Background Dissociative seizures are paroxysmal events resembling epilepsy or syncope with characteristic features that allow them to be distinguished from other medical conditions. We aimed to compare the effectiveness of cognitive behavioural therapy (CBT) plus standardised medical care with standardised medical care alone for the reduction of dissociative seizure frequency. MethodsIn this pragmatic, parallel-arm, multicentre randomised controlled trial, we initially recruited participants at 27 neurology or epilepsy services in England, Scotland, and Wales. Adults (≥18 years) who had dissociative seizures in the previous 8 weeks and no epileptic seizures in the previous 12 months were subsequently randomly assigned (1:1) from 17 liaison or neuropsychiatry services following psychiatric assessment, to receive standardised medical care or CBT plus standardised medical care, using a web-based system. Randomisation was stratified by neuropsychiatry or liaison psychiatry recruitment site. The trial manager, chief investigator, all treating clinicians, and patients were aware of treatment allocation, but outcome data collectors and trial statisticians were unaware of treatment allocation. Patients were followed up 6 months and 12 months after randomisation. The primary outcome was monthly dissociative seizure frequency (ie, frequency in the previous 4 weeks) assessed at 12 months. Secondary outcomes assessed at 12 months were: seizure severity (intensity) and bothersomeness; longest period of seizure freedom in the previous 6 months; complete seizure freedom in the previous 3 months; a greater than 50% reduction in seizure frequency relative to baseline; changes in dissociative seizures (rated by others); health-related quality of life; psychosocial functioning; psychiatric symptoms, psychological distress, and somatic symptom burden; and clinical impression of improvement and satisfaction. p values and statistical significance for outcomes were reported without correction for multiple comparisons as per our protocol. Primary and secondary outcomes were assessed in the intention-to-treat population with multiple imputation for missing observations. This trial is registered with the International Standard Randomised Controlled Trial registry, ISRCTN05681227, and ClinicalTrials.gov, NCT02325544.

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Background: Osteoarthritis (OA) is a common and disabling constant Musculoskeletal Disorder that causes significant weight on individual, Health Care Systems, and social economy. With the maturing of the populace and the commonness of undesirable way of life practices, the predominance and disease burden of OA are expanding day by day. Objective: To find the prevalence of knee osteoarthritis and quality of life among middle-aged adults. Methodology: A descriptive cross-sectional survey was conducted at the major hospitals and physical therapy clinical setups of Pakistan from April to July 2019 (4 months) after approval of IRB/ERC (SRMCH/MS/20/12/41) Suleman Roshan medical college hospital, Tando Adam. The total sample was n=300 selected using non-probability convenience sampling. The middle-aged adults (40-65 years) having moderate to severe knee pain, both male and female were included. According to the American college of rheumatology the criteria for assessing OA by using history, physical examination, and radiographic findings: pain in the knee and one of following over 50 years of age, less than 30minutes of morning stiffness crepitus on active motion and osteophytes and quality of life assessed according to WHOQOL-100 score. The results of the study are presented as frequency, percentages, and mean ±SD. The data were analysed through SPSS 21.Results: The mean age of the study participants (n=300) was a 48.96±6.804 year. The majority of the participants were female (n=208) and the remaining n=92 were male. The prevalence of OA in the middle aged adults (n=300) n=170 (56.7%). The significantly reduced QoL among patient having knee OA (37.19±23.22 ver 42.51±22.69, p<0.05) as compare to those having knee pain without Knee OA.Conclusion: The prevalence of knee pain in middle-aged adults is high and their quality of life is moderately affected. Key words: Knee, Middle-aged, Osteoarthritis, Prevalence, Quality of life.

BACKGROUND AND AIM Physical inactivity and obesity are the two emerging problems in Pakistan. Schools have been identified as an essential setting for health promotion through physical activity participation. Many schools in Pakistan mainly concentrate on the higher study level and insufficient attention towards children’s physical health that may impair due to low physical activity level and increased sedentary behavior leading to obesity and other health issues. The study aims to assess the level of physical activity in school children. METHODOLOGY A cross-sectional exploration was lead at schools of district T. M.Khan Sindh from Oct-2019 to Feb-2020. Raosoft Tool was used to a calculated sample of the study. The instrument utilized for information assortment contains the Physical Activity Questionnaire for Children (PAQ-C) to survey active work. Information was entered and broke down by the SPSS-22 version. RESULTS Four hundred kids were comprised in an investigation; 328 observers were girls, and 72 were boys. The mean age ± SD of the members was 13.79 ± 1.522. The mean BMI ± SD of the members was 25.05 ± 1.19, which falls into the classification of overweight. CONCLUSION The survey indicated that school-going children have no physical activity to a low level of Physical Activity. KEYWORDS Body Mass index, Children, Obesity, Physical Activity, Physical education, School