Publications by authors named "Syed Amir Gilani"

69 Publications

Translation, cross-cultural adaptation and psychometric properties of Urdu version of upper limb functional index; a validity and reliability study.

BMC Musculoskelet Disord 2022 Jul 20;23(1):691. Epub 2022 Jul 20.

Dean Faculty of Allied Health Sciences, Directorate of International Linkages, The University of Lahore, Lahore, Pakistan.

Background: The upper limb functional index is broadly used outcome measure for musculoskeletal disorders of the upper limb. The main objective of the study was to translate and validate the upper limb functional index (ULFI) outcome measure in the Urdu language.

Methods: Upper limb functional index was translated into Urdu language using Beaton et al. guidelines through forward and backward translation along with the expert committee reviews. Two fifty (n = 250) Urdu-speaking patients with sub-acute or chronic conditions of upper limb musculoskeletal disorders were included in the study. The mean age was 32.33 ± 4.67 years. The data were collected from the physical therapy department of The University of Lahore Teaching hospital. All participants completed the upper limb functional index-Urdu (ULFI-U), Numeric pain rating scale (NPRS), Quick Disability of arm, shoulder, and hand (QuickDash), and (health survey) SF-12 at baseline while only ULFI-U at day three. Reliability was assessed through internal consistency by Cronbach's alpha and test-retest reliability by intra-class correlation (ICC). Content validity was measured by Lynn and Lawshee method. Spearman's correlation has been used to measure criterion validity. The construct validity was measured through hypothesis testing. The structural validity has been explained through factor analysis by exploratory factor analysis (EFA) using Maximum likelihood extraction (MLE) with Promax rotation.

Results: The English version of ULFI was translated into the Urdu language with minor alterations. The Urdu version ULFI has demonstrated high levels of reliability with intra-class correlation (ICC 0.91) and Cronbach's alpha (α = 0.94). The content validity index found as 0.808, the criterion validity for ULFI-U correlating with quick Dash was found excellent (r = 0.845) and ULFI-U established strong correlation with 6 domains of SF-12(r = 0.697 to 0.767) and weak correlation with its 2 domains and NPRS(r = 0.520). A two-factor structure was obtained using EFA.

Conclusions: The ULFI-U is a valid and reliable patient-reported outcome (PRO) that can be used to assess upper limb musculoskeletal disorders in Urdu-speaking patients.

Trial Registration: This study was registered in the U. S National Library on clinicaltrial.gov under registration no. NCT05088096 . (Date: 21/10/2021).
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http://dx.doi.org/10.1186/s12891-022-05628-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9297551PMC
July 2022

Digital technologies in management of chronic pain - a systematic review.

J Pak Med Assoc 2022 Jun;72(6):1158-1165

Department of Radiology, Faculty of Allied Health Sciences, The University of Lahore.

Objective: To determine the effectiveness of digital health technologies in the management of chronic pain.

Methods: The systematic review comprised search for randomised controlled trials and controlled clinical trials involving patients with chronic pain published between 2010 and 2020. The search was conducted on PubMed, Google Scholar, MEDLINE, National Centre for Biotechnology Information, and National Library of Medicine databases. Risk bias tool was used to evaluate the biasness in the studies and Pedro scale was used to assess the quality of the included articles.

Results: Of the 33 articles fully assessed, 14(42.42%) were analysed. All the studies analysed were randomised controlled trials and scored 6-10 on the Pedro scale which showed high quality of methodology. The studies typically reported statistically significant benefits of digital health technologies in the management of chronic pain. One of the main benefits was enhanced pain coping skills of the patients. Additionally, majority of the studies included increased adherence to exercise as an essential advantage.

Conclusions: All the studies analysed reported favourable conclusions regarding the use of digital intervention for chronic pain management.
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http://dx.doi.org/10.47391/JPMA.3885DOI Listing
June 2022

Virtual Reality Training Using Nintendo Wii Games for Patients With Stroke: Randomized Controlled Trial.

JMIR Serious Games 2022 Jun 13;10(2):e29830. Epub 2022 Jun 13.

University Institute of Physical Therapy, University of Lahore, Lahore, Pakistan.

Background: Stroke is a leading cause of disability. It is difficult to devise an optimal rehabilitation plan once stroke survivors are back home. Conventional rehabilitative therapies are extensively used in patients with stroke to recover motor functioning and disability, but these are arduous and expensive. Virtual reality (VR) video games inspire patients to get involved in their therapeutic exercise routine in a fun way. VR in the form of games provides a fruitful, secure, and challenging learning environment for motor control and neural plasticity development in rehabilitation. The effects of upper limb sensorimotor functioning and balance are the main focus of this trial.

Objective: The aim of this study is to compare the effects of VR training and routine physical therapy on balance and upper extremity sensorimotor function in patients with stroke.

Methods: It was a single assessor-blinded randomized clinical trial. A total of 74 participants with their first chronic stroke were included and rehabilitated in a clinical setting. The lottery method was used to randomly assign patients to either the VR group (n=37) or the routine physical therapy group (n=37). The VR group received a 1-hour session of VR training for 3 weekdays over 6 weeks, and the routine physical therapy group received different stretching and strengthening exercises. The outcome measuring tools were the Berg Balance Scale for balance and the Fugl-Meyer Assessment (upper extremity) scale for sensorimotor, joint pain, and range assessment. The assessment was done at the start of treatment and after the 6 weeks of intervention. Data analysis was done using SPSS 22.

Results: The trial was completed by 68 patients. A significant difference between the two groups was found in the Berg Balance Scale score (P<.001), Fugl-Meyer Assessment for motor function (P=.03), and Fugl-Meyer Assessment for joint pain and joint range (P<.001); however, no significant difference (P=.19) in the Fugl-Meyer Assessment for upper extremity sensation was noted.

Conclusions: VR training is helpful for improving balance and function of the upper extremities in the routine life of patients with stroke; although, it was not found to be better than conventional training in improving upper limb sensation. VR training can be a better option in a rehabilitation plan designed to increase functional capability.

Trial Registration: Iranian Registry of Clinical Trials RCT20190715044216N1; https://www.irct.ir/user/trial/40898/view.
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http://dx.doi.org/10.2196/29830DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9237768PMC
June 2022

Interobserver agreement on the sonographic severity grading of shoulder impingement syndrome.

Ultrasound J 2022 Jun 1;14(1):22. Epub 2022 Jun 1.

The University of Lahore, Lahore, Pakistan.

Background: Shoulder impingement syndrome is the painful entrapment of the soft tissues between the acromion and the humeral head. The severity of shoulder impingement could be graded according to the limitation of shoulder joint moment. The reliability of sonographic findings in the grading of shoulder impingement severity grading is required to be evaluated by the consistency of findings between the observers.

