Upper Cross Syndrome is a common muscular imbalance involving head, neck and shoulder region. It exhibits a common postural disruption linked with tonal abnormalities of the pectoral girdle musculature and cervicothoracic part of the body. This syndrome is characterized by neck pain and its restricted range of motion, forward head posture and rounded shoulders. It is usually seen in persons who work for longer period of time in misaligned body position. This study was intended to check the prevalence of Upper crossed syndrome in medical students of Women Medical College, Abbottabad. For this purpose, a descriptive cross-sectional survey was conducted. A total of 305 students of age group 18-25 years were recruited. Data was sought in two phases. In the first phase, participants were asked to fill a self-designed questionnaire containing demographics and other symptomology of Upper Cross Syndrome which included pain in neck region, duration of study hours, frequently used electronic gadget for study, total study hours, stiffness around neck and chest, area and type of pain while studying and presence of headache. In the second phase, restricted neck range of motion was assessed using a goniometer, forward head posture was checked using the wall and ruler and posture analysis was done to check for rounded shoulders by a physiotherapist. The study employed convenient sampling technique for data collection. The data was first entered and then analyzed by SPSS version 22 software which fetched percentages for each variable. In order to find whether any correlation between the two variables exist or not, a chi-square test was conducted using SPSS version 22 and values were interpreted (p-value <0.05). As a result, among the 305 subjects, 72.13% felt tightness around the neck while 36.07% students reported pain in neck after prolong usage of either mobile phone or laptop. Subsequent restriction in range of motion of the neck was reported by 32.13% participants. About 47.86% subjects who filled the questionnaire were diagnosed with rounded shoulders after a detailed posture analysis by a physiotherapist. Among those 47.86% subjects, moderate pectoral muscle stiffness was reported by 67.45% students while 19.6% had severe pectoral stiffness. Forward head posture was observed by the physiotherapist utilizing wall and ruler method in 84.5% of all the participating subjects. Among the recruits who experienced any sort of neck or shoulder girdle pain, 20% reported using pain killers for relief, 7.21% have had physiotherapy treatment protocol while 72.79% took no treatment at all. Thus it was concluded that a significant number of medical students in Women Medical College, Abbottabad were suffering with Upper cross syndrome either due to excessive smart phone usage or poor study posture. Keywords Upper Cross Syndrome (UCS), Cervical, Shoulder, Musculoskeletal (MSK), Forward Head Posture (FHP).

Many modifications have been introduced in the field of medical education in recent past with a shift from didactic to more student focused teaching strategies. Modular study system for final year MBBS students was introduced in the subject of Obstetrics and Gynecology in 2018 session. Objectives: To determine the students′ perception about modular teaching and various instructional strategies through feedback in the subject of Obstetrics and Gynecology at undergraduate level. Study Design: Cross sectional study. Setting: University Medical and Dental College, Faisalabad. Period: 1st January to 30th October 2018. Material & Methods: Eight modules were designed in the subject of obstetrics and gynecology for final year MBBS students. In order to ascertain the quality of teaching and to monitor the effectiveness of teaching methodologies, feedback was obtained.  A written questionnaire was designed to collect feedback. Interpretation of collected data was performed on SPSS 20. Results: Total 136 students participated in study by giving back properly filled questionnaire. Modular teaching was appreciated as an effective method by 93.4% students. Case based teaching, small group sessions and problem based learning were considered most favored teaching methods (97.7%, 97.1% and 94.85%) respectively by the students. Conclusion: Modular teaching was found to be an interesting and a useful teaching - learning experience by majority of students. Almost all students showed positive acceptance for various teaching methods. Students’ feedback was also useful in identifying course components that need improvement so that appropriate measures can be made to improve the overall quality and effectiveness of the course in future.

