This study provides evidence to the relevant clinicians and professionals on the utility of therapeutic ultrasound combined with thumb spica splint in the conservative management of DQD.

Background: Caregiver burden is a multidimensional response to physical, psychological, emotional, social and financial stressors, usually associated with the experience of caring and can be objective or subjective. The objective of current study was to explore the caregiver burden among parents of hearing impaired and intellectually challenged children in Pakistan. Methods: A Comparative cross sectional survey was conducted on n=162 parents of hearing impaired (HI) and intellectually challenged (IC) children from July 2018 to February 2019. Convenient sampling technique was used to collect the data from Parents of hearing impaired and intellectually challenged children with age range 1-16 years in National Institute of Rehabilitation Medicine and Al-Farabi Special Education Institute Islamabad. Caregiver Burden Inventory was used to assess the caregiver burden. Results: The results showed a greater need for respite and other services in both groups. Parents of intellectually challenged children need more respite and other services as compared to hearing impaired children (60.62±11.43 ver. 45.74±11.20, p<0.001). A total of 3 (4.0%) parents of hearing impaired children reported rare need for respite and other services, 32(42.7%) reported sometimes and 40(53.3%) reported frequent need. On the other hand 12(13.8%) parents of intellectually disabled children reported sometimes, 66(75.9%) reported quite frequently and 9(10.3%) nearly always a greater need for respite and other services. Conclusion: The parents of hearing impaired or intellectually challenged children face significant burden of their disabled child. In addition, due to cognitive deficits that lead to behavioural abnormalities the parents of intellectually challenged children face more burden and stress.

Background: Primary dysmenorrheal (PD) due to its high prevalence is considered health issue since it affects different aspects of life including physical functions and work productivity. Objective: To find association between symptoms of primary dysmenorrheal, physical functions and work productivity. Material & Methods: A cross-sectional survey 99 subjects with primary dysmenorrhea was conducted. Numeric pain rating scale, daily record of severity of problems (DRSP) for overall symptoms of primary dysmenorrhea, short form-36 for physical function and role limitation were used to collect data. Simple linear regression was used to explore the relationship among variables. Results: Mean age and age at menarche were 21.06±2.59 and 13.15±1.03 years respectively. The results showed that pain had significantly negative association with physical function (r=-0.20, p=0.02) but insignificantly associated with role limitation due to physical health(r=0.08, p=0.20). The symptoms of primary dysmenorrhoea on DRSP also showed significant negative association with physical function(r=-0.36, p=0.00), role limitation due to physical health(r=-0.18, p=0.03) and positively associated with productivity or efficiency (r=0.64, p=0.00) on DRSP scale. Physical function was also positively associated with role limitation due to physical health (r=0.42, p=0.00). Conclusion: the study concluded that pain reduces the physical functioning in primary dysmenrhea. The overall symptoms of primary dysmenohea also reduce physical functioning, role limitation due to physical health and work related productivity and efficiency. Keywords: Primary dysmenorrhea, physical function, physical health, DRSP, Numeric pain rating scale.

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