Purpose: To assess the interobserver agreement in the sonographic severity grading of shoulder impingement syndrome with the help of a ratio between acromion-to-greater tuberosity distance in the abduction and neutral arm position.

Material And Methods: Patients were examined by two independent observers in the coronal approach with neutral arm position. Acromion-to-greater tuberosity distance was measured in abduction and neutral shoulder position. The ratios of the distances in the abduction and neutral position were calculated to grade the severity of shoulder impingement syndrome.

Results: A total of 78 shoulders were included in this study. A strong agreement was found for the grading of shoulder impingement severity grading between the two independent observers with Kappa value of 0.94. And correlation between the results of the two observers for the severity grading of shoulder impingement syndrome was significant at 0.01 level.

Conclusion: Severity grading of the shoulder impingement syndrome was performed based on the ratio of acromion-to-greater tuberosity distance in abduction and neutral arm position. However, the sonographic findings were consistent and a strong interobserver agreement was seen in this sonographic severity grading.
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http://dx.doi.org/10.1186/s13089-022-00272-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9160167PMC
June 2022

Inter-rater reliability of pressure biofeedback unit among individuals with and without chronic low back pain.

Pak J Med Sci 2022 Mar-Apr;38(4Part-II):987-991

Prof. Dr. Syed Amir Gilani MBBS,DMRD (Pak) MPH(Pak) PhD(Ultrasound) PhD (Public Health), : University Institute of Physiotherapy, The University of Lahore, Lahore, Pakistan.

Objectives: To determine the inter-rater reliability of pressure biofeedback unit among individuals with and without chronic low back pain.

Methods: This cross-sectional survey was conducted from February 2021 to March 2021 at the Physiotherapy Department of the Sindh Institute of Physical Medicine and Rehabilitation. Sixteen subjects which were recruited with and without chronic low back pain.(CLBP). During the test, abdominal drawing in movement was monitored by measuring a change in pressure detected in PBU. Each test was performed once by two trained assessors with period of seven days. Reliability indices of Pressure Biofeedback (PBU) measures including the Intraclass correlation coefficient [ICC] and Band Altman plot were analyzed.

Results: This study found an intra-class correlation coefficient (ICC) = 0.94 [95% confidence interval (CI) (0.37, 0.99] for inter-rater reliability in healthy individuals, and an ICC of 0.97 (95% CI 0.97, 0.98) for inter-rater reliability in CLBP. The interrater agreement (Limits of Agreement-LOA=5.92, -3.9 mmHg) in CLBP and the interrater agreement (LOA=5.75, -3.25 mmHg) in healthy individuals were within the limits of agreement on 95% of occasions.

Conclusion: Pressure Biofeedback Unit has showed excellent inter-rater reliability in measuring Transverse Abdominis muscle activity for individuals with and without chronic LBP.
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http://dx.doi.org/10.12669/pjms.38.4.4952DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9121930PMC
July 2021

Impact of Refractive Errors on the Academic Performance of High School Children of Lahore.

Front Public Health 2022 6;10:869294. Epub 2022 May 6.

Faculty of Allied Health Sciences, The University of Lahore, Lahore, Pakistan.

Introduction: The process of learning begins in childhood and accurate vision can greatly affects a child's learning capacity. It is documented that visual impairment in children can have a significant impact on their performance at school as well as their social interaction and development.

Objective: This research aimed to study the impact of refractive corrections on the academic performance of high school children in Lahore.

Methodology: A total of 2,000 students with equal distribution of gender, public, private school, and locality were included in the study. All students were screened for defective vision. The academic performance before and after corrections was recorded on the prescribed proforma.

Results: The prevalence of refractive error was high among the public high schools 244 (59.2%) as compared to the private schools 168 (40.8%). The area-based prevalence was higher among the students in urban settings 255 (62%) while in rural it was 157 (38%). It was found that in the public sector, the average score of academic results before the intervention was 56.39 ± 13.24 which was increased to 60.27 ± 14.94 after the intervention while in the private sector, before the intervention, the average score was 63.53 ± 17.50 which was improved to 67.12 ± 18.48. It was found to be statistically significant at -value < 0.05.

Conclusion: A significant impact was observed in the average academic scores of the results after refractive corrections.
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http://dx.doi.org/10.3389/fpubh.2022.869294DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9120632PMC
May 2022

Effects of low-intensity pulsed ultrasound on pain and functional disability in patients with early-stage lumbar spondylolysis: A randomized controlled trial.

J Bodyw Mov Ther 2022 04 7;30:125-131. Epub 2022 Feb 7.

University Institute of Public Health, University of Lahore, Lahore, Pakistan.

Background: Low Intensity Pulsed Ultrasound (LIPUS) is beneficial in accelerating fracture recovery, enhancing their capacity to execute tasks of daily life and, as a result, their autonomy.

Objective: To compare the outcomes of routine physical therapy and routine physical therapy along with LIPUS in patients with early-stage lumbar spondylolysis.

Methods: Thirty-four (29 males and 5 females) patients exhibiting symptomatic low back pain for at least four weeks were recruited and randomly divided into control group (CG) and intervention group (IG) group. Randomization was done by using goldfish bowl method and allocation was done by using sealed envelope method. Parallel assignment was done. Numeric Pain Rating Scale (NPRS) was utilized for the measurement of pain and Oswestry Disability Index (ODI) for functional disability. Patients were assessed at baseline, at the end of 12th and 20th week. Interventions were applied by two physical therapists (one male and one female) having more than eight years of clinical experience for 10 weeks on alternate days.

Results: Intervention group reported significant percentage change of 47% at 12th week and 65% at 20th week for pain and 42% at 12th week and 81% at 20th week for functional disability compared with 40% at 12th week and 37% at 20th week for pain and 3% at 12th week and 25% at 20th week follow-up for functional disability from baseline in control group.

Conclusion: Low-intensity pulsed ultrasound has significantly reduced pain and functional disability in patients with early-stage lumbar spondylolysis by using following parameters; 1.1-MHz oscillation frequency, 1-kHz pulsed frequency, 100-mW/cm spatial intensity, 2 ms pulse duration, 100Hz pulse repetition rate, 20% pulse duty cycle, and 20-min duration on alternate days.
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http://dx.doi.org/10.1016/j.jbmt.2022.02.025DOI Listing
April 2022

Combined effects of virtual reality techniques and motor imagery on balance, motor function and activities of daily living in patients with Parkinson's disease: a randomized controlled trial.

BMC Geriatr 2022 04 30;22(1):381. Epub 2022 Apr 30.

Riphah College of Rehabilitation and Allied Health Sciences, Riphah International University, Faisalabad Campus, Faisalabad, Pakistan.

Background: Parkinson's disease (PD) is the second most prevalent neurodegenerative disorder, impairing balance and motor function. Virtual reality (VR) and motor imagery (MI) are emerging techniques for rehabilitating people with PD. VR and MI combination have not been studied in PD patients. This study was conducted to investigate the combined effects of VR and MI techniques on the balance, motor function, and activities of daily living (ADLs) of patients with PD.

