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....

Education opens numerous revenues to register economic expansion all around the world with specific reference to developing nations. Advancement of Pakistan in education indicators has been severely insufficient during the previous decades. Decreased financing along with inefficiency in budget expenditure plus weak management system have crippled the education sector ensuing poor educational outcomes. Outcome-based Education (OBE) has recently gained much attention in Pakistan. OBE is used in education because it clearly focuses and organizes everything in an educational system around what is necessary for all students to be able to do at the end of their learning. OBE proposes an influential and interesting option of transforming and organizing medical education. Therefore, the basic aim of this review is to highlight the tertiary education system of Pakistan and the need to shift from teacher centered to Outcome Based Education system. The review also addresses the major factors that impact student learning outcomes. Data bases were searched including Cochrane and Medline. Search strategy was designed by combining Boolean operators and key terms related to review objectives. Seven studies were included in the paper regarding the effectiveness of Outcome Based Education in different disciplines of education. The findings suggested five important factors from the literature that impact student learning outcomes including, assessment strategies, learning objectives based on level of complexity, student preferred learning styles, English language competency and Employer requirements. However, limitations were recognized in the methodology section and further recommendations were given for future researchers.

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