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Objective: To determine drug compliance among patients with rheumatological and musculoskeletal diseases and to identify the reasons behind poor compliance. Study Design: Cross-sectional study. Place and Duration of Study: Department of Rheumatology Lady Reading Hospital, Peshawar Pakistan, from Aug 2020 to Feb 2021. Methodology: All patients aged 16 to 70, of either gender with inflammatory rheumatic diseases who were prescribed conventional DMARDs for at least six months were included in the study. Results: Two hundred and eighteen patients were included in the study. There were 59(27.1%) males and 159(72.9%) females with a mean age of 38.56±4.75years. There were 156 SPRA patients (71.5%), while SLE and SNIA accounted for 22(10.1%) and 17(7.8%) cases, respectively. Methotrexate was the most commonly prescribed medicine, 158(72.5%) while 90(41.3%) patients were prescribed Hydroxychloroquine and 43(19.7%) patients were prescribed Sulfasalazine. Regarding compliance, 112 (51.4%) patients were found to have good drug adherence. On the other hand, side effects and lack of awareness were found to be the most common cause of poor medication adherence. Conclusion: We concluded that adherence to medication among patients with inflammatory rheumatic and musculoskeletal diseases is poor. [ABSTRACT FROM AUTHOR]

Objective: To investigate the frequency of Depression in Patients with Rheumatic and Musculoskeletal diseases with particular emphasis on gender and compliance to treatment. Study Design: Descriptive, Cross-sectional study. Setting: Department of Rheumatology at Lady Reading Hospital, Peshawar. Period: August 2020 to February 2021. Material & Methods: A total of 189 patients were assessed with their detailed history, examination, and lab data collected. Depressive symptomatology was evaluated using DSM - 4 criteria. SPSS 26 was utilised for data analysis, and a p-value of<0.05 was considered statistically significant. Results: 131 (69.3%) were female and 58 (31.7%) were male patients. Seropositive Rheumatoid Arthritis ranked the highest concerning the diagnosis with 128 cases (68.25%). Methotrexate was the most commonly used drug with 134 (70.9%) patients receiving it. A total of 169 (89.4%) patients had Depressive disorder, with females outnumbering males, a finding reaching statistical significance (p=0.04). Conclusion: Undiagnosed Depression is common in patients affected by Rheumatic and Musculoskeletal diseases, especially among the female population. Routine screening for depressive symptoms with subsequent referral to the mental health service may serve detection of this comorbidity and improve patient outcomes. [ABSTRACT FROM AUTHOR]

Objective: To investigate the frequency of Depression in Patients with Rheumatic and Musculoskeletal diseases with particular emphasis on gender and compliance to treatment. Study Design: Descriptive, Cross-sectional study. Setting: Department of Rheumatology at Lady Reading Hospital, Peshawar. Period: August 2020 to February 2021. Material & Methods: A total of 189 patients were assessed with their detailed history, examination, and lab data collected. Depressive symptomatology was evaluated using DSM - 4 criteria. SPSS 26 was utilised for data analysis, and a p-value of<0.05 was considered statistically significant. Results: 131 (69.3%) were female and 58 (31.7%) were male patients. Seropositive Rheumatoid Arthritis ranked the highest concerning the diagnosis with 128 cases (68.25%). Methotrexate was the most commonly used drug with 134 (70.9%) patients receiving it. A total of 169 (89.4%) patients had Depressive disorder, with females outnumbering males, a finding reaching statistical significance (p=0.04). Conclusion: Undiagnosed Depression is common in patients affected by Rheumatic and Musculoskeletal diseases, especially among the female population. Routine screening for depressive symptoms with subsequent referral to the mental health service may serve detection of this comorbidity and improve patient outcomes. [ABSTRACT FROM AUTHOR]

Objectives: To find the prevalence of fibromyalgia in patients with early knee osteoarthritis. Methodology: In this observational cross-sectional study 115 patients (age 18-49) in which 65 females and 50 males were selected from the Department of Rheumatology, Lady Reading Hospital Peshawar from August 2020 and February 2021. The American College of Rheumatology 1990 criteria and American Classification Criteria 1986 were used for the diagnosis of fibromyalgia in early knee osteoarthritis. Results: Mean age of the patients was 37.38 ± 9.14 years. There were 50 patients (females= 38, males = 12) who reported fibromyalgia. Moreover, there were 41 patients with hypertension, 3 with diabetes, and 1 with ischemic heart disease. Similarly, 3 patients reported hypothyroidism while 1 patient-reported chronic kidney disease. As regards fibromyalgia, 50 patients with early OA were found to have fibromyalgia comprising 43.5% of the total patients. Conclusion: It is concluded that fibromyalgia is a commonly occurring disease among patients with early knee osteoarthritis. This condition affects both sexes, although females are far more likely to develop fibromyalgia as compared to males. The results of this study further highlighted the need for awareness, early diagnosis, and timely management of Fibromyalgia preventing patients from being over-treated for early knee OA. [ABSTRACT FROM AUTHOR]

