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Incomplete vaccination coverage is hazardous for the upcoming generations of a country. Child immunization against various vaccine-preventable diseases is a focus all over the world. The vaccination schedule information is a vital component of vaccination coverage, and its failure leads to incomplete immunization among newborns. Education, employment, and urban facilities are also essential for the complete immunization of a child. There is a significant difference in vaccination coverage due to all these factors. The main objective of this study was to explore the reasons for incomplete vaccination coverage due to the factors mentioned earlier, like why the information gap is there and what makes uneducated parents vulnerable to incomplete immunization, and why the urban-rural disparity exists regarding complete vaccination coverage in Punjab, Pakistan. The researchers conducted in-depth interviews of the mothers having at least one child from 1-2 years of age to explore factors responsible for incomplete vaccination coverage. Insufficient vaccination coverage was related to perceived adverse effects, cultural settings, information gap, lifestyle, parental employment and occupation, the risk to the immune system, risk perception about the disease, perception of efficacy, and misconception about vaccination. In-depth interviews proved vital for exploring underlying reasons for incomplete vaccination coverage. The current study explicates the profound views of respondents on why they refuse vaccination for their children. There should be a rigorous focus on increasing awareness of vaccination.

The objective of this article is to investigate a coupled implicit Caputo fractional $ p $-Laplacian system, depending on boundary conditions of integral type, by the substitution method. The Avery-Peterson fixed point theorem is utilized for finding at least three solutions of the proposed coupled system. Furthermore, different types of Ulam stability, i.e., Hyers-Ulam stability, generalized Hyers-Ulam stability, Hyers-Ulam-Rassias stability and generalized Hyers-Ulam-Rassias stability, are achieved. Finally, an example is provided to authenticate the theoretical result.

Introduction: Sedentary life style and low physical activity have become major health problem among young generation now days. Musculoskeletal problems are common in students and working adults, associated with ergonomic problems. Objective: To determine the role of physical activity among medical students. Methods: This observational study was performed from August 2021 to January 2022 on medical students of Fatima Memorial Medical College, Lahore, Pakistan after approval of synopsis from Advanced Studies and Research Board, using non-probability convenient sampling technique to collect data from male and female participants doing physical activity after obtaining written informed consent. This survey was conducted by using International Physical Activity Questionnaire to determine physical activity levels, in mild, moderate and vigorous levels. Data was analyzed for descriptive and inferential statistics by Statistical Package for Social Sciences 23.0 and continuous variables were calculated by using mean and standard deviation while categorical variables by using frequency and percentages. Results: According to the results of the study out of total 362 students, 21% students perform vigorous activity, 45% students do moderate activity and 33.9 % students do mild activity. Conclusion: The frequency of physical activity among medical students was measured which showed most of the students were involved in walking for more than 30 minutes to 1 hour and they focus on their health and fitness.

Background: Sciatica or more commonly sciatic nerve pain is characterized by low back pain that radiates down towards knee or below knee, paresthesia associated with tingling or numbness and weakness of muscles of foot and leg. Most important cause of sciatica is herniated disc which cause nerve root entrapment. Other causes may include lumbar stenosis or spinal tumors. The goal of the study is to determine the effects of graston instrument technique soft tissue mobilization in patients with sciatic nerve entrapment. Methods: Patients were recruited and allocated randomly in two groups. Group A (Lumbar traction with neural mobilization) and Group B (Graston technique along with lumbar traction and neural. 4 weeks of intervention were given to both groups. Results: The 4 weeks treatment session resulted in a significant improvement in pain reduction and improved MODI in patients of group B (Graston technique along with lumbar traction and neural mobilization), which was not more apparent in the group A (lumbar traction with neural mobilization manipulation group). Graston technique along with lumbar traction and neural mobilization was found to be more effective than lumbar traction and neural mobilization alone. Conclusion: This study concluded that Graston technique together with neural mobilization and lumbar traction was successful in alleviating pain and impairment in patients with sciatic nerve entrapment. Together with neural mobilization and lumbar traction, the Graston technique considered more superior to neural mobilization along with lumbar traction alone in terms of the aforementioned outcome measures dependent on means.

