Group Mean Age Research Articles

Novel single nucleotide polymorphism (rs1600485907) of IL-41 gene associated with systemic lupus erythematous

This study evaluated the serum concentrations of IL-41 and the detection of specific single nucleotide polymorphisms (SNPs) (rs1600485907, rs762398841, and rs575275512) within the IL-41 gene in female subjects diagnosed with systemic lupus erythematosus (SLE). The study sample comprised 124 female patients who had been diagnosed with SLE, with an equivalent number of healthy control volunteers. The levels of serum were determined using the application of an enzyme-linked immunosorbent assay (ELISA) technology, while SNPs were determined by conventional polymerase chain reaction (PCR), and subsequent Sanger sequencing. The results revealed that the mean age of the healthy control group was 31.64 years, whereas the mean age of the group diagnosed with SLE was 33.66 years. The findings of the present investigation indicate that the individuals under examination demonstrated an average disease duration of 9.0 years, whereas the average SLEDAI-2k score for those diagnosed with SLE was 11.0. The concentrations of ESR, CRP, urea, creatinine, C3, and C4 in individuals diagnosed with SLE showed a statistically significant elevation in comparison to the control cohort. The analysis of patients’ anti-nuclear antibodies (ANA) revealed that 89% of individuals have ANA, whereas 95.61% display anti-dsDNA. Significantly elevated levels of serum IL-41 were seen in patients diagnosed with SLE in comparison to healthy controls. A receiver operating characteristic (ROC) analysis was performed on a cohort of patients diagnosed with SLE to assess the diagnostic efficacy of IL-41 in discriminating between SLE patients and non-afflicted persons. The study determined that the specificity of IL-41 was 82.26%, representing the percentage of accurate negative outcomes. In contrast, the sensitivity of IL-41 was found to be 84.68%, indicating the percentage of accurate positive outcomes. The computed value for the area under the curve (AUC) was found to be 0.937. The statistical analysis revealed a significant connection between the existence of both heterozygote and homozygote mutant genotypes of IL-41 (rs1600485907) and an increased vulnerability to the formation of SLE. In conclusion, it has been shown that individuals diagnosed with SLE demonstrate heightened concentrations of IL-41in their circulating blood plasma. Furthermore, a particular genetic variation, specifically a single nucleotide polymorphism (SNP) denoted as rs1600485907 located within the IL-41 gene, has been recognized as a potential susceptibility factor for the onset of this disorder.

APGAR SCORE: COMPARISON OF GENERAL ANAESTHESIA VS SPINAL ANAESTHESIA

Caesarean section is a common obstetric operation performed to save the lives of both the mother and baby. This study aimed to compare the APGAR score of neonates in patients who received general anesthesia or spinal anesthesia during the procedure. For this prospective randomized controlled trial, 160 ASA class I and II patients who underwent elective caesarean section at 37 weeks or more of gestation were selected. The patients were randomly divided into two equal groups, A and B, with 80 patients in each group. Group A received spinal anesthesia with a 25-gauge pain spinal needle using hyperbaric bupivacaine 1.5ml, while Group B received general anesthesia with an endotracheal tube. After the baby's delivery, the APGAR score was assessed at 1 minute and recorded on a proforma. The results showed that the mean APGAR score at 1 minute in group A was 8.49, while in group B, it was 6.53. The mean age in group A was 30.09 ± 3.35 years, and in group B, it was 29.86 ± 3.16 years. The mean birth weight of neonates in group A was 2999.80 ± 275.78 grams, while in group B, it was 3066.25 ± 281.66 grams.In conclusion, the study found that the APGAR score was better in spinal than in general anesthesia.

Optical Coherence Tomography Findings in Bipolar Disorder Patients and the Related Factors.

