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Objective: Post-traumatic stiff hand is common a condition which causes pain and disability, the paraffin wax bath and joint mobilizations have the key role in its rehabilitation. We conducted the present study to determine the efficacy of paraffin wax bath with mobilization techniques compared with joint mobilization alone. Methodology: This single blind randomized control trial was conducted on 71 patients in department of physical therapy and rehabilitation, Riphah International University Islamabad, and patients with post-traumatic stiff hand after distal upper extremity fractures, were included. The patients were randomized into two groups: the joint mobilization techniques with paraffin wax bath were included in group A, and joint mobilization techniques without paraffin wax bath in group B. The study variables were pain score on visual analogue scale (VAS) 0/10, thumb function score (TFS) and passive range of motion (PROM) of wrist flexion, extension, radial and ulnar deviation, and were compared at baseline and at completion on plan-of-care after six weeks. Results: Seventy one patients with post-traumatic stiff hand were enrolled and placed randomly into two groups. The baseline characteristics were similar in both groups. Six week after intervention, patients in group A had more improvement in pain score (p=0.001), TFS (p=0.003), and PROM of wrist flexion (p=0.002), extension (p=0.003), radial deviation (p=0.013), and ulnar deviation (p=.004), as compared to group B. However, in group B the improvement was less in pain score (p=0.104), TFS (p=0.520), and PROM of wrist flexion (p=0.193), extension (p=0.1081), radial deviation (p=0.051), and ulnar deviation (p=.168), as compared to group A. Conclusion: Paraffin wax bath with joint mobilization techniques are more effective than mobilization techniques without paraffin wax bath in the rehabilitation of post traumatic stiff hand.

Aim: The aim of the study was to identify the challenges and problems faced by student nurses and paramedic students during the clinical practice stage of their education. Design: The current study utilized a cross-sectional research design. Methods: A sample of 259 students was selected through convenience sampling, comprising 127 student nurses and 132 paramedic students. An adapted self-administered questionnaire, the Clinical Learning Environment Supervision and Nurse Teacher (CLES+T) evaluation scale was used to collect data, with the permission of the author. Socio-demographic characteristics were shown in the form of frequency and percentages. Findings concerning the evaluation of clinical learning were calculated in the context of descriptive statistical analysis, such as mean and standard deviation. An independent sample t-test was applied to compare the findings. Results: The mean age of respondents was 21.39 years, of whom 60 (61.8%) were male and 99 (32.2%) were female. The highest mean score (3.87 ± 0.77) was awarded to Nursing Care Provided on the Ward, while the lowest mean score was achieved for Supervisory Relationships on the Ward (3.71 ± 0.84). Conclusion: The study showed overall satisfaction with the clinical environment. Male and paramedic students were least satisfied. Considerable improvement is needed in the context of Pedagogical Atmosphere and Supervisory Relationships on the ward.