Predicting overstriding with wearable IMUs during treadmill and overground running.

Running injuries are prevalent, but their exact mechanisms remain unknown largely due to limited real-world biomechanical analysis. Reducing overstriding, the horizontal distance that the foot lands ahead of the body, may be relevant to reducing injury risk. Here, we leverage the geometric relationship between overstriding and lower extremity sagittal segment angles to demonstrate that wearable inertial measurement units (IMUs) can predict overstriding during treadmill and overground running in the laboratory. Ten recreational runners matched their strides to a metronome to systematically vary overstriding during constant-speed treadmill running and showed similar overstriding variation during comfortable-speed overground running. Linear mixed models were used to analyze repeated measures of overstriding and sagittal segment angles measured with motion capture and IMUs. Sagittal segment angles measured with IMUs explained 95% and 98% of the variance in overstriding during treadmill and overground running, respectively. We also found that sagittal segment angles measured with IMUs correlated with peak braking force and explained 88% and 80% of the variance during treadmill and overground running, respectively. This study highlights the potential for IMUs to provide insights into landing and loading patterns over time in real-world running environments, and motivates future research on feedback to modify form and prevent injury.

Using inertial measurement units to estimate spine joint kinematics and kinetics during walking and running.

Optical motion capture (OMC) is considered the best available method for measuring spine kinematics, yet inertial measurement units (IMU) have the potential to collect data outside the laboratory. When combined with musculoskeletal modeling, IMU technology may be used to estimate spinal loads in real-world settings. To date, IMUs have not been validated for estimates of spinal movement and loading during both walking and running. Using OpenSim Thoracolumbar Spine and Ribcage models, we compare IMU and OMC estimates of lumbosacral (L5/S1) and thoracolumbar (T12/L1) joint angles, moments, and reaction forces during gait across six speeds for five participants. For comparisons, time series are ensemble averaged over strides. Comparisons between IMU and OMC ensemble averages have low normalized root mean squared errors (< 0.3 for 81% of comparisons) and high, positive cross-correlations (> 0.5 for 91% of comparisons), suggesting signals are similar in magnitude and trend. As expected, joint moments and reaction forces are higher during running than walking for IMU and OMC. Relative to OMC, IMU overestimates joint moments and underestimates joint reaction forces by 20.9% and 15.7%, respectively. The results suggest using a combination of IMU technology and musculoskeletal modeling is a valid means for estimating spinal movement and loading.

Biomechanical Tradeoffs in Foot Function From Variations in Shoe Design.

There is debate and confusion over how to evaluate the biomechanical effects of running shoe design. Here, we use an evolutionary perspective to analyze how key design features of running shoes alter the evolved biomechanics of the foot, creating a range of tradeoffs in force production and transmission that may affect performance and vulnerability to injury.

Abundance and characteristics of microplastics in a freshwater river in northwestern Himalayas, India - Scenario of riverbank solid waste disposal sites.

Microplastics (MPs) are one of the challenging and established contaminants that have adverse implications on human health. The focus of this study was to quantify and analyze the contribution of unscientific municipal solid waste (MSW) disposal sites to the MPs in the Jhelum River and the risk associated with it. Quantitative analysis of our study showed a mean MP concentration of 1474 ± 1026 particles/m3 for the entire stretch of the river. All the sites confirmed the presence of MPs with the concentration ranging from 600 particles/m3 to 2500 particles/m3. The size distribution of MPs suggested that 34 % of the microplastics ranged between 300 µm to 75 µm while 66 % of the particles varied between 300 µm to 5 mm. The concentrations of MPs downstream of unscientific disposal sites were found to increase threefold to that of upstream. The Fourier Transform Infrared Spectroscopy (FT-IR) confirmed the presence of polyethylene (PE) in the majority followed by polyvinyl chloride (PVC) and polypropylene (PP). The flakes were dominant throughout the river followed by filaments, fragments, and spherules. Count based Pollution level indexing (PLI) estimated 3-14 times MP contamination in the river with respect to contamination in glacial runoffs. The risk assessment study of the MPs indicated an increase of around 10.2 % in ingestion rates of MPs due to the unscientific disposal of MSW on the banks of the freshwater body. The values of polymer hazard index (PHI) and potential ecological risk index (PERI) were in the extreme case of pollution (PHI>1000 and PERI>1200). This study manifests the adversities of unscientific municipal solid waste disposal for timely waste management.