This study was conducted to determine the prevalence of common risk factors among known cases of adhesive capsulitis in Abbottabad. Study was done on 253 patients selected through non-probability convenient sampling technique. Data was collected from Shaheena Jameel (Frontier) Hospital, Abbottabad, Ayub Medical Complex, Abbottabad and Physiotherapy Clinic of WIRS, Abbottabad and data was analyzed using SPSS version 27.0 and MS Excel 2010. This study showed that common risk factors of adhesive capsulitis were DM (29.2%), cardiac disease (14.2%), Stroke (12.4%), history of immobilization of shoulder joint (13%), upper limb neuropathies (8.3%), thyroid disorders (7.1%), COPD (6.3%), having two or more comorbidities or risk factors (4%) and idiopathicity (5.5%). This study showed that 56.5% patients got PT treatment and 43% patients did not seek PT treatment for frozen shoulder. This study concluded that systemic conditions, neurological diseases and immobilization were more prevalent risk factors of adhesive capsulitis in patients attending hospitals of Abbottabad. In small number of people, adhesive capsulitis was labeled idiopathic. Prevalence of usage of physiotherapy treatment was quite high among the patients of adhesive capsulitis.

Objectives: To assess the correlation of different obstetrical factors with the hemoglobin level in multiparous pregnant females in Taif KSA. Anemia in pregnancy is a multifactorial phenomenon, among which obstetrical factors like parity, previous H/O abortions, inter pregnancy interval, mode of delivery etc are frequently associated. Study Design: Observational study. Setting: Outpatient department in King Faisal Hospital (KFH), Taif, Saudi Arabia. Period: 1st June 2018 and 31st August 2018. Material & Methods: Conducted in 200 pregnant women by random sampling technique. Hemoglobin value and all patient’s data was noted. All data was fed to SPSS version 23.0 and statistically analyzed using chi square test for qualitative and student’s t test for quantitative data. Results: The study was conducted in 200 patients that showed that there was no statistically significant association of increasing parity, inter pregnancy interval, mode of delivery (NVD or Cesarean section) & history of anemia and PPH in preceding pregnancy with the Hemoglobin level. While history of previous abortion is associated and a risk factor for anemia in pregnancy, 50% with history of 01 previous abortion had anemia while 100% of the cases with history of 02 previous abortions had moderate anemia. (Table-II). This association was observed statistically significant with p value of 0.001. Conclusion: This study concluded that anemia is a predictable as well as preventable entity. Obstetrical factors may be the contributory factors of anemia in pregnancy. Health education awareness programs, regular antenatal visits and iron supplements can be helpful to improve heath of pregnant women.

Background: To study the effect of oral and intravenous maternal hydration in patients with isolated oligohydramnios in terms of mean change in amniotic fluid.Methods: A total number of 38 patients included in the study which fulfill the selection criteria.  Patients were randomly divided in two groups. Amniotic fluid index (AFI) of all patients was measured before the hydration therapy according to the method of Phelan et al.  In maternal oral hydration (Group A), every patient was instructed to drink two liters of water over two hours daily for 1 week. In intravenous hydration (Group B), every woman infused two liters of 0.9% normal saline in two hour daily for 1 week. After 48 hours and 1 week of oral and intravenous hydration, the AFI was reassessed by the same observer. Patients were monitored closely for sign and symptoms of fluid overload. Data was stratified for mean difference in improvement in amniotic fluid index.Results: After oral hydration therapy AFI was 5.926±0.4593 after 48 hours and 8.286±0.6000 after 7 days in Group A. In Group B AFI was 5.784±0.4622 after 48 hours and 7.868±0.2810 after 7 days of intravenous hydration. P value after 48 hours is 0.348 and p=0.014 after 7 days means oral hydration therapy significantly increase amniotic fluid index.Conclusions: Oral maternal hydration significantly increase the amniotic fluid index in patients with isolated oligohydramnios. It is simple, safe and non-invasive method.

