CORRELATION OF MYOFASCIAL TRIGGER POINTS WITH UPPER LIMB DISABILITY IN POST MASTECTOMY FEMALES IN PAKISTAN

Aims of Study: The objective was to correlate myofascial trigger points and upper limb disability in post-mastectomy females. Methodology: This six-month duration study included 45 participants aged 18 or older, using non-probability convenience sampling, who had undergone mastectomy at least six months prior. Numeric pain rating scale, Simon’s trigger point criteria and a disability questionnaire were used to assess disease complications. Results: A study involving 45 female participants (mean age 42.8±6.754) found that 33.3% had mild pain, 55.6% had moderate pain, and 11.1% had severe pain. Additionally, 46.7% had mild disability and 53.3% had moderate disability. There was a significant correlation between myofascial trigger points and upper extremity disability. Limitations and Future Implication: The limitations include the small sample size used in study and limited generalization of findings due to cultural and contextual factors. Further research is needed to explore interventions and understand the long-term impact of myofascial trigger points on upper limb function. Originality: This research is original in its focus on the correlation between myofascial trigger points and post-mastectomy upper limb disability. Conclusion: This study concluded that there is a highly significant relation between trigger points in muscles and disability of upper extremity in female patients after mastectomy.

Asymmetric effects of exchange rate changes on trade balances: Pakistan versus 20 major trading partners

Since its inception in (1947), Pakistan has been experiencing several episodes of trade imbalance, disapproving balance of payments and exchange rate volatility. Particularly, Pakistan has experienced currency devaluation for the very first time in 1955 followed by 1972 and 1996. Similarly, in the most recent five fiscal years, Pakistani currency experienced the highest currency devaluation in history. If the currency of a domestic country depreciates, it boosts the domestic country's exports, whereas at the same time imports from the foreign country decreases-higher exports over imports lead to higher trade balances. The depreciated exchange rate cannot adjust trade imbalances instantaneously, rather it first worsens trade balances before achieving equilibrium is known as J-curve. As far as the literature of J-curve in the context of Pakistan is concerned, numerous studies have addressed this important issue using both the aggregate and disaggregate trade data. All the studies have assumed the exchange rate to be symmetric only-implying that currency depreciation improves trade balances while appreciation deteriorates it with the same magnitude. Nevertheless, trade balances respond to exchange rate changes in a nonlinear way therefore, the relationship could be asymmetric. To the best of our knowledge, there has been no study in Pakistan which discusses the asymmetries of the exchange rate and trade balances. Particularly, among the existing literature on J. curve in the context of Pakistan, it is typically confined to only the symmetric relationship of the exchange rate and trade balances which yield mixed outcomes. Hence in this regard, the current the study applies Non-linear Autoregressive Distributed Lag Model (NL-ARDL) of Shin et al., (2014) to examine the asymmetric effects of exchange rate changes on the bilateral trade balances of Pakistan and its 20 major trading partners (i.e., France, Japan, Korea, China, India, Indonesia, Germany, United States of America, United Kingdom, Saudi Arabia, Switzerland, Malaysia, Singapore, Belgium, Canada, Hong-Kong, Australia, Spain, Netherland, and Italy). The data for this study is retrieved from the International Monetary Fund (IMF)and State Bank of Pakistan (SBP) for the period 1982QI-2018Q2. The nonlinear model incorporates both the short run and long run asymmetries of exchange rate changes on trade balances. Specifically, the findings of this study found that the short-run asymmetric effects of real exchange rate exist for countries such as the United Kingdom, Malaysia, Germany, Australia, Netherland, Indonesia, Spain, France, Saudi Arabia and Switzerland that subsequently lasted into long-run asymmetric effects for only five trading partners. This short-run and long-run asymmetries suggest that exchange rate depreciation and appreciation have significantly different impacts on trade balances. Also, the results of the nonlinear model yield more evidence in support of the J-curve phenomenon- implying that Pak. Rupee depreciation causes immediate trade deterioration combined with the long-run improvement which however exists incase of Australia and Netherland