Impact of guillain barre syndrome on psychosocial functionings of patients in islamabad

GuillainBarre Syndrome (GBS) is a rare autoimmune disease of unknown causes that affects peripheral nervous system. Objectives: To review the impacts of the GuillainBarre Syndrome on the psychosocial functioning of the patients and to assess the relationship between GuillainBarre Syndrome and the psychosocial functioning Methodology: Comparative cross sectional survey was conducted on 100 participants (50 GBS patients from Shifa International Hospitals and 50 normal participants from Islamabad in 6 months time from February to July 2013. Data collected through Structured Questionnaire in hospital settings for GBS patients and normal persons from Islamabad through Psychosocial functioning scale and social functioning scale and analyzedby using SPSS version 17

Effectiveness of stretching of the flexor retinaculum with ultrasonic therapy in the management of carpal tunnel syndrome

Aims & Objective: The objective of study was to compare the effectiveness of manual stretching of the flexor retinaculum with or without ultrasonic therapy. Methods: The study was started by selecting the 50 patients from the out patients department of Al-nafees Hospital AlipurFarash and National institute of Rehabilitation Medicine Islamabad with history of carpal tunnel syndrome. The 25 patients in experimental group were treated with manual stretching of flexor retinaculum and ultrasound and 25 patients of control group were treated with manual stretching of flexor retinaculum. Every session was started by assessment of improvement of the symptoms in each patient. Data was collected through Numeric pain rating scale, point Paresthesia assessment scale and muscle strength by hydraulic hand dynamometer. Independent sample t-test was used to analyze the data with p ≤ 0.05. Results: The mean age of subjects was 1.78±0.64 and 41 subjects have CTS of Right hand remaining 9 subjects were left handed. After the completion of the treatment program it was observe that there was no difference in the effectiveness of manual Stretching of flexor retinaculum with ultra sound therapy and manual stretching of flexor retinaculum alone. The NPRS, paresthesia and muscle stretch showed p≥0.05 between experimental and control groups. Conclusion: This study proved that manual stretching of the flexor retinaculum along with ultra sonic therapy have same affects as manual stretching of the flexor retinaculum alone

Assessing Gait & Balance in Adults with Mild Balance Impairment:G&B App Reliability and Validity

Smartphone applications (apps) that utilize embedded inertial sensors have the potential to provide valid and reliable estimations of different balance and gait parameters in older adults with mild balance impairment. This study aimed to assess the reliability, validity, and sensitivity of the Gait&amp;Balance smartphone application (G&amp;B App) for measuring gait and balance in a sample of middle- to older-aged adults with mild balance impairment in Pakistan. Community-dwelling adults over 50 years of age (N = 83, 50 female, range 50-75 years) with a Berg Balance Scale (BBS) score between 46/56 and 54/56 were included in the study. Data collection involved securing a smartphone to the participant's lumbosacral spine. Participants performed six standardized balance tasks, including four quiet stance tasks and two gait tasks (walking looking straight ahead and walking with head turns). The G&amp;B App collected accelerometry data during these tasks, and the tasks were repeated twice to assess test-retest reliability. The tasks in quiet stance were also recorded with a force plate, a gold-standard technology for measuring postural sway. Additionally, participants completed three clinical measures, the BBS, the Functional Reach Test (FRT), and the Timed Up and Go Test (TUG). Test-retest reliability within the same session was determined using intraclass correlation coefficients (ICCs) and the standard error of measurement (SEM). Validity was evaluated by correlating the G&amp;B App outcomes against both the force plate data and the clinical measures using Pearson's product-moment correlation coefficients. To assess the G&amp;B App's sensitivity to differences in balance across tasks and repetitions, one-way repeated measures analyses of variance (ANOVAs) were conducted. During quiet stance, the app demonstrated moderate reliability for steadiness on firm (ICC = 0.72) and compliant surfaces (ICC = 0.75) with eyes closed. For gait tasks, the G&amp;B App indicated moderate to excellent reliability when walking looking straight ahead for gait symmetry (ICC = 0.65), walking speed (ICC = 0.93), step length (ICC = 0.94), and step time (ICC = 0.84). The TUG correlated with app measures under both gait conditions for walking speed (r -0.70 and 0.67), step length (r -0.56 and -0.58), and step time (r 0.58 and 0.50). The BBS correlated with app measures of walking speed under both gait conditions (r 0.55 and 0.51) and step length when walking with head turns (r = 0.53). Force plate measures of total distance wandered showed adequate to excellent correlations with G&amp;B App measures of steadiness. Notably, G&amp;B App measures of walking speed, gait symmetry, step length, and step time, were sensitive to detecting differences in performance between standard walking and the more difficult task of walking with head turns. This study demonstrates the G&amp;B App's potential as a reliable and valid tool for assessing some gait and balance parameters in middle-to-older age adults, with promise for application in low-income countries like Pakistan. The app's accessibility and accuracy could enhance healthcare services and support preventive measures related to fall risk.</p