UWB Circular Fractal Antenna with High Gain for Telecommunication Applications.

The present study proposes a new, highly efficient fractal antenna with ultra-wideband (UWB) characteristics. The proposed patch offers a wide simulated operating band that reaches 8.3 GHz, a simulated gain that varies between 2.47 and 7.73 dB throughout the operating range, and a high simulated efficiency that comes to 98% due to the modifications made to the antenna geometry. The modifications carried out on the antenna are composed of several stages, a circular ring extracted from a circular antenna in which four rings are integrated and, in each ring, four other rings are integrated with a reduction factor of 3/8. To further improve the adaptation of the antenna, a modification of the shape of the ground plane is carried out. In order to test the simulation results, the prototype of the suggested patch was built and tested. The measurement results validate the suggested dual ultra-wideband antenna design approach, which demonstrates good compliance with the simulation. From the measured results, the suggested antenna with a compact volume of 40 × 24.5 × 1.6 mm3 asserts ultra-wideband operation with a measured impedance bandwidth of 7.33 GHz. A high measured efficiency of 92% and a measured gain of 6.52 dB is also achieved. The suggested UWB can effectively cover several wireless applications such as WLAN, WiMAX, and C and X bands.

Impact Of Restorative Material On Fracture Strength Of Root Canal Treated Teeth: An In Vitro Study.

BACKGROUND: There are several materials available in the market for the core buildup of endodontically treated teeth. The purpose of our study is to evaluate the fracture resistance of endodontically treated teeth restored with composite resin, amalgam and glass ionomer cement as core buildup materials. METHODS: Forty-eight sound-extracted mandibular premolar teeth were randomly divided into 4 groups of 12 teeth each. The first group served as a control and consisted of intact sound teeth. In all of the remaining teeth, root canal treatment was performed first. In Group II composite resin was used as the core build-up material Group III amalgam and Group IV GIC. Teeth were then subjected to fracture using a universal testing machine. RESULTS: One Way ANOVA test was performed to study the differences in the data of the four groups. The mean forces required for fracture were 1050 N for control teeth, 738 N for composite, 872 N for amalgam and 567 N for GIC. The variation is of statistical significance as depicted by a p-value of 0.003. CONCLUSIONS: The highest strength was shown by intact sound teeth. Teeth restored with composite resin and amalgam had similar strengths and those with GIC had significantly lower resistance to fracture.

Design of a Tri-Band Wearable Antenna for Millimeter-Wave 5G Applications.

A printed monopole antenna for millimeter-wave applications in the 5G frequency region is described in this research. As a result, the proposed antenna resonates in three frequency bands that are designated for 5G communication systems, including 28 GHz, 38 GHz, and 60 GHz (V band). For the sake of compactness, the coplanar waveguide (CPW) method is used. The overall size of the proposed tri-band antenna is 4 mm × 3 mm × 0.25 mm. Using a watch strap and human tissue, such as skin, the proposed antenna gives steady results. At 28 GHz, 38 GHz, and 60 GHz, the antenna's gain is found to be 5.29 dB, 7.47 dB, and 9 dB, respectively. The overall simulated radiation efficiency is found to be 85% over the watch strap. Wearable devices are a great fit for the proposed tri-band antenna. The antenna prototype was built and tested in order to verify its performance. It can be observed that the simulated and measured results are in close contact. According to our comparative research, the proposed antenna is a good choice for smart 5G devices because of its small size and simple structure, as well as its high gain and radiation efficiency.