This study's purpose is to determine the effects of current episode and the mood stabilizers on chorioretinal layer thicknesses of bipolar disorder (BD) patients using spectral-domain optical coherence tomography (SD-OCT). Sixty-seven patients were diagnosed with BD I and using lithium (Li) or valproic acid (VPA), of whom 20 were manic, 24 were depressive, and 23 were in remission, and 49 healthy individuals were included in the study. Peripapillary retinal nerve fiber layer (RNFL), ganglion cell layer, and macular thicknesses of the participants were measured automatically using SD-OCT, and their choroid layer thicknesses were measured manually using the depth imaging mode of SD-OCT. Statistical analysis of the data was performed using Statistical Package for the Social Sciences version 23.0. The patient group's mean age was 39.78 ± 11.78, and the control group's mean age was 42.06 ± 12.10. The mean disease duration was 13.22 ± 8.23 in the patient group, and 26 patients were using Li. While peripapillary RNFL thicknesses were lower in the patient group (P < .05), other layer measurements were similar between the groups. Moreover, the episodes experienced by BD patients did not affect chorioretinal SD-OCT measurements. The patients on VPA had significantly lower RNFL thicknesses compared to the control and the Li groups, and all chorioretinal measurements were similar between the Li and the control groups. As a result of the study, it was established that neurodegenerative processes play a role in the pathophysiology of BD and the usage of Li is protective against the neurodegeneration of RNFL. Retinal changes measured with SD-OCT can be used for the diagnosis and prognosis of BD and for evaluating responses to mood stabilizers.

Effects of fasciatherapy versus fascial manipulation on pain, range of motion and function in patients with chronic neck pain

BackgroundNeck pain is among the common musculoskeletal problem that hinders a person’s daily activities. Fascial tightness is a familiar cause of chronic neck pain that is often neglected and can further cause neck disability and a limited range of motion.ObjectiveThe purpose was to compare the effects of fascia therapy and fascial manipulation on pain, range of motion and function in patients with chronic neck pain.MethodsA randomized clinical trial was conducted from February to August 2022 in the Riphah Rehabilitation Centre, Lahore, Pakistan. Fifty-two participants of both genders, aged 18–40 years with chronic neck pain of at least 3–6 months were included. Group A (n = 26) received fascia therapy along with a conventional physical therapy protocol of hot pack, strengthening and stretching, while group B (n = 26) received the fascial manipulation treatment with conventional physical therapy. All the participants were assessed at baseline and after 3 weeks (3 sessions per week). Numeric Pain Rating Scale (NPRS), Neck Disability Index (NDI) and Goniometer (range of motions) were the outcome measures. SPSS 25 was used for the data analysis and normality of the data through the Shaphiro-Wilk test (p > 0.05), and parametric tests were applied.ResultsThe mean age of group A was 24.82 ± 2.64 years, and group B was 24.17 ± 2.20 years. The independent t-test result showed no significant difference (p ≥ 0.05) in all parameters except in cervical extension and right-side bending (p < 0.05). At the same time, the pair-wise comparison showed significant results (p < 0.05) for all outcome measures in both groups.ConclusionDBM fascia therapy improved cervical extension and side bending (right) more than the fascial manipulation group.It is concluded that DBM fascia therapy shows more improvement as compared to other group.Trial registration numberThis study was registered at ClinicalTrials.gov ID: NCT05272111 on 09/03/2022.

Subtalar Joint Fusion For STJ OA before vs after Total Ankle Replacement: Does it affect patient outcomes? – A 10 year follow up clinical study

Category: Ankle; Hindfoot Introduction/Purpose: There is paucity of literature reporting outcomes in patients who undergo subtalar joint fusion surgery before vs. after having a Total Ankle Replacement (TAR). We aimed to study the PROMs in patients who underwent a staged approach of Subtalar arthrodesis (STJA) followed by TAR vs patients who underwent TAR followed by further STJA surgery. Methods: All patients who underwent a STJA surgery and TAR surgery (in either order) between 2006 and 2010 included in this study. patient reported outcomes including WOMAC (Western Ontario McMasters Osteoarthritis score), SF-36 general health score and patient satisfaction scores were compared between groups. They analysed pre-operatively and at 1, 2, 5 and 10 years post-operatively. Out of 210 TARs performed, 14 patients underwent a two staged procedure between 2006 and 2010 by a single surgeon. 5 patients had STJ fusion after TAR (Group A) and 9 patients had STJ fusion before TAR (Group B). Results: Mean age of Group A and B was 52.5 years and 62.1 years respectively. 1 patient in Group A and 3 patients in Group B were deceased. Both groups reported improvement in scores for WOMAC, SF -36 from pre-op to 1 year post operatively (p &lt; 0.05) and the results plateaued to 5 years with slight decline in scores from 5 to 10 years. At 2 years, Group B reported lower scores for stiffness (9.6±11.7 vs. 64.3 ±27.4) p=0.002, At 5 years, Group A reported lower scores than group B for General health and mental health components of SF-36 scores (p=0.044); however, there was no differences between groups for WOMAC, SF-36 and patient satisfaction outcomes at 10 years post-operatively. Conclusion: There were similar outcomes reported by patients who underwent STJA either before or after TAR at average of 10 year follow up in this series