Methods: This study was a single-centered, two-armed, parallel-designed randomized controlled trial. A total of 44 patients of either gender who had idiopathic PD were randomly allocated into two groups using lottery methods. Both groups received Physical therapy (PT) treatment, while the experimental group (N: 20) received VR and MI in addition to PT. Both groups received assigned treatment for three days a week on alternate days for 12 weeks. The Unified Parkinson's Disease Rating Scale (UPDRS) (parts II and III), Berg Balance Scale (BBS), and Activities-specific Balance Confidence (ABC) Scale were used as outcome measures for motor function, balance, and ADLs. The baseline, 6, and 12 weeks of treatment were assessed, with a 16 week follow-up to measure retention. The data was analysed using SPSS 24.

Results: The experimental group showed significant improvement in motor function than the control group on the UPDRS part III, with 32.45±3.98 vs. 31.86±4.62 before and 15.05±7.16 vs. 25.52±7.36 at 12-weeks, and a p-value < 0.001. At 12 weeks, the experimental group's BBS scores improved from 38.95±3.23 to 51.36±2.83, with p-value < 0.001. At 12 weeks, the experimental group's balance confidence improved considerably, from 59.26±5.87to 81.01±6.14, with a p-value of < 0.001. The experimental group's ADL scores improved as well, going from 22.00±4.64 to 13.07±4.005 after 12 weeks, with a p-value of < 0.001.

Conclusion: VR with MI techniques in addition to routine PT significantly improved motor function, balance, and ADLs in PD patients compared to PT alone.

Trial Registration: IRCT20200221046567N1 . Date of registration: 01/04/2020.
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http://dx.doi.org/10.1186/s12877-022-03035-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9055773PMC
April 2022

Role of low-intensity pulsed ultrasound on lumbar spondylolysis: A systematic review.

J Pak Med Assoc 2022 Mar;72(3):522-525

University Institute of Public Health, The University of Lahore, Pakistan.

Objective: To systematically review the role of low-intensity pulsed ultrasound on lumbar spondylolysis.

Methods: Literature search was conducted on PubMed, Embase, CINAHL, Web of Science, PEDro and Scopus databases to identify relevant studies published between 2010 and 2020 by using medical subject headings and applying Booleans, such as low-intensity pulsed ultrasound OR interventional ultrasound AND lumbar spine OR lumbar region AND spondylolysis OR stress fracture. Unpublished studies were hand-searched in the journals, abstracts of conferences were reviewed, and citation index was used for searching experts in the field and then contacting them for information. Studies included were the ones that had at least one of the following outcomes: bone union rate, treatment period to bone union and time to return to previous activities.

Results: Of the 243 studies identified, 228(94%) were full text articles and only 2(0.8%) studies were critically appraised for qualitative synthesis based on bone union rate, treatment period to bone union, and time to return to previous activities.

Conclusions: Low-intensity pulsed ultrasound was found to be effective for bone union and a useful therapy for quick return to playing sports in patients with lumbar spondylolysis.
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http://dx.doi.org/10.47391/JPMA.3320DOI Listing
March 2022

Effects of virtual reality exercises and routine physical therapy on pain intensity and functional disability in patients with chronic low back pain.

J Pak Med Assoc 2022 Mar;72(3):413-417

Department of Physiotherapy, Govt. Services Hospital, Lahore, Pakistan.

Objectives: To compare the effects of Virtual Reality exercises and routine physical therapy on pain and functional disability in patients with chronic low-back pain.

Methods: The single-blind randomised controlled trial was conducted from April to October 2020 at the Physiotherapy Department of the Government Services Hospital, Lahore, Pakistan, and comprised patients of either gender, aged 25-50 years with chronic non-radiating low-back pain who were randomised into two equal groups. Group A received routine physical therapy, while group B received Virtual Reality exercises with routine physical therapy. Visual Analogue Scale and Modified Oswestry Disability Index were used to measure outcomes at baseline and after 4th, 8th and 12th sessions. Data was analysed using SPSS 24.

Results: Of the 84 patients, there were 42(50%) in each of the two groups. There were 28((33%) males and 56(66.6%) females. The mean age in group A was 37.5±12.5 years and in group B it was 38.2±11.8 years. Pain score at baseline was 6.62±1.04 in group A and 6.50±1.24 in group B which decreased to 3.32±0.81 and 1.00±0.60 respectively after the 12th session (p<0.05). Functional disability score at baseline was 65.08+8.94 in group A and 69.16±9.13 in Group B which decreased to 40.56±8.59 and 16.04±6.82 respectively after the 12th session (p<0.05). Group B showed significantly better results than group A (p<0.05).

Conclusions: Virtual Reality exercises in combination with routine physical therapy had dominant effect on functional disability and low-back pain.

Trial Registration Number (irctid): IRCT20200330046895N1.
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http://dx.doi.org/10.47391/JPMA.3424DOI Listing
March 2022

Effects of non-surgical decompression therapy in addition to routine physical therapy on pain, range of motion, endurance, functional disability and quality of life versus routine physical therapy alone in patients with lumbar radiculopathy; a randomized controlled trial.

BMC Musculoskelet Disord 2022 Mar 16;23(1):255. Epub 2022 Mar 16.

University Institute of Physical Therapy, Faculty of Allied Health Sciences, The University of Lahore, Lahore, Pakistan.

Background: Lumbar radiculopathy is an extensively common complaint reported by patients of low back pain (LBP), resulting in several impairments. A comparatively novel technique, non-surgical spinal decompression (NSD), is introduced, which uses a sensitive computerized feedback mechanism and decompresses the spinal nerve roots through segmental distraction. The objective of this study was to determine the effects of NSD therapy in addition to routine physical therapy on pain, lumbar range of motion (ROM), functional disability, back muscle endurance (BME), and quality of life (QOL) in patients with lumbar radiculopathy.

Methods: A total of sixty patients with lumbar radiculopathy were randomly allocated into two groups, an experimental (n = 30) and a control (n = 30) group, through a computer-generated random number table. Baseline values were recorded before providing any treatment by using a visual analogue scale (VAS), Urdu version of Oswestry disability index (ODI-U), modified-modified Schober's test (MMST), prone isometric chest raise test, and Short Form 36-Item Survey (SF-36) for measuring the pain at rest, functional disability, lumbar ROM, BME, and QOL, respectively. All patients received twelve treatment sessions over 4 weeks, and then all outcome measures were again recorded.