Mortality in Hip Fracture Patients During the COVID-19 Pandemic: A Retrospective Analysis in a District General Hospital in the United Kingdom.

Introduction Hip fracture is commonly seen in elderly patients because of low-energy trauma. It carries significant morbidity and mortality. Scoring systems such as the Nottingham hip fracture score (NHFS) have shown a good correlation with increased mortality as the value of these scores increases. In our study, we aim to ascertain the hip fracture mortality in our population, compare the mortality in hip fractures compared to previously reported figures in literature and nationally reported figures during the first year of the COVID-19 pandemic, and also ascertain the usefulness of NHFS in predicting mortality in hip fractures. Methods We gathered mortality data on hip fracture patients admitted to our unit from January 1, 2020 to December 31, 2020. NHFS was calculated for all patients and the 30-day mortality rate was compared to previously reported hip fracture mortality rates using the standard mortality ratio (SMR). One-year mortality was stratified by placing patients in high and low NHFS groups. The log-rank test was used to compare hip fracture survival at one month and at one year in the high NHFS (NHFS >4) group and low NHFS group (NHFS value 4 or below). Additionally, a log-rank test was used to compare one-month and one-year survival in hip fractures managed with hemiarthroplasty, dynamic hip screw and intramedullary nail. Results In 2020, 388 patients were admitted with hip fractures to our unit. The crude mortality rate was 3.9% at 30 days and 20.88% at one year. Compared to the National Hip Fracture Database report for 2020, the incidence risk ratio for mortality was 0.46 (p-value<0.05). The SMR at 30 days was 0.34 (CI=0.17-0.51) and the SMR at one year was 0.63 (CI=0.49-0.77). The survival rate was higher at 30 days and one year in the low NHFS group compared to the high NHFS group (p-value<0.01). The survival rate at one month and one year were similar in groups managed with hemiarthroplasty, dynamic hip screws, and intramedullary nails (p-value>0.05). Conclusions Hip fracture mortality has been decreasing steadily and we noted a lower rate of hip fracture mortality compared to figures reported previously as per NHFS studies even though the study was conducted during the COVID-19 pandemic period. We also noted lower 30-day mortality in our hospital as compared to the national 30-day mortality rate for hip fracture patients in 2020.

Impact of COVID-19 Pandemic on the Length of Hospital Stay in Hip Fracture Patients: A Single Centre Study.

Background Hip fracture is a debilitating injury, especially in older individuals, which is associated with significant morbidity and mortality. In recent decades, there has been a great focus on early rehabilitation and discharge after hip fractures. The aim of such efforts is to minimize the financial and clinical burden of this condition. We conducted our study during the COVID-19 pandemic and compared the length of hospital stay (LOS) in 2020 to the LOS in 2019. Additionally, we studied the factors which may impact the LOS, such as premorbid status according to established scoring systems, the type of fracture, an operation performed, and time to surgery. Methods We collected the data regarding the length of stay (in days) for all hip fracture patients admitted to our unit from 1st January 2019 until 31st December 2020. We then compared the mean LOS for both years using the t-test. We calculated the Nottingham Hip Fracture Score (NHFS) and American Society of Anaesthesiologists (ASA) scores for patients admitted in 2020 and calculated the correlation between increasing values of these scores and the LOS. We also compared the mean LOS for patients admitted in 2020 based on the type of fracture and type of management. We studied the correlation between the time to surgery and the LOS for patients admitted in 2020. Results Three hundred and eighty-eight patients were admitted with hip fractures in 2020, and 452 were admitted in 2019. LOS in 2020 was significantly lower (23.39 days) compared to 2019 (31.36 days) with p<0.01. While evaluating data from 2019, it was noted that there was a small positive correlation between LOS and NHFS (r=0.231, p<0.001) and LOS and ASA (r=0.18, p<0.001). The mean LOS for intracapsular fractures was noted to be lower than that of extracapsular fractures, but this was not statistically significant (p=0.17). An ANOVA test showed that the mean LOS for patients undergoing hemiarthroplasty, dynamic hip screws (DHS), and intramedullary nails (IMN) was significantly longer than for patients managed with total hip replacement or patients managed non-operatively (F=3.551, p<0.01). Conclusion Hip fracture patients admitted to our department were discharged quicker during the first year of the COVID-19 pandemic. The LOS for hip fractures increases with an increase in their NHFS or ASA scores. Extracapsular and intracapsular fractures lead to roughly the same periods of inpatient stay. Patients undergoing hemiarthroplasty, DHS, or IMN stay longer in the hospital compared to other treatment modalities.

