Objective: to assess the frequency of De Quervain's tenosynovitis and its association with SMS texting. Method: a cross-sectional survey was conducted among undergraduate students studying in different physical therapy schools of Karachi belonging to both public and private sectors. Sample size was 300 students which were selected through convenience sampling. Data was collected through self-administered questionnaire and severity of the pain was assessed through Universal Pain Assessment Tool and De Quervain's tenosynovitis was diagnosed through Finkelstein test. Data entry and analysis were done using computer software SPSS version 20. Frequency and percentages were taken for categorical variable. Chi-square was applied to determine association between different variables and Finkelstein test. P value < 0.05 was considered significant. Results: male/female ratio was 1:4. Regarding the use of cell phones, majority 165 (55%) were using regular cell phones, another 89 (30%) were using touch screen and 38 (13%) were using QWERTY key pads. Almost half of the students were frequently using cell phones for texting, out of them 132 (44%) texted less than 50 messages per day. Another 96 (32%) did texting between 50-100 texts. Out of 300 students who filled the questionnaire 125 (42%) students were experiencing pain in the thumb/wrist. Finkelstein test when done on students almost half (n=149) showed positive results. It was noted that as frequency of mobile phone usage increased progressively more and more people showed positive Finkelstein Test (p value 0.000). Conclusion: the result of the study concluded that almost half of the students use their mobile phones for texting more than 50 S.M.S per day and because of their mobile key pads and high speed of texting they experienced pain and weakness over the base of the thumb/wrist which shows the De Quervain's positive in that students and there is a positive association between the thumb pain and frequent text messaging.

There are many barriers to starting a medical institution in Pakistan. Some of the career barriers are entrepreneurship, gender barriers, and lack of knowledge about funding issues. Additionally, purchasing power parity (PPP) related barriers can hinder starting a healthcare startup. Additionally, academic issues can cause a lack of entrepreneurship in healthcare organizations. By understanding these barriers and working to overcome them, healthcare organizations can drive more innovation and growth within their organizations. Job barriers, gender barriers, funding issues, and barriers related to purchasing power parity are some of them. However, while expanding these barriers further, the structural issues are at the core of Pakistan's prevention of healthcare entrepreneurship. According to numerous studies, the state's small business policy, administrative procedures (new company registration, licensing, etc.), tax laws, access to finance (bank loans, grants, etc.), ensuring private property protection, and the standard of living in the country. , political instability/corruption, international trade barriers, a shortage of skilled manpower (HR), and an inefficient judicial system are structural barriers to healthcare startups in Pakistan. This critical reflection discusses these factors in detail and provides empirical evidence to support his claims.

Background: Healthcare professionals experience stressful working conditions that can lead to burnout. This study investigates the association between psychosocial working conditions and burnout among healthcare professionals in a tertiary care hospital in Karachi, Pakistan. Methodology: This cross-sectional study was conducted at three different facilities of Dr. Ziauddin Hospital, Karachi, from July 2021 to December 2021. Two standardized surveys were used to assess the psychosocial working conditions and burnout. The selected participants were associated with the institutional healthcare facility and were working as house officers, residents, nurses, dentists, and allied health professionals. Results: out of 384 distributed questionnaires, only 172 participants completed and returned the questionnaire. The mean score of burnouts was 46.24 with an SD value of 16.1 when assessed with the different levels of burnout (i.e., no burnout, stressed out, mild burnout, burned out, server burnout), it was found that the majority of the participants' n=56 (32.6%) had mild burnout and n=55 (32%) had burnout while severe burnout was found in n=22 (12.8%). Conclusion: Our study results indicate that there is a significant increase in healthcare professionals' level of burnout in a tertiary care system.

OBJECTIVE To Study the effectiveness of Home management versus OPD management in Low back pain patients. STUDY DESIGN The study was a quasi experimental study design. STUDY SETTINGS & PARTICIPANTS Participants aged between 30 to 70 years suffering from low back pain for more than 3 months were inducted in the study. They were divided into two groups, one which was provided intervention at home and the other which was given physiotherapy in OPD setting. INTERVENTIONS A pre and post assessment was done at 6 months based on Oswestry low back pain disability questionnaire. Analysis was done by application of Independent sample t test. P value less than 0.05 was taken as significant. RESULTS A total of 100 participants were equally divided for OPD and home management. Oswestry low back pain disability questionnaire was administered pre and post intervention and Independent T test was applied to find the difference between the mean pretest and posttest scores for OPD and home managed patients which were taken 6 months apart. A significant difference was observed as p value was < 0.00 CONCLUSION The results of the study concluded that OPD management for chronic low back pain not only reduces pain but also reduces chance of disability. But patient satisfaction was higher in home manage group in comparison to OPD in personal care.

Objective: To assess the clinical outcome in treatment naïve and non-cirrhotic patients with HCV genotype 3 infection after treatment with Sofosbuvir with declastasvir and valpatasvir (in case of non-responsiveness). Methods: Study included 263 participants. The inclusion criteria were HCV genotype 3 infection confirmed through PCR, age above 18 years, treatment naïve and non-cirrhotic. HCV PCR below the threshold of quantification at 12th week of treatment was defined as SVR12 (sustained virological response). The patients were started on a fixed dose generic combination of declastasvir 60 mg and Sofosbuvir 400 mg and PCR was performed at 12, 24 and 48 weeks. PCR positive patients at 24 weeks were given valpatasvir with Sofosbuvir. Results: There were 162 males and 101 females. PCR performed at 12 weeks showed that 251 patients (95.4%) became PCR negative and 12 (4.56%) remained positive. Repeat PCR of these 12 patients started on valpatasvir and Sofosbuvir at 48 weekswas negative. The treatment was well tolerated by all.Probability of positive HCV PCR at 12 weeks decreases by 0.73 with one unit increase in the hemoglobin, whereas one unit increase in TLC reduces the probability of HCV PCR at 12 weeks, positive by 0.001. Conclusion: The combination of Sofosbuvir and declastasvir is a cheap and effective treatment strategy for treatment naïve and non-cirrhotic HCV genotype 3 infections. Those not responding will achieve PCR negativity with a 6 month therapy of Sofosbuvir and valpatasvir combination. A high hemoglobin level and high total leucocyte count are predictors of good treatment response.