Comparative Study of Efficacy Between Platelet-Rich Plasma vs Corticosteroid Injection in the Treatment of Lateral Epicondylitis

Background: Lateral epicondylitis, commonly known as "tennis elbow," is a painful condition affecting the tendons on the outer part of the elbow. Managing lateral epicondylitis is essential to relieve discomfort and improve the patient's quality of life. Various treatment options are available for lateral epicondylitis, including Platelet-Rich Plasma (PRP) therapy and corticosteroid injections. The technique if proved better in pain control would be later on preferred as it will contribute significantly to reduce indoor patient burden, earlier recovery of patients and to their overall satisfaction. Objective: To assess and comparative effectiveness of corticosteroid injections with platelet-rich plasma injections in the management of lateral epicondylitis. Study Design: Randomized controlled trial (RCT). Settings: Department of Orthopedic Surgery, PIMS, Islamabad Pakistan. Duration: From December 2019 to May 2020. Methods: Overall, 162 adult patients having clinical features of chronic lateral epicondylitis unilateral/bilateral not responding to conservative management of either gender with age between 18-60 years were included. Patients were randomly assigned into two intervention groups. Patients of Group A underwent local steroid injections, while Group B received platelet-rich plasma (PRP) injections. Patients of the PRP group, were administered 2 mL of PRP, derived from their own blood, at the most sensitive spot on the lateral epicondyle. Patients of the steroid group, were given 2 mL of methylprednisolone (40 mg/mL). Following the injections, patients were instructed to rest for 15 minutes and advised against massaging the treated area. VAS score was calculated at baseline before giving treatment in both groups and was subsequently assessed at 6th week, 3rd month and 6th month post therapy. VAS score was compared in both groups at different time intervals using student-t test for independent samples. Results: Mean age in group A was 47.4 ± 7.5 years and in group B was 48.1 ± 8.2 years. In group A, 56.8% of the participants were males, and 43.2% were females, whereas in group B, 54.3% were males, and 45.6% were females. Baseline average score of VAS was almost equal among both groups at baseline (7.69 ± 1.03 and 7.74 ± 1.06) in group A and B respectively. At 6th weeks, average score of VAS in steroid group was 3.7 ± 1.79 and in PRP group was 3.23 ± 2.05 (P=0.440). At 3 months, average score of VAS in steroid group was 2.73 ± 1.48 and it was 2.53 ± 1.82 SD in PRP group (P=0.451). At 6 months, VAS average score was noted significantly decreased 2.11±1.29 compared to steroid group was 4.83 ± 2.11 (P=0.001). Conclusion: The study revealed that PRP injections are more effective than local steroid injections for chronic lateral epicondylitis. Initial VAS scores were similar for both treatments up to three months, but PRP showed significantly better results at the 6-month follow-up, indicating its long-term effectiveness.

Exploring the relationship between frailty and executive dysfunction: the role of frontal white matter hyperintensities.

Frailty is a geriatric syndrome frequently associated with executive dysfunction and white matter hyperintensities (WMH). But the relation between executive dysfunction and brain changes is poorly understood in frail subjects. Our hypothesis is that frontal-WMH mediates the association between frailty and executive dysfunction. A convenience sample of 113 subjects older than 65 years without dementia was studied with neuropsychological test, a structured clinical interview, physical examination and brain MRI. They were classified as robust or pre-frail and frail using the frailty phenotype score (0-5). The frontal WMH (F-WMH) were manually graduated (0-6) using the "Age-Related White Matter Changes score" from FLAIR sequences at a 3 Tesla brain MRI. A mediation analysis was done for testing whether F-WMH could act as a link factor between frailty phenotype score and executive dysfunction. The group's mean age was 74 ± 6 years, subjects with higher frailty score had more depressive symptoms and worse performance in executive function tests. A regression analysis that explained 52% of the variability in executive functions, revealed a significant direct effect of frailty score (Standardized βcoeff [95% CI] -0.201, [-0.319, -0.049], and F-WMH (-0.152[-0.269, -0.009]) on executive functions, while the F-WMH showed a small partial mediation effect between frailty and executive functions (-0.0395, [-0.09, -0.004]). Frontal matter hyperintensities had a small mediation effect on the association between frailty and executive dysfunction, suggesting that other neuropathological and neurofunctional changes might also be associated with executive dysfunction in frail subjects.