Comparison of Lateral and Crossed K-wires for Paediatric Supracondylar Fractures: A Retrospective Cohort Study.

Background Supracondylar elbow fractures occur most frequently in children aged five to seven years and have equal incidence in both genders. They are classified as flexion or extension type injuries with extension type being more common. We aimed to ascertain radiological stability with lateral and crossed wires in this study. We also identified any complications after operative management of these injuries. Methods As part of this retrospective cohort study, we identified all patients who presented with this injury from January 1, 2020, until February 28, 2022. Basic demographic data and type of operation were noted. Baumann angle (BA) and lateral capitellohumeral angle (LCHA) were measured intra-operatively and x-rays were done at the final clinic appointment. The mean of these angles in lateral and crossed wire groups was compared using paired sample t-test. Unpaired t-test was used to compare the means of both groups with normal values for these angles based on previous studies (BA=71.5±6.2 degrees, LCHA= 50.8±6 degrees). Results Fifty patients were admitted during this period. Thirty-three patients had lateral wires and 17 had crossed wires for fixation. No significant change was noted in the mean BA and mean LCHA in both groups on x-rays done intra-operatively and final clinic follow-up (no loss of reduction). No significant difference was noted between BA and LCHA noted for both groups at the final clinic follow-up with previous studies outlining normal values for these angles. No cases of iatrogenic neurovascular injury were identified. Four patients (8%) were referred to physiotherapy due to stiffness. Conclusion Both lateral and crossed wire configurations led to achievement of good radiological stability with BA and LCHA within normal limits. No loss of reduction was noted with both techniques and no risk of iatrogenic nerve injuries was noted in experienced hands.

Computational studies on phylogeny and drug designing using molecular simulations for COVID-19.

Since the first appearance of a novel coronavirus pneumonia (NCP) caused by a novel human coronavirus, and especially after the infection started its rapid spread over the world causing the COVID-19 (coronavirus disease 2019) pandemics, a very substantial part of the scientific community is engaged in the intensive research dedicated to finding of the potential therapeutics to cure this disease. As repurposing of existing drugs represents the only instant solution for those infected with the virus, we have been working on utilization of the structure-based virtual screening method to find some potential medications. In this study, we screened a library of 646 FDA approved drugs against the receptor-binding domain of the SARS-CoV-2 spike (S) protein and the main protease of this virus. Scoring functions revealed that some of the anticancer drugs (such as Pazopanib, Irinotecan, and Imatinib), antipsychotic drug (Risperidone), and antiviral drug (Raltegravir) have a potential to interact with both targets with high efficiency. Further we performed molecular dynamics simulations to understand the evolution in protein upon interaction with drug. Also, we have performed a phylogenetic analysis of 43 different coronavirus strains infecting 12 different mammalian species.Communicated by Ramaswamy H. Sarma.

Ameloplasty is counterproductive in reducing microleakage around Resin Modified Glass Ionomer and Resin based fissure sealants.

