EFFECTS OF CRANIOCERVICAL FLEXION EXERCISES AND SCAPULAR STABILIZATION EXERCISES IN NECK PAIN AND FORWARD HEAD POSTURE AMONG FEMALES WEARING HEADSCARVES

Background: In neck related problems, limited cervical ranges are considered a major contributor leading to forward head posture and increased disability. Methodology: The study design was a randomized clinical trial. Total of 50 subjects were recruited that fulfilled the selection criteria. Subjects were divided into two groups. Craniocervical flexion exercises group A (n=25) and Scapular stabilization exercises group B (n=25). Numeric Pain Rating Scale (NPRS) and Neck Disability Index (ND1) were subjective while the goniometer and plumb line were used as objective modes of assessment. Baseline and after 4 weeks of treatment values were assessed by using SPSS 21. Results: Both groups showed improvement in plumb line values, forward head posture and cervical spine mobility. NPRS, and NDI score values after the 4-week exercise program showed significant results (p-value<0.05). Outcomes except for plumb line value and NDI score indicated statistically significant improvement in the Craniocervical flexion exercise group than the scapular stabilization exercise group (p-value<0.05). However, in NPRS no statistical difference (p-value>0.05) was found between the two groups. Conclusion: Only females were recruited. Further studies can correlate with spatiotemporal features. The idea and conceptual framework were original.

Epidemiology of Principal Viral Respirtaory Pathogens in Pakistani Children and Molecular Characterization of Influenza A/H3n2 and Respiratory Syncytial Viruses

21 ABSTRACTBSTRACTBSTRACTBSTRACTBSTRACTBSTRACTBSTRACT Acute respiratory infections (ARI) are associated with high morbidity and mortality rates at the global level. Approximately 20% of the deaths attributable to pneumonia globally occur in Pakistan with nearly one half the infections among children younger than 5 years of age. The objectives of this study were to define the molecular epidemiology of respiratory viruses in Pakistani children and to identify viral genotypes causing respiratory infections. In this study, we analyzed 1941 respiratory samples collected over three winter seasons and tested for common respiratory pathogens using real time PCR. We found 76% prevalence rate for viral pathogens with Influenza and RSV predominant among 0.01-6 and 12-24 months age groups respectively. Fever and cough were identified as significant clinical parameters along with malnutrition and maternal breastfeeding. Furthermore, phylogenetic analysis of representative Influenza A/H3N2 viruses showed that recent viruses belonged to subgroup 3C.3 and carried important amino acid substitutions in the H3 hemagglutinin, while no substitutions attributable to neuraminidase resistance were detected. We genotyped the Respiratory Syncytial viruses subtypes and analyzed the two surface glycoproteins G and F of over100 isolates. All RSV-A strains carried 297 amino acids long G protein and clustered in the NA1/GA2 genotype. We also reported a novel RSV B genotype BA-13 and two other genotype variants (BA-9 and BA-10). We analysed the fusion protein F in RSV A isolates at the binding sites for the monoclonal antibodies Palivizumab and Motavizumab specifically and found that the N276S substitution in over 90% of RSVA and all RSVB viruses. This work highlights the need for respiratory disease surveillance as it will support the development of appropriate public health surveillance programs to inform health planning.