Background: There is a noticeable change in the approach with which women nowadays seek help for diseases like breast cancer, primarily due to awareness campaigns, but what happens after surgical procedures is of great significance too. This study focused on the several psychological connotations attached to mastectomy and how the patients cope. Objective: To understand the pattern of anxiety and level of depression among Pakistani patients undergoing mastectomy. Materials and Methods: The sample size consisted of 88 patients who had undergone mastectomy at the different surgical units of the Civil Hospital, Karachi, from January 2012-December 2014; The questionnaire was administered before they were discharged i.e. within 3 days of surgical procedures. The patients were asked if they were willing to participate in this study, those who agreed signed the consent form and then we preceded by asking questions with a standardized tool. A self made questionnaire was constructed keeping in mind the nature and specification of the disease, which consisted of 20 questions related to anxiety and depression, focusing on a mixture of psychological and physiological symptoms. Results: There were a total of 88 patients out of which 36 (41%) were aged 51 to 60 years, 24 (27.2%) of the patients were in the age category of 41 to 50 years, 17 aged 61 and above (19.3%) and only 11 (12.5%) 30-40 years of age, the youngest of all the age categories. The pattern of depression and anxiety was found to be similar among all age categories, severe depression and anxiety predominating over moderate level of such symptoms, with only relatively few patients sufering mild or no depression symptoms. Conclusions: It was concluded that going through mastectomy leads to moderate to severe levels of depression and anxiety, primarily because the females feel incomplete and insecure after losing a part of themselves.

Objective: This systematic review was conducted to explore the current evidences on effects of trigger point dry needling as a treatment strategy on pain and range of motion among the subjects with lower extremity myofascial trigger areas. Methods: A systematic review was performed and searched databases including Cochrane Library, PubMed, SPORTDiscus and PEDro. PRISMA guidelines were followed. Inclusion and exclusion of studies were made according to PICOS format. Ten studies were recruited for assessment based on eligibility. Cochrane Risk of Bias tool was used to assess the Randomized and Non-Randomized controlled trials and the methodological assessment was also performed using PEDro 10-point scale. Data synthesis was performed by Vote Counting Method as a descriptive tool. Results: Seven of the total ten studies deemed High score on PEDro and three were scored Fair on the scale. Each of the ten studies documented improvement in the pain over time with the dry needling strategy. None of the studies targeted the other outcomes like anxiety and sleep disturbances related with myofascial trigger points. Conclusion: On basis of the best evidences available dry needling seems to be effective in pain reduction related to lower extremity myofascial trigger points. Evidence also suggests that there is not much positive effect of myofascial trigger point dry needling on depression, anxiety, muscular strength and quality of life. Keywords: Acupuncture therapy, Dry Needling, Lower extremity, Myofascial trigger points Continuous....

The researchers investigate Pakistani Premier Imran Khan’s (IK) speech in which he called Bilawal Bhutto Zardari – Sahiba. Similarly, the leaders strongly need to convince their supporters when they deliver speeches on public platforms. However, utilizing the persuasive political power, the Premier (IK) propagated identity to promote the specific ideology to gain political benefits. The present research employs Political Discourse Analysis (PDA), to understand the social and political persuasive style employed by the premiere. The researchers have analyzed the data employing a qualitative approach. There are reliable findings to suggest that IK has successfully used stable vocabulary (taboo) to persuade the specific supporters, convincing them to deform the identity of Bilawal Bhutto. Later, the Premier faced considerable criticism from the opposition. However, for the time being, he successfully dominated through sociological and persuasive power sourcing the meaning-making structures of power. Hence, the politicians often convince their supporters/followers to utilize political-strategic tools and to remain in their political procession against their opponents.

Objective: To evaluate the effect of positioning on gross motor function and spasticity in spastic quadriplegic cerebral palsy children with Gross Motor Function Classification System level IV and V. Methods: A quasi-experimental study was conducted at two Paediatric Physical Therapy Centres from November 2018 to July 2019. The study was comprised of seventy four children with quadriplegic cerebral palsy aged between 3 to 8 years. Data was obtained and gross motor functional abilities and spasticity were assessed by GMFM-88 and Modified Ashworth Scale respectively. Twenty four-hour positioning in specific seats, night positioning and standing frames for six months. The child was being positioned in 24 hours according to his challenges for the period of six months. Semi reclined positioning was performed to manage aspiration, oral leak and to develop retention. Prone positioning was done to develop righting reactions, functional sitting position was used in the treatment regime to attain better upright position and neutral pelvic standing using standing frames. SPSS 24 was used to analyse the data. Results: Paired t-test reported significant improvement in the test scores in lying position, rolling, sitting position, crawling, kneeling, standing, walking or running. n=59 subjects exhibited improvement in the spasticity before and after interventional procedures, while n=15 showed no improvement as the value of p<0.05. Conclusion: Twenty-Four-hour proper body positioning and postural techniques improved gross motor functioning in all of the five dimensions of functioning. The overall spasticity in quadriplegic cerebral palsy children was also reduced due to appropriate positioning techniques.  Continuous....

BackgroundNeedle phobia, clinically termed as Belonephobia strongly influences psychological behaviors. Physiological responses include palpitations, shortness of breath, nervousness and fainting. In Nepal, first year MBBS students prick their own finger for hematology practical. They use to suffer from Belonephobia and pain due to finger prick. The main objective of this study was to determine influential fear factors and assessment of pain during hematology practical. Material and Methods:One hundred and forty two first year medical students of basic sciences participated in the study. Standard pricking was performed by blood lancet in the middle and side of the middle finger during hematology practical for the assessment of pain in Young Baker scale and visually rating scale. They also responded to a questionnaire on factors associated with fear of needles and lancets, symptoms etc. Corresponding Author Results:Out of 142 students, numbers of males were 76 and females were 66. Belonephobia persisted among 65.2% females and 42.1% males, p<0.01. Watching others during lancing or receiving injection was a significant fear factor. Lateral side pricking was preferred by students for less pain. Mild, moderate, "hurts little bit", "little more", "even more" were the maximum response for pain sensation. Conclusion:Positive approaches like separation of lancing area, systematic exposure, behavioral therapy, counseling and administration of anti-anxiety drugs for severely needle phobics, can alleviate fear and anxiety. Female students need more assistance. Development of proper strategies and necessary interventions are required, which will facilitate to overcome this phobia.