Urdu translation, cross-cultural validation and reliability of ECOS-16 questionnaire among post-menopausal women with osteopenia.

BACKGROUND: Escala de Calidad de vida Osteoporosis (ECOS-16) was originally developed in Spanish to evaluate the quality of life (QoL) in post-menopausal women (PMW) with osteoporosis or osteopenia based on the osteoporosis-specific QoL instruments. ECOS-16 has been translated into several languages, but the Urdu version is not yet available. OBJECTIVE: To translate the ECOS-16 Questionnaire into Urdu and determine its validity and reliability in PMW with osteopenia. METHODS: This was a linguistic validity and reliability study. ECOS-16 was translated into Urdu using Beaton's guidelines. Content validity was examined using Waltz's four-point ordinal scale. Twenty osteopenia-afflicted PMW aged 48-70 underwent pilot testing for face validity. Discriminant validity was determined by an independent T-test between PMW women with and without osteopenia. Convergent validity was assessed using Spearman's correlation coefficient. Cronbach's alpha and Intraclass correlation coefficient (ICC2,1) assessed internal consistency and test-retest reliability. The factor analysis was used to describe the factors. RESULTS: Each question's content validity ratio (CVR) was 0.83-1.00, while the scale's S-CVR was 0.96. Each question's Likert scale content validity index (CVI) was 0.91-0.93, while the scale's S-CVI was 0.91. Significant discriminant validity was found between groups in weeks I and II (p-value < 0.001). A correlation coefficient of 0.89 and 0.96 (p-value < 0.001) between Urdu ECOS-16 total score and SF-36 and EQ-5D scores suggests convergent validity. One component explained 83.86% of Urdu ECOS-16's variance in factor analysis. Excellent test-retest reliability (ICC2,1 = 0.990, 95% CI, 0.985-0.994, p-value < 0.001). Cronbach's alpha for standardized items was 0.995. CONCLUSION: ECOS-16 translated in Urdu is a valid and reliable questionnaire to assess QoL in PMW with osteopenia. It has a simple and easy language that can be understood easily by the Urdu-speaking population.

Gamified Exercise with Kinect: Can Kinect-Based Virtual Reality Training Improve Physical Performance and Quality of Life in Postmenopausal Women with Osteopenia? A Randomized Controlled Trial.

BACKGROUND: Osteopenia, caused by estrogen deficiency in postmenopausal women (PMW), lowers Bone Mineral Density (BMD) and increases bone fragility. It affects about half of older women's social and physical health. PMW experience pain and disability, impacting their health-related Quality of Life (QoL) and function. This study aimed to determine the effects of Kinect-based Virtual Reality Training (VRT) on physical performance and QoL in PMW with osteopenia. METHODOLOGY: The study was a prospective, two-arm, parallel-design, randomized controlled trial. Fifty-two participants were recruited in the trial, with 26 randomly assigned to each group. The experimental group received Kinect-based VRT thrice a week for 24 weeks, each lasting 45 min. Both groups were directed to participate in a 30-min walk outside every day. Physical performance was measured by the Time Up and Go Test (TUG), Functional Reach Test (FRT), Five Times Sit to Stand Test (FTSST), Modified Sit and Reach Test (MSRT), Dynamic Hand Grip Strength (DHGS), Non-Dynamic Hand Grip Strength (NDHGS), BORG Score and Dyspnea Index. Escala de Calidad de vida Osteoporosis (ECOS-16) questionnaire measured QoL. Both physical performance and QoL measures were assessed at baseline, after 12 weeks, and after 24 weeks. Data were analyzed on SPSS 25. RESULTS: The mean age of the PMW participants was 58.00 ± 5.52 years. In within-group comparison, all outcome variables (TUG, FRT, FTSST, MSRT, DHGS, NDHGS, BORG Score, Dyspnea, and ECOS-16) showed significant improvements (p < 0.001) from baseline at both the 12th and 24th weeks and between baseline and the 24th week in the experimental group. In the control group, all outcome variables except FRT (12th week to 24th week) showed statistically significant improvements (p < 0.001) from baseline at both the 12th and 24th weeks and between baseline and the 24th week. In between-group comparison, the experimental group demonstrated more significant improvements in most outcome variables at all points than the control group (p < 0.001), indicating the positive additional effects of Kinect-based VRT. CONCLUSION: The study concludes that physical performance and QoL measures were improved in both the experimental and control groups. However, in the group comparison, these variables showed better results in the experimental group. Thus, Kinect-based VRT is an alternative and feasible intervention to improve physical performance and QoL in PMW with osteopenia. This novel approach may be widely applicable in upcoming studies, considering the increasing interest in virtual reality-based therapy for rehabilitation.