Correlation of glycated haemoglobin status with the foot ulcer

Background: Diabetic foot ulcer is a well-documented complication of uncontrolled diabetes and its association with the variables involved in Diabetes like FBS, RBS and HBA1C has been thoroughly researched. This research aims to identify the association of diabetic foot ulcer under Wagner classification with HBA1C classes. Objectives were to determine the severity of diabetic foot ulcer at various level of HBA1C and determine the association. Methods: A observational cross-sectional study with 160 diabetic patients who after giving consent filled questionnaires. The information was analyzed using SPSS v26 (IBM) through Chi Square test. The results were tabulated and inferred from. Results: The study included Sample size of 160 Patients. Here in the study mean age for group A was 41.2 years, for group B it was 29.6 years and for group C it was 25.8 years. Majority 40% patients in group A had T2DM. In group B we found that 51.7% patients had T2DM followed by 48.2% patients with T1DM. In group C we found that majority 67.01% patients had T2DM. We found that site of ulcer was improving with increasing duration of follow up. Initially we found 30% patients with infection at dorsum aspect of foot. After follow up day 9 we found improvement in ulcer infection Conclusions: This research further supplemented an already strongly established association between uncontrolled diabetes and diabetic foot ulcer. We focused on specifically HBA1C and how increased lab values are linked with different grades of Diabetic Foot ulcer and found a strong association demanding a proactive approach towards patient care and education. HbA1c has a linear relationship with the grades of Wagner classification of diabetic foot.

Comparative Analysis of the Impact of Positional Release Technique (PRT) and Ischemic Compression (IC) on Headache Disability and Pain in Cervicogenic Headache (CGH) Patients

Headache originating from the bony structures or soft tissues of the neck is commonly known as cervicogenic headache. This study was conducted to determine the effects of the positional release technique (PRT) and ischemic compression (IC) on pain and headache disability among patients with cervicogenic headache (CGH). For this purpose, a randomized clinical trial was conducted. Data was collected from the Physiotherapy Department of Sharif Medical Complex, Lahore. A total of 36 CGH patients were assigned into two groups, randomly. The first group was treated with PRT and the other with IC. Both groups were given 12 sessions of therapy over a span of 4-weeks. HDI (Headache Disability Index) and NPRS (Numeric Pain Rating Scale) were used to measure the treatment effect on pain and headache disability before and after treatment. Among the participants (N = 36), the mean age of Group A and Group B was 26.22 ± 2.90 and 24.55 ± 2.55, respectively. A significant difference was found between the mean values of pre- and post-HDI and NPRS, with p-values 0.025 and 0.031, respectively and after treatment p value was 0.001 &amp; 0.00 respectively. The results favoured the use of PRT because there was more variation in the mean values of PRT as compared to IC. Also, the mean values of pre- and post-HDI and NPRS scores varied significantly. Notably, a significant difference was not found between the mean values of both techniques at the beginning of treatment (pre-treatment). However, a significant difference was observed between the mean values of both techniques following treatment (post-treatment) in favour of PRT, since the mean values of PRT varied more than those of IC.