Women have been wearing high heels for decades and they remain a must-have for females going out on the town or to the workplace every day. It causes prolonged pressure on the muscles, bones, and tissues of the feet and ankles, on the other hand, may cause chronic foot discomfort or abrupt injuries that need surgical intervention in the feet and ankle. Objective: To determine an association between foot pain and high-heeled shoes in working women. Methods: A cross-sectional study was conducted to measure the prevalence of foot pain among females wearing heeled footwear, focusing only working women. A sample size of 285 was taken. Foot Health Status Questionnaire was used to collect data from the respondents from different areas of Lahore. The data was collected from office workers and school teachers. Considering inclusion and exclusion criteria. females were requested to participate. The questionnaire consisted of 13 questions that were used in this survey. The questionnaire had multiple options out of which only one option was to be selected which was nearest to representing their condition of foot. All the data was analyzed on SPSS (version 25) software. A scoring of 0-100 was used to calculate the results. Results: According to this study, a majority of 162 females had mild to moderate foot pain, 84.4% of females had foot pain and 15.6% of females had no pain. Foot pain had a statistically significant association with walking, climbing stairs, and doing work or activities, (P-value 0.000). Respondents having foot pain couldn’t do all the above activities normally. Restrictions and limitations were found among the respondents with foot pain. A P-value of less than 0.05 indicates that there is a significant association between the severity of foot pain and difficulties during work or activities of daily life Conclusions: The study concluded that there is very high prevalence of foot pain (96%) among females wearing high heels. Long term use of high heels significantly affects the foot health and activities of respondents.

Finite Impulse Response (FIR) filter model emulates the Inter Symbol Interference (ISI) in a wireless communication channel. An equalizer, typically an Infinite Impulse Response (IIR) filter, behaves as an inverse filter to the FIR filter to remove the effects of the ISI. IIR filters are generally avoided due to tractability issues, and an FIR filter, with an adaptive signal processing algorithm to minimize the error due to the ISI, is deployed at the receiver. However, the filter is observed to quickly reach a steady state where further iterations do not yield a reduction in the error. This can be attributed to relatively slow variations in the steady state error which prevent further reduction of the errors. This work focuses on converting the low frequency error variations to high frequency variations by the use of multirate signal processing. As such, the steady state error can be damped as well, providing further reduction in the error and an enhanced adaptive filter performance.

Introduction: Phantom vibration syndrome, also known as hypovibochondria or ring-xiety, may occur among individuals carrying digital devices. Phantom vibration syndrome is the mistaken belief that a device is vibrating when it is not. The current study investigates this phenomenon among medical staff who often interact with digital devices throughout duty hours. Objective: The objective of the study was to determine the frequency of Phantom vibration syndrome in medical staff. Methods: A cross-sectional survey of medical staff was conducted. A convenience sample of 150 physicians, surgeons, allied health professionals, and medical assistants was used. Online survey invitations were sent by email, WhatsApp, and other channels. The data was analysed by SPSS 25.0. The Fisher exact test was used to compare phantom vibrations to categorical data. Results: The results showed that out of 190 medical staff, there were 133 (72.7%) having phantom vibration syndrome. It was significantly associated (p=0.000) with younger age groups from 21-40 year, was seen more in surgeon, physicians and then nurses (p=0.029), associated more with carrying cell phone (p=0.003), more in carrying device in breast and back pocket (p=0.001), more in keeping device on vibration always or most of time (p=0.008) and more in using device from 11-15 or more hours (p=0.001). It was equally distributed in both male females (p=0.176) Conclusion: The study concluded that phantom vibration syndrome was highly prevalent in medical staff. The findings were associated with the length of time the product was used and were more prevalent among surgeons, medical physicians, and nurses in a decreasing order. most respondents regarded the feelings as bothersome and worth stopping and even changing the device. Keywords: Phantom Vibration Syndrome, Medical Staff, Health Practitioner, Digital Devices

In this typescript, we study system of nonlinear implicit coupled differential equations of arbitrary (non–integer) order having nonlocal boundary conditions on closed interval [0, 1] with Caputo fractional derivative. We establish sufficient conditions for the existence, at least one and a unique solution of the proposed coupled system with the help of Krasnoselskii’s fixed point theorem and Banach contraction principle. Moreover, we scrutinize the Hyers–Ulam stability for the considered problem. We present examples to illustrate our main results.

