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Abstract Background Nonspecific neck pain (NSNP) is a well-established global burden affecting. It is also a common problem in Pakistan. The burden of neck pain is also increasing day by day due to poor work ergonomics, and increased use of computers and mobiles after the pandemic. An individual’s poor posture is often associated with forward head posture (FHP). Limited evidence is available about the effects of neck stabilization (NSE) and dynamic exercises (NDE) for nonspecific neck pain particularly in patients with FHP. This aimed to compare the effects of NSE versus NDE among patients having NSNP with FHP in reducing pain, disability, forward head posture and improving neck range of motion. Methods It is a single-blinded randomized clinical trial with 60 patients aged 18–40 years, with moderate intensity NSNP for > 3 weeks and 0.05) for post-treatment mean VAS, neck ROM, NDI and plumb line measurement. Conclusion Between NSE and NDE, no one is more beneficial than another. Both are equally effective in alleviating pain, increasing ROM, decreasing functional disability, and improving forward head posture in patients with NSNP. Trial Registration Registered trial at ClinicalTrials.gov Identifier: NCT05298631, 28/03/2022, prospectively registered.

Background: Pain in the sacroiliac joint is the most prevalent and often overlooked. The sacroiliac joints are thought to be sources of pain in roughly 10% to 25% of patients with chronic lower back pain. Due to the biomechanical nature of the joint, muscle imbalance is the most important cause of sacroiliac joint dysfunction. The hamstring and gluteus medius are the primary muscles involved in postural dysfunction-related muscle imbalance; however, the quadratus lumborum’s role in the compensatory mechanism is becoming more apparent, and its potential for treatment in conjunction with gluteus medius strengthening has not yet been investigated. Gluteus medius exercises, along with conventional treatment, are routinely given to patients with sacroiliac joint dysfunction; however, the aim of this study is to explore the additional effects of the muscle energy technique (MET) on the quadratus lumborum along with strengthening of the gluteus medius on pain, disability and quality of life of patients with sacroiliac joint dysfunction. Methods: Using a computer-generated random number table, seventy patients with unilateral sacroiliac joint pain were divided equally and randomly into two groups. Prior to initiating treatment, baseline measurements were taken using a hand-held dynamometer, visual analog scale (VAS), Oswestry Disability Index (ODI-U) and short form 36-item survey (SF-36v2) to assess strength, pain, functional disability and quality of life, respectively. Over the course of four weeks, all patients received twelve sessions, and both the pre- and post-intervention outcome measures were documented. Results: After 4 weeks of treatment, both groups showed statistically significant (p < 0.005) mean improvements in muscle strength, pain, disability and quality of life before and after intervention. However, the mean improvements in post-intervention on a dynamometer, VAS, ODI and SF-36 were better in the MET with exercise group (METGME) as compared to the conventional group with exercise (CTGME), with a larger effect size. Conclusions: The muscle energy technique, applied to the quadratus lumborum in combination with gluteus medius strengthening, is more effective clinically and significantly in improving pain, disability and quality of life in comparison to conventional treatment of sacroiliac joints with gluteus medius exercises.

BackgroundDiabetes and cancer are the leading causes of mortality all over the world. Infectious diseases are more common and/or life-threatening in patients with diabetes. Cancer patients with diabetes are individuals that are more susceptible to the current COVID-19 pandemic. We investigated the clinical features of survivor and non-survivor COVID-19-infected cancer patients with diabetes.Patients and MethodsWe did a retrospective study of 43 diabetic cancer patients with PCR-confirmed COVID-19 infection from Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan between March 03, 2020, and May 18, 2021. These patients either were discharged from the hospital or had died by Jun 16, 2021. Clinicopathological and radiological features were compared between survivors and non-survivors by fisher’s exact test and chi-square test.ResultsForty-three diabetic cancer patients with SARS-CoV-2 infection were enrolled and the majority were males 26 (60.5%). The overall mean age was 61.67 ± 11.80. 39 (90.7%) had solid tumors and 3 (7.0%) had hematological malignancies. Fever (74.4%) and dyspnea (58.1%) were the most common symptoms. Complications were reported in 36 (83.7%) patients; during the course of the disease. Additionally, all the deceased patients (n=15) had acquired the complications. 11 (25.6%) patients were admitted to an intensive care unit (ICU). Furthermore, 29 (67.4%) out of 43 patients showed abnormal features in the radiological findings. We found significantly elevated levels of C-reactive protein (P=0.005), serum lactate (P=0.01), albumin (P=0.02), alkaline phosphate (P=0.03), and neutrophil count (P=0.04) in the non-survivors as compared to the survivors.ConclusionCancer patients with diabetes are a vulnerable population in the current pandemic. Identifying how diabetes in cancer patients affects the severity of SARS-CoV-2 infection is crucial for the clinical management of these patients. Rigorous scrutiny of clinicopathological features of COVID-19 infected cancer patients with diabetes especially values of C-reactive protein, lactate, albumin, alkaline phosphate, neutrophils, and regular monitoring of blood glucose levels may play a critical role in the outcome of the disease.