Results: By using the ANCOVA test, a statistically significant (p < 0.05) between-group improvement was observed in VAS, ODI-U, BME, lumbar ROM, role physical (RP), and bodily pain (BP) domains of SF-36, which was in favour of NSD therapy group. The between-group difference was 1.07 ± 0.32 cm (p < .001) for VAS, 5.65 ± 1.48 points (p < .001) for ODI-U, 13.93 ± 5.85 s (p = 0.002) for BME, 2.62 ± 0.27 cm (p < .001) for lumbar flexion, 0.96 ± 0.28 (p < .001) for lumbar extension, 5.77 ± 2.39 (p = 0.019) for RP and 6.33 ± 2.52 (p = 0.016) for BP domain of SF-36. For these outcomes, a medium to large effect size (d = 0.61-2.47, 95% CI: 0.09-3.14) was observed.

Conclusion: It was concluded that a combination of non-surgical spinal decompression therapy with routine physical therapy is more effective, statistically and clinically, than routine physical therapy alone in terms of improving pain, lumbar range of motion, back muscle endurance, functional disability, and physical role domain of quality of life, in patients with lumbar radiculopathy, following 4 weeks of treatment.

Trial Registration: WHO Iranian registry of clinical trials ( IRCT20190717044238N1 ) Dated: 23.12.2019.
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http://dx.doi.org/10.1186/s12891-022-05196-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8924735PMC
March 2022

Effects of High-Energy Extracorporeal Shockwave Therapy on Pain, Functional Disability, Quality of Life, and Ultrasonographic Changes in Patients with Calcified Rotator Cuff Tendinopathy.

Biomed Res Int 2022 4;2022:1230857. Epub 2022 Mar 4.

University of Lahore, University Institute of Physical Therapy, Lahore, Pakistan.

Objective: The current trial was designed to evaluate the effects of high-energy shockwave therapy on objective and subjective outcomes among participants with calcified rotator cuff tendinopathy.

Methods: This parallel-group, randomized trial consists of 42 patients affected by calcific tendinopathies divided into two groups of 21 participants. Patients having calcified tendinopathy aged between 30 and 65 years with type A or B calcification were selected in the trial after signing the written consent form. Participants in the ESWT+RPT group received eight sessions of shockwaves, while the RPT group was treated by routine physical therapy. About 2000 shockwaves of 0.32 mJ/mm, 120 Hz per treatment, were given as 12 sessions for the first six weeks (2 sessions/week). Pain intensity and shoulder functional ability, ultrasonographic changes, and quality of life were assessed with the numeric pain rating scale (NPRS), Constant-Murley score (CMS), ultrasonography, and Western Ontario rotator cuff index (WORC).

Results: There were significant differences regarding NPRS and CMS between the two groups, at baseline and 6th and 12th weeks after intervention ( < 0.05). Within-group differences also showed statistically significant results after treatment (all < 0.05). Significant results were seen in the WORC and ultrasonographic results pre- and posttreatment; more significant findings were found in the experimental group as compared to others.

Conclusion: High-energy shockwave therapy has been proved to be effective and thus strongly recommended for the management of calcified rotator cuff tendinopathy, improving the pain, functionality, and quality of life of these participants and decreasing the size of calcified deposits. Shockwave therapy is proved to be superior to routine physiotherapy.
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http://dx.doi.org/10.1155/2022/1230857DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8916860PMC
April 2022

Effectiveness of Low-Level Laser Therapy in Patients with Discogenic Lumbar Radiculopathy: A Double-Blind Randomized Controlled Trial.

J Healthc Eng 2022 27;2022:6437523. Epub 2022 Feb 27.

University Institute of Physical Therapy, The University of Lahore, Islamabad, Pakistan.

Purpose: To determine the effectiveness of low-level laser therapy (LLLT) in patients with discogenic lumbar radiculopathy and correlation among pain intensity, functional disability, and lumbar range of motion (LROM). . A double-blind RCT was conducted at physical therapy departments of different hospitals of Islamabad, Pakistan. The study period was March 2020 to August 2021. . The study comprised 110 patients with acute LBP and unilateral discogenic lumbar radiculopathy. . The outcomes of the treatment were measured on the first day and then after 18 sessions from each patient's pain intensity, functional disability, L-ROM, and straight leg raise by using visual analogue scale, Oswestry disability index, dual inclinometer, and straight leg raise test.

Methods: A total of 110 participants with a mean age of 38 ± 7.4 years were randomly assigned into two groups of 55 each. The experimental group of 55 patients was treated with LLLT and conventional physical therapy. The control group of 55 patients was treated with conventional physical therapy alone. Both groups had received 18 treatment sessions. The data were analyzed through SPSS-21.0.

Results: The results of the Wilcoxon signed-rank test score as well as Mann-Whitney U test indicated a statistically significant difference in values ( < 0.05 in all instances) within the groups and between the groups, respectively.

Conclusions: The LLLT is proved as an efficient adjunct therapy to conventional physical therapy for discogenic lumbar radiculopathy.
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http://dx.doi.org/10.1155/2022/6437523DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8898844PMC
May 2022

Psychometric Properties of the Urdu Translation of Berg Balance Scale in People with Parkinson's Disease.

Int J Environ Res Public Health 2022 02 18;19(4). Epub 2022 Feb 18.

Riphah College of Rehabilitation and Allied Health Sciences, Riphah International University, Faisalabad 38000, Pakistan.

Background: The most common assessment tool used in clinical settings to detect changes in balance performance is the Berg Balance Scale (BBS). Thus, the purpose of this study was to translate the BBS into Urdu and investigate the psychometric properties (acceptability, internal consistency reliability, interrater reliability, construct validity) for individuals with Parkinson's disease (PD).

Methods: Eighty patients of either gender with idiopathic Parkinson's disease, stages I-III on the modified Hoehn-Yahr (H&Y) scale, with intact cognition according to the Mini Mental Score Examination (MMSE) score (greater than or equal to 24) and independent of transfers, were included in this study. The BBS was translated according to international guidelines based on forward and backward translation processes. The test-retest reliability as well as intra- and inter-observer reliability was assessed by calculating the intra-class correlation coefficient (ICC). The internal consistency of the entire BBS score was assessed by calculating Cronbach's α. The convergent validity was assessed by correlating the scale with the Unified Parkinson Disease Rating Scale (UPDRS) parts II and III and the Activity-specific Balance Confidence Scale (ABCS). The construct validity was assessed using a factor analysis.

Results: The mean age of the subjects was 62.35 ± 5.74 in years (range: 60-87 years). The ICC for intra- and inter-observer reliability was 0.95 ( < 0.0001) and 0.99 ( < 0.001), respectively. Cronbach's α was calculated as 0.81, which showed acceptable internal consistency of the Urdu version of the BBS. The test-retest reliability (ICC) of the Urdu version of the BBS was determined as 0.97 for the total score, and ranged from 0.66-0.95 for individual items. In terms of validity, the Urdu version of the BBS was correlated with the ABCS (in the positive direction) and UPDRS-II and III (in the negative direction) (r = 0.53, < 0.001; r = -0.68, < 0.001, r = -0.78, < 0.0001), respectively.

