Journal of Health Wellness and Community Research

Background: Emotional abuse and gaslighting in romantic relationships are increasingly recognized as serious threats to young adults’ mental health, yet limited empirical research has explored their independent and combined effects, particularly within non-Western cultural contexts. Objective: This study aimed to examine the relationships among gaslighting, emotional abuse, and mental well-being in young adults involved in romantic relationships, and to evaluate their predictive effects and potential gender differences. Methods: A cross-sectional correlational design was employed with a sample of university students (n = 204; 108 men, 96 women), aged 18–35, from the University of Management and Technology, Lahore. Participants currently or previously involved in a romantic relationship of at least four months were included. Standardized tools—the Gaslighting Relationship Exposure Inventory, the Emotional Abuse Questionnaire, and the Warwick–Edinburgh Mental Well-Being Scale—were administered. Ethical approval was obtained from the UMT Ethics Committee in accordance with the Declaration of Helsinki. Statistical analyses were conducted using SPSS v27, employing Pearson correlation, multiple linear regression, and independent t-tests. Results: Emotional abuse significantly predicted reduced mental well-being (β = −0.30, p < .01), while gaslighting, though correlated with both emotional abuse (r = 0.49, p < .01) and mental well-being (r = −0.15, p < .01), was not a significant predictor. No gender differences were observed across variables. Conclusion: Emotional abuse exerts a stronger negative impact on mental well-being than gaslighting, though both are harmful. These findings underscore the need for early psychosocial screening and gender-inclusive interventions targeting emotional abuse in young adult populations.

Background: Office workers are at high risk of developing low back pain due to prolonged sitting and sedentary work patterns, which can negatively impact functional ability, stress levels, and overall well-being. Although yoga has shown benefits for chronic musculoskeletal conditions, the feasibility and effectiveness of chair-based yoga within occupational settings remain underexplored. Objective: To evaluate the short-term effects of chair yoga therapy on pain intensity, functional ability, and perceived stress among office employees with low back pain. Methods: A single-group pre–post observational study was conducted at Gulf Medical University, Ajman, UAE, from September to November 2023. Thirty-one employees aged 25–60 years with self-reported low back pain and no prior chair yoga experience were enrolled. Participants completed six sessions of chair yoga over three weeks. Outcomes included Visual Analog Scale (VAS) for pain, Back Pain Functional Scale (BPFS) for function, and Perceived Stress Scale (PSS) for stress, measured pre- and post-intervention. Data were analysed using paired t-tests with effect sizes and 95% confidence intervals. Results: Chair yoga did not significantly reduce VAS pain scores (mean change −0.29, p=0.161). However, BPFS improved significantly by 6.78 points (p<0.001, d=1.12), and PSS decreased by 5.75 points (p<0.001, d=1.01). Conclusion: Chair yoga produced meaningful improvements in functional ability and stress reduction, though no significant short-term analgesic effect was observed. Its accessibility and workplace adaptability support its integration into occupational health programs.

Background: Upper Cross Syndrome (UCS) is an increasingly recognized postural disorder characterized by muscle imbalance, often associated with sedentary occupations and poor ergonomic practices. Despite its clinical significance, there is limited evidence regarding the prevalence and impact of UCS among working women in low- and middle-income urban environments. Objective: This study aimed to determine the prevalence of Upper Cross Syndrome and assess its association with posture changes and functional limitations among working women in Karachi. Methods: A cross-sectional observational study was conducted with 180 working women, aged 20–60 years, from diverse occupational settings in Karachi. Postural assessment was performed using the Reedco tool, and functional status was evaluated via the Modified Oswestry Neck Disability Index. Logistic regression was used to identify significant predictors of UCS, adjusting for demographic and occupational factors. Results: The prevalence of UCS was 6.1%. Functional difficulties in lifting (OR 2.23, p = 0.015), personal care (OR 2.30, p = 0.007), and disturbed sleep (OR 1.76, p = 0.002) were significantly associated with UCS. Age and headache frequency were not significant predictors. Moderate pain and postural deviations were prominent among affected individuals. Conclusion: UCS represents a relevant occupational health issue among working women in Karachi, with functional impairment and poor posture as key risk factors. Workplace ergonomic interventions are recommended to reduce the burden of UCS.