Introduction: Erythrocytes have flexible, non-nucleated bi-concave shape with lipid bilayer cytoskeleton. Any alterations of erythrocyte shape make it susceptible to hemolysis. Blood for transfusion purpose is routinely stored in Citrate Phosphate Dextrose Adenine (CPDA-1) containing blood bags. During storage, blood undergoes an array of different morphological changes termed as “storage lesions” which makes it more fragile. This study was aimed to determine the structural and functional modifications in erythrocytes in CPDA-1 blood stored in local blood bank of KPK. Material & Methods: Blood from twenty healthy volunteer donors was taken and kept in CPDA-1 containing blood bags at Institute of Basic Medical Sciences (IBMS), Khyber Medical University (KMU). Hb-levels and Erythrocyte, Reticulocyte counts, Mechanical Fragility Index (MFI) and immunofluorescence staining for ankiyrin1 protein were performed on fresh blood samples. Samples for reticulocyte count was taken for 5 consecutive days while for the remaining parameters, blood was taken at 5 days interval till day 20th. The light and fluorescence micrographs were obtained accordingly and osmotic fragility tests were performed. Results: A significant mean reduction in erythrocyte counts and Hb-level was observed from day 0 to 20 (p=0.001), while MFI increased from day 0 to day 20 (12.88%±7.58 p=0.001). Reticulocyte count also decreased from day 0 up to day 5 (p=0.001). A weak association was observed between changes in MFI and erythrocyte morphology from day 0 to 20 (r=0.349), while the intensity and pattern of ankyrin1 protein expression appeared to change from day 10. Conclusion: Blood stored for a week has same properties as fresh blood, however, important structural alterations start to appear after the first week of storage and worsen with time. Therefore, to gain better transfusion results, blood stored for up to one week can safely be transfused.

There is recently an increasing reports of reduction in sperm counts along with other reproductive disorders that is ascribe to the use of drugs and environmental chemicals. In this regard conducting toxicological studies on male reproductive is of paramount importance. This study evaluates salicylidene salicylhydrazide (SCS) for any possible toxicological effects on male reproductive system. Male BALB/c mice were daily administered withSCSat 5, 25, and 50 mg/kg for 7 and 14 days. The body and testes weights were measuredand the testes were subjected to histological tissue processing techniques. The extent of testicular toxicity was evaluated by using modified Johnsen scoring system for assessing the level of spermatogenesis, and morphometric analysis by measuring the diameter of the seminiferous tubules, thickness of germinal epithelium, and area of interstitial cells of Leydig. The body and testes weights showed that the various doses of SCS have no substantial effects after 7 and 14 days. The tested doses of SCS did not produce any distinguishable change in the normal histological features of seminiferous tubules and interstitium after 7 days. However, after 14 days, the 50 mg/kg dose of SCS was associated with vacuolization and loosening of germinal epithelium. These mild-to-moderate histopathological aberrations was confirmed from morphometric analysis in this dose group in which a decrease in the seminiferous tubules diameter and reduction in the thickness of germinal epithelium along with an increase in the interstitial area were observed. These findings concluded that SCS is considered to be relatively safe.

There is recently an increasing reports of reduction in sperm counts along with other reproductive disorders that is ascribe to the use of drugs and environmental chemicals. In this regard conducting toxicological studies on male reproductive is of paramount importance. This study evaluates salicylidene salicylhydrazide (SCS) for any possible toxicological effects on male reproductive system. Male BALB/c mice were daily administered withSCSat 5, 25, and 50 mg/kg for 7 and 14 days. The body and testes weights were measuredand the testes were subjected to histological tissue processing techniques. The extent of testicular toxicity was evaluated by using modified Johnsen scoring system for assessing the level of spermatogenesis, and morphometric analysis by measuring the diameter of the seminiferous tubules, thickness of germinal epithelium, and area of interstitial cells of Leydig. The body and testes weights showed that the various doses of SCS have no substantial effects after 7 and 14 days. The tested doses of SCS did not produce any distinguishable change in the normal histological features of seminiferous tubules and interstitium after 7 days. However, after 14 days, the 50 mg/kg dose of SCS was associated with vacuolization and loosening of germinal epithelium. These mild-to-moderate histopathological aberrations was confirmed from morphometric analysis in this dose group in which a decrease in the seminiferous tubules diameter and reduction in the thickness of germinal epithelium along with an increase in the interstitial area were observed. These findings concluded that SCS is considered to be relatively safe.

