Background: The COVID-19 pandemic has had the impact that may contribute to a rise in mental health problems. The novel coronavirus disease (COVID-19) is spreading rapidly, increasing the stress and challenges for healthcare professionals around the world. Objective: To explore the levels of anxiety and perceived stress among students due to the COVID-19 pandemic in Lahore, Pakistan. Methodology: An online cross-sectional survey was conducted in Lahore in the duration of 6 months on n=249 participants sampled through a non-probability convenient sampling technique. Participants with an age group between 15-30 years residing in Lahore were included in the study. The survey was done on all the medical students in this range so it could not affect the generalizability of results. Students with Ongoing physical or previous mental illness were excluded. Perceived Stress Scale (PSS) and generalized anxiety disorder were questionnaires converted into Google Forms and were distributed to students of medical discipline through WhatsApp, Instagram, and Facebook. Results: The mean age of the study participant was 22.0±1.94 years. The mean score of the perceived stress scale (PSS) was found to be 16.90±4.21 which showed that out of n=249 students n= 181(72.69%) reported moderate stress. While n=30(12.04%) students had low stress. While remaining high-stress levels were found among n=38(15.2%) students. The mean score of General Anxiety Disorder was found to be 18.45 ±3.16 which showed that out of 249 students, 35.74% (n= 71) students showed Mild Anxiety Level and 12.05% (n=30) showed Severe Anxiety Level. Conclusion: It was concluded that most of the medical students from Lahore reported stress and anxiety. However, higher stress and anxiety were reported among younger age groups and greater stress was found in females as compared to males. Keywords: anxiety; COVID-19; GAD- 7; mental health; perceived stress

Objective: To compare the effects of Post Isometric Relaxation (PIR) of gluteus maximus and Static Stretching (SS) of hip flexors on pain and functional status in patients with Anterior Innominate Dysfunction. Methodology: A quasi experimental trial was conducted on thirty six patients of Anterior Innominate Dysfunction. All were randomly allocated to post isometric relaxation group and static stretching group. Both groups were treated with 12 treatment sessions in 4 weeks at frequency of 3 sessions per week. Numeric Pain Rating Scale (NPRS) and Modified Oswestry Disability Index (MODI) were used to measure the treatment effect at baseline, after 2 weeks and after 4 weeks. Data was analyzed by SPSS 21. Results: Mean Age of Group A (PIR) was 34.28±7.76 and Group B (SS) was 35.72±7.16. Mean BMI of participants was 23.84±3.29. Across group, both post isometric relaxation and static stretching had shown significant results with P value <0.05. But within group, post isometric relaxation had shown more significant results as compared to static stretching with P value <0.05. Conclusion: Both treatment techniques; Post isometric relaxation and Static stretching are effective and produced significant difference in NPRS and MODI score to improve pain and functional status but PIR had shown more promising results in patients with anterior innominate dysfunction. Key words: Sacroiliac Joint Dysfunction (SIJD), Muscle Energy Technique (MET), MODI (Modified Oswestry Disability Index).

Background:Lumbopelvic pain (LPP) is common during pregnancy associated with postpartum depressive symptoms. These negatively affect maternal health and behavior, such as exercise and physical activity ultimately leads to kinesiophobia. Objective: To determine the association of kinesiophobia with postpartum depression in females with lumbo-pelvic pain. Methods: A cross-sectional study was conducted on 89 postpartum women with lumbo-pelvic pain within six months of delivery in Jinnah Hospital, Lahore. Nonprobability convenience sampling was used to collect the data. Females presenting with lumbo-pelvic pain were selected on the basis of inclusion and exclusion criteria. Lumbo-pelvic pain severity, kinesiophobia and depression were measured by Visual Analogue Scale, Tampa Scale and Zung Self Rating Depression Scale, respectively. Pearson correlation was used to determine the correlation between kinesiophobia and depression. Results: The mean age of participants was 29.14 + 3.28 years. The mean pain score of lumbosacral pain was 1.989, Kinesiophobia was 47.5169 and depression was 60.2247. There was significant strong positive correlation (r=0.786, p<0.001) between Kinesiophobia and postpartum depression among female having lumbosacral pain. Conclusion: There was strong association of kinesiophobia with postpartum depression in females with lumbo-pelvic pain Key words: Depression, kinesiophobia, lumbo-pelvic pain, pregnancy

Background: Quadriceps avoidance is a reflex deficit disorder of quadriceps activation after total knee arthroplasty (TKA) that can lead to abnormal gait kinematics. It is patient apprehension due to pain, to prevent quadriceps activation that induces deforming forces at the knee joint. Aim: To describe the frequency of ‘quadriceps avoidance’ among patients after total knee arthroplasty. Study Design: Descriptive case series. Methodology: The study sample size comprised of 55 post-TKA patients (Male: 16; Female: 39), who were the ages of 40-80 years. Participants were recruited who had undergone unilateral total knee replacement and attended an outpatient physiotherapy clinic of Ghurki trust teaching hospital and Surgimed hospital Lahore. Participants were undergone ‘quadriceps avoidance gait’ testing at approximately 02 weeks and 01 month postoperatively by using a diagnostic observational questionnaire, designed according to the observational gait analysis. Data was evaluated by using SPSS version 23. All qualitative data was presented in frequency form and quantitative data was in the form of mean±SD. Results: Mean age of patients was 58.98 with range minimum of 40 years to a maximum of 80 years. Out of a sample size of 55, 25 (45.5%) patients were diagnosed with quadriceps avoidance after TKA, 11(20%) were male patients out of 16 and 14 (25.5%) were female patients out of 39 which showed ‘stiff knee gait’ pattern. Conclusion: It was concluded that quadriceps avoidance after total knee arthroplasty was one of major complication of abnormal gait pattern which can lead to knee joint deformities if left uncorrected. Keywords: Total knee arthroplasty, Quadriceps avoidance, Gait kinematics, Gait kinetic