OBJECTIVE: To compare the microleakage around resin modified glass ionomer cement (RMGIC) based sealants and flowable resin based sealants placed with or without ameloplasty in extracted human teeth. METHODS: This in-vitro experimental study was conducted at the Operative Dentistry Department, Dow University of Health Sciences, Karachi, Pakistan from June 2017 to December 2018. Sixty extracted human molars and premolars were assigned to four groups (n=15) each, according to the type of fissure sealant (flowable resin based sealant or resin modified glass ionomer based sealant) used and either placed with or without ameloplasty. Specimens were thermocycled and then immersed in 1% methylene blue for 24 hours. Specimens were then sectioned and examined using stereo-microscope (50X) for microleakage that was scored on an ordinal scale. Mann-Whitney U test and Ordinal regression were applied. Level of significance kept at 0.05. RESULTS: There was a statistically significant difference (p-value <0.001) between the two sealant types for the microleakage scores. Sealants placed with ameloplasty demonstrated significantly higher microleakage values (p-value <0.001). CONCLUSION: Microleakage was found to be more pronounced in RMGIC based sealants compared to the resin based sealants. Ameloplasty resulted in higher leakage around the sealants irrespective of the chemistry of material.

Accuracy of working length measurement with endo motor having built-in apex locator and comparison with periapical radiographs.

OBJECTIVE: To determine the accuracy of working length measurement with endomotor having builtin apex locator by comparing it with periapical radiographs. METHODS: The cross-sectional study was conducted at the Department of Operative Dentistry, Dr Ishrat-ul-Ibad Khan Institute of Oral Health Sciences, Dow University of Health Sciences, Karachi, from January to June 2014, and comprised permanent maxillary anterior teeth with mature apices. A preoperative radiograph was taken by using standardised paralleling technique. The access cavity was prepared by a high speed water-cooled diamond bur. After doing initial filing and drying the canal, the working length was taken with an endomotor with built-in apex locator in dual mode using the Protaper Rotary File S1. The length was measured using a millimeter scale. After attaining tentative working length from the pre-operative radiograph, 1mm was subtracted from the radiographic apex. A stainless steel K-file was placed in the canal at this length and a radiograph was taken by paralleling technique using intraoral film holder. The electronic and radiographic findings were noted. Accuracy was considered positive if the endomotor reading was 0-2mm short of the radiographic working length. Data was analysed using SPSS 16. RESULTS: Of the 96 cases, working length with X-Smart Dual was acceptable in 85(88.5%) cases, and unacceptable in 11(11.5%) cases. CONCLUSIONS: Accuracy of working length measurement with endomotor having built-in apex locator was found to be a better measuring tool compared to the conventional periapical radiographs.

Stiffness of the human foot and evolution of the transverse arch.

The stiff human foot enables an efficient push-off when walking or running, and was critical for the evolution of bipedalism1-6. The uniquely arched morphology of the human midfoot is thought to stiffen it5-9, whereas other primates have flat feet that bend severely in the midfoot7,10,11. However, the relationship between midfoot geometry and stiffness remains debated in foot biomechanics12,13, podiatry14,15 and palaeontology4-6. These debates centre on the medial longitudinal arch5,6 and have not considered whether stiffness is affected by the second, transverse tarsal arch of the human foot16. Here we show that the transverse tarsal arch, acting through the inter-metatarsal tissues, is responsible for more than 40% of the longitudinal stiffness of the foot. The underlying principle resembles a floppy currency note that stiffens considerably when it curls transversally. We derive a dimensionless curvature parameter that governs the stiffness contribution of the transverse tarsal arch, demonstrate its predictive power using mechanical models of the foot and find its skeletal correlate in hominin feet. In the foot, the material properties of the inter-metatarsal tissues and the mobility of the metatarsals may additionally influence the longitudinal stiffness of the foot and thus the curvature-stiffness relationship of the transverse tarsal arch. By analysing fossils, we track the evolution of the curvature parameter among extinct hominins and show that a human-like transverse arch was a key step in the evolution of human bipedalism that predates the genus Homo by at least 1.5 million years. This renewed understanding of the foot may improve the clinical treatment of flatfoot disorders, the design of robotic feet and the study of foot function in locomotion.

