Objective: This study aimed to emphasize facilitation training and strengthening of abdominal and core muscles in improving the inter-recti distance (IRD) and associated low back pain (LBP) among young postpartum females. Materials and methods: A single-blinded randomized controlled trial, among forty young postpartum females, was conducted at a community health center. The females were divided into two equal groups through the envelope method where Group A received abdominal crunch training protocol whereas group B received double straight leg raise (DSLR) exercise protocol for 6 weeks and pre and post IRD and Oswestry disability index (ODI) scores were recorded. Results: Group A showed improvement in IRD with a mean difference of 1.95±0.4 whereas in group B it was found to be 2.85±0.35 when assessed through finger palpation method.  The mean difference of IRD, when measured through digital nylon caliper method in abdominal crunch and DSLR exercise group was 4.06±0.74 and 1.2±0.49 respectively. Moreover, ODI scores of group A were 2.70±1.05 whereas, group B scores were found to be 1.1±0.06 showing that LBP reduced in participants who performed abdominal crunch exercise. Conclusion: This study reveals that 6 weeks of exercise protocol was observed to be effective in the management of DRA. Thus, abdominal crunch exercise seemed to produce promising results in a reduction of IRD and associated LBP.

Objective: To explore the experiences and perceptions of midwives practising the midwifery-led care model at two private facilities of women and children hospital in Karachi, Pakistan. Methods: The descriptive qualitative data was collected through semi-structured questionnaires with 10 midwives. Results: The findings of the study revealed one theme and four related categories. The theme of the study emerged as ‘struggling to be a professional midwife’ and the related four categories were: (i) asking to perform within the full scope of practice, (ii) obstetricians’ reliance and trust in midwives' expertise, (iii) raising concerns about expensive midwifery services, and (iv) encountering barriers to practise midwifery as independent practitioners. Conclusion: Midwives face some challenges practising the midwifery-led care model such as lack of visibility in society, low salaries and increased workload due to the shortage of staff. Lack of higher education was also highlighted by the midwives as they have no opportunities for career growth. This study will increase midwives' autonomous role and decision-making in the clinical setting.

OBJECTIVES Administrationof sit and reach (SR) box as an intervention tool for retaining the hamstring flexibility as a treatment regime in order to prevent as well predict future low back pain complications. Improvement of hamstring flexibility through SR box, administrationof SR box as an assessment tool in patients with reduced hamstring flexibility causing low back pain complications. Also implementation of SR box for training purpose in clinical practice to evaluate the efficacy of the SR box in retention of hamstring flexibility in both genders. STUDY DESIGN A quantitative experimental study inclusive of simple random sampling was done. The independent variables were age and gender. Flexibility retention and treatment were the dependent variables which were assessed by a Sit-and-reach box. MEASUREMENTS The subject pool for this study consisted of 40 volunteers that were selected on the basis of simple random sampling and were recruited in the study after assessing hamstring tightness through toe-touching, straight leg raise and piriformis test to exclude any specific pathology or disorders. RESULTS Flexibility showed marked increase in most of the applicants on 5th trial after a 4 week training regime by sit and reach box. CONCLUSION Achievements in flexibility are preserved for no less than 2 weeks after a stretching program. It additionally created the impression that 2 sets; each consisting of 3 repetitions of a sit-and-reach test is adequate for boosting extensive increment in flexibility. KEYWORDS Sit-And-Reach, Stretching, Flexibility, Hamstring, Low Back Pain, Straight Leg Raise.

Medication administration requires comprehensive knowledge about drug dosage calculation and its related knowledge. In order to build this skill, the curriculum of nursing education includes basic mathematics, drug dosage calculation and a pharmacology course. In our nursing school, during the BScN year two semester II it was identified that few students are encountering problem related to these courses and thus they are not scoring well although it is expected to get 100% in mathematics and drug calculation whereas 70% passing grade is needed in pharmacology. Case based scenarios were planned as a strategy to support the students' learning. The faculties planned scenarios with integration of pharmacology and drug calculation and prepare some reading material to be send prior to the tutorial. This helped in improving the score of the student. At the same time some challenges were identified that scheduling at the mid of the semester is difficult due to booked venues and faculty hours. Therefore, scheduling extra time for tutorial increased workloads for faculty and students, students at times were not coming prepared for tutorial day. It is advised that such remedial strategies shall be consider in the planning phase of the semester, use of ICT will help in self-directed learning and continuous development of scenario shall be practiced.

Colostomy formation brings lot of changes in patients' physical, social, spiritual, sexual and psychosocial health. The modified elimination pattern, after the permanent colostomy may deteriorate patients' quality of life. Lack of patient preparation for the procedure may lead to impair the domains of patient quality of life. The prior education, patient involvement and continuous facilitation of patient in his recovery period may enhance patients' ability to cope with changes in their life after permanent colostomy and enhanced their quality of life after the modified elimination pattern.