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This document summarizes a Cochrane Review titled "Exercise therapy for treatment of acute non-specific low back pain." The review examined the benefits and harms of exercise therapy for adults with acute nonspecific low back pain compared to sham/placebo treatment or no treatment. The review included 23 studies with a total of 2674 participants. The findings suggest that exercise therapy may not have a significant effect on pain or functional status compared to sham/placebo treatment, no treatment, or other conservative treatments. However, the certainty of evidence was generally low or moderate. The review did not report on perceived recovery, health-related quality of life, or adverse events. The authors concluded that exercise therapy does not provide any benefit for acute nonspecific lower back pain. They suggest that exercise therapy may still have a role in the treatment of chronic low back pain, but personalized approaches, patient education, shared decision-making, and alternative evidence-based interventions should be considered by rheumatologists when treating acute low back pain. Regular monitoring and reassessment of treatment plans are also important. [Extracted from the article]

Objectives: To find out the personal, professional, and educational challenges in training by the post-graduate residents of Obstetrics and Gynecology in the three tertiary care hospitals of Peshawar during the Covid-19 Pandemic. Methods: This was a web-based cross-sectional study conducted among the postgraduate residents of Gynecology and Obstetrics in the three main teaching hospitals of Peshawar, from 1st April 2020 to 31st July 2020. A structured survey using Google forms was distributed among 98 postgraduate residents through emails and social media platforms. The challenges faced and their severity was assessed using the Likert Scale. Results were analyzed in Microsoft Excel. Results: Total number of participants was 98, with 99% being female. The mean age was 28.3±1.8 years. Their worst fear was of the family getting infected (86.7%). Their greatest challenge was the inability to practice social distancing due to the nature of their work (85%) amidst a lack of PPEs (51%). Their training suffered due to inadequate opportunities for elective surgeries (78%). Conclusion: Post-graduate residents in Gynaecology/Obstetrics faced substantial personal, professional, and educational challenges while training during the covid-19 pandemic. [ABSTRACT FROM AUTHOR]

Objective: To determine the frequency of various groups of patients undergoing C-section in a tertiary care hospital in Peshawar, using WHO Ten Group ROBSON Classification of C sections. Material and Methods: A descriptive cross-sectional study was conducted in the Department of Obstetrics and Gynaecology, Khyber Teaching Hospital Peshawar from January-March 2019 on patients delivered in the facility. The patients were classified into 10 groups based on WHO Robson's criteria and the C-section rate determined in each group. The data was analyzed in MS excel. Results: Out of the total 1364 deliveries during this period, 330 were by C sections, making the C-section rate 24%. The biggest contributor to the overall C-section rate was Group 5 (38%) followed by Group 2 (15%), Group 4 (12%), and Group 1 (11%). Conclusion: Robson classification is a useful tool to classify and analyze C-section rates. Although the rate of C sections in our setup is not very low, it can be further lowered by devising strategies to curtail sentinel C sections and performing interventions like induction of labor and pre-labor C sections, only if they are evidence-based. [ABSTRACT FROM AUTHOR]

Background: Acute poisoning including drug overdose is responsible for significant morbidity and mortality. The objectives of this study were to determine the frequency and distribution of acute poisoning in set up of a medical intensive care unit. Material & Methods: This was a record based, cross-sectional study conducted at Medical ICU of Khyber Teaching Hospital, Peshawar, Pakistan from Feb. 1, 2015 to March 15, 2015. Ninty two patients with acute poisoning admitted to medical ICU between March 2009 and October 2014 were included. The demographic variables were; gender, age in years and marital status. The research variables were; the type of poisons, the number of poisons, route of poisons, mode of poisons, the need for ventilatory, inotropic and renal support, duration of stay, and outcome of patients. Counts and percentages were calculated for the nominal and means and SDs for numeric variables. Chi-square goodness of fit test was applied. Results: Out of total of 92 patients, 55 (59.8%) were females and 37 (40.2%) were males with female to male ratio of 1.49:1. The mean age of the sample was 26.8±13.9 years. The mean duration of stay for the sample was 3.14±0.52 days. The differences of counts (frequencies) among different attributes of all the ten nominal variables except gender were statistically significant, assuming that all attributes have equal expected counts. Conclusion: Acute poisoning is a common medical emergency. These patients commonly need ventilatory and inotropic support, and have high mortality rates. Proper triage and timely admission to intensive care unit may improve outcome of these patients. [ABSTRACT FROM AUTHOR]

In this study, novel three-phase hybrid (inorganic-organic) composite comprising Fe0.01La0.01Al0.5Zn0.98O ceramic particles (FLAZPs), conducting polymer polyaniline (PANI) and grapheme oxide (GO) was synthesized. The ceramic particles were produced by sol-gel technique. For the homogeneous dispersion of FLAZPs particles in the PANI matrix, in-situ free-radical polymerization of aniline (PANI precursor) was performed. FLAZPs distributed in the matrix during the polymerization process. GO was synthesized via modified Hummer's method which was then blended with two-phase composite using simple one-pot blending technique. The prepared materials were subjected to FT-IR, TGA, XRD and SEM to analyze their physical properties. FT-IR showed the successful complexation of the materials with one another. XRD confirmed the crystalline nature and phase distribution in the composites. FLAZPs enhanced the thermal stability of PANI and GO in the composites. SEM showed that ceramic particles are in the range from micro to nanometer and are well dispersed in the PANI matrix in two-phase composite. Furthermore, GO prevented the agglomeration of particles while interacting with PANI in the three-phase composite. Extensive dielectric studies were carried out which showed that PANI and GO have about the same additional effect on various dielectric properties of FLAZPs. The AC conductivity (σ = 7.79 x 10-1 Ω-1cm-1) achieved by two-phase and three-phase composites is much higher in comparison to pure FLAZPs (σ = 3.17 x 10-1 Ω-1cm-1). [ABSTRACT FROM AUTHOR]

