Journal of Health and Rehabilitation Research

Determination Adenoidectomy and Tonsillectomy in Children with Obstructive Sleep Apnea: Are They Effective in Improving Sleep Quality and Cognitive Function

Aliya Ali, Hassan Abbas, Saba Sarwar — Sun