Journal of Health and Rehabilitation Research

Awareness and Knowledge of Biosimilars Among Rheumatologists and Patients

Muhammad Shiraz Niaz — 2025-01-31

Background: Biosimilars offer cost-effective alternatives to biologics in rheumatology; however, their adoption remains hindered by physician hesitancy and patient misconceptions. Despite increasing clinical use, knowledge gaps persist, affecting prescribing behaviors and treatment adherence. Objective: This study aimed to assess awareness, perceptions, and barriers to biosimilar adoption among rheumatologists and patients, identifying key factors influencing acceptance. Methods: A cross-sectional survey was conducted among 22 rheumatologists and 66 patients in clinical rheumatology settings. Structured questionnaires evaluated demographic characteristics, familiarity with biosimilars, prescribing patterns, and patient acceptance. Data were analyzed using SPSS v25, employing chi-square tests and t-tests to assess statistical significance, with p-values <0.05 considered significant. Results: Among rheumatologists, 80% (n=18, p=0.021) were very familiar with biosimilars, and 75% (n=16, p=0.017) had received formal education, yet only 70% (n=15, p=0.015) had prescribed them. Among patients, 60% (n=40, p=0.003) rated their biosimilar knowledge as poor, and 55% (n=36, p=0.006) were unsure about their safety and efficacy. A significant gap in physician-patient communication was observed, with 65% (n=43, p=0.008) of patients never discussing biosimilars with their rheumatologist. Conclusion: Rheumatologists demonstrated strong biosimilar knowledge, yet prescribing reluctance persisted, while patients exhibited significant uncertainty and reliance on non-medical information. Targeted education and structured communication strategies are essential to improve biosimilar adoption, ensuring cost-effective and evidence-based treatment.

Relationship Between Dietary Patterns and Symptom Severity in Gastroesophageal Reflux Disease (GERD): A Patient-Centered Survey

Qaisar Farooq — 2025-01-31

Background: Gastroesophageal reflux disease (GERD) is a prevalent condition significantly influenced by dietary patterns. Understanding the relationship between diet and GERD symptom severity is crucial for effective management, particularly in populations with unique dietary practices, such as Pakistan. Objective: This study aimed to explore the association between dietary habits and GERD symptom severity in the Pakistani population, focusing on culturally specific dietary triggers and their impact on quality of life. Methods: A patient-centered cross-sectional survey was conducted among 76 participants aged 18 years and above, recruited from outpatient clinics and community settings. Data were collected using a structured questionnaire, including demographic information, medical history, dietary habits (assessed via a modified Food Frequency Questionnaire), and GERD symptom severity (evaluated using the GERD-Q tool). Statistical analyses, including chi-square tests and logistic regression, were performed using SPSS version 25. Results: Among participants, 65% (n=49) were diagnosed with GERD, and 35% (n=27) reported symptomatic but undiagnosed GERD. Frequent consumption of spicy foods (50%, n=38), fried foods (45%, n=34), and caffeinated beverages (65%, n=49) was strongly associated with increased symptom severity (p < 0.001). Moderate to severe symptoms were reported by 70% (n=53), significantly impacting daily activities and sleep. Despite treatment, 40% (n=30) expressed dissatisfaction with their management plan. Conclusion: Dietary patterns play a critical role in GERD symptom severity and quality of life in the Pakistani population. Culturally tailored dietary interventions and improved management strategies are needed to address this burden effectively.

Combined Effects of Diaphragmatic Breathing with Subtle Touch Technique in Asthmatic Patients

Muhammad Iqbal Iqbal — 2025-01-31

Background: Asthma is a chronic inflammatory respiratory disorder affecting pulmonary function and quality of life. While pharmacological treatments remain the primary management approach, non-pharmacological interventions such as diaphragmatic breathing and subtle touch techniques have shown potential in improving respiratory function and reducing symptom severity. However, limited research exists on their combined effectiveness in asthma patients. Objective: To compare the effectiveness of diaphragmatic breathing combined with the subtle touch technique (DSTB) versus the subtle touch technique alone (STB) in improving pulmonary function, symptom severity, and quality of life in asthma patients. Methods: A randomized clinical trial was conducted with 40 participants aged 40-65 years, diagnosed with mild to moderate asthma. Participants were randomly allocated into Group A (DSTB) or Group B (STB) and received their respective interventions for 6 weeks, 2 sessions per week. Outcome measures included the Asthma Control and Severity Assessment Tool, Breathlessness, Cough, and Sputum Scale (BCSS), Modified Dyspnea Scale, SF-36 Quality of Life Questionnaire, and spirometry (FEV1, FVC). Statistical analysis was performed using SPSS v25, employing t-tests, Mann-Whitney U tests, and Wilcoxon signed-rank tests, with p < 0.05 considered significant. Results: Post-intervention, Group A showed significant improvements in FEV1 (p = 0.022) and FVC (p < 0.001). Quality of life scores significantly improved in Group A (76.06 ± 4.50) compared to Group B (83.10 ± 5.76, p = 0.000). Symptom severity scores decreased significantly in Group A (69.56 ± 10.92 vs. 79.14 ± 13.16, p = 0.009). Physical activity levels and six-minute walk distance also improved more significantly in Group A than Group B (p = 0.002, p = 0.000, respectively). Conclusion: Diaphragmatic breathing combined with the subtle touch technique significantly improves pulmonary function, reduces symptom severity, and enhances quality of life in asthma patients, supporting its role as an effective non-pharmacological adjunct to conventional asthma treatment.