Comparison of Retrograde, Primary and Secondary Bonding Materials with Tooth Substance.

OBJECTIVE: To compare the microleakage of MTA (mineral trioxide aggregate) and resin-modified GIC (glass ionomer vitremer) as retrograde endodontic material. STUDY DESIGN: Experimental study. PLACE AND DURATION OF STUDY: Operative Department of DIIKIOHS (DUHS) and NED University, Karachi, from February to June 2014. METHODOLOGY: Forty human anterior teeth were divided into four groups. Each tooth was endodontically treated. Apical cavity preparations were performed on all teeth. The retropreparations were filled either with MTA (Group 1), Vitremer (Group 2), or only covered with nail polish (Group 3). The root surfaces of the first three groups were coated with nail polish. In Group 4 (positive control), neither retrograde filling was placed nor the nail polish was applied. The teeth were then suspended in 2% methylene blue dye solution for 10 days at 37°C. Sections were made along the long axis of teeth to determine the depth of linear dye penetration. Using Mann-Whitney test the comparison, p-value <0.05 was considered as statistically significant. RESULTS: MTA had no significant difference in apical dye leakage (p = 0.122) than did the vitremer. CONCLUSION: MTA is equivalent to vitremer in preventing microleakage when used as retrograde filling material.

An In-VitroEvaluation of Microleakage at the Cervical Margin Between two Different Class II Restorative Techniques Using Dye Penetration Method.

OBJECTIVE: To evaluate the coronal microleakage of packable composite using conventional incremental and posterior bulk fill flowable composite using Smart Dentine Replacement Single Step technique in the cervical margins of class II cavities in dentine using the dye penetration method. STUDY DESIGN: In-vitroInterventional study. PLACE AND DURATION OF STUDY: Department of Operative Dentistry, Dr. Ishrat-ul-Ebad Khan Institute of Oral Health Sciences (DIKIOHS), Karachi, from November 2012 to April 2013. METHODOLOGY: One hundred and twenty extracted teeth (molars and premolars) were collected and randomly divided into two experimental groups (n=60 each) and were stored in normal saline until used. Fractured samples were excluded. Standardized class II proximal box only cavities were prepared and restored with conventional methacrylate based composite using incremental technique (Group A, n=40) and low stress methacrylate resin based composite SDR using single step technique (Group B, n=40). Samples were sectioned horizontally below the cervical margins and specimen disks were prepared. The specimens were thermocycled and sealed with acid resistant varnish leaving a 1-mm interface around cervical margin and immersed in 2% methylene blue buffered solution for 24 hours. Leakage was scored 0 - 4 and measured in mm. It washed and sectioned to evaluate under stereomicroscope. RESULTS: Mean penetration was 2.4280 ±0.79 mm for Group Aand 1.015 ±0.45 mm for Group B (p < 0.001). Maximum dye penetration score for group Awas 4 and group B was 3. CONCLUSION: SDR technique in combination with total etch technique at the cervical margin of class II restorations improved the marginal seal, when were placed in dentine and thermocycled.

The forgotten disease - Lemierres syndrome.

Lemierre's syndrome refers to septic thrombosis of deep veins of the neck, is a rare and often life threatening complication following upper respiratory tract infections. We present here a case of Lemierre's syndrome in a previously healthy 30 years old female who had a febrile illness for two weeks with associated dysphagia, hoarse voice and right sided neck swelling. She was investigated for retropharyngeal and parapharyngeal abscess, granulomatosis with polyangiitis, tuberculosis and thyroiditis but finally concluded as Lemierre's syndrome based on the findings of thrombosis of the deep neck veins following respiratory tract infection, septic pulmonary emboli and clinical recovery with antibiotics and supportive care. Lemierres syndrome can be fatal if diagnosis and treatment is delayed. Strong clinical suspicion leads to early diagnosis and may prevent life threatening organ dysfunction.

Effect of different tetra pack juices on microhardness of direct tooth colored-restorative materials.