314 Comparison of hemorrhoidectomy by LigaSure and conventional Milligan Morgan's Technique

Abstract Aim To compare outcomes of hemorrhoidectomy by LigaSure and conventional Milligan Morgan’s hemorrhoidectomy. Methods In this randomized controlled trial, we enrolled a total of seventy adult patients of either gender between age 17-80 years. All the enrolled patients presented with 3rd or 4th degree haemorrhoids and were planned for hemorrhoidectomy. The patients were assigned to two treatment groups. Group A (Milligan Morgan’s) patients were enrolled from one hospital and Group B (LigaSure) patients were enrolled form second hospital. Post-operative pain was assessed in both groups using VAS at 6, 12 and 24 hours along with amount of blood loss during the surgery. Duration of surgery (min) was estimated and compared in both the groups. Results There were 62.9% males and 37.1% females in group A and 80.0% males and 20.0% females in group B (P=0.112). Mean age in group A and group B patients was 43.3 years ± 11.3 SD and 46.4 years ± 8.2 SD respectively. In group A, there were 68.96% patients having grade III and 31.4% patients having grade IV haemorrhoids and in group B, 57.1% patients had grade III and 42.9% patients had grade IV haemorrhoids (P=0.322). Mean VAS at 6 hours, 12 hours 24 hours, mean amount of blood loss during the surgery and mean duration of surgery was significantly shorter (P=0.001) in patients of group A as compared to patients of group B. Conclusions The LigaSure method had significantly lower degree of post operative pain, lesser amount of blood loss during the surgery and shorter duration of surgery as compared to Milligan-morgan method.

Use of Xbox Kinect 360 Videogame for Rehabilitation of Sports Specific ACL Sprain During Lockdown Period Due to COVID-19 Pandemic

Background: Anterior cruciate ligament is one of the two ligaments inside the middle section of the knee joint that forms an “X” shape. Its main function is to prevent the tibia from sliding forward relative to the femur. The ACL also assists with preventing excessive knee extension, knee varus and valgus movements, and tibial rotation. Kinect works in almost all room lighting conditions and can simultaneously track two active users. For full-body, head-to-feet tracking, the recommended user distance from the sensor is approximately 1.8 m for a single user; when two people are to track simultaneously, they should stand approximately 2.5 m away from the device. Kinect requires a minimum user height of 1 m. With the players themselves becoming the ‘game controller’ via their body movements and gestures, Kinect-enabled game titles lend themselves comfortably to the class of exergames (‘exercise games’), although the amount of physical activity involved and calories burned can vary significantly from title to title Materials and method: Twenty-six participated in the study. These subjects were divided into two groups, 13 subjects in each. Group A was administrated with the traditional training, and Group B was administrated with the X BOX Kinect training. Results: Comparison of mean and standard deviation of subjects aged (18-25) between Group A (Traditional Training) and Group B (X box Kinect 360 Training). The mean age of Group A was 20.7143±1.98278, and Group Bs was 20.6571±2.21711, respectively. The paired t-test value was 15.728. There was no significant difference between age groups. But in both Kujala score and muscle girth scores with p-value &lt;0.001** (i.e., p &lt;0.05 at 95 % confidence interval), the pre and post-values of Kujala score and muscle girth were statistically significant. Conclusion: Comparing traditional treatments with or without adding extra Kinect 360 training sessions would be very interesting, being that it may be a good addition to the treatment for post-operative ACL rehab, ACL sprains conservative management, and maintaining Knee joint fitness when sports players in a home without exposure of COVID -19. KEYWORDS: Xbox Kinect-360, ACL Sprain, Home-Based Exercises, Kujala Scale, COVID-19, Remote Rehabilitation.

Conjunctival Impression Cytology and Tear Film Changes in Sarcoidosis: A Subjective and Objective Diagnosis Study.

To evaluate sarcoidosis-induced tear film changes using subjective and objective diagnostic tests, particularly conjunctival impression cytology (IC), and to compare the results with healthy individuals. This study evaluated clinical data collected between January 2019 and January 2021 from 57 right eyes of 57 sarcoidosis patients without ocular involvement (Group 1) and 33 right eyes of 33 healthy individuals with similar demographic characteristics (Group 2). The Schirmer I test, tear break-up time (TBUT), fluorescein staining, and conjunctival IC were all performed as part of the conjunctival and corneal examinations following a thorough ophthalmological examination. The Ocular Surface Disease Index (OSDI) was used to assess subjective ocular symptoms. The mean ages in Groups 1 and 2 were 49.26±3.18 and 51.91±2.89 years, respectively (p=0.720). The mean Schirmer I test, TBUT, and OSDI scores differed significantly (p<0.05 for all), with Group 1 having a significantly higher percentage of dry eyes than Group 2. Group 1 had significantly higher Nelson's grading system grades than Group 2 based on conjunctival IC analysis (p=0.001). There were no significant differences in visual acuity (p=0.17) or intraocular pressure (p=0.14) between groups. Sarcoidosis patients had significantly higher Nelson grades in conjunctival IC, as well as significantly higher percentages of dry eye as determined by the Schirmer I test, TBUT, and OSDI. Reduced tear quantity and quality may destabilize the tear film layer, resulting in a variety of ocular symptoms.