Conclusion: The Urdu version of the BBS is a reliable and valid scale to be used in balance assessment of population diagnosed with PD with excellent psychometric properties.
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http://dx.doi.org/10.3390/ijerph19042346DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8872175PMC
February 2022

Reliability of knee joint sonography in the evaluation of gouty arthritis.

J Ultrason 2021 Nov 15;21(87):e300-e305. Epub 2021 Dec 15.

UIRSMIT, The University of Lahore, Pakistan.

To determine the reliability of knee joint sonography in the evaluation of gouty arthritis. A search of Google Scholar, PubMed, NCBI, MEDLINE, and Medscape databases, from 1988 up to 2020. The key search terms used were knee joint; knee joint ultrasound; gout; gouty arthritis, knee joint pain; sensitivity; specificity. The reviewer independently screened the titles and abstracts of the relevant articles and full-text downloads to determine whether the inclusion or exclusion criteria were met. In total, 103 articles were identified through the database search. In addition, 11 articles were identified through other sources. Then, screening was performed, and 9 articles were removed due to duplication. Further screening was done for 105 articles, and 27 articles were excluded due to insufficient information. Seventy-eight full-text articles were assessed for eligibility. A total of 13 full-text articles were excluded due to research performed on animals, as the study had been designed as a review of only human studies. Sixty-three studies were included that had a qualitative synthesis. The knee is a weight-bearing joint and may be affected by a myriad of different pathological conditions, therefore a proper diagnosis is of prime importance for a proper management plan. Ultrasound is a non-invasive, radiation-free, and readily available modality that has high sensitivity and specificity in the evaluation of gouty arthritis.
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http://dx.doi.org/10.15557/JoU.2021.0051DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8678699PMC
November 2021

Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life Years for 29 Cancer Groups From 2010 to 2019: A Systematic Analysis for the Global Burden of Disease Study 2019.

JAMA Oncol 2022 Mar;8(3):420-444

Department of Computer Science and Engineering, University of Kurdistan Hewler, Erbil, Iraq.

Importance: The Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019) provided systematic estimates of incidence, morbidity, and mortality to inform local and international efforts toward reducing cancer burden.

Objective: To estimate cancer burden and trends globally for 204 countries and territories and by Sociodemographic Index (SDI) quintiles from 2010 to 2019.

Evidence Review: The GBD 2019 estimation methods were used to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life years (DALYs) in 2019 and over the past decade. Estimates are also provided by quintiles of the SDI, a composite measure of educational attainment, income per capita, and total fertility rate for those younger than 25 years. Estimates include 95% uncertainty intervals (UIs).

Findings: In 2019, there were an estimated 23.6 million (95% UI, 22.2-24.9 million) new cancer cases (17.2 million when excluding nonmelanoma skin cancer) and 10.0 million (95% UI, 9.36-10.6 million) cancer deaths globally, with an estimated 250 million (235-264 million) DALYs due to cancer. Since 2010, these represented a 26.3% (95% UI, 20.3%-32.3%) increase in new cases, a 20.9% (95% UI, 14.2%-27.6%) increase in deaths, and a 16.0% (95% UI, 9.3%-22.8%) increase in DALYs. Among 22 groups of diseases and injuries in the GBD 2019 study, cancer was second only to cardiovascular diseases for the number of deaths, years of life lost, and DALYs globally in 2019. Cancer burden differed across SDI quintiles. The proportion of years lived with disability that contributed to DALYs increased with SDI, ranging from 1.4% (1.1%-1.8%) in the low SDI quintile to 5.7% (4.2%-7.1%) in the high SDI quintile. While the high SDI quintile had the highest number of new cases in 2019, the middle SDI quintile had the highest number of cancer deaths and DALYs. From 2010 to 2019, the largest percentage increase in the numbers of cases and deaths occurred in the low and low-middle SDI quintiles.

Conclusions And Relevance: The results of this systematic analysis suggest that the global burden of cancer is substantial and growing, with burden differing by SDI. These results provide comprehensive and comparable estimates that can potentially inform efforts toward equitable cancer control around the world.
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http://dx.doi.org/10.1001/jamaoncol.2021.6987DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8719276PMC
March 2022

Prevailing treatment methods for lumbar spondylolysis: A systematic review.

Medicine (Baltimore) 2021 12;100(51):e28319

University Institute of Public Health, University of Lahore, Lahore, Pakistan.

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http://dx.doi.org/10.1097/MD.0000000000028319DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8702222PMC
December 2021

A Novel Virtual Reality Training Strategy for Poststroke Patients: A Randomized Clinical Trial.

J Healthc Eng 2021 18;2021:6598726. Epub 2021 Nov 18.

Physical Therapy Department, University of Lahore, Lahore 42000, Pakistan.

Stroke patients suffer impairments including sensory, motor, visual, and cognitive areas, as well as gait and balance manifestations making activities of daily living difficult. In such conditions, virtual reality training can be a potential rehabilitation tool in comparison to conventional physical therapy to cater to the burden of this disability; hence, this randomized clinical trial compared the effects of virtual reality training and conventional physical therapy on balance and lower extremity function in stroke patients. The sample of 68 poststroke participants from Kanaan Physical Therapy and Spine Clinic, Lahore, Pakistan, were divided into  = 34 cases each using the lottery method with one group given virtual reality training and the other received conventional physical therapy. Each group received 60 minutes intervention, 3 days per week for 6 weeks. The Berg balance scale and the Fugl-Meyer assessment-lower extremity scale were employed for data collection preintervention, immediate postintervention, and 6 weeks postintervention. The statistically significant differences between virtual reality and conventional physical therapy groups for the Berg Balance score ( < 0.001), Fugl-Meyer assessment (FMA)-lower extremity domains of FMA-motor function ( < 0.001), FMA-joint pain, and joint range ( < 0.001); however, there is no significant difference (=0.202) for time vs. group interaction and significant ( < 0.001) for the time main effect for FMA sensation. Hence, virtual reality training is more effective to restore balance and lower extremity function compared to conventional physical therapy in stroke patients. The results of the study have significant implications for the clinicians with better case management enhancing quality of life of patients along with the dearth of local literature, thus providing base for future research from a developing country's perspective.
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http://dx.doi.org/10.1155/2021/6598726DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8616657PMC
February 2022

The effects of whole body vibration on gait after chronic stroke: A Randomized Controlled Clinical Trial.

J Pak Med Assoc 2021 Nov;71(11):2511-2514

University Institute of Public Health, The University of Lahore, Pakistan.

Objective: To determine the effects of whole body vibration therapy on gait in chronic stroke patients.