Background: Pain and anxiety associated with local anesthetic injection remain persistent challenges in dental practice, often deterring patients from seeking timely treatment. While various pharmacological and non-pharmacological approaches have been employed to mitigate injection-related pain, their effectiveness remains inconsistent. Low-level laser therapy (LLLT), a form of photobiomodulation, has demonstrated analgesic, anti-inflammatory, and tissue-healing properties in multiple clinical contexts, but its efficacy in reducing pain during anesthetic administration is inconclusive. Objective: This study aimed to evaluate whether pre-treatment with LLLT reduces pain intensity at the injection site of local anesthesia in adult patients undergoing endodontic procedures. Methods: A randomized controlled split-mouth trial was conducted on 30 adult patients requiring bilateral endodontic treatment. Each patient received LLLT (635 nm, 10 J/cm², 210 mW, four 25-second cycles) on one side before anesthetic injection, while the opposite side served as a control. Pain intensity was measured immediately after injection using a 10 cm Visual Analogue Scale (VAS). Data were analyzed with the Mann-Whitney U test for group comparisons and subgroup analyses by age and gender, with a significance threshold of p<0.05. Results: The mean VAS pain score was 6.80 ± 1.24 for the LLLT-treated side and 6.93 ± 1.46 for the control side, with no statistically significant difference (p=0.612). Female participants reported higher pain scores than males in both groups, and younger patients experienced more intense pain compared with older participants. No participant reported complete absence of pain. Conclusion: Pre-treatment with LLLT did not significantly reduce injection-site pain compared with standard practice. Age and gender appeared to influence pain perception, but these trends were not statistically significant. Larger, multicenter trials with optimized laser parameters and stratified analysis are recommended to further investigate the clinical utility of LLLT in dental pain management

Background: Self-medication among university students is a growing public health concern, particularly in settings where prescription medicines are easily accessible and digital health information is widely used. The rapid adoption of AI chatbots and online platforms may further influence self-diagnosis and self-prescription practices. Objective: To determine the prevalence and pattern of self-medication among university students in Lahore, Pakistan, and assess its association with AI chatbot and internet-based health information use. Methods: A cross-sectional descriptive-analytical study was conducted among 451 medical and non-medical university students in Lahore. Data were collected using a structured self-administered questionnaire assessing sociodemographic characteristics, AI and internet use, self-medication practices, knowledge, attitudes, drug categories, adverse effects, and actions after adverse effects. Associations were analyzed using chi-square tests, odds ratios, 95% confidence intervals, and effect sizes where applicable. Results: Online symptom searching was reported by 363 students (80.5%), internet-based self-diagnosis by 319 (70.7%), and online self-prescription by 254 (56.3%). Medical students had higher odds of online symptom searching, internet-based self-diagnosis, online self-prescription, and antibiotic self-medication. Antibiotics were the most common self-medicated drug category (51.4%), and adverse effects were reported by 255 students (56.5%). Conclusion: AI and internet-based health information use is highly prevalent and associated with self-medication behaviors among university students in Lahore. Targeted AI health literacy, antimicrobial stewardship education, and stronger regulation of prescription-only medicines are needed.

Background: Chronic non-specific neck pain is highly prevalent among working women and is commonly associated with pain, reduced cervical endurance, sleep disturbance, and functional disability. Exercise-based rehabilitation is widely used, and Pilates has shown potential benefit, but the added value of breathing re-education remains insufficiently defined. Objective: To evaluate the effectiveness of Pilates exercises combined with breathing re-education on pain intensity, deep cervical flexor endurance, sleep disturbance, and neck-related disability in working women with chronic non-specific neck pain. Methods: A parallel-group randomized controlled trial was conducted at Ghurki Trust Teaching Hospital, Lahore, from June 2024 to January 2025. Fifty-six participants were randomized, and 52 completed the study. Participants were allocated to either Pilates plus breathing re-education or Pilates alone for 6 weeks, with supervised sessions conducted three times weekly. Outcomes included Numeric Pain Rating Scale, Craniocervical Flexion Test, Insomnia Severity Index, and Neck Disability Index-Urdu, assessed at baseline, week 3, and week 6. Results: The combined intervention demonstrated greater improvement than Pilates alone across all outcomes by week 6. Pain decreased from 5.58±0.50 to 3.03±0.45 versus 5.42±0.70 to 4.15±0.61, endurance increased from 18.42±1.27 to 22.46±1.17 mmHg versus 18.35±1.09 to 19.38±1.06 mmHg, ISI decreased from 17.38±3.51 to 11.65±3.19 versus 18.73±2.63 to 16.38±2.45, and NDI decreased from 24.73±5.35 to 13.46±5.51 versus 24.08±4.76 to 20.65±4.54. Significant between-group and time effects were reported for major endpoints. Conclusion: Pilates combined with breathing re-education was more effective than Pilates alone in improving pain, endurance, sleep disturbance, and disability over six weeks in working women with chronic non-specific neck pain.

