EFFECTS OF CERVICAL MUSCLES STRENGTHENING WITH AND WITHOUT SHOULDER EXERCISES IN POST-MASTECTOMY PATIENTS WITH NECK PAIN

Background of the Study: To compare the effects of cervical muscles strengthening with and without shoulder exercises on post- mastectomy patients with neck pain. Methodology: It was a randomized clinical trial, conducted in physical therapy department of a clinical setting through Dynamometer. Sample size of 24 patients were taken. Non-probability convenience sampling technique was used. A written consent form was taken from patients meeting inclusion criteria and were randomly allocated. In one group, patients were treated with cervical Muscles strengthening with shoulder exercises. In other group, patients were treated with cervical Muscles strengthening alone. Treatment was given once a day for three weeks. Muscle strength was examined using dynamometer, Baseline data was taken before treatment on first day after inclusion in study and again on the last day after treatment. SPSS 25 was used to analyze the data. Results: Wilcoxon signed rank test was used to compare individuals within the group which showed significant results in both groups, p-value 0.000 (i.e. <0.001) for neck strength. Between groups comparison was done using Mann-Whitney U Test and it showed no significant changes for cervical extensors (p- value;0.143) , cervical side bending (right) (p-value; 0.315) and cervical side bending (left) (p-value; 0.853) strength differences, but however cervical flexors strength showed statistically significant results as p-value was 0.003. Conclusion: It was concluded that Cervical strengthening along with shoulder Rehabilitation can help improve the strength of cervical flexors. However, both the groups have equally resulted in improved cervical extensor, Side bending right and left strength.

Dynamics of Gender Based Violence in Pakistani Schools: A Study of Selected Districts in Khyber Pakhtunkhwa

The present study titled “Dynamics of Gender Based Violence in Pakistani Schools: A Case Study of Selected Districts of Khyber Pakhtunkhwa” was carried out in Districts Peshawar and Mardan with the sole purpose of eliciting the students’ perception on violence. The study intends to find reasons of school violence through its perpetrators, in light of its manifestations on the basis of gender, ethnicity and class, by looking into the methodologies owned by the schools and suggesting policy recommendations. A sample size of 522 respondents (54.6% boys and 45.4% girls) was randomly selected on proportional allocation basis from Grade 10 students. Frequency and percentage distribution was carried out at univariate level. Moreover, chi-square test was used to determine the level of association between variables (both independent and dependent). Majority of 87.74% respondents lived at home, out of whom 44.25% were male and 43.49% were female. The respondents living away from home during academic session shows a highly significance relation with gender of respondents (p=0.000). A high proportion of 40.04% respondents were having monthly income in range of less than 20000 PKR (lowest on the scale), 31.8% had 20001 to 40000 PKR monthly income, and the remaining 28.16% had 40001 or above PKR monthly income, having significant relation with gender (p=0.001). The Relationship of Gender found highly significant (p=0.000) with both language spoken at home and classroom. The results also indicates insignificant relation between religion and gender (p=0.187) but significant relation with sectarian associations (p=0.033). Similarly, level of significance is extremely high between use of intoxicants and gender of students (p=0.002). Gender was also significantly associated to perception regarding gender based preferences for admission in science subjects (p=0.000). The level of significance was also high of gender with the issue ‘whom not to return to school if get marries and child born’ (p=0.000). The relationship between gender of respondent with exposure to Physical violence (p=0.930), psychological violence (p=0.085) and to economic violence (p=0.232) all were insignificant except sexual violence (p=0.000). Visits of media teams at school took place to monitor violence was significantly associated with gender (p=0.005). Analyzing the data further at bi-variate level found non-significant association between exposure to violence and age with physical violence (p= 0.549), psychological (p=0.263), sexual violence (p=0.210) and economic violence (p=0.796). A significant relationship was found between income level and exposure to psychological violence and significant relationship of ‘Cash Pocket Money Received’ with physical violence and psychological violence. Family interest in school violence was non-significant with physical, psychological, sexual and economic violence. The role of peers/friends had a nonsignificant relationship with physical, sexual and economic violence. However, significant relation was established with psychological violence. There was high level of association between ‘poverty and 10 exposure to punishment’ with physical violence, psychological violence and sexual violence. The association being nearer to authority or relative of teachers receiving less punishment at school is extremely close as it shows physical violence, psychological violence, sexual violence and economic violence. Physical appearance of students also had significant relation with sexual violence, nonsignificant relation shown for physical violence, psychological and economic violence. ‘Punishment never serves improvement in academics’ was significant with physical violence, psychological violence. Violence based School dropout was significantly linked to all physical violence, psychological violence, sexual violence and economic violence. Adoption of violent behavior and loss of creativity was found significant with sexual violence. Relationship between “Teachers are Main Perpetrators of GBV at Schools” and physical violence, psychological violence were significant. However, sexual violence and economic violence were found non-significant. The study found significant relationship between “Peer pressure is most important in gender role formation” with physical violence and sexual violence. Similarly, relationship between the religious cultural violent reaction causes under reporting sexual violence at school was found significant with physical violence, and sexual violence, however the relationship of religious violent reaction causing under reporting in sexual violence at school was found non-significant with Psychological violence, and economic violence. The study concluded the persistence of culture of violence despite strong role of religion and traditional stature of the study area. Moreover, male had a key role as perpetrator of violence in all modes and manifestations, whereas, sexual assaults were kept confidential in fear of social stigmatization. In addition, media role was found passive and government had a neglected approach about this vital aspect of academics at district management level. A vibrant policy with respect to male role containment as perpetrator of violence at school is to be achieved. Special focus is to be given on students living in hostels. Egalitarian approach to both genders as potential threat of sexual violence is important to be realized. Strong liaison of the family and school on the basis of sharing the issues pertaining to child wellbeing are forwarded as few policy recommendations in light of the study