Methods: The randomised, assessor-blinded, controlled clinical study was conducted at the Physiotherapy Department, Lahore General Hospital, Lahore, Pakistan, from November 2017 to April 2019, and comprised chronic stroke patients wh were randomly divided into two equal groups, with group A reciving routine physiotherapy and group B reciving whole-body vibration therapy. Both the groups received 12 sessions each. Vibration therapy was given with an amplitude of 3mm and frequency of 20Hz. Sessions comprised 5 bouts of 120 seconds with 60s rest intervals for 6 days/week for 2 weeks in erect standing position. The outcome measure was the score of timed up and go test and 10-meter walk test before and after intervention. Data was analysed using SPSS 21.

Results: Of the 64 patients, there were 32(50%) in each of the two groups. Significant difference was seen post-intervention in both the groups (p<0.05) although both groups were statistically same in terms of Timed Up and go Test, 10 Meter walk Test Slow Speed and 10 Meter walk Test Fast Speed (p>0.05).

Conclusions: Walking speed improved with both treatments i.e. whole-body vibration therapy and routine physiotherapy in chronic stroke survivors.

Clinical Trial Number: Identifier: IRCT20190328043131N1:https://www.irct.ir/user/trial/38832/view.
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http://dx.doi.org/10.47391/JPMA.711DOI Listing
November 2021

Comprehensive Analysis of Genes Associated With Sudden Infant Death Syndrome.

Front Pediatr 2021 15;9:742225. Epub 2021 Oct 15.

Faculty of Medicine and University Hospital of Cologne, Institute of Virology, University of Cologne, Cologne, Germany.

Sudden infant death syndrome (SIDS) is a tragic incident which remains a mystery even after post-mortem investigation and thorough researches. This comprehensive review is based on the genes reported in the molecular autopsy studies conducted on SIDS so far. A total of 20 original studies and 7 case reports were identified and included in this analysis. The genes identified in children or adults were not included. Most of the genes reported in these studies belonged to cardiac channel and cardiomyopathy. Cardiac channel genes in SIDS were scrutinized for further analysis. After screening and removing the duplicates, 42 unique genes were extracted. When the location of these genes was assessed, it was observed that most of these belonged to Chromosomes 11, 1 and 3 in sequential manner. The pathway analysis shows that these genes are involved in the regulation of heart rate, action potential, cardiac muscle cell contraction and heart contraction. The protein-protein interaction network was also very big and highly interactive. SCN5A, CAV3, ALG10B, AKAP9 and many more were mainly found in these cases and were regulated by many transcription factors such as MYOG C2C1 and CBX3 HCT11. Micro RNA, "hsa-miR-133a-3p" was found to be prevalent in the targeted genes. Molecular and computational approaches are a step forward toward exploration of these sad demises. It is so far a new arena but seems promising to dig out the genetic cause of SIDS in the years to come.
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http://dx.doi.org/10.3389/fped.2021.742225DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8555024PMC
October 2021

Prognostic Significance of Substance P/Neurokinin 1 Receptor and Its Association with Hormonal Receptors in Breast Carcinoma.

Biomed Res Int 2021 13;2021:5577820. Epub 2021 Oct 13.

Research Laboratory on Neuropeptides (IBIS), Virgen del Rocío University Hospital, Seville, Spain.

Expression and immunolocalization of Substance P (SP)/Neurokinin-1 Receptor (NK-1R) in breast carcinoma (BC) patients and its association with routine proliferative markers (ER, PR, HER2/neu, and Ki-67) were evaluated. A cross-sectional study was performed on 34 cases of BC. There were 23 cases of group A (grade III), 8 of group B (grade II), and only 3 cases of group C (grade I). All samples were then processed for SP and NK-1R immunohistochemistry for few cases. 14/23 cases (61%) of group A, 7/8 cases (88%) of group B, and 2/3 (67%) cases of group C were SP positive. Overall, strong staining (≥10% tumor cells), labeled as "+3," was observed in 9/14 (64.2%) cases of group A and 1/8 (12.5%) cases of group B. Moderate staining labelled as "+2" (in ≥10% tumor cells) was observed in 3/14 (21.4%) cases of group A and 4/8 (50%) cases of group B. Weak positive staining "+1" was observed in only 2/14 (14.28%) cases of group A, 2/8 (25%) cases of group B, and all 2/2 (100%) cases of group C. SP and NK-1R are overexpressed in breast carcinomas, and there is significant association between the grade of tumor and their overexpression.
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http://dx.doi.org/10.1155/2021/5577820DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8528600PMC
February 2022

Comparison between shear wave elastography and serological findings for the evaluation of fibrosis in chronic liver disease.

J Ultrason 2021 Aug 9;21(86):e186-e193. Epub 2021 Sep 9.

Radiology, The University of Lahore, Pakistan.

In this study, we sought to examine the optimal cutoff values for predicting different stages of liver fibrosis, and to determine the level of agreement between shear wave elastography and aspartate aminotransferase to platelet ratio index (APRI) and fibrosis-4 index (FIB-4) scores in patients with chronic liver disease. A descriptive, cross-sectional study was performed at the Radiology Department of Shaukat Khanum Memorial Hospital Lahore from 1 Jun 2019 until 1 June 2020. FIB-4 and APRI scores were determined by the following formula: FIB-4 = (age × AST) ÷ (platelet count × (√ (ALT)) and APRI = (AST÷AST upper limit of normal) ÷ platelet × 100. Data was analyzed with the help of SPSS version 24.0 and Microsoft Excel 2013. Eighty individuals were conveniently selected, of which 62.5% were men and 37.5% were women. The mean age of the subjects was 43.47 SD ± 13.85 years. APRI and FIB-4 scores predicted F4 patients using the cutoff values of 0.47 (Sn. 72%, Sp. 70%) and 1.27 (Sn. 78%, Sp. 73%), respectively. The cutoff values of 0.46 for APRI and 1.27 for FIB-4 predicted F3-F4 patients (Sn. 74% and 77%; Sp. 76% and 76%), respectively. To predict F1-F4 compared to F0, the cutoff value was 0.34 (Sn. 68%, Sp. 75%) for APRI, while the cutoff value for FIB was 0.87 (Sn. 72%, Sp. 75%). The findings suggest that FIB-4 shows better diagnostic accuracy than APRI. This study provides optimal cutoff values for different groups of fibrosis patients for both serum markers. Also, the diagnostic accuracy of FIB-4 for predicting liver fibrosis was found to be superior to APRI in all disease stages.
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http://dx.doi.org/10.15557/JoU.2021.0030DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8438924PMC
August 2021

Translation and validation of the stroke impact scale 3.0 into Urdu for Pakistan.

NeuroRehabilitation 2021 ;49(3):391-402

Faculty of Allied Health Sciences, University of Lahore, Lahore, Pakistan.

Background: The Stroke Impact Scale version 3.0 (SIS 3.0) is a self-reported outcome measure designed to assess quality of life (QoL) following a stroke. Although the psychometric properties of the SIS 3.0 are identified as superior to the generic QoL scales, it has not been translated and tested in Pakistan.