Caregivers’ burden among parents of children with Cerebral Palsy

Introduction: Caregivers help a person in those actions which cannot be performed by an individual independently; a person’s personal needs, environmental barriers that hinders an individual’s abilities etc. This ultimately puts an increased burden on the caregiver. This study was conducted to determine the levels of caregivers’ burden among the parents of children with cerebral palsy. Material & Methods: A cross-sectional survey was conducted on 298 parents of children with cerebral palsy. Non-probability convenience sampling technique was used to collect data from the parents coming to the National Institute of Rehabilitation Medicine, Islamabad. The parents of children with cerebral palsy who were having auditory, cognitive or visual impairment were excluded from this study. Demographic information form and Caregiver Burden Inventory were used for the data collection. The data was analysed through IBM SPSS version 21 and results were presented in the form of frequency, percentages and mean ± sd with p-value wherever needed. Results: the result of this study showed a greater need for respite and other services for caregivers of children with cerebral palsy. The overall Caregiver Burden Inventory score was 45.19 ± 11.9. Out of the total included participants, 163 (54.33%) participants sometimes needed relief, 116 (36.67%) needed frequent need for relief and other services while 19 (6.33%) of the included parents rarely needed relief and other services. Conclusion: Majority of the caregivers of children with cerebral palsy needed relief and other services (compromise the growth, physical and emotional health and social relationship) to manage caregivers’ burden

Comparing Holmium (Ho): YAG Laser with Pneumatic Lithoclast for Treatment Efficacy of Ureteric Stones

Background: Holmium YAG (yttrium-aluminum-garnet) laser, a comparatively new technique, can clear all types and sizes of stones and is only being used in two institutes of Karachi, Pakistan. The study aimed to compare pneumatic lithoclast and holmium YAG laser, to evaluate stone-free rate (SFR), postoperative complications, operative duration, and effectiveness. Methods: This cross-sectional research included 60 patients with age 16-65 years having ureteric stones, reporting to kidney center, Urology Department, Karachi, Pakistan. CT Scan of Kidneys, Ureter, and Bladder (KUB) were used to record stone size, laterality, and location within the ureter. Patients were divided into two clusters of 30 each, group A (Ho: YAG laser) and group B (pneumatic Lithoclast) having 0.5 to 02 cm of size ureteric stones. An Independent two-sample “t” test was used to assess the difference for the continuous variables. A p-value of ≤0.05 was considered statistically significant. Results: Stone sizes distribution was 1.3±0.3cms and 1.4±0.3cms for A and B groups respectively (p=0.8). The insignificance of the p-value demonstrated no substantial divergence between both groups and stone sizes. Clearance from the proximal ureter was noted 26(84.6%) in group A and 41.7% in group B with (p<0.05). A reduced lithotripsy activation period of 30.8±3.7mins was associated with stone size (p<0.05). Conclusion: Holmium: YAG Laser had better stone-free rate (SFR), with 84% clearance than pneumatic. Improved and effective clearance reduces the risk of residual stones within a lesser time, required for getting back to normal life routines. Keywords: Lasers; Ureteric Stones; Ho: YAG Laser; Pneumatic Lithoclast; Kidney Stones

Fourth-generation glucose sensors composed of coppernanostructures for diabetes management: A critical review

More than five decades have been invested in understanding glucose biosensors. Yet, this immensely versatile field has continued to gain attention from the scientific world to better understand and diagnose diabetes. However, such extensive work done to improve glucose sensing devices has still not yielded desirable results. Drawbacks like the necessity of the invasive finger pricking step and the lack of optimization of diagnostic interventions still need to be considered to improve the testing process of diabetic patients. To upgrade the glucose-sensing devices and reduce the number of intermediary steps during glucose measurement, fourth-generation glucose sensors (FGGS) have been introduced. These sensors, made using robust electrocatalytic copper nanostructures, improve diagnostic efficiency and cost-effectiveness. This review aims to present the essential scientific progress in copper nanostructure-based FGGS in the past ten years (2010 – present). After a short introduction, we presented the working principles of these sensors. We then highlighted the importance of copper nanostructures as advanced electrode materials to develop reliable real-time FGGS. Finally, we cover the advantages, shortcomings, and prospects for developing highly sensitive, stable, and specific FGGS

Biomass and soil carbon stocks in relation to the structure and composition of Chir Pine dominated forests in the lesser Himalayan foothills of Kashmir

