OBJECTIVE To determine the awareness and perception of Physical Therapy as a career among the intermediate students of Karachi. STUDY DESIGN It is a cross sectional study. STUDY SETTINGS AND PARTICIPANTS The settings of this study were two Private and two Government sector Intermediate colleges, offering Pre-medical and participants were students studying in these colleges. SAMPLING TECHNIQUE Non-probability convenience sampling technique. RESULTS Results revealed that only 13.5% of students were well aware of physical therapy as a profession in government and private colleges whereas, 31% in government colleges and 26.5% in private colleges had little knowledge. While 28% government and 30.5% in private were totally unaware of it. 75.7% and 83.5% from government and private sector students responded that physical therapy will be most rewarded in Orthopedic/Musculoskeletal fields respectively. CONCLUSIONS The awareness of Physical Therapy as a career among intermediate students would help in creating more effective marketing strategies. Unfortunately, a small percentage of the students are aware of physiotherapy and the services provided by this profession which implies that there is an urgent need for marketing campaign.

It has been ascertained that musculoskeletal issues arising from the upper thoracic spine are often incorrectly diagnosed as cervical in nature, by both the therapists and the medical professionals equally. This may be due to the reason that the lower cervical and upper thoracic vertebrae are closely linked with regards to cervical movements, predominantly, flexion, and extension. Symptoms from the upper thoracic spine can also bring up pain in the arm and forearm, thus, mimic a heart attack1. One such condition of upper thoracic spine is of T4 vertebra - the T4 syndrome. In 1994, Evans P, discussed the basic science behind the genesis of T4 syndrome and argued that, the term upper thoracic disorder might be a more accurate term, in view of the fact that, the condition generally ranges between T1 to T72. However, it is generally referred to as T4 or T3 syndrome3. If we examine the vertebral column, the compressive load at T1 is about 9% of body weight, increasing to 33% at T8 and 47% at T124. In between each one of these vertebrae, lie the facet joints and discs, which help in maintaining the weight and directing the movement among the individual vertebrae. When either of these joints gets injured, damage in turn can be imposed on the nerves

BACKGROUND Back pain is one of the most frequently seen health problems, affecting 9 out of 10 people in a population at some point during their lives. The lower back is the region most commonly affected. Low-back pain can be debilitating, and it is often challenging to treat Low Back Pain. OBJECTIVE The objective of this review is to evaluate the efficacy of High-Velocity Low-Amplitude (HVLA) Spinal Manipulative Therapy (SMT) for Non Specific Low Back Pain (NSLBP). STUDY DESIGN Systemic review METHODS Only articles that had adult (18 years and above) participants were included in this review and studies that classified the intervention as HVLA spinal manipulation were included. Studies that included spinal manipulation other than HVLA or studies of spinal manipulation under anesthesia were excluded. RESULTS Eight full text papers and three systemic reviews justifying the inclusion criteria are reviewed which revealed that high velocity low amplitude spinal manipulative therapy have significant effect in alleviating low back pain. CONCLUSION Spinal manipulation therapy is a distinctive approach that considerably decreases nonspecific low back pain however there is need of further clinical trials into this subject focusing solely on high velocity low amplitude spinal manipulation.