Objective: To validate the Urdu version of the SIS 3.0 (USIS 3.0) for Pakistan.

Methods: A prospective cohort of 116 patients with mild to moderate stroke reported their recovery using the USIS 3.0. The patients were concurrently assessed on the established tools to assess the validity and were re-evaluated to determine the test-retest reliability, precision, minimal detectable change (MDC), and minimal clinically important difference (MCID).

Results: The reliability and internal consistency of USIS were satisfactory except for the emotion domain. The correlations of USIS with the established tools were strong. The discriminant validity was also significant across the levels of the modified Rankin scale (MRS). Only hand function and communication domains exhibited significant floor and ceiling effects, respectively. Regarding weighted K, values ranged from 0.53 to 0.88.

Conclusions: The USIS 3.0 has satisfactory psychometric properties and can be used in clinical and research settings for stroke survivors.
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http://dx.doi.org/10.3233/NRE-210064DOI Listing
November 2021

Efficacy of pedagogical framework in neonatal resuscitation skill learning in a resource-limited setting: a randomized controlled trial.

BMC Med Educ 2021 Aug 18;21(1):436. Epub 2021 Aug 18.

Department of Zoology, The Government College University, Lahore, Pakistan.

Background: The educational efficacy in neonatal resuscitation relies on the subject and teaching strategies. Therefore, it is imperative to test diverse educational methods if they are more instructive to engage students in active learning and practicing knowledge. Hence, the present study aims to investigate the efficacy of a pedagogical framework in neonatal resuscitation skill learning among nursing students in a resource-limited setting.

Methods: A single-blind randomized controlled trial was conducted between October 2020 to March 2021. Sixty nursing students in the 3rd and 4th year of professional training were randomly allocated to the pedagogy and the traditional group. The pedagogy group learned via 6-step LSPPDM (Learn, See, Practice, Prove, Do, Maintain) pedagogy including lectures, video, clinical observation, skill sessions under supervision, and self-directed practice. The traditional group learned through 2-step (Learn, Practice) method that included lectures and skill sessions under supervision. The outcomes measured included technical and non-technical skills in neonatal resuscitation. The technical skill deals with steps such as stimulation, ventilation, oxygenation, intubation, chest compression, medications, and reporting. Non-technical skills refer to teamwork skills that focus on the interaction between leader and helper. Both skills were measured through previously published validated tools two times before and after the intervention by blinded assessors in a simulated delivery room.

Results: Overall, the skill was significantly improved in both groups after intervention. Yet, the results showed that the mean difference of technical skill score in the pedagogy group (24.3 ± 3.5) was significantly higher (p <  0.001) compared to the traditional group (16.2 ± 2.4). Likewise, the mean difference of non-technical skill score in the pedagogy (36.9 ± 1.9) was highly significant (p <  0.001) compared to the traditional group (31.2 ± 1.7).

Conclusions: The LSPPDM pedagogy was found more effective in enhancing technical and non-technical skills in neonatal resuscitation compared to the traditional method. The results of this study support the efficacy of the 6-step LSPPDM pedagogy in the education of nursing students regarding neonatal resuscitation in a resource-limited setting.

Trial Registration: Prospectively registered at ClinicalTrials.gov ( NCT04748341 ).
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http://dx.doi.org/10.1186/s12909-021-02846-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8371841PMC
August 2021

Effect of whole-body vibration on obstacle clearance and stair negotiation time in chronic stroke patients; A randomized controlled trial.

J Bodyw Mov Ther 2021 Jul 4;27:698-704. Epub 2021 Jun 4.

University Institute of Public Health, Faculty of Allied Health Sciences, University of Lahore, Lahore, Pakistan. Electronic address:

Objective: To assess the effect of Whole-Body Vibration (WBV) and Routine Physiotherapy (RP) on obstacle crossing and stair negotiation time in chronic stroke patients.

Methods: The current study was randomized, parallel-group, assessor-blinded, clinical trial conducted in Physiotherapy Department of Lahore General Hospital, involving 64 patients with chronic stroke. Patients were randomly allocated to 2 groups, i.e., the WBV group (n = 32) and the RP group (n = 32). The WBV group was given additional twelve sessions of vibration therapy (amplitude of 3 mm and frequency of 20 Hz), 6 days/week for 2 weeks. The outcome measures were change in score of height and depth of obstacles cleared, i.e., 6, 8, 10 & 12 inches height and 6, 8, 10 & 12 inches depth and stair negotiation time, i.e., Stair-Climb Test. Chi square test, Independent sample t-test and Paired sample t-test were used to analyze the data.

Results: Results show that higher number of patients improved in crossing the maximum height and maximum depth of obstacles in the WBV group but improvement was significant only in height, i.e., (p < 0.05). In the WBV group, Stair Negotiation Time decreased significantly as compared to the RP group, i.e., (p < 0.05).

Conclusions: The present study concluded that both study groups, i.e., RP and WBV, improved despite better results for the latter. Speed of stair climbing and capacity to cross obstacles improved with the WBV therapy in chronic stroke survivors.

Trial Registration: IRCT, IRCT20190328043131N1. Registered 03 august 2019 - Retrospectively registered, https://www.irct.ir/user/trial/38832/view.
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http://dx.doi.org/10.1016/j.jbmt.2021.05.012DOI Listing
July 2021

Role of extracorporeal shockwave therapy in patients with rotator cuff tendinopathy: synthetic analysis of last two decades.

J Pak Med Assoc 2021 Jun;71(6):1627-1632

Department of Management, University of Management & Technology, Lahore, Pakistan.

Objective: To explore current evidence on the effectiveness of shockwave therapy in patients with rotator cuff tendinopathy.

Methods: The meta-analysis study was conducted at University of Lahore from May 2019 to December 2019 and comprised search on Cochrane, Medline, Embase, Physiotherapy Evidence Databasedatabases and other sources as well as unpublished grey literature related to shockwave therapy in patients with rotator cuff tendinopathy published between 2000 and 2019. Methodological quality assessment was performed using Cochrane risk of bias tool and the included studies were critically appraised using the Physiotherapy Evidence Databasescale.

Results: Of the 11 studies shortlisted, data was not extractable from 2(18%). Of the 9(82%) studies analysed, 8(89%) were randomised trials and 1(11%) was randomised pilot study. Overall, 4(44.4%) studies had high quality and 5(55.6%) fell in the fair category.

Conclusions: There was no consensus found on the efficacy of extracorporeal shockwave therapy compared to traditional rehabilitation among patients with rotator cuff tendinopathy.
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http://dx.doi.org/10.47391/JPMA.02-190DOI Listing
June 2021

Enhanced Neurokinin-1 Receptor Expression Is Associated with Human Dental Pulp Inflammation and Pain Severity.