Correlation of monocytopenia with aging in COVID-19 infected patients.

Objectives: To observe the effect of aging on monocyte count in COVID-19 infected patients. Study Design: Observational study. Setting: Rawal Institute of Health Sciences Islamabad, Pakistan Institute of Medical Sciences Islamabad. Period: April 2021 till July 2021. Material &amp; Methods: Adult humans of total 100 in numbers, suffering from corona virus with positive PCR test were selected. They were divided in two groups with 50 patients in group A and 50 patients in group B. Inclusion criteria was COVID-19 infected patients belonging to both genders without any blood disorder. All adults below the age of 18 years with blood disorder diseases were excluded. The age limit in group A was below 50 years and in group B was above 50 years. Monocyte count of all the patients was noted from the record in the laboratory of Rawal institute of health sciences and Pakistan institute of Medical sciences Islamabad. The age of the patients was confirmed from their CNIC. Results: Data was checked for normality by using Shapirowilk test of normality and comparison of monocyte count in between two groups was done by using Mann Whitney U test a significant difference was seen. Monocyte count in group A was 172/ µl and in group B was 122/ µl of blood. The mean age in group A was 32.3 years and in group B was 65.9 years. The p value of 0.00 shows a significant correlation of aging with monocytopenia. Conclusion: Corona virus infected patients with increased age (&gt; 50) years showed more reduction in monocyte count as compared to patients with lower age (&lt; 50) years.

Investigation of the choroidal structure in non-neovascular age-related macular degeneration patients with reticular pseudodrusen

BackgroundThis study aimed to compare choroidal thickness, total choroidal area (TCA), luminal area (LA), stromal area (SA) and choroidal vascularity index (CVI) in patients with reticular pseudodrusen (RPD) and drusen. MethodsA total of 100 eyes of 100 patients with non-neovascular age related macular degeneration (AMD) with five or more medium drusen (63–125 µm) and RPD in two or more quadrants were recruited to the study. 48 eyes of 48 patients with RPD were assigned as Group 1 and 52 eyes of 52 patients with drusen were assigned as Group 2. 40 right eyes of 40 healthy subjects were included as controls. Patients with neovascular AMD or advanced non-neovascular AMD were excluded from the study. After a detailed ophthalmic examination, infrared reflectance images and OCT with enhanced depth imaging mode was obtained from all patients. TCA, SA, LA and CVI were calculated using the Image J program. The data were analyzed for statistics using SPSS software. ResultsThe female/male ratio was 56/44 in the patient groups and 20/20 in the control group. The mean age was 73.63±6.14 (61–91) years for Group 1 and 69.43± 6.97 (59–87) years for Group 2 (p=0.005). The mean age of Group 3 patients was 71.14±8.17 (60–79) years and was statistically similar to Groups 1 and 2 (p=0.09 and p=0.12, respectively). Choroidal thickness, TCA, SA and LA were significantly lower in Group 1 (p<0.001). CVI and foveal thicknesses were not significantly different between Group 1 and 2 (p=0.214 and p=0.384 respectively). CVI was significantly lower in Group 3 (p<0.01). RPD was most commonly seen in the superior quadrant followed by temporal, nasal, and inferior quadrants. ConclusionsTCA, SA and LA, which reflect choroidal vasculature, were decreased in patients with RPD. These parameters can help evaluate the pathophysiology of the disease.