Effects of kinect-based virtual reality training on bone mineral density and fracture risk in postmenopausal women with osteopenia: a randomized controlled trial.

Osteopenia is a condition characterized by low bone mineral density (BMD) that increases fracture risk, particularly among postmenopausal women (PMW). This study aimed to determine the effects of Kinect-based VRT on BMD and fracture risk in PMW with osteopenia. The study was a prospective, two-arm, parallel-design, randomized controlled trial. The study enrolled 52 participants, 26 randomly assigned to each group. In the experimental group, Kinect-based VRT was provided thrice weekly for 24 weeks for 45 min/session. Both groups were instructed to engage in a daily 30-min walk outdoors. The fracture risk assessment tool (FRAX) was used to calculate fracture risk, and dual-energy X-ray absorptiometry was used to measure lumbar spine and femur neck BMD. Both variables were assessed at baseline and 24 weeks afterwards. After 24 weeks of Kinect-based VRT, the experimental group showed significant BMD increases in the right and left femoral necks and lumbar spine (p value < 0.001). In the control group, the BMD at the right and left femoral necks showed fewer significant changes (p value < 0.022 and 0.004, respectively). In the control group, lumbar spine BMD did not change (p = 0.57). The experimental group showed significantly lower FRAX scores for hip fracture prediction (HFP) and hip prediction of major osteoporotic (HPMO) at both femoral necks (p value < 0.001) than the control group (p = 0.05 and p = 0.01, respectively), but no significant change at the left femoral neck for HFP (p = 0.66) or HPMO (p = 0.26). These findings indicate that a Kinect-based VRT intervention resulted in significantly increased BMD and a reduced fracture risk, as predicted by HFP and HPMO measurements. These improvements were more pronounced in the experimental group than in the control group. Thus, Kinect-based VRT may be utilized as an effective intervention to improve BMD and reduce fracture risk in postmenopausal women with osteopenia.

The Leading Role Of Evidence-Based Practices In The Treatment Of Patients With Substance Use Disorders: A Systematic Review.

Objective: To explore the effectiveness of motivational interviewing, motivational enhancement therapy, and cognitive behaviour therapy for patients with substance use disorders, and to estimate the effect of such comparison in patient care setting. METHODS: The systematic review was conducted from September 2021 to February 2022, and comprised search on MEDLINE, EMBASE, Web of Science, PsycINFO, Google Scholar, Science Direct, PubMed, Clinical Trials.gov and OvidSP databases for experimental studies and randomised controlled trials related to substance use disorders published in peer-reviewed English-language journals between 2001 and 2021. Quality of the studies was assessed using the Modified Cochrane Collaboration risk of the bias assessment criteria. RESULTS: Of the 314 studies initially identified, 41(13%) were subjected to full-text assessment, and, of them, 16(39%) were reviewed and analysed. There were 8(50%) studies done is the United States, 4(25%) in the United Kingdom, and 1(6.25%) each in Germany, Australia, South Korea and South Africa. All the 16(100%) studies were intervention-based, with 6(37.5%) being randomised controlled trials. There were 8(50%) studies using motivational interviewing and cognitive behaviour therapy, 5(31.25%) had significant results with a combination of motivational enhancement therapy and cognitive behaviour therapy, 3(18.75%) supported motivational enhancement therapy and cognitive behaviour therapy in combination, and 2(12.5%) studies combined motivational interviewing, motivational enhancement therapy and cognitive behaviour therapy, reporting significant results while simultaneously addressing multiple patient variables. Conclusion: All studies were heterogeneous. Motivational interviewing produced short-term treatment outcomes and played a supportive role in sustaining motivation. Motivational enhancement therapy was an effective therapeutic intervention that significantly addressed inadequate causes, and enhanced motivation for treatment. Cognitive behaviour therapy had a short-term impact and remained influential in the long term as well in handling cognitive and behavioural setbacks.