Ethical leadership continues to receive considerable attention due to its influence on various job outcomes, therefore this study was conducted to examine the effect of ethical leadership on job outcomes (employee wellbeing and worker's voice) and to demonstrate that how good faith direct the relationship between ethical leadership and job outcomes. This study was conducted in the Non-Government organizations in Peshawar. Information was gathered from 180 workers working in 6 diverse NGO's in Peshawar. Information was gathered through an organized questionnaire and convenience sampling technique was used. The results of this study showed that ethical leadership was positively related to employee well-being and employee voice. The findings of the study show that there is a strong relationship between ethical leadership, employee voice, employee well-being. The main contribution of this study was to find the significant moderating effect of conscientiousness on both dependent variables. The future implication shows that organizations can identify those aspects through which employee work outcome can be improved. The use of ethical leadership strategies can allow managers to build a positive attitude in employees which results in employee well-being. [ABSTRACT FROM AUTHOR]

The present study was conducted to evaluate the managerial perception for the signaling effect of dividend payout. Research study was conducted in non financial firms of Pakistan Stock Exchange. A sample of 217 was estimated which were used for the data collection with the help of questionnaire. Study has used mixed methodology approach to get more accurate and precise findings about the signaling effect of dividend payout in Pakistan Stock Exchange. Study has used interview schedule from qualitative and closed ended questionnaire from quantitative methods after evaluating the previous studies conducted in the different parts of the world. Regression model was used for the answer of research questions posted. The results of regression model states that Current earnings, past dividend, liquidity, taxation, managerial perception, and investor perception and share prices have significant effects on the dividend payout. The findings of interview schedule show that the investors are always interested in getting dividend all the time but to avoid the taxes, they prefer capital gain. It also concluded that previous dividend ratio cannot or sometimes it has minimal role in the estimation of dividend ratio for the present year. Consistent payment of dividend can be taken as the best managerial performance and will transmit a 'good signal' to the market. [ABSTRACT FROM AUTHOR]

The current study aims to investigate the relationship between perception of job insecurity and its various outcomes based upon the research model proposed by Charkhabi in 2017 and validated among three countries (USA, Iran, Belgium). It also focuses to investigate the possible role of Trust (TRS) on leadership as a moderator, while Psychological Contract Breach (PCB) as a mediator to explain this relationship. In the final step Boundary Less Career Orientation (BCO) is used as moderated mediation between the effect of JI and outcomes. The Model is based upon three different theories, as Social Exchange theory (SET) is based to explain the relationship between (PCB) and job out comes, While Conservation of Resource Theory (COR) is use to validate the moderating role of (BCO). Finally Stress Theory (STH) was applied to investigate the role of trust as a moderator. Data was obtained from Higher Education Sector. Adopted questionnaires after validation through CFA were used, and response was analyzed through Preacher and Hayes, 2008 modeling. Results indicate that PCB effectively mediates the relationship between JI and various outcomes (Burnout, Effective Commitment, Life Satisfaction, Psychological Coping Reaction, Work Satisfaction, and Psychological Distress). On other side (BCO) moderate differently the relationship between Pharmaceutical and Education sector. Even some of the moderation results were positive but in opposite direction. Finally trust in management (Leaders) moderation findings indicate that it buffer the relationship between JI and specific out comes, as Trust is negatively associated with Burnout, psychological distress, normative commitment and coping reaction, while positively associated with employees effective commitment, supervisor satisfaction, and life satisfaction. [ABSTRACT FROM AUTHOR]

Objective: The aim of the study was to see the radiographic appearance (erosions and joint space narrowing [JSN]) in hand and foot joints of patients of rheumatoid arthritis (RA)coming to a tertiary care hospital in Islamabad, Pakistan. Study Design: Cross-sectional descriptive study. Place and Duration of Study: The study was conducted in Department of Rheumatology at Pakistan Institute of Medical Sciences from June, 2013 till December, 2013. Subjects and Methods: Both male and female patients of RA coming to Rheumatology outpatient department were recruited in the study after taking their consent. X-rays of both hands and feet were performed in each of these patients. These X-rays were scored using simple erosion narrowing score. Results: There were total 153 patients in the study, 121 (79.10%) females and 32 (20.90%) males. The mean duration of RA was 6.36 ± 5.47 years. Joint erosions were found in 142 (92.81%) patients. All of these 142 (100%) patients had hand joint erosions. Only 63 (44.36%) patients had foot joint erosions as well. Radiographic changes (combined erosions and JSN) were found in 3712 (39.13%) hand joints and 335 (9.12%) foot joints. Conclusion: Both erosions and JSN were seen predominantly in hand joints of our RA patients, with the foot joints showing much less radiographic changes. Therefore, doing X-Rays of only hands may be sufficient in RA patients for diagnostic and prognostic purposes. [ABSTRACT FROM AUTHOR]

Objective We present 13 patients with retroperitoneal fibrosis, focusing on clinical features, radiological characteristics, treatments and their outcomes. Methods Retrospective review of the medical records was performed of all retroperitoneal fibrosis patients diagnosed and treated in our department between 2012 and 2017. Results Twelve patients were male, with a median age of 64 years. Eleven patients presented with abdominal pain or back pain or both. Aetiologies varied from idiopathic to malignancy and vasculitis. Twelve patients had PET scans. These showed 18F-fluorodeoxyglucose-avid retroperitoneal soft tissue around the abdominal aorta in the vast majority, with five scans also demonstrating localized or generalized uptake by the aorta. In all cases except one, glucocorticoids were applied as the first-line therapy. Further immunosuppressive therapy was required in 10 cases. Conclusion Our patients were male and older in age compared with the existing literature. PET scans were very helpful in diagnosis of retroperitoneal fibrosis. Rituximab was found to be an effective treatment in six of our patients. [ABSTRACT FROM AUTHOR]