Background: Laser technology has gained increasing relevance in modern dentistry due to its precision, minimally invasive nature, and favourable patient outcomes; however, its routine adoption in developing countries remains limited. Objective: To evaluate the level of knowledge, awareness, and perception of laser dentistry among undergraduate dental students and dental professionals in Pakistan and to identify perceived barriers to its clinical implementation. Methods: A descriptive cross-sectional survey was conducted among 263 dental students and practitioners across Pakistan using a structured, self-administered online questionnaire. Data on demographics, knowledge, perceptions, and perceived barriers related to laser dentistry were collected and analysed using descriptive and inferential statistics. Results: Although 61.6% of participants reported awareness of laser applications in dentistry, only 25.1% had practical experience. Most respondents perceived laser dentistry as providing greater precision (87.8%), patient comfort (85.2%), and improved treatment quality (89.4%). Dental professionals demonstrated significantly higher awareness and usage compared with students. High equipment cost (78.0%) and lack of training opportunities (57.4%) were the most commonly reported barriers. Conclusion: While attitudes toward laser dentistry among dental trainees and professionals in Pakistan are highly positive, limited training exposure and structural constraints restrict its widespread clinical adoption. Strengthening curricular integration and expanding accessible training opportunities may enhance effective implementation of laser-assisted dental care.

Background: Plantar fasciitis (PF) is a prevalent cause of heel pain that compromises gait and occupational functioning. Teachers experience prolonged standing on hard surfaces, yet quantitative links between PF severity and work productivity in this workforce remain under characterized. Objective: To estimate the apparent prevalence of PF in a convenience sample of teachers and assess the association of PF severity with work productivity and activity limitation. Methods: A cross-sectional study (March–August 2025) enrolled teachers aged 30–45 years from institutions in Sialkot, Daska, Gujranwala, and Hafizabad. Eligibility required 7–8 working hours/day and routine use of hard, non-cushioned footwear. PF was examined using the Windlass test; pain and function were measured by the Plantar Fasciitis Pain/Disability Scale (PFPS; 0–100, higher worse), and productivity by the Work Productivity and Activity Impairment (WPAI) questionnaire over the past 7 days. Spearman’s ρ estimated associations. Results: Of 318 participants (29.6% male; mean age 34.9 years), 122 were Windlass positive, yielding an apparent prevalence of 38.4% (95% CI 33.2–43.8). PFPS correlated with WPAI absenteeism (ρ=0.455; p<0.001), presenteeism (ρ=0.569; p<0.001), overall work impairment (ρ=0.455; p<0.001), and total activity limitation (ρ=0.601; p<0.001). Windlass positivity showed smaller associations: absenteeism (ρ=0.182; p<0.001), presenteeism (ρ=0.380; p<0.001), overall work impairment (ρ=−0.179; p<0.001), and activity limitation (ρ=0.386; p<0.001). Conclusion: In this teacher cohort, greater PF severity—especially by PFPS—was associated with higher presenteeism and activity limitation. Findings support symptom–function screening and ergonomic interventions; generalizability is limited by the exposure-conditioned, convenience design.

Background: Antimicrobial resistance (AMR) represents a critical threat to global health, with drug-resistant infections projected to cause more deaths than cancer by 2050. Conventional antibiotics are increasingly failing due to misuse, overprescription, and the rapid evolution of resistance mechanisms. At the same time, innovation in antibiotic discovery has stagnated, creating an urgent need for alternative therapeutic strategies. Plant-derived phytochemicals have gained attention for their structural diversity, multi-target modes of action, and potential to reverse resistance mechanisms. Objective: This review aims to comprehensively evaluate the potential of plant-derived phytochemicals as novel antimicrobial agents and resistance-modifying adjuvants, highlighting their mechanisms of action, synergistic potential with conventional antibiotics, clinical applications, and translational challenges. Methods: A narrative review methodology was employed, sourcing relevant studies from PubMed, Scopus, Web of Science, and Google Scholar (2000–2025). Inclusion criteria focused on studies investigating the antimicrobial activity, molecular targets, synergistic interactions, and clinical relevance of plant-derived compounds. Results: Phytochemicals demonstrated activity across a wide microbial spectrum by inhibiting efflux pumps, disrupting membranes, interfering with DNA and protein synthesis, and enhancing antibiotic efficacy. Several compounds have progressed to clinical evaluation, showing efficacy in infections such as UTIs, respiratory diseases, and gastrointestinal infections. Conclusion: Plant-derived phytochemicals offer a promising adjunct or alternative to conventional antibiotics. Further mechanistic studies, optimized formulations, and rigorous clinical trials are essential for clinical translation.

Background: Regenerative dentistry, an emerging branch of dental science, focuses on biological restoration of oral tissues using advanced techniques such as stem cell therapy, tissue engineering, platelet-rich plasma, and guided tissue regeneration. While these approaches are widely recognized internationally, their clinical adoption remains inconsistent in developing countries like Pakistan due to training, cost, and infrastructure limitations. Objective: This study aimed to assess the awareness, knowledge, and adoption of regenerative dentistry among dental students and practitioners in Pakistan and to identify barriers that hinder its integration into routine clinical practice. Methods: A descriptive cross-sectional study was conducted from June to September 2025 using a structured, close-ended online questionnaire distributed among dental professionals and senior undergraduate students across Pakistan. Convenience sampling yielded 204 responses. Data were analyzed using descriptive and inferential statistics in SPSS v27 to determine awareness levels, clinical adoption rates, and perceived barriers. Results: Of 204 respondents, 91.7% were aware of regenerative dentistry, 74.5% understood its scope, and 68.1% were familiar with its clinical applications. The most recognized approaches were stem cell therapy (79.9%) and guided tissue regeneration (73%). However, only 28.9% reported implementing regenerative endodontics and 32.8% used guided tissue regeneration clinically. Key barriers included insufficient training (66.7%), low patient awareness (62.7%), high costs (52.9%), and limited infrastructure (38.2%). Nearly all participants (98%) supported incorporating regenerative dentistry into curricula. Conclusion: Despite widespread awareness of regenerative dentistry among Pakistani dental professionals, clinical adoption remains limited due to educational, economic, and infrastructural constraints. Integrating regenerative concepts into dental curricula, enhancing hands-on training, improving resource availability, and increasing patient awareness are crucial for translating knowledge into clinical practice.

Background: Children with cerebral palsy frequently experience impaired muscle strength, mobility, and functional independence. High-intensity circuit training (HICT) may complement conventional rehabilitation, although its additional benefits remain uncertain. Objective: To compare the effects of HICT combined with conventional rehabilitation versus conventional rehabilitation alone on functional outcomes in children with spastic cerebral palsy. Methods: A two-group randomized controlled trial was conducted at the National Special Education Center, Peshawar, Pakistan, from March 2022 to March 2023. Forty-six children aged 7–15 years were allocated equally to experimental and control groups (n=23 each). Interventions were delivered three times weekly for eight weeks. Outcomes included GMFM-88, 6MWT, TUG, TUDS, MAS, and MMT. Descriptive statistics and parametric or non-parametric comparisons were reported. Results: GMFM-88 scores increased by 3.57 and 3.30 percentage points in the experimental and control groups, respectively. Walking distance increased by 17.18 and 18.52 m, while TUG time decreased by 0.57 and 0.80 s, respectively. TUDS time decreased by 1.90 and 1.63 s. The descriptive between-group differences were small and varied across outcomes. Conclusion: Both rehabilitation approaches were associated with improved functional performance. The additional effectiveness of HICT over conventional rehabilitation alone could not be established from the available comparative results

Background: Problematic smartphone use is increasingly recognized among university students and may interfere with learning and academic activities; however, evidence regarding its relationship with academic performance among nursing students remains inconsistent. Objective: To assess the relationship between smartphone addiction and academic performance among nursing students enrolled in selected private institutions in Peshawar. Methods: An analytical cross-sectional study included 103 sixth- and eighth-semester nursing students from Al Shahama Medical Institute and Rehman College of Nursing. Data were collected using a structured questionnaire covering sociodemographic characteristics, smartphone-related behaviours, and self-reported grade point average (GPA). Smartphone addiction levels and GPA categories were summarized using frequencies and percentages. Pearson's correlation was used to assess the relationship between total smartphone-addiction score and GPA, with p<0.05 considered statistically significant. Results: Of 103 participants, 83.5% were male, 72.8% were younger than 25 years, and 71.8% were single. High smartphone addiction was reported in 56.3%, while 39.8% had moderate addiction. Good academic performance was observed in 47.6% of participants. Smartphone addiction showed a negligible negative correlation with GPA (r=−0.032, 95% CI −0.224 to 0.163; p=0.752). Conclusion: Smartphone addiction was common among the participating nursing students, but no statistically significant relationship with academic performance was demonstrated.

Background: Timely nephrology referral is important for the evaluation and management of chronic kidney disease (CKD), yet delayed referral remains common in resource-limited settings. Objective: To identify demographic and clinical factors associated with delayed nephrology referral and examine referral timing in relation to renal and biochemical characteristics and the interval to dialysis initiation. Methods: This cross-sectional study included 179 adults with CKD evaluated at a tertiary nephrology unit in Peshawar, Pakistan, between December 2023 and March 2024. Patients were categorized as early (>6 months before dialysis), late (3–6 months), or ultra-late (<3 months) referrals. Demographic, socioeconomic, clinical, laboratory, and referral data were analyzed using descriptive statistics, group comparisons, and univariate logistic regression. Results: Of 179 patients, 60 (33.5%) were referred to early, 16 (8.9%) late, and 103 (57.5%) ultra-late. Late/ultra-late referral was associated with older age, male sex, rural residence, and impaired ambulation. Compared with early referral, late/ultra-late referral was characterized by higher serum creatinine, blood urea nitrogen, potassium, HbA1c and lower eGFR and sodium (all p<0.001). Male sex (OR 2.63, 95% CI 1.36–5.07) and rural residence (OR 5.54, 95% CI 2.71–11.33) were associated with greater odds of delayed referral. Conclusion: Delayed nephrology referral was common and was associated with demographic disparities, poorer kidney function, and an adverse biochemical profile at specialist assessment

Background: Hand hygiene is essential for preventing healthcare-associated infections, yet adherence may differ across clinical settings. Evidence from secondary-level public hospitals in Pakistan remains limited. Objective: To compare self-reported hand hygiene compliance among nurses working in the intensive care unit (ICU) and General Ward of DHQ Hospital, Bhakkar. Methods: A comparative cross-sectional study recruited 80 nurses (ICU = 34; General Ward = 46) through purposive sampling. A structured questionnaire assessed self-reported hand hygiene frequency across the five World Health Organization moments using a five-point Likert scale. Total scores ranged from 5 to 25. Data were analyzed using Welch's t test, Mann–Whitney U test, and categorical association tests. Results: The questionnaire demonstrated good internal consistency (Cronbach's α = 0.87). Complete-score analyses included 79 nurses. ICU nurses reported higher mean compliance scores than General Ward nurses (22.94 ± 2.32 versus 20.04 ± 5.06; mean difference = 2.90, 95% CI 1.20–4.59; p = 0.001; Cohen's d = 0.70). High self-reported compliance was identified in 84.8% of ICU nurses and 60.9% of General Ward nurses (Fisher–Freeman–Halton p = 0.022). Conclusion: ICU nurses reported significantly higher hand hygiene frequency scores than General Ward nurses. Findings indicate an association between clinical unit and self-reported practices but do not establish actual bedside adherence

Background: Safe blood transfusion requires appropriate knowledge and consistent clinical practices among nursing personnel involved in patient identification, compatibility verification, blood administration, monitoring, and recognition of transfusion reactions. Objective: To assess knowledge and self-reported practice regarding safe blood transfusion among nursing personnel at Ali Fatima Hospital, Lahore. Methods: A descriptive cross-sectional study was conducted from February to June 2026 among 50 participants selected through convenience sampling. Registered nurses and final-year BSN students were assessed using an investigator-developed structured questionnaire comprising eight knowledge items and 11 self-reported practice items. Data were analyzed descriptively using frequencies, percentages, means, standard deviations, ranges, and 95% confidence intervals. Results: All 50 participants were female; 30 (60.0%) were aged 20–24 years and 26 (52.0%) were final-year BSN students. The mean knowledge score was 6.34 ± 0.89 out of 8, with a 95% confidence interval of 6.09–6.59 and an observed range of 4–8. The mean self-reported practice score was 8.88 ± 1.21 out of 11, with a 95% confidence interval of 8.54–9.22 and an observed range of 4–11. Conclusion: Participants correctly identified many of the transfusion-safety concepts and appropriate clinical responses assessed by the questionnaire. The findings provide a descriptive estimate of transfusion-related knowledge and intended practice within this single institutional sample.

Background: Early identification of patients at risk of severe acute pancreatitis (AP) remains clinically important. The neutrophil-to-lymphocyte ratio (NLR) is inexpensive, rapidly available, and has been investigated as a prognostic biomarker, but reported thresholds, measurement times, and target outcomes vary substantially. Methods: A systematic review with exploratory quantitative synthesis was conducted using PubMed/MEDLINE, Google Scholar, and Semantic Scholar. Adult studies evaluating admission or early-hospitalization NLR against severe AP, persistent organ failure, intensive care admission, pancreatic complications, mortality, or related adverse outcomes were eligible. Studies were grouped according to NLR timing, target outcome, exposure definition, and effect measure; statistically incompatible estimates were not pooled. Results: Of 149 records screened, 10 primary studies were included in qualitative synthesis and five contributed numerical estimates to graphical quantitative synthesis. Higher NLR was consistently associated with more severe disease. Study-specific AUROCs were 0.760 for admission NLR predicting persistent organ failure, 0.785 for 48-hour NLR predicting severe AP, and 0.998 for day-0 NLR distinguishing mild from combined moderately severe/severe AP. These estimates were not pooled because timing and target outcomes differed. Association estimates also remained separate: NLR ≥11 was associated with persistent organ failure (HR 1.37, 95% CI 1.00–1.89), NLR ≥10 with severe hypertriglyceridemia-induced AP (OR 6.71), and continuous admission NLR with severe AP (OR 3.78, 95% CI 2.83–5.06). Conclusion: NLR is a practical adjunct for early AP risk stratification, but current evidence does not support a universal threshold or single pooled prognostic effect. Prospective validation using standardized timing and outcomes is required.

Background: Quadratus lumborum syndrome is associated with low back pain, restricted lumbar mobility, and functional limitation. ELDOA and Muscle Energy Technique (MET) are used in musculoskeletal rehabilitation, but evidence regarding their combined effects in this condition remains limited. Objective: To compare the effects of ELDOA combined with MET versus ELDOA combined with conventional physical therapy on pain, lumbar range of motion, and functional disability in patients with quadratus lumborum syndrome. Methods: A single-center randomized controlled trial was conducted at Islam Teaching Hospital, Sialkot. The manuscript reports 38 participants aged 18–45 years who received treatment three times weekly for six weeks. Group A received ELDOA plus MET, whereas Group B received ELDOA plus conventional physical therapy. Outcomes included the Numeric Pain Rating Scale (NPRS), Modified Oswestry Disability Index (MODI), lumbar range of motion, and quadratus lumborum test. Shapiro–Wilk testing demonstrated non-normal distributions; Mann–Whitney U and Wilcoxon signed-rank tests were applied with p<0.05. Results: Post-treatment differences favored Group A for NPRS (mean ranks 13.05 vs. 27.95, p<0.001), MODI (12.65 vs. 28.35, p<0.001), lumbar flexion (26.20 vs. 14.80, p=0.002), lateral rotation (24.23 vs. 16.78, p=0.042), and quadratus lumborum test scores (26.63 vs. 14.38, p=0.001). Lumbar extension also differed significantly from post-treatment (p<0.001), although a significant baseline difference was present (p=0.011). Conclusion: ELDOA combined with MET was associated with more favorable short-term pain, disability, and selected lumbar mobility outcomes than ELDOA combined with conventional physical therapy. Keywords: ELDOA; Muscle Energy Technique; Quadratus Lumborum Syndrome; Low Back Pain; Range of Motion; Functional Disability.