Objectives: The objective of this study was to evaluate the diagnostic accuracy of saline infusion hysterosonography for detection of uterine cavity abnormalities using Hysteroscopy as the gold standard. Study Design: Analytical Quasi Experimental study. Setting: Obstetric and Gynaecology Department Madina Teaching Hospital Faisalabad. Period: July 2017 to December 2017. Materials and Methods: Sixty patients presented with abnormal uterine bleeding were included in the study. Transvaginal ultrasound, SIS and hysteroscopy performed for evaluation of the uterine cavity for any abnormality. Results: SIS helped in detection of intacavitary abnormalities in 39 out of 60 patients indicating sensitivity of 88. 64 % and specificity of 100 % as hysteroscopy confirm the findings in all the patients. The NPV is 76 % and PPV of 100 % taking hysteroscopy as gold standard. The diagnostic accuracy of saline infusion sonography is 91%. Conclusion: The addition of SIS to TVS significantly improved the sensitivity and specificity for detecting intracavitary pathology. It can be used as an alternative procedure whenever hysteroscopy is not available.

The purpose of the current study was to find out the frequency of married females with urinary incontinence including stress, urge and mixed incontinence in Mansehra city and how it is affecting the daily life of females as compared to women without urinary incontinence. District Headquarter Hospital, Mansehra, Helping Hand Institute of Rehabilitation Sciences, Mansehra and Taj Health Complex, Mansehra. For the current study married women with age 18 to 65 years were selected while females with tumor, sexually transmitted diseases or female on any sedative was excluded from the study. Non- probability purposive technique was used for the sampling technique and “Questions for Urinary Incontinence Diagnosis” was used as outcome measuring tool. For the current study, 385 participants were selected. Prevalence ratio was found to be 72.5% with either type of urinary incontinence while 27.5% participants were found without any type of urinary incontinence. Mean gravidity of females with urinary incontinence was 3.46(±2.093) for (n=279) while mean gravidity of females without urinary incontinence was 2.78(±1.957) for (n=106). Urinary Incontinence is the most prevalent condition among females and it was found that every 7th female is suffering from either type of Urinary Incontinence. It can occur in any age and in any person but mostly occur in females due to the issues related with pregnancy, delivery and menopause.

Background: According to World health organization anemia is most common among females during pregnancy and child birth. Maternal and fetal morbidity and mortality is high due to anemia in pregnancy as it is a contributing factor in poor pregnancy outcome. It is the main cause of maternal death, almost 29% of women die due to anemia in pregnancy. Half of the maternal mortality causes are related to anemia in pregnancy either directly or indirectly. What so ever is the cause of anemia in pregnancy, its management is important for mother and child health. The consequences of anemia have serious health implications especially among pregnant females. Methodology: The cross-sectional study was conducted to find prevalence of anemia during first, second and third trimester of pregnancy and factors related to cause of anemia. A total of 340 pregnant females of government and private hospitals of Lahore city during the period from February 2017 to August 2018 were included in study after sample size calculation through convenient sampling. Sociodemographic, economic status, education level, number of children born to females and gestational period were the factors that were studied among anemic pregnant females. Data analysis was done and frequencies of continuous variables and descriptive analysis for categorical variables were determined. Prevalence of anemia was determined by multinomial logistic regression. Results: Our study showed females were with mean age 27.9 (±SD=5.4) and in age group 31-39 years (53.8%) were more anemic during pregnancy as compared to females <30 years of age. Most of the females (67.1%) were housewives and had primary level of education (49.1%). Among these females (30%) were with mild anemia, (53.5%) were with moderate anemia and (16.5%) were with severe anemia. The mean hemoglobin level was 9.8g/dl (SD=±1.6). Among pregnant females 152(45%) were anemic during third trimester of pregnancy. Result showed 167(48.8%) females were anemic having children > 3. Sociodemographic factors, education level, number of children born to female, economic status all were significantly associated with moderate anemia during pregnancy (p=0.00). Conclusion: Our study showed that although the prevalence of anemia is more among pregnant females but the severe anemia was less. So, it is a preventable health problem which can be controlled by different public health approaches to reduce the burden of disease on the health system. The strategies to control anemia in reproductive age women is important to prevent it among pregnant women. the early diagnosis and immediate correction of anemia is important to reduce the complications of pregnancy and its poor outcome. Early identification of factors is significantly important in managing the problem. Keywords: anemia, pregnancy, prevalence of anemia, gestational period.