Enrichment and animal age, not biological variables, predict positive welfare indicators in zoo-housed carnivores

The development of evidence-based zoo animal welfare science and the use of the 'five domains' have inspired zoos to increase animal welfare, particularly recognising positive welfare states. We tested whether natural biology (number of habitats, latitudinal range, sociality, body weight) or husbandry variables (mean age of group, group size and presence of extra enrichment) predict rates of positive welfare indicators (activity, play and engagement with the environment) in the Order Carnivora from collecting data from previously published articles. For each behaviour, species (n = 23) medians were analysed using phylogenetically informed mixed-model regression. Activity data were from 136 animals (n = 23 species), environmental interaction from 55 animals (n = 15 species) and play from 27 animals (n = 7 species). Biological variables did not predict rates of behaviour at a species or an individual animal level, but husbandry variables did. At an individual level, activity and play decreased in older animals. Activity and interaction with environment also increased with additional enrichment. This study is the first to quantify positive behaviours performed by zoo housed Carnivora and shows that they display indicators of positive welfare, if appropriate husbandry including environmental enrichment is provided.

Outcome and mortality rate of COVID-19 infection among health workers and general population

Objective: To determine the outcomes and mortality rate of Covid-19 infection among health workers and general population. Material and methods: An observation study was conducted in Department of Pulmonology Pak Red Crescent Medical College &amp; Teaching Hospital,Dina Nath, Kasur, Punjab. Total 210 Covid-19 patients which were divided in two groups equally, group A healthcare workers and group B general population. Outcomes and mortality rate were assessed between both groups using Chi Square and Independent Samples T-test. Results: Mean age in group A was was 41.29±11.37 years while 42.61±16.15 years in group B. ICU admissions was significantly lower in group A 7 (6.7%) while 22 (21.0%) in group B. Mechanical ventilation need was significantly lower 6 (5.7%) in group A than group B 19 (18.1%). Mortality rate was significantly lower in group A than group B 4 (3.8%) vs 15 (14.3%). The mean hospital stay in group A was significantly shorter 9.41±3.333 days than in group B 13.18±3.956 days. Conclusion: From our study we conclude that the mortality rate was higher in the general population as well as the admission to ICU and need for mechanical ventilation as compared to the healthcare workers.

Epidemiological Characteristics and Trends of Primary Hip Arthroplasty in Five Tertiary Hospitals: A Multicenter Retrospective Study.

The number of primary hip arthroplasty (PHA) has increased sharply in recent years. Whether the epidemiological characteristics and trends of PHA have changed are unknown. This study aims to analyze the epidemiological characteristics and trends of those patients are urgent for public health institutions. The data of patients who underwent PHA in five tertiary hospitals from January 2011 to December 2020 were retrospectively reviewed. A total of 21,898 patients were included, most of whom were aged 60-69 years (25.1% males and 31.5% females). According to the hospitalization date, the patients were divided into two groups (Group A and Group B). The patients admitted between January 2011 and December 2015 were designated as Group A (7862), and those admitted between January 2016 and December 2020 were designated as Group B (14036). The patient data of the two groups, including sex, age, disease causes, body mass index (BMI), comorbidities, surgical procedures, hospital stay duration, and hospitalization costs, were analyzed by Pearson chi-Square test, Student t test or Mann-Whitney U test. More women were included in Group B than in Group A (58.5% vs 52.5%, P < 0.001). The mean age of Group B was less than that of Group A (62.27 ± 14.77 vs 60.69 ± 14.44 years, P < 0.001). Femoral head necrosis was the primary pathogenic factor in both groups, with a higher proportion in Group B than in Group A (55.5% vs 45.5%, P < 0.001). Significant differences were found between the two groups in BMI, comorbidities, surgical procedures, hospital stay duration, and hospitalization costs. Total hip arthroplasty (THA) was the most common surgical procedure in both groups, with a higher proportion in Group B than in Group A (89.8% vs 79.3%, P < 0.001). The proportion of patients with one or more comorbidities was significantly higher in Group B than in Group A (69.2% vs 59.9%, P < 0.001). In addition, Group B had a shorter hospital stay duration and higher hospitalization costs than Group A. Femoral head necrosis was the primary etiology for PHA in this study, followed by femoral neck fracture and hip osteoarthritis. Patients who underwent PHA exhibited a higher percentage of femoral head necrosis; underwent THA more often; and had larger BMIs, more comorbidities, higher medical costs, and younger age in the past decade.

