%), i.e., below Pakistani rupees (PKR) 15,000. Nearly half of the pregnant women were familiar with PFMEs (51.69%). They had relatively better knowledge about PFMEs regarding preventing urine leaks (43.38%), reducing back pain (40.00%), preventing excessive weight gain (46.49%), preventing swelling of extremities (47.01%), and increasing energy and stamina during pregnancy (40.52%). Moreover, 50.39% of pregnant women believed childcare activities barred them from performing PFMEs. However, a meager number of pregnant women (6.75%) were performing PFMEs. The overall knowledge of PFMEs among most pregnant women was poor (64.16%). The study observed various deficiencies in PFME-related knowledge among pregnant women and some difficulties performing these exercises. Only a meager number of the recruited sample reported the regular practice of PFMEs, indicating a dire need to increase the awareness and adherence of women in the local community.

Sana Sameet
Published online: 23 December 2022
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Cerebral palsy (CP) affects movement, balance, and posture, leading to activity limitations, motor disability, and musculoskeletal problems. Health-related quality of life (HRQoL) assessment is critical in helping practitioners suggest interventions for children with CP. Therefore, this study was conducted to determine the parent-reported HRQoL among children with CP in Pakistan. Using a purposive sampling technique, 184 parents were interviewed face-to-face with the KIDSCREEN-52 questionnaire to assess their children's subjective health and well-being. The data were analyzed using descriptive statistics, chi-square, and Mann‒Whitney tests. The HRQoL scores for physical activity and health were significantly lower for male children (median = 20.00) than for females (median = 10.00) (p < 0.001), which was also the lowest across all other dimensions of HRQoL. Male children scored higher than females in some domains, such as general mood and bullying, while female children scored higher in domains such as free time and friends, but these differences were not statistically significant (p > 0.05). The overall HRQoL score was low for both male (median = 43.84) and female (median = 42.26) children. However, there was no significant difference in the proportion of children with low and medium HRQoL scores based on gender. This study concluded that physical activities and health were the poorest dimensions of HRQoL. The results help better understand children's lived experiences as perceived by their parents, highlighting various aspects of health that could be optimized to enhance the overall quality of life. Our findings highlight the need for targeted interventions to improve the HRQoL of children with CP, especially regarding physical activity and health.

Umer Javed
Published online: 26 December 2022
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Oral health is one of the significant indicators determining the population’s overall health and well-being status. Good oral health is a fundamental human right irrespective of demographic differences. Therefore, this study compared the barriers to accessing oral healthcare facilities among males and females living in peri-urban communities. This comparative cross-sectional study was conducted in the peri-urban communities of Sargodha. Using the random number method, this study used a simple random sampling technique to identify 320 houses; 160 males and 160 females who met the inclusion and exclusion criteria were interviewed. Data were analyzed using descriptive statistics and a chi-square test. The results showed that more males (78.13%) were users of dental services than females (53.75%); however, a meagre number of both genders were making regular visits to oral healthcare facilities. Expensive treatment was one of the significant barriers to visiting oral healthcare facilities for males (85.00%) and females (75.63%). Moreover, time shortage was a significant barrier, mainly reported by almost three-fourths of the males (72.50%), but fewer females (20.63%) considered it a vital barrier (p < 0.05). Furthermore, for both genders, various barriers varied widely, including fear of the dentist, avoiding treatment, lack of awareness, family pressure to avoid visiting clinics, and reliance on home remedies (p < 0.05). Therefore, this study concluded that more males than females visit oral healthcare services. However, most males and females do not visit oral healthcare facilities for regular checkups but for any oral health problem ailment. Both males and females make out-of-pocket expenditures to afford oral health services. Males preferred private oral healthcare facilities, whereas females preferred public healthcare facilities to provide oral healthcare services. Males and females observed the cost of treatment for oral healthcare issues, shortage of time, and fear as the key barriers to accessing oral healthcare facilities.

Mohsin Azhar
Published online: 30 December 2022
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Obstetrical brachial plexus injury (OBPI) is a severe nerve injury that is destructive with expected lifelong repercussions among affected children. A child with morbidity can affect a family in several ways, encompassing social, relational, financial, and emotional states. However, such effects on households remain mostly unrecognized, where the focus remains solely on the child’s health or his/her treatment endeavors, with little attention given to the parent's emotional state. Therefore, this study aimed to measure psychological distress among parents of children with OBPI. This descriptive cross-sectional study recruited 100 parents with children aged between 18 months and 16 years under treatment for OBPI who visited different healthcare facilities using a purposive sampling technique. Data were collected by conducting face-to-face interviews. The study used the General Health Questionnaire-12 (GHQ-12) to assess parents’ psychological distress. The positive items were assigned scores from 0 to 3 (i.e., always to never), and the negative items were assigned scores from 3 to 0 (i.e., always to never). The outcome score ranged between 0 and 36, with higher scores indicating a greater likelihood of general psychological distress. Descriptive statistics were calculated to achieve the study objectives. Most children suffering from OBPI were male (64%) rather than female (36%). All positive items of the GHQ-12 questionnaire had an average low score, indicating parents were not feeling reasonably happy, less able to concentrate on their routine work, somewhat incapable of making decisions, and unable to enjoy day-to-day activities. In contrast, negative items had an average high score, indicating that parents constantly felt under strain, could not overcome difficulties, felt unhappy and depressed, and lost confidence. The average GHQ-12 score was 23.47 ± 2.54, depicting a high level of psychological distress among parents of children with OBPI. Our study concluded that parents of children with OBPI are at potential risk of various psychological problems. Therefore, health personnel should be aware of these parents’ psychological adjustment and refer them for psychological support when necessary.