Mobile Health (mHealth) applications are transforming stroke rehabilitation, through personalized care and datadriven insights. These applications employ AI-driven algorithms, tele-rehabilitation, wearable technologies, and gamification to enhance recovery process. The objective of this mini review is to explore the transformative role of Mobile Health (mHealth) applications in stroke rehabilitation, highlighting its capacity to transcend geographical barriers and establish extensive support networks connecting stroke survivors, caregivers, and healthcare professionals. Particularly in developing countries like Pakistan, where healthcare resources may be limited, mHealth offers a viable solution to bridge the gap in stroke care. By facilitating access to rehabilitation services, mHealth can significantly improve outcomes for stroke survivors in these regions. This integration of mobile technology with stroke rehabilitation not only promises personalized and more effective rehabilitation but also presents a unique blend of technology and compassion. This evolution in healthcare holds the potential to redefine stroke recovery, marking a significant milestone in the journey towards more inclusive, efficient, and compassionate care solutions.

Stroke is the leading global cause of death and disability and the need for stroke rehabilitation services in increasing. The usual stroke rehabilitation protocol involves a combination of therapeutic exercises, occupational therapy, speech therapy and counselling sessions depending upon the severity of the deficit and associated co-morbidities. However, there is a need for better protocols and new therapies for improving outcomes after stroke rehabilitation. The term 'task-oriented training' (TOT) refers to guided rehabilitation training of patients' limb function using goal oriented tasks, which can be used to enhance neuroplasticity in brain after injury. Task oriented training could be modified with action selection and environmental enrichment to fulfill the limitations of stroke like, holistic approach, outcome/goal based intervention, proper dosage for desirable outcomes. This mini review provides an overview of the TOT and to identify gaps and challenges in stroke rehabilitation related to integrating TOT.

Early, coordinated, and multidisciplinary rehabilitation plays a major part in motor recovery after stroke. The conventional stroke rehabilitation primarily includes physical therapy, occupational therapy, and speech therapy. However, with these conventional methods, many stroke survivors still have a residual functional disability which impairs their ability to perform activities of daily living. This could be attributed to the insufficient therapy dose, low engagement and motivation of the patient, and lack of objective feedback to achieve significant improvements in function. Various technology-based stroke rehabilitation interventions have been developed in the last few decades which have shown promising results in improving stroke patients' functional mobility and independence. The use of technology promotes repetitive, task-specific training, active engagement of patients, integrating constructive and concurrent feedback, and accurately measuring functional improvement. This review summarizes the important technological advances in stroke rehabilitation, including exergames, telerehabilitation, robotic-assisted systems, virtual and augmented reality, wearable sensors, and smartphone applications.

Virtual reality (VR) uses computer-generated simulations to create a virtual environment for users which appears, sounds, and feels like real-life objects and events. The use of VR in rehabilitation is relatively new and has demonstrated to be an effective tool in achieving desired clinical outcomes by active engagement of participants. Over the past few years, the use of VR in rehabilitation has rapidly increased because of its advantages over traditional rehabilitation techniques. These include better patient adherence to the rehabilitation protocols with high levels of engagement and motivation. This review summarises the available evidence on the role of VR in rehabilitation, its effects, and scope across different clinical conditions and outcomes. We also describe the current status of VR utilization in rehabilitation settings across Pakistan and highlight the need for further research.

Competing Interests: The authors declare no conflicts of interest.

The aim of the study is to identify the main causes of stress and to identify the perception difference of stress in first and final year DPT students Students in universities can experience stress in balancing the different demands on them - academic, interpersonal, intrapersonal, and professional or work related. A comparative Cross-sectional study was conducted using self-administered questionnaires including socio demographics A total of 177 university students (first year 109 & final year 68 students) were included in the period March, to September 2015 in a private medical college Islamabad. Significantly valid tool (The Medical Student Stressor Questionnaire) (MSSQ) was used to measure the stress level. The research was conducted according to the principles of the Declaration of Helsinki. Three stressors academic related inter/intrapersonal related and group activities related stressors were causing high stress in all DPT students. There was significant difference in perception of stressors among first and final year DPT students.

The Nintendo Wii-fit plus is a type of Virtual Reality exer-gaming with graphical and auditory response system. A case series was conducted at Shifa Tamer-e-Millat University Islamabad from January-July 2016. Sixteen adults more than 60 years age (07 males and 09 females) were recruited through convenient sampling. The specified Wii fit plus training was provided to all patients and the games included the Soccer heading, Ski slalom, table tilt and yoga. Berg balance test, time up and go and functional reach test were used before and after 06 weeks of treatment (4 days / week). Data was analysed by SPSS V-20. The mean age of the sample was 67.56±7.29 years, with 56% female and 44% males were in sample. There was a statistically significant difference in pre and post Berg Balance Score, time up and go test and functional reach. In this case series Wii-fit plus training was effective in improving dynamic balance and mobility in older adults. This should be explored further in large trials.