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: Achilles tendinopathy is highly prevalent and caused by intrinsic or extrinsic factors. The multiple minor traumas can lead to achilles tendinopathy. Physical therapy treatment includes soft tissue mobilization and exercises. Objective: To compare ultrasound and transverse friction massage in chronic Achilles tendinopathy. Methodology: The study was a randomized control trial from 1st March 2019 to 15th August 2019. The non-probability convenient sampling technique was used to include n=76 patients having pain and activity limitation of Achilles tendon and randomly allocated into groups A and B by lottery method. The outcome measuring tools were numeric pain rating scale (NPRS) for pain, the Victorian Institute of Sports Assessment- Achilles questionnaire (VISA-A) for severity and goniometry for ROM. The Group A was treated with transverse friction massage and the group B was treated with ultrasound therapy. Both groups also performed eccentric exercises. The assessment was done at the baseline on the 1st session, at end of the 9th and 18th session. The data was analysed by SPSS 23 using independent t-test and repeated measures ANOVA. Results: The results of RM-ANOVA with pairwise comparison showed that both groups improve significantly (p<0.05) throughout the treatment duration with large effect size for all variables. While comparing the groups with independent t-test, TFM group showed more improvement in all variables as compared to UST group (p<0.05) after 3rd week as well as after 6th week of intervention. Conclusion: The Transverse friction massage (TFM) was more effective than ultrasound therapy (UST) when combined with eccentric exercises in improving pain severity of tendinopathy and ROM of ankle. Keywords: Achilles tendon, eccentric exercises, pain stretching, myofascial release, ultrasonic therapy, tendinopathy.

Aim: To find prevalence of helmet induced headache among bikers. Methods: A cross sectional study using convenient sampling was conducted on male bike riders of Lahore. After approval from ethical committee participants were selected on the basis of inclusion and exclusion criteria. Informed consent was taken. 102 participants filled out self-made questionnaire. Data was analyzed by using SPSS version 21 in form of frequencies, mean, standard deviation and pie chart. Results: The mean age of participants was 22.77±1.72 years. A total of 52 participants (51%) were reported having headache. Prevalence of helmet induced headache came out to be 6(11.5%) among bikers. A total of 83% used helmet occasionally and 18.17% reported to use it always. The duration of headache for half of the participants (50%) was 20-30 min after wearing helmet, 38.5% had headache duration lasting for 1-5 days in a month. Majority had stabbing (25%) type of pain, among them only (9.6%) visited hospital due to headache. Conclusion: There was high prevalence of headache (stabbing and aching) in bikers but mostly didn’t report complaint of headache specifically while wearing helmet or after removing it. Keywords: Headache, helmet, prevalence, primary prevention

Objectives: To determine the impact of having private health insurance during the period of maternity on low birth-weight (LBW) infants.Methods: This retrospective case-control study was carried out at a tertiary care hospital in Tabuk, Saudi Arabia, between January 2020 and January 2021. Using non-probability sampling, secondary medical data were obtained at the Department of Obstetrics & Gynecology from two groups: insured and non-insured mothers who had 150 LBW infants (LBWI) (<2.5 kg) as well as normal newborns. Data were analyzed using SPSS, version 24 (IBM Corp., Armonk, NY). A univariate analysis was performed for each variable followed by a logistic regression analysis to explain the relationship between the dependent (LBW) and independent variables (health insurance status, prenatal care, and inter-pregnancy interval).Results: Out of 300 mothers, the majority were in the age group 21-34 years (86%). The LBWI mothers were insured in about 55% of cases. Around 43% had insurance for 1-2 years, and 44.7% of insured mothers were covered by a "class A" health plan. The findings revealed a significant correlation between the duration of maternal insurance coverage period and LBW; it reduced the risk of LBW by 95% CI. The inter-pregnancy interval was 51.3%, with a p-value of 0.33. Conclusion: Private health insurance offers coverage, stability, and consistency in Saudi Arabia, which results in better birth outcomes by decreasing both infant mortality and morbidity rates among insured females.

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