Identification of Non-steroidal Aromatase Inhibitors via In silico and In vitro Studies

INTRODUCTION: Breast cancer is the most common cancer affecting women worldwide, including Pakistan. More than half of breast cancer patients have hormone-dependent breast cancer, which is developed due to the over-production of estrogen (the main hormone in breast cancer). METHOD: The biosynthesis of estrogen is catalyzed by the aromatase enzyme, which thus serves as a target for the treatment of breast cancer. During the current study, biochemical, computational, and STD-NMR methods were employed to identify new aromatase inhibitors. A series of phenyl-3- butene-2-one derivatives 1-9 were synthesized and evaluated for human placental aromatase inhibitory activity. Among them, four compounds 2, 3, 4, and 8 showed a moderate to weak inhibitory activity (IC50 = 22.6 - 47.9 µM), as compared to standard aromatase inhibitory drugs, letrozole (IC50 = 0.0147 ± 1.45 µM), anastrozole (IC50 = 0.0094 ± 0.91 µM), and exemestane (IC50 = 0.2 ± 0.032 µM). Kinetic studies on two moderate inhibitors, 4 and 8, revealed a competitive- and mixed-type of inhibition, respectively. RESULT: Docking studies on all active compounds indicated their binding adjacent to the heme group and interaction with Met374, a critical residue of aromatase. STD-NMR further highlighted the interactions of these ligands with the aromatase enzyme. CONCLUSION: STD-NMR-based epitope mapping indicated close proximity of the alkyl chain followed by an aromatic ring with the receptor (aromatase). These compounds were also found to be non-cytotoxic against human fibroblast cells (BJ cells). Thus, the current study has identified new aromatase inhibitors (compounds 4, and 8) for further pre-clinical and clinical research.

Effectiveness of Mulligan mobilization and Kinesio-taping technique on the anterior innominate dysfunction in females.

OBJECTIVE: To determine the effects of Mulligan mobilisation with Kinesio Tex tape on pain and disability in anterior innominate dysfunction in females. METHODS: The quasi-experimental study was conducted from March to August 2018 at the Allied Hospital and Javeed Medical Complex, Faisalabad, Pakistan, and comprised women with anterior innominate dysfunction. The subjects were divided into group A, which was treated with therapeutic ultrasound, Mulligan mobilisation and Kinesio taping, and group B, which was treated with therapeutic ultrasound and Mulligan mobilisation. Data was taken at baseline and after 10 days to measure pain and disability using visual analogue scale and Modified Oswestry Disability Questionnaire. Data was analysed using SPSS 20. RESULTS: Of the 30 women, there were 15(50%) in group A with a mean age of 32.80±6.02 years and 15(50%) in group B with a mean age of 34.20±6.51 years. Both groups showed significant improvement in pain and disability post-treatment (p<0.05), with group A showing more improvement than group B in terms of disability (p=0.001), but not in terms of pain (p=0.20). CONCLUSIONS: Both Mulligan mobilisation along with Kineso Tex tape and Mulligan mobilisation alone were found to be effective in reducing pain and disability, with the tape showing better improvement in pain and disability compared to those receiving mobilisation alone.

Knowledge and attitude of Pakistani women towards antenatal exercise: A cross-sectional survey across Lahore.

Exercise has become a significant part of antenatal care. Adequate knowledge amongst pregnant females is important to encourage them to work on it. The aim of this study was to attain information on the level of knowledge, attitude and practice towards antenatal exercise amongst women in Lahore, Pakistan. This was a cross-sectional survey in which a Knowledge, Attitude and Practice (KAP) questionnaire was used to gather data from 250 pregnant females. The data was analysed using SPSS version 16.0 found the following results: relaxation and breathing n=136 (54.4%), back care exercises n=178 (71.2%) were the main known antenatal exercises. Prevention of back pain n=111 (44.4%), excess weight gain n=127 (50.8%), strengthening muscles n=141 (56.4%) and better ability to cope with labour n= 115 (46.0%) were perceived as advantages. In the survey, n= 218 (87.2%) of the females had a negative attitude towards antenatal exercises. The survey confirmed most of the pregnant females in Lahore had inadequate knowledge and a negative attitude towards antenatal exercises.

Inhibition of pluripotency networks by the Rb tumor suppressor restricts reprogramming and tumorigenesis.

Mutations in the retinoblastoma tumor suppressor gene Rb are involved in many forms of human cancer. In this study, we investigated the early consequences of inactivating Rb in the context of cellular reprogramming. We found that Rb inactivation promotes the reprogramming of differentiated cells to a pluripotent state. Unexpectedly, this effect is cell cycle independent, and instead reflects direct binding of Rb to pluripotency genes, including Sox2 and Oct4, which leads to a repressed chromatin state. More broadly, this regulation of pluripotency networks and Sox2 in particular is critical for the initiation of tumors upon loss of Rb in mice. These studies therefore identify Rb as a global transcriptional repressor of pluripotency networks, providing a molecular basis for previous reports about its involvement in cell fate pliability, and implicate misregulation of pluripotency factors such as Sox2 in tumorigenesis related to loss of Rb function.