Quantification of carbon stocks is critical to evaluate the potential of an ecosystem to mitigate the impact of global climate change in the REDD + scenario. Present research project was designed to gauge the sequestered carbon in Chir Pine (Pinus roxburghii) dominated forests in the foothills of the western Himalayan region of Kashmir which constitute a significant regional carbon pool. The study outcomes revealed an average carbon stock value of 94.3 Mg/ha from which 68 Mg/ha was shared by soil organic carbon (SOC); whereas average biomass carbon share was 26.3 Mg/ha. P. roxburghii was the most noteworthy species containing an average carbon stock value of 5.93 Mg/ha followed by Quercus incana (3.59 Mg/ha) and Olea cuspidata (2.26 Mg/ha). Average forest biomass was chronicled as 52.5 Mg/ha from which tree biomass was 49.34 Mg/ha. Shrub and herb biomass contributed 1.95 and 0.53 Mg/ha correspondingly whereas the Leaf litter and deadwood necromass produced an average of 0.67 Mg/ha. Ordination analysis revealed that the forest carbon stocks were significantly influenced by the species composition, structural attributes as well as anthropogenic disturbances. Current study has resulted in generating a standard baseline dataset of the regional carbon stocks with diverse implications for sustainable carbon management in REDD + perspective

Grazing intensity impacts on soil carbon stocks of Western Himalayan Alpine paddocks

Overgrazing in the fragile Himalayan alpine grassland ecosystems is a major cause of substantial loss of soil organic carbon (SOC). The current study was conducted to analyze the effects of grazing on SOC in seven alpine grasslands of Kashmir. SOC was found to be greatly influenced by severe grazing and varied between 43.1 and 120 Mg/ha. Average SOC was found to be 70.5 Mg/ha; it was 90.6 Mg/ha in non-grazed areas (NGAs) and 50.4 Mg/ha in highly grazed areas (HGAs). The highest value of SOC was 139.1 Mg/ha (in NGA) whereas the lowest was 30.3 Mg/ha (HGA). An average of 1632.7 domestic animals reserved by 278 households were recorded per site. The study determined that an increased herd size results in a decreased SOC level. Grazing regime was a countering factor for SOC at all study sites and caused SOC loss of up to 103.3 Mg/ha. Besides intensive grazing, SOC was also found to be influenced by site physiognomy and microclimatic variations. Grazing management is urgently needed in the Western Himalayan alpine grasslands to enhance SOC levels

Comparison of instrument-assisted soft tissue mobilization and proprioceptive neuromuscular stretching on hamstring flexibility in patients with knee osteoarthritis

Background The association between hamstring tightness and knee osteoarthritis (KOA) is significant because tight hamstrings can put more strain on the knee joint, reduce its range of motion, and cause compensatory movements that worsen the KOA. Objective To compare the effects of instrument-assisted soft tissue mobilization (IASTM) and proprioceptive neuromuscular (PNF) on hamstring flexibility in patients with KOA. Methods Data for the randomized controlled trial (NCT05110326) was collected from n = 60 participants randomly divided into group A received IASTM and group B received PNF stretching. In group A, the therapist made 30 strokes gentle strokes with the tool from the origin to the insertion while holding the plane at a 45-degree angle over the treatment area. In group B, PNF stretching was done with three repetitions and 10 seconds rest between each, after isometric contraction of the hamstring muscle using approximately 50% of their maximum strength, holding it for 8 seconds, and then releasing it. A 30-minute session was given to each patient three times per week and was given for 6 weeks. Outcome measures were the visual analog scale (VAS) for pain intensity, the active knee extension test (AKET) for hamstring flexibility, and the Western Ontario and McMaster Universities Arthritis Index (WOMAC) for the health status of KOA patients. Results The study found a significant interaction (p < 0.001) between interventions and time across several measurements. After 6 weeks, both interventions resulted in significant improvements (p < 0.001) across all dependent variables, with group A (IASTM) showing more significant improvement in hamstring flexibility, pain reduction, and health status (p < 0.001) compared to group B (PNF). Conclusions Both the IASTM technique and PNF stretching resulted in increased hamstring flexibility, decreased pain, and enhanced general health. The IASTM technique, however, showed potential benefits over PNF stretching in terms of flexibility, pain relief, and public health enhancement. Physical therapists and manual therapists may prioritize the usage of the IASTM technique for patients who want to make significant changes in these areas

Quality Assurance Tests of the CMS Endcap RPCs

In this note, we have described the quality assurance tests performed for endcap Resistive Plate Chambers (RPCs) at two different sites, Pakistan Atomic Energy Commission (PAEC) and National Centre for Physics (NCP), in Pakistan. This paper describes various quality assurance tests both at the level of gas gaps and the chambers. The data has been obtained at different time windows during the large scale production of CMS RPCs of RE2/2 and RE2/3 type. In the quality assurance tests, we have investigated parameters like dark current, strip occupancy, cluster size and efficiency of RPCs