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Objectives: The aims and objectives were, to know about the approach of people towards seeking medical advice with different options of healers, to observe thinking, feeling and various actions of people including level of self medication, and to know perception of people regarding various practices done by the healers. Data Source: People living in urban slum areas of Karachi. Design of Study: Cross sectional Study. Setting: Karachi. Period: July to October 2008. Subjects and Methods: It was Knowledge, attitudes and practices (KAP) study carried out on a sample of 300 permanent household members aged ≥ 16 years of middle and poor class living in urban slum areas of Karachi. Results: The mean age of the study participants was 38.27 with standard deviation of 17.57. 182 (61 %) were male while 118(39 %) were female. Out of 300 study participants (n=300) 260 (86.6 %) consult allopathic healers including 169 (56.33 %) MBBS general practitioners and 91 (30.3 % ) non qualified or quacks,25 (8.3 %) consult homeopaths, 11 ( 3.6 % ) Hakims, and only 4 (1.33 % )consult faith healers (P < 0.05).148 (49.33 %), participants belong to middle class group, while 152 (50.66 % ) were from poor class. 50 % study participants do self medication at home prior to consultation for heath. Conclusions: Health seeking behavior is a complex phenomenon in developing countries like Pakistan where poverty overrides all other factors in decision of selecting a healer. It is recommended that people should be educated in choosing a healer which should be a qualified one.

Background Neck pain is a common musculoskeletal issue that has been seen as high in terms of disability. Muscle Energy Techniques (MET) are advanced soft tissue techniques to treat Mechanical Neck Pain (MNP). This study compares the Autogenic inhibition (AI) technique with the Reciprocal Inhibition (RI) technique providing conventional treatment to improve functional outcomes. Methods A randomized control trial was conducted at Sindh Institute of Physical Medicine & Rehabilitation, Karachi, Pakistan from August 28, 2021, to December 31, 2021 among 20–50 years old patients with Moderate intensity MNP for more than 4 weeks and with limited Neck ROMs. The sample were divided randomly and allocated into two groups (groups 1 and 2). Group 1 and 2 received 12 sessions of AI and RI with Conventional therapy respectively. The randomization sheet was generated online from randomization.com for a sample size of 80 and two groups of study ‘AI’ and ‘RI’ with a ratio of 1:1 by an independent statistician. Pain (primary outcome), range of motion, and functional disability (secondary outcomes) were assessed through visual analog scale (VAS), Goniometer, and Neck disability index (NDI) at baseline, 1st, and last session respectively. Mean and standard deviation, frequency, and percentages were calculated. Chi-square test and independent t-test compare baseline characteristics. The Repeated Measure Two-Way ANOVA compared mean VAS, NDI, and ROM. The significant P-value was less than 0.05. Results The mean duration of neck pain was 8 weeks. There was a more significant (p < 0.001) improvement in pain (ES = 0.975), disability (ES = 0.887), neck ROMs; flexion (ES = 0.975), extension (ES = 0.965), right and left lateral flexion (ES = 0.949 and 0.951), and right and left rotation (ES = 0.966 and 0.975) in the AI group than the RI group at 12th session. Conclusion The Autogenic Inhibition-MET is more beneficial than Reciprocal Inhibition-MET in improving Pain, Range of Motion, and Functional Disability in patients with Sub-Acute and Chronic Mechanical Neck Pain. Therefore, it is a beneficial technique to add with conventional neck pain therapy to get better treatment outcomes in MNP patients. Trial Registration Prospectively registered on ClincalTrials.Gov with ID: NCT05044078.

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