Lower awareness of health knowledge, physical growth and development, women bearing children at early ages face higher risk of maternal health problems, disability and death, reinforces risking problems for their newborns as a result, early marriages are always being a very big issue in developing countries specially in primitive uncivilized districts of Asia including India, Pakistan and Bangladesh etc. Moreover it's a controversial fact that in civilized society, evidences of getting married in early ages are greatly increased because of our religious beliefs, norms and social impacts. Due to early marriages young girls don't have the ability to deal with responsibilities, early pregnancy and pregnancy-related mortality and morbidity, causing major physiological and psychological health issues in adolescent girls, resulting in losing relationship confidence and ability to maintain a healthy relationship. Purpose of the study was to evaluate the aspects of psychological disturbances occurring in married young girls along with depression rate and educational withdrawal, with comparison of unmarried young girls of the same age specifically there is a strong correlation between a woman's age at marriage and the education that she receives. Uniformly across the countries, early marriage is associated with lower educational attainment. Observational study was conducted through multi logistic structured questionnaire and girls in b/w age of 13 to 35 were included. On the basis of above study it is concluded that early marriage, multiple responsibilities and early pregnancies are risk factors of depression and it is further evaluated that married girls are at higher level when compared with unmarried.

It is confirmed that early marriage and early childbirth leads to higher rates of adolescent fertility and pregnancy related complications. According to UNICEF (1994) unfortunately the mortality rate of the married girls aged between 15-19 years is twice as compare to the girls who marry after the age of 20 years. As their bodies are immature that's why their health is affected by giving birth to a child. Millions of children are affected by the tradition of early marriage at is being practiced and widespread in many regions of South Asia. Early marriage is also called as child marriage that is marriage below the age of 18 when girls are too weak to shoulder their responsibilities physiologically, psychologically and socially. Early married females are more prone to diseases like HIV/AIDS and obstetrics obstacles. They are also affected psychologically and they may become victim of depression, anxiety and other mood disorders. An observational study was conducted between married and unmarried female to know their perspective about getting married early and to highlight whether it is a positive response according to them. Results showed that in relation to unmarried girls the married females were also not in favor of getting married early as they are equally invaded by health problems. Mental distress and depressive symptoms are more common in married females. Girls prefer doctors for concerning their reproductive health problems while girls can also concerned their mothers but they are in minority. Many health consequences are being reported by early married females and they were hesitated to share them with their in laws. Most of them approached lady doctors whereas few were relying on their mothers for their problems to be solved. Marriages below the age of 18 is not helping the females infract its demolishing their self esteem, their will to study and their physiological well being also.

The purpose of this randomized control trial was to observe the effect of naturebased physical activity in achieving post traumatic growth and to estimate the combined effect of nature and physical activity on the psychophysiological outcomes. A 3-month therapy was provided to participants meeting eligibility criteria to receive the walk-in nature (experimental group) or sit-in nature (control group) in the 1:1 ratio. At baseline and 3-month follow-up, participants were assessed with Trauma Symptom Checklist 40, Traumatic Stress Scale, Post-Traumatic Growth Inventory (PTGI), Cortisol, C-Reactive Protein (CRP), Interleukin-6 (IL-6), Brain-Derived Neurotropic Factor (BDNF) and heart rate variability. There was a significant effect of nature-based physical activity on traumatic stress and post-traumatic growth in comparison with the sit-in control. A significant post-interventional difference was observed in the mean PTGI score [F = 5.412, p = 0.022] between the experimental and control groups after 3 months of intervention. All the biochemical estimates, including CRP, BDNF, IL-6, and cortisol levels, were significantly altered in both post-intervention study groups (p < 0.01). Taken together, these results show that nature-based physical activity significantly improves psychophysiological outcomes induced as a result of post-traumatic growth and also reduces traumatic stress. K E Y W O R D S nature-based therapy, physical activity, post-traumatic growth, psychophysiological outcomes, traumatic stress 1 | INTRODUCTION For the past 25 years, health care providers have been severely affected by target killing and terrorism in Karachi, Pakistan. Health care providers are working in severe stress conditions, and several studies have identified that they are highly affected, and the majority of them are dealing with traumatic stress (Kerai et al., 2017). Trauma has a mutual impact on the brain and body, causing psychological and physical distress. Exposure or re-exposure to trauma can alter cognition, memory, and behaviours in different human brain developmental stages (Gur et al., 2019;Lupien et al., 2018). It can cause severe emotional dysregulation, physical disorders, somatisation, hypervigilance, etc. (D'Andrea et al., 2011; SAMHSA, 2014).However, the literature on trauma offers a philosophical shift from pathogenic to a salutogenic paradigm, mainly focussing on the positive post-trauma changes, empirically known as the domain of posttraumatic growth (PTG) (Griffin et al., 2020;Tedeschi et al., 2018).Evidence from several studies suggest that positive growth with favourable health outcomes have also been documented in individuals who discover healthy ways to cope and heal from trauma

Karachi is one of the biggest City in Asia and since past 20 years terrorism in Karachi is increasing frequently, due to these terrorist activities people living here have developed several phobias and anxiety disorders. To contrast the occurrence of traumatic events and its relationship with symptoms of post-traumatic stress disorder in Karachites. Survey of residents of Karachi was conducted between January 12, 2011 and March 4, 2012. Symptoms of PTSD were assessed using questionnaire related to psycho social factors that prone to PTSD .Out of total 164 both male and females, 62% of respondents reported appetite changes due to these terrifying activities, 58% of respondents reported hostile personalities , depression & mood fluctuations, while remaining 30% reported insomnia. 76.82% reported depression According to their economical condition 71% Middle class was highly affected as compare to upper class and lower class. There was also a significant difference observed among the populations who are engaged both in education and also doing jobs for survivals. 88% of them were found frustrated & protesting against the situation of the city. The results of the current study suggest that the trauma incident by the resident population is significant. Stresses tend to be numerous and chronic. The trauma experienced correlated strongly with psycho social, somatic, PTSD symptoms and depression.

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