Biomed Res Int 2021 5;2021:5593520. Epub 2021 May 5.

University Institute of Public Health, Faculty of Allied Health Sciences, The University of Lahore, Lahore, Pakistan.

Substance P (SP) is a peptide involved in many biological processes, including nociception and inflammation. SP has a high affinity for its receptor neurokinin-1 (NK-1R). SP/NK-1R complex plays a major role in the interactions going on during the onset of dental pain and inflammation. . To identify the expression of NK-1R in healthy and inflamed human dental pulp, as well as to identify any association with severity of dental pain. . This case-control study included ten irreversibly inflamed samples of dental pulp, which were extirpated from patients presenting with chief complaint of dental pain due to caries. Ten healthy pulps, extirpated from those teeth which were indicated for extraction due to orthodontic reasons, were used as the control group. Visual analog scale (VAS) and modified McGill Pain Questionnaire were used to assess the characteristic and severity of pain. Immunohistochemical study was performed using monoclonal antibodies against NK-1R. . The results showed that the NK-1R was expressed intensely in patients with higher pain score. The mean pain score in cases was 7.0 ± 2.0. The healthy dental pulps had negative or mild NK-1R staining of +1 intensity. The NK-1R score in cases was 2.4 ± 0.516 and 0.2 ± 0.4216 in controls. There was significant difference in NK-1R score between both groups ( value <0.05). There was a strong positive correlation between the pain score and NK-1R expression score. As the pain increased, the NK-1R expression score was also increased (0.95, value 0.000). . NK-1R is overexpressed in inflamed dental pulp. SP/NK-1R modulation may provide a novel approach for the treatment of pulpal inflammation and pain.
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http://dx.doi.org/10.1155/2021/5593520DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8121577PMC
September 2021

Role of High Resolution Computed Tomography chest in the diagnosis and evaluation of COVID -19 patients -A systematic review and meta-analysis.

Eur J Radiol Open 2021 13;8:100350. Epub 2021 May 13.

University Institute of Radiological Sciences and Medical Imaging Technology, The University of Lahore, Lahore, Pakistan.

Background: Recent studies reported that CT scan findings could be implicated in the diagnosis and evaluation of COVID-19 patients.

Objective: To identify the role of High-Resolution Computed Tomography chest and summarize characteristics of chest CT imaging for the diagnosis and evaluation of SARS-CoV-2 patients.

Methodology: Google Scholar, PubMed, Science Direct, Research Gate and Medscape were searched up to 31 January 2020 to find relevant articles which highlighted the importance of thoracic computed tomography in the diagnosis as well as the assessment of SARS-CoV-2 infected patients. HRCT abnormalities of SARS-CoV-2 patients were extracted from the eligible studies for meta-analysis.

Results: In this review, 28 studies (total 2655 patients) were included. Classical findings were Ground Glass Opacities (GGO) (71.64 %), GGO with consolidation (35.22 %), vascular enlargement (65.41 %), subpleural bands (52.54 %), interlobular septal thickening (43.28 %), pleural thickening (38.25 %), and air bronchograms sign (35.15 %). The common anatomic distribution of infection was bilateral lung infection (71.55 %), peripheral distribution (54.63 %) and multiple lesions (74.67 %). The incidences were higher in in the left lower lobe (75.68 %) and right lower lobe (73.32 %). A significant percentage of patients had over 2 lobes involvement (68.66 %).

Conclusion: Chest CT-scan is a helpful modality in the early detection of COVID-19 pneumonia. The GGO in the peripheral areas of lungs with multiple lesions is the characteristic pattern of COVID-19. The correct interpretation of HRCT features makes it easier to detect COVID-19 even in the early phases and the disease progression can also be accessed with the help of the follow-up chest scans.
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http://dx.doi.org/10.1016/j.ejro.2021.100350DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8119228PMC
May 2021

Wheat straw: A natural remedy against different maladies.

Food Sci Nutr 2021 Apr 27;9(4):2335-2344. Epub 2021 Feb 27.

University of The Gambia Serrekunda Gambia.

In millennia, much attention has been paid toward agro-industrial waste which consists of lignin and cellulosic biomass. In this perspective, biomass waste which consists of lignocellulosic mass is an inexpensive, renewable, abundant that provides a unique natural resource for large-scale and cost-effective bioenergy collection. In this current scenario, efforts are directed to briefly review the agro-industrial lignocellulosic biomass as a broad spectrum of numerous functional ingredients, its utilization, and respective health benefits with special to wheat straw. Wheat straw is lignocellulosic mass owing to the presence of cellulose, hemicellulose, and lignin. Its microbial culture is the most important and well adjusted, for a variety of applications in the fermentation substrate, feed, food, medicine, industry, and agriculture in order to increase soil fertility. In industrial fermentation, wheat straw can be used as substrates for the production of a wide range of hydrolytic enzymes, drugs, metabolites, and other biofuels as a low-cost substrate or a natural source. Conclusively, wheat straw is the best source to produce bioethanol, biogas, and biohydrogen in biorefineries because it is a renewable, widely distributed, and easily available with very low cost, and its consumption is protected and environment friendly. Wheat straw is a moiety which has health benefits including anti-inflammatory, antimicrobial, anti-artherogenic, anti-allergenic, antioxidant, antithrombotic, etc.
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http://dx.doi.org/10.1002/fsn3.2030DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8020915PMC
April 2021

Prevalence and risk factors associated with prenatal depression among pregnant women in Faisalabad, Pakistan.

Pak J Pharm Sci 2020 Sep;33(5(Supplementary)):2355-2360

Directorate of Medical Sciences, Department of Eastern Medicine, Government College University, Faisalabad, Pakistan.

To determine the prevalence of prenatal depression and explore its association with socio-demographic risk factors, stressful life events and women autonomy/decision-making. The recognition of these problems would play a substantial role in the strategic development of interventions for those Pakistani women who have been suffering from prenatal depression. Analytical cross-sectional study conducted in Allied hospital Faisalabad during a period of 18 months (1st Jan 2019 to 30 June 2020). Data was collected by using simple random sampling technique. EPDS was used to measure prenatal depression. A modified kuppuswamy scale, Life Events and Difficulties Schedule (LEDS) and women autonomy/decision making scale was used to assess the risk factors. A total of 380 women were included in the study. The mean age (in years) ± SD was 29.37±5.27. According to cut-off score >10 on Edinburg postnatal depression scale the prevalence of depression was found as 51.6%. The findings revealed that women education, socio-economic class, BMI, pregnancy duration, history of miscarriage, contraception, stressful life events and women autonomy had significant association with prenatal depression (P<0.05). Socio-demographic factors, stressful life events in previous life and women autonomy are significant predictors of prenatal depression that need to be addressed in order to sustain safe motherhood.
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September 2020
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