Objective: To assess the knowledge, attitude and practices ofbreast self examination (BSE) in women attendinggynecological units of major public sector hospitals ofKarachi. Study Design: Cross sectional survey. Patients and Methods: All women of age between 20-50 years of either marital status attending Gynae OPDof Civil Hospital and Jinnah Postgraduate Medical Center, Karachi from May 2010 to December 2010 wereincluded in the study. A verbal consent of each participant was obtained before collecting the data. The datawas collected through a structured questionnaire have information on socio economic data, knowledge aboutBreast SelfExamination, symptoms, risk factors and preventive methods regarding breast cancer, attitude ofthe respondent and practices regarding Breast Self Examination. Results: Out of 412 respondents, majority belongs to 30-39 years age group (43.7%). Knowledge about breastself examination was found in only 22.8% respondents. Knowledge about symptoms, risk factors and preventivemeasures regarding Breast cancer were 25.3%, 28.7% and 26.0% respectively. However majority of the women98.9% who have the knowledge were practice the Breast SelfExamination monthly or fortnightly. The attituderegarding Breast Self Examination was very encouraging as 97.3% of the respondents promised not only toadopt it in future but also recommend it to their relatives and other friends. Conclusion: The knowledge about Breast SelfExamination was very low in the respondent which is the easierway of early detection of different breast diseases specially, breast cancer. However those who know it aredoing it well. The attitude of the respondents was very encouraging. Awareness programme should be developedto promote it for early detection of Breast cancer.

Objective: To assess the knowledge, attitude and practices ofbreast self examination (BSE) in women attending gynecological units of major public sector hospitals ofKarachi. Study Design: Cross sectional survey. Patients and Methods: All women of age between 20-50 years of either marital status attending Gynae OPD of Civil Hospital and Jinnah Postgraduate Medical Center, Karachi from May 2010 to December 2010 were included in the study. A verbal consent of each participant was obtained before collecting the data. The data was collected through a structured questionnaire have information on socio economic data, knowledge about Breast SelfExamination, symptoms, risk factors and preventive methods regarding breast cancer, attitude of the respondent and practices regarding Breast SelfExamination. Results: Out of 412 respondents, majority belongs to 30-39 years age group (43.7%). Knowledge about breast self examination was found in only 22.8% respondents. Knowledge about symptoms, risk factors and preventive measures regarding Breast cancer were 25.3%, 28.7% and 26.0% respectively. However majority of the women 98.9% who have the knowledge were practice the Breast SelfExamination monthly or fortnightly. The attitude regarding Breast SelfExamination was very encouraging as 97.3% of the respondents promised not only to adopt it in future but also recommend it to their relatives and other friends.

Objective: To assess the knowledge, attitude and practices ofbreast self examination (BSE) in women attending gynecological units of major public sector hospitals ofKarachi. Study Design: Cross sectional survey. Patients and Methods: All women of age between 20-50 years of either marital status attending Gynae OPD of Civil Hospital and Jinnah Postgraduate Medical Center, Karachi from May 2010 to December 2010 were included in the study. A verbal consent of each participant was obtained before collecting the data. The data was collected through a structured questionnaire have information on socio economic data, knowledge about Breast SelfExamination, symptoms, risk factors and preventive methods regarding breast cancer, attitude of the respondent and practices regarding Breast SelfExamination. Results: Out of 412 respondents, majority belongs to 30-39 years age group (43.7%). Knowledge about breast self examination was found in only 22.8% respondents. Knowledge about symptoms, risk factors and preventive measures regarding Breast cancer were 25.3%, 28.7% and 26.0% respectively. However majority of the women 98.9% who have the knowledge were practice the Breast SelfExamination monthly or fortnightly. The attitude regarding Breast SelfExamination was very encouraging as 97.3% of the respondents promised not only to adopt it in future but also recommend it to their relatives and other friends.