PURPOSE: To examine the effect of apple and orange juices on the surface hardness of direct tooth-colored restorative materials. MATERIALS AND METHODS: The materials included resin-modified glass ionomer cement (Vitremer 3M™ ESPE™ Core buildup restorative) and composite resin (Filtek™ 3M™ ESPE™ Z350). A total of 45 disks of each restorative material were prepared. The disks were divided into groups of 15, which were immersed for 7 days in deionized water (G1/G4, control group), apple juice (G2/G5), or orange juice (G3/G6). The pH of the apple juice was approximately 4.8 and the pH of the orange juice was approximately 4.9. Surface hardness tests were performed before immersion and at various times following immersion. Statistical analysis included two-way ANOVA with repeated measurement and Tukey's test. RESULTS: Exposure to juices significantly reduced the hardness of both materials (p < 0.05), while deionized water did not affect the surface hardness of either material. The ionomer cement experienced a greater reduction than the composite resin (p = 0.000). There was no significant difference in the effect of apple and orange juices. CONCLUSION: Juice box-type fruit juices reduced the hardness of direct tooth-colored restorative materials. Material selection should be considered when planning restorations in patients who have experienced tooth surface loss. In terms of the materials evaluated in this study, the composite material provides greater durability under acidic conditions.

Knowledge and awareness of harmful effect of substance abuse among users and non-users: a cross-sectional study from Bari Imam.

OBJECTIVES: To determine the prevalence of substance abuse among adult population of Nurpur Shahan and assess the participants' knowledge and awareness regarding substance abuse. METHODS: This was a cross-sectional study conducted in the households of Nurpur Shahaan, adjacent to Bari Imam on the outskirts of Islamabad, Pakistan, during January 2010. A structured questionnaire was used and 200 adults of ages 18 and above were assessed about their awareness of substance abuse, its social effects and health hazards. All collected data was entered into SPSS ver. 10. The independent variables in the study were age, gender, marital status, social class, education level and knowledge of substance abuse. The dependent variables were substance abuse, type of substance abuse, attitude towards using and attitude towards quitting. RESULTS: Out of the 200 adults consenting to participate in the survey, 65 (33%) were reported to suffer from substance abuse, while 135 (67%) claimed not to be in the habit. Awareness about the dangers of substance abuse was higher among non-users (59.4%) as compared to the users, but 40.6% users continued to use drugs despite knowing that adverse effects would follow. Non-user respondents were more aware of the risks involved (75.8%) than the users (23.4%). It remained unclear whether anxiety and depression were an outcome of addiction or a defence mechanism to perpetuate maladaptive behaviour of substance abuse. CONCLUSIONS: Substance abuse is prevalent among the lower and lower middle classes of Pakistan, with a propensity among male victims, to blame external circumstances, which they feel are beyond their control.

Health related quality of life in pregnant women: a comparison between urban and rural populations.

OBJECTIVE: To study mental and physical health of pregnant women and compare the differences between those residing in urban and rural settings. METHODS: A Cross-Sectional Survey was conducted on pregnant women (n=179) in urban and rural areas of Islamabad in January 2009. SF-12, a validated instrument for mental and physical health assessment was used and translated into Urdu. Responses were decoded as per SF-12 analysis protocol. Independent sample t-test was done to compare the quantitative variables. The level of statistical significance was p<0.05. The survey was filled either by the participant or the research team and was anonymous. All the researchers were trained in the interview technique in order to make sure that each question carried the same meaning during the actual survey. This was done to standardize the survey methodology. RESULTS: A total of 179 survey forms were collected, 83 and 96 from both rural and urban areas respectively. Role Limitations because of Physical Problems (p=0.020), General Health Perceptions (p=0.001) and Role Limitations because of Emotional Problems (p=0.023) had statistically significantly lower scores in rural women as compared to urban women. CONCLUSION: Self-perceived mental and physical health was better in urban pregnant women than in rural women.