Menopause which is the last menstrual period, is an unalterable and universal part of the age progression involving the female reproductive system. Menopause is labeled after 12 consecutive months of amenorrheic stage. The type of osteoporosis which is most commonly occurred after menopause can be stated as primary type 1, which is also termed as postmenopausal osteoporosis. The current study was done to evaluate the prevalence of osteoporosis following menopause in women of Pakistan. Methods: A descriptive study was conducted on 100 females having age above 40 years. The sample size was calculated using the WHO calculator keeping the Study had a six months’ time period and data was collected from Lahore General Hospital and Fatima Memorial Hospital. Nonprobability convenience sampling technique was used. The bone mineral density was measured using the DEXA scan. Osteoporosis following menopause was labeled on the basis of WHO criteria. The selected variables were described utilizing the descriptive statistics which is frequency tables, bar graphs and percentages. Results: Dual energy X-Ray absorptiometry showed that n=39 (39%) participants were severely osteoporotic with fractures, n=19 (19%) females were found to be osteoporotic, n=29 (29%) osteopenic and n=13 (13%) were normal. Conclusion: Females following early menopause are at high risk of low bone density that is osteoporosis. Fragility of bone is increased in menopausal women leading to fall injuries and fractures.

To determine the translation and validation of questionnaire FADI into Urdu.METHODS:It was a cross cultural adaptation study. Data of 130 patients of age 16 to 50 year, was taken from hospital, general population or the people who are visiting orthopedic surgeon in the duration of 6 months. Guidelines of Gullimen F have been followed by researcher for this study. RESULTS:The results remained in the favor of Urdu translation. Value of the cronbach alpha coefficient (0.96-0.97) showed the excellent internal consistency. Composite reliability (CR) i.e 0.964 indicates excellent validity. Average variance extracts (AVE) (0.532) which indicates that all the items are having acceptable convergent validity. Intra-class correlation coefficient (ICC) value (0.966) indicates the excellent consistency. P value of FADI index 1.000 and P value of Urdu score .059 showed that there is non-significant difference of mean Urdu score with English score. Kappa statistics of all the items are mentioned in statistical results.CONCLUSION:This study concluded that The FOOT & ANKLE DISABILITY INDEX (FADI) QUESTIONNAIRE converted in Urdu have excellent internal consistency, high reliability of the items, excellent validity and acceptable convergent validity.

To determine the association between heavy bag lifting with posture among secondary school students. METHODS: This study was a cross sectional survey. Based on sample of convenience, total 380 Students of both gendersbelonging to Beaconhouse School System, KIPS School System,Educators School and The Punjab School System were included with an age 14 to 17 years (school grade 9 to 12). The data was collected using the Reedco scale and Grimmer’s Questionnaire for assessment of posture and, use of heavy bags andits associated pain, respectively. RESULTS: The majority of participants in this consisted of young adults above 12 years (39%) and below 12years (34%) with male predominant (54%). 370 students out of 380 were carrying heavy bags. The types of bags they mostly carry were backpacks (51%), satchel (34%) and others (15%). 48% of these students never used lockers and 40% of them often use locker 55% of them never use waist belt to carry bag. Most of the students 48% spend 11 to 20 minutes for carrying bag per day.61% of them carry extra load (water bottles, lunch boxes, guide books) with them also. Out of 380 students 246 had pain in different body regions due to heavy bags 64% had neck pain and 53% had upper back pain while 19% had shoulder pain. Out of 184 students that carry bag from 11 to 20 minutes, 115 had poor neck posture, 133 had poor shoulder posture 25 had poor head posture and 5 had poor upper back pain and that carry from 21 to 30 minutes out of 167 students 122 had bad neck posture and 132 had poor shoulder posture 50 had poor head posture 105 had poor upper back posture. CONCLUSION: There was found significant association between heavy bag lifting and poor posture with related pain in regions of cervical followed by upper back in secondary school students.