IntroductionHepatitis B is a vaccine-preventable disease, and hepatitis C is amenable to treatment. Both are highly prevalent in the prison population. This project provides a comprehensive evaluation of current hepatitis services at Her Majesty’s Prison Birmingham, assessing progress since previous work and proposing further suggestions for improvement.MethodsA review of hepatitis services was undertaken in 2013, in the context of underperformance against national targets. This revealed that the hepatitis B vaccination and hepatitis C testing coverage was 22% and 0%, respectively. A resulting service improvement plan included interventions such as the development of a bloodborne virus (BBV) policy, implementing opt-out testing and introducing dried blood spot testing for ease of administration. In 2015, national guidelines were used to evaluate current practice, with comparison to previous practice. The indicators assessed included BBV policy, vaccination and testing protocols, prisoner education and reporting of results. Discussions were held with prison stakeholders to address areas that required development, producing a revised action plan.ResultsHepatitis services were available to all prisoners starting their sentence in 2015, n=4998. Testing was offered on an opt-out basis to all entrants, increasing the testing coverage by 7.6% from 2013. Vaccination was offered to 57% of entrants, with coverage slightly lower than 2013, largely due to prisoner refusal. In light of this, many strategies were devised to educate prisoners, increase opportunities to receive testing and vaccination, and decrease the risk of patients being lost to follow-up. An update in 2016 saw progress in many of these areas.DiscussionBeing in prison provides offenders with stability in their lifestyle and easier access to healthcare services. By optimising these services in line with national guidance, and implementing specific strategies to encourage uptake of hepatitis testing and vaccination, we may be better able to serve this vulnerable sector of the population.

The objective of this study was to determine the effects of cervical stabilisation exercises on respiratory strength in chronic neck pain patients with forward head posture. The study was conducted from August 2020 to February 2021, at the Jinnah Hospital, Lahore; 44 patients who fulfilled the eligibility criteria were randomly assigned to two groups—experimental group and control group—. Baseline measurement was taken for numeric pain rating scale, neck disability index, craniovertebral angle, single breath count, and spirometry and all the measurements were retaken at the completion of the fourth week. Results were not significant (p>0.05) before the treatment in both groups but post-intervention results revealed significant differences in both the groups (p<0.05), with the experimental group showing more improvement. Four weeks of cervical stabilisation with isometric exercises is more effective in the management of pain, forward head posture, neck disability and respiratory strength as compared with the four weeks of isometric exercises programme alone. Keywords: Stabilisation, neck pain, posture, respiratory strength.

The purpose of this study was to determine the effects of manual lumbar decompression on pain, range of motion, and function in patients with acute vs chronic lumbar radiculopathy. Thirty patients fulfilling the eligibility criteria at Tehsil Headquarter Civil Hospital Daska were randomly placed into three groups: acute group (n=10), chronic group (n=10), and control group (n=10). Mean age of the participants was 33.3±8.5 years and the mean body mass index was 25.0±4.4. There were 12 males and 21 female participants. Group A and Group B were treated with decompression, lumbar mobilisation, hot packs, TENS and exercise therapy, while the patients in Group C were treated with lumbar mobilisation, hot packs and exercise therapy. ---continue

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