EFFECTS OF PHYSICAL THERAPY-BASED MANAGEMENT APPROACHES FOR TENSION TYPE HEADACHE

Background of the Study: Multiple Physical Therapy approaches have recently been developed and reported in the literature for providing better results in the treatment regimens of tension-type headaches. The advancement in the field of Physical therapy towards the treatment approaches of tension-type headaches has become the driving force for writing this article. Methodology: Studies comparing the effects of physical therapy management with conventional treatment approaches are included in the meta-analysis. PRISMA guidelines were used for performing the qualitative analysis and assessment of risk of biases. Results: According to the findings of nine randomized controlled trials, the analysis of the results had revealed that physical therapy intervention demonstrated a significant improvement in reducing headache severity. In a random effect model, the pool effects of physical therapy strategies in terms of Standardized Mean Difference had an impact of 1.41, which according to a Cohen rule of thumb displays a larger effect of physical therapy management in significant decrease in pain intensity among tension-type headache patients Conclusion: The study has concluded that physical therapy-based management strategies as provided in several RCTs analyzed in this review article revealed a pool effect of moderate size in managing the frequency of pain and a larger effect size in managing pain intensity and duration. Further, it was concluded that tension-type headaches can be effectively managed through physical therapy-based approaches.

U. S. War Against Terrorism and its Impact on Pak-U. S. Relations 2001-2008

Pakistan has been facing security threats since its independence, and looking for security assurances from external sources. Its alignment policy with the U.S. has been primarily based on its heightened sense of insecurity at different times. This sense of insecurity and the U.S. need for allies brought the two countries together during the Cold War. Military collaboration has been an important component of this alliance. Since then, the U.S.-Pakistan security relationship has been a roller coaster ride with periodic highs and lows at both ends. This relationship has been based on periods of friendship as well as mutual distrust. Pakistan and the U.S. developed new security strategies in the region to face the growing threat from Afghanistan in the 1980s and after 2001. American economic aid and the arms sales packages were meant to meet Pakistan’s security needs during the Cold War and the Afghanistan Jihad. This was also meant to promote U.S. interests in the region. The U.S. has enforced a reactive policy towards Pakistan by relating aid to other requirements, such as nuclear nonproliferation, strengthening of democratic institutions and to fight terrorism. After September 11, 2001, Pakistan and the U.S. once again formed a security partnership. Pakistan by virtue of its geopolitical environment became a natural and frontline ally in the U.S led global War on Terror. However, Pakistan’s role in this war is a complex phenomenon in terms of its implications. Though, Pakistan was an isolated country prior to 9/11 due to nuclear sanctions, military takeover by General Musharraf, and close ties with the Taliban regime in Afghanistan. Pakistan once again became a U.S. ally to fight terrorism. This new relationship brought new opportunities and challenges for the two allies. While the War on Terrorism has made Pakistan to pay a heavy price, it has managed to build a sustainable 10 relationship with the U.S. However, the future remains uncertain pertaining to the conclusions of the War on Terror, and future developments in Afghanistan. This dissertation analyzes the deciding factors in the Pakistan-U.S. relationship in the post 9/11 era. While the main focus remains on the complex dynamics of the relations, and Pakistan’s role in the War on Terror is highlighted.