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BACKGROUND: In the recent era, musculoskeletal disorders have affected millions of people worldwide. Chefs and other workers of the catering industry are at high risk of physical stresses, which makes them susceptible to develop various musculoskeletal pains and disorders. OBJECTIVE: The aim of the study is to examine the frequency of musculoskeletal symptoms among chefs working in restaurants of Islamabad and Rawalpindi. METHODS: A cross-sectional observational study was conducted on 307 chef participants from the restaurants of the twin cities. The participants were included via convenient sampling and data was collected through Nordic Musculoskeletal Questionnaire (NMQ), Fatigue Assessment Scale (FAS) and Numeric Pain Rating Scale (NPRS) from February to July 2021. RESULTS: Out of 307 participants, 285 were males and 22 were females with a mean age of 32.87±7.03 years. The working duration of 192 chefs were 9-12 hours while 106 and 9 chefs worked only for 4-8 and more than 12 hours, respectively. A total of 101 chefs reported lower back and knee pain. The chefs presented with pain in the shoulders, upper back and ankle as well as feet areas were 98, 93 and 26 respectively. CONCLUSION: Chefs can develop musculoskeletal symptoms including pain as a result of increased physical stress on their bodies during their work, specifically in the lower back and knee area.

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Introduction: Lumbar disc surgery is a common procedure for patients with lower back pain associated with lumbar disc herniation. This study aims to evaluate the impact of active physiotherapeutic rehabilitation on global/functional improvement and subjective pain score reduction among patients 1-2 months following lumbar disc surgery. The outcomes of this study are to assess the impact of active physiotherapeutic rehabilitation on functional improvement and subjective improvement in pain behavior post active rehabilitation. The outcomes are measured as pain assessed using the visual analog scale, global measurement of improvement, back pain functional status, and return to work. Methods: Databases, including MEDLINE/PubMed (10 June 1996, 2022), Web of Science (10 June 1997, 2022), Scopus (15 March, 10 June 2004, 2022), CINAHL Plus (10 June 1961, 2022), and Cochrane (10 June 1993, 2022) were reviewed without any language restrictions. All studies were systematically screened; however, only randomized controlled trials were eligible against the inclusion/exclusion criteria. All statistical tests were conducted in Review Manager (RevMan) 5.4. The quality of studies was appraised using the grading of recommendations assessment, development, and evaluation (GRADE) approach and the risk-of-bias 2 (RoB 2) tool. Results: Fifteen articles were identified, enrolling a total of 2188 patients, where the majority of active rehabilitation interventions continued for 3 months. All these interventions began 1-2 months postoperatively, and quantitative findings were presented as mean scores. The subjective pain scores were significantly lower in the interventional group, with a mean difference (MD) of -7.01 (p = 0.004). The pain disability score was considerably lower in the interventional group, with an MD of -3.94 (p = 0.002). Global improvement was higher in the interventional group (OR = 1.94, p = 0.0001). Conclusions: This study presents significant improvement in all parameters concerning pain and functionality. Postoperative rehabilitation requires optimization concerning timing, duration, intensity, and associated components to benefit patients post lumbar disc surgery.

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Nanotechnology is an intensive branch of science due to the unique features of nano range particles (1-100 nm). Their nano size results in a high surface area of absorption when orally administered. Monosodium urate crystal excessive deposition causes a commonly known inflammatory disease called gout into the synovial joints. Previously it has been observed that copper oxide nanoparticles (CuONPs) had a significant effect in reducing the serum uric acid levels in BALB/c mice as well as reducing the inflammation in the ankles of mice. This study was made to investigate the antioxidant and histopathological changes in hyperuricemic BALB/c mice upon the oral administration of copper oxide nanoparticles. Different concentrations of copper oxide nanoparticles 5, 10, and 20 ppm were given orally to gouty mice. To investigate the antioxidant activity of CuONPs, various antioxidant protocols were applied. It was noted that the nanoparticle-treated group of 20 ppm showed no significant changes in superoxide dismutase (SOD), peroxidase (POD), catalase (CAT), thiobarbituric acid reactive substances (TBARS), and ROS values while the protein estimation values of the negative control group exhibited a significant increase (0.001). When compared to negative control, no significant effect was shown on the interpretation of histopathological changes of muscles, kidney, and liver tissues.

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OBJECTIVE: To determine and compare the clinical outcome of Cyriax manipulation and traditional physical therapy for the treatment of cervical discogenic problems in terms of pain, range of motion and disability. METHODS: The randomised controlled trial was conducted at Benazir Bhutto Hospital, Rawalpindi, Pakistan, from January to June, 2018, and comprised patients having prolapsed intervertebral disc with neck or arm pain who were then randomly allocated into control and experimental groups using the sealed envelope method. The control group received cervical isometrics 10 repetitions ×1 set, 4 days/week and targeted muscle strechings 10 repetition × 1 set/day for 4 days/week. The experimental group received 10 min pre-manipulative massage and Cyriax manipulation protocol. Data was analysed using SPSS 20. RESULTS: Of the 40 subjects, there were 20(50%) in each of the two groups. The experimental group showed significance difference in terms of numeric pain rating scale, range of motion and the neck disability index (p<0.05 each). CONCLUSIONS: Cyriax manipulation was found to be significantly better than the traditional treatment of physiotherapy for cervical discogenic pain.

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OBJECTIVE: To find out the effect of deep cross-friction massage on spasticity in children with cerebral palsy. METHODS: This double-blind randomised controlled trial was conducted at the National Institute of Rehabilitation Medicine, Islamabad, Pakistan, from January to July 2013, and comprised paediatric patients with spastic diplegic cerebral palsy. The participants were equally divided into control and treatment groups by a staff member unaware of the treatment (allocation ratio 1:1). The control group received routine physiotherapy, while the experimental group was additionally given deep cross-friction massage for 30 minutes, 5 times a week lasting 6 weeks. The outcome was measured using Modified Ashworth Scale and functional level scale before the treatment and 6 weeks later. Baseline information and characteristics of the patients were also recorded. SPSS 20 was used for data analysis. RESULTS: Of the 60 patients, there were 30(50%) in each group. The control group consisted of 14(46.7%) males and 16(53.3%) females compared to 16(53.3%) males and 14(46.7%) females in the experimental group (p=0.72). The overall mean age was 6.03±1.73 years. All patients (100%) were followed up for a period of 6 weeks and there was not a significant (p=0.26) improvement in experimental group compared to control group evident on Modified Ashworth Scale. The experimental group, however, had significant improvement after 6 weeks compared to the baseline values (p<0.001). However, functional level did not improve (p=0.55) by the end of study. CONCLUSIONS: Deep cross-friction massage is an efficacious treatment option for the management of spasticity in children with cerebral palsy.

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