Role of Post-Isometric Relaxation of Quadriceps and Core Stability Exercises in Vertical Jump Performance

Objective: To determine the role of post isometric relaxation of quadriceps and core stability exercises in vertical jump performance. Methods: A Randomized Clinical Trial, conducted in Islamic International University after having the ethical permission from Institutional review Board of Riphah International University Islamabad. Sampling technique was Non-probability convenience sampling with the sample size of 30 athletes, that were divided by sealed and envelop method into core stability exercise treated group (n=17) and Post isometric relaxation treated group (n= 13). Male Athletes within age range of 20-35 years and playing at the domestic level were&#x0D; included and athletes with history of sprain or strain in lower limbs within last 6 month, having neuromusculoskeletal and cardiovascular pathology were excluded from the study. Force plate was used to measure the different parameters of jump. Data were entered and analyzed through SPSS version 22. Results: The mean age of group A and B was 20.35 + 2.01 and 20.03 + 2.42 in years respectively. BMI of core stability exercise treated group and Post isometric relaxation treated group was 22.35 + 2.32, 22.58 + 1.95 respectively in kg/m2. Comparison between core stability exercise treated group and Post isometric relaxation treated group showed that there was no significant immediate effects (F= 1.235; p= 0.852) of treatment on three style of jumps.&#x0D; Conclusion: No significant immediate effects of treatment on three styles of jumps was found.

Comparison of efficacy of methylprednisolone with dexamethasone in moderate to severe COVD-19 patients in a tertiary care hospital

Background: The aim was to compare efficacy of methylprednisolone with dexamethasone in moderate to severe COVID-19 patients in a tertiary care hospital. Method: A retrospective observational study was conducted by collecting data of moderate to severe COVID-19 patients admitted to covid wards of a tertiary care hospital for a period of six months. Demographic data, information about SpO2 changes, duration of hospitalization, marker status and ventilation status were parameters collected and used to compare between two groups. Results: Total number of patients in this study were 130. Out of which 65 patients who were on Methylprednisolone belonged to group A and 65 patients taking dexamethasone belonged to group B. In group A 56 (86.2%) were males and 9 (13.8%) were females. In group B 51 (78.5%) were males and 14 (21.5%) were females. Mean age in group A was 54.75±14.96 (age range b/w 25-80 years) and in group B was 55.43±15.83 (age range between 23-84 years). Patients in group A showed more presence of comorbidity (44.6%) as compared to group B (32.3%). Mean SpO2 level on day 1 in group A was 86.37±7.58 and in group B was 88.11±4.38. On day of discharge mean SpO2 level was 95.05±1.54 in group A and 94.63±2.09 in group B. Mean length of hospital stay in group A was 9.78±7.38 and in group B was 7.88±4.76. Improvement in marker status for group A was 100% and for group B 95.4%. Ventilation status in both groups showed 100% improvement. Conclusions: Both steroids are effective in management of moderate to severe COVID-19 patients.

Comparison between rood inhibitory approach and bobath reflex inhibiting patterns to improve gross motor function and reduce spasticity in hemiplegic children of encephalitis

Objectives: To compare the effects of Rood Inhibitory approach and Bobath Reflex Inhibiting pattern to improve Gross motor Function and reduce spasticity in Hemiplegic Children of Encephalitis. Methods: A randomized clinical trial was conducted comprising of 22 patients recruited from different clinics of Faisalabad. Participants from both genders, in age range from 08-12 years were recruited and randomly allocated into two groups. Treatment group A received Rood inhibitory approach and treatment group B received Bobath Reflex inhibiting pattern. Measurement of Modified Ashworth scale were recorded at pre-treatment and weekly for 4 weeks, while (GMFM-88 and GMFM- 66) was assessed at baseline and at end of 4th week. SPSS version 22 was used to analyze the data. Result: Mean age in Group A was 10.00+1.673 years and in Group B was 9.82+1.537 years. Total 11 were male and 11 were female. There was significant improvement in mean MAS score at 2nd week, 3rd week and 4th week post treatment readings (p value &lt; 0.05). There was significant improvement in mean (GMFM-88 and GMFM- 66) at 4th week post treatment readings (p value &lt; 0.05).