Background: Smartphone-related thumb activity may contribute to wrist symptoms, but associations with findings suggestive of De Quervain’s tenosynovitis remain uncertain. Objective: To determine the frequency of positive provocative wrist-test findings and their association with smartphone-use characteristics among medical and healthcare students in Mirpurkhas. Methods: This cross-sectional study included 250 students recruited through convenience sampling at Bhitai Group of Colleges and Ibn-E-Sina University, Mirpurkhas, during January–June 2023. A self-administered questionnaire assessed phone use and functional difficulty, alongside a provocative wrist assessment. Analyses included frequencies, Wilson confidence intervals, Pearson’s chi-square and conditional exact tests, Cramér’s V, and Holm adjustment for six functional comparisons. Results: Participants were predominantly female (63.2%) and aged 18–22 years (79.2%). Positive wrist-test findings occurred in 165 participants (66.0%; 95% CI: 59.9–71.6%). Test status was not significantly associated with daily phone-use duration (p = 0.965), message frequency (p = 0.054), device type (p = 0.875), estimated weight (p = 0.370), or typing speed (p = 0.633). Initial associations with selected functional activities did not remain significant after Holm adjustment. Conclusion: Positive provocative wrist-test findings were common, but the assessed smartphone-use characteristics were not significantly associated with test status. These findings do not establish clinically confirmed disease or causation

Background: Helicobacter pylori infection remains common in symptomatic populations, but prevalence and associated clinical, endoscopic, and socioeconomic factors vary across Middle Eastern settings. This review estimated pooled prevalence and summarized factor-specific associations with H. pylori positivity. Methods: PubMed, Web of Science, Google Scholar, and Semantic Scholar were searched through 1 June 2026 for observational studies involving symptomatic adult or pediatric patients tested for H. pylori. Prevalence was synthesized using a random-effects model. Clinical, endoscopic, demographic, socioeconomic, and environmental factors were evaluated as separate associations rather than combined into category-wide summary effects. Methodological quality was assessed using the Joanna Briggs Institute checklist. Results: Eleven studies comprising 10,814 participants with assessable H. pylori status were included. Pooled prevalence was 37.62% (95% CI 27.02–48.21%), with substantial heterogeneity (I²=99%). Positive clinical associations included abdominal pain, anorexia, pallor/low hemoglobin, weight loss, and hematemesis; vomiting showed a large but highly imprecise estimate. Endoscopic associations included antral nodularity, gastric and duodenal erosions, duodenal ulcer, gastritis, mosaic gastritis, and esophagitis/GERD. Environmental and socioeconomic associations included daycare/community contact, large household size, illiteracy, bed sharing, low income, street-food consumption, unsafe water supply, and overcrowding. Conclusion: H. pylori infection is common but heterogeneous among symptomatic regional populations. Several clinical, endoscopic, and socioeconomic factors are associated with positivity, but these observational associations should not replace guideline-recommended diagnostic testing. Keywords: Helicobacter pylori; Prevalence; Dyspepsia; Associated Factors; Endoscopic Findings; Socioeconomic Factors; Middle East

Background: Platelet-to-lymphocyte ratio (PLR) is an inexpensive inflammatory index proposed for early severity stratification in acute pancreatitis (AP), but reported associations, thresholds, and diagnostic performance are inconsistent. This review evaluated PLR in relation to AP severity, persistent organ failure, mortality, and other adverse outcomes. Methods: PubMed/MEDLINE, Google Scholar, and Semantic Scholar were searched, with a September 2026 update using Elicit. Human primary studies assessing PLR in AP severity or prognosis were eligible. Outcomes were stratified by clinical definition to avoid combining Revised Atlanta severe AP, moderately severe/severe AP, persistent organ failure, mortality, imaging-defined severity, and score-defined severity. Risk of bias was assessed according to study type using QUIPS and QUADAS-2. Results: Forty-seven records were screened; 25 primary studies were included. Higher PLR was frequently associated with greater AP severity, but findings were heterogeneous and often attenuated in multivariable or comparative analyses. Reported PLR AUROCs included 0.621-0.720 for severe AP, 0.569-0.731 for persistent organ failure, and 0.693 for 28-day mortality. Sensitivity and specificity varied substantially across thresholds and etiologic subgroups. NLR, CRP-based indices, BISAP, SOFA, modified Marshall, and CT-based scores often showed stronger discrimination. Heterogeneity in severity definitions, timing, etiology, and reporting precluded a single universal PLR threshold or defensible pooled diagnostic estimate. Conclusion: PLR is associated with AP severity in several populations but has inconsistent standalone prognostic performance. Its most appropriate role is as an adjunct to established clinical, laboratory, and radiological assessment rather than an independent severity classifier. Standardized prospective studies are needed with predefined outcome-specific thresholds and timing. Keywords: Keywords: Acute Pancreatitis; Platelet-to-Lymphocyte Ratio; PLR; Disease Severity; Persistent Organ Failure; Prognostic Biomarkers; Inflammatory Markers; Risk Stratification