The Role of Technology in Speech-Language Therapy: Perceptions, Effectiveness, and Challenges in a Resource-Limited Setting

Quratul Ain — 2025-01-31

Background: The integration of technology in speech-language therapy has expanded globally, offering new approaches such as mobile applications, teletherapy platforms, and artificial intelligence (AI)-based tools. However, in resource-limited settings like Pakistan, adoption remains inconsistent due to infrastructural, financial, and training constraints. Objective: To assess the perceptions, effectiveness, and challenges of using technology in speech-language therapy among speech-language pathologists (SLPs), clients, and researchers at Chughtai Medical Center, Lahore, Pakistan. Methods: A cross-sectional survey was conducted over six weeks using an online questionnaire distributed to 178 participants. The survey assessed demographics, technology usage, perceived effectiveness (Likert scale 1–5), barriers, and future perspectives. Quantitative data were analyzed using IBM SPSS Statistics 25, applying descriptive statistics, chi-square tests, and t-tests to determine associations (p < 0.05 considered significant). Results: Technology usage was reported by 50% (n = 89) of participants, with 40% (n = 71) using mobile apps, 30% (n = 53) using teletherapy, and 10% (n = 17) utilizing AI tools. Perceived effectiveness for language development was rated 3.5/5, client engagement 3.2/5, and teletherapy 3.0/5. Major barriers included technical issues (60%, n = 107), lack of training (50%, n = 89), and cost (40%, n = 71). AI effectiveness was significantly lower than traditional technology (p < 0.0001). Conclusion: Despite moderate effectiveness, technology adoption in speech-language therapy is limited by infrastructural and financial challenges. Policy-driven solutions, training programs, and improved accessibility are essential for optimizing digital interventions.

Health Disparities in Pakistan: Analyzing the Impact of Socioeconomic, Geographic, and Educational Determinants on Healthcare Access and Outcomes

Khadija Liaqat — 2025-01-31

Background: Health disparities in Pakistan are significantly influenced by socioeconomic status, geographic location, and educational background. Limited access to healthcare, financial constraints, and inadequate health literacy contribute to unequal health outcomes, particularly among rural populations and lower-income groups. Objective: This study aims to analyze the impact of demographic, socioeconomic, and geographic determinants on healthcare access, health literacy, out-of-pocket expenditures, and chronic disease prevalence in Pakistan. Methods: A cross-sectional survey was conducted among 378 participants selected through stratified random sampling to ensure urban and rural representation. Data was collected using structured questionnaires covering demographics, socioeconomic status, healthcare access, health literacy, financial burden, and chronic disease prevalence. Ethical approval was obtained, and confidentiality was maintained. Quantitative data were analyzed using SPSS version 25, employing chi-square tests for categorical variables and independent t-tests/ANOVA for continuous variables. P-values <0.05 were considered statistically significant. Results: Among 378 participants (mean age: 35.4 ± 12.1 years, 58% male), 65% had healthcare access, and 42% demonstrated health literacy. Urban residents (75%) had significantly higher healthcare access than rural counterparts (50%) (p<0.05). Males exhibited greater health literacy (48%) than females (35%) (p<0.05). Out-of-pocket expenditure was PKR 15,000 ± 5,000, higher among females (PKR 16,500 ± 5,200). Chronic illness prevalence was 30%, with hypertension predominant in rural areas (35%) and diabetes in urban settings (25%). Higher education correlated with improved healthcare access (80%) and lower chronic disease prevalence (15%) (p<0.05). Conclusion: Significant disparities in healthcare access, financial burden, and chronic illness prevalence exist in Pakistan, influenced by socioeconomic and geographic factors.

Leveraging Telemedicine for Enhanced Healthcare Accessibility: A Narrative Review of Patient Satisfaction, Appointment Adherence, and Cost-Effectiveness

Umar Farooq — 2025-01-31

Background: Telemedicine has emerged as a transformative approach to healthcare delivery, addressing geographical and logistical barriers. Its effectiveness in improving access, patient satisfaction, and appointment adherence requires comprehensive evaluation, especially in the context of digital disparities and socioeconomic challenges. Objective: This narrative review aims to assess the impact of telemedicine on healthcare access, patient satisfaction, and appointment compliance while identifying challenges and areas for improvement. Methods: A systematic literature search was conducted across PubMed, Scopus, Web of Science, and Google Scholar, covering studies from 2015 to 2024. Keywords included "telemedicine," "patient satisfaction," "appointment adherence," and "healthcare access." Studies were screened for relevance, and quantitative findings were extracted. Inclusion criteria encompassed peer-reviewed articles reporting patient outcomes, adherence rates, and accessibility improvements. Results: Telemedicine reduced waiting times by 30–50% and improved appointment adherence by 20–40%. Patient satisfaction rates ranged from 70% to 95%, with comparable diagnostic accuracy to in-person visits. However, digital literacy barriers affected 15–25% of patients, and technological limitations hindered access in 10–30% of low-income populations. Cost-saving analyses were limited but indicated a reduction in travel expenses by 25–60%. Conclusion: Telemedicine significantly enhances healthcare access and patient satisfaction while improving appointment adherence. However, digital disparities and socioeconomic barriers must be addressed through hybrid models and inclusive policy frameworks to ensure equitable and sustainable telehealth expansion.

The Growing Prevalence of Virtual Autism: A Cause for Concern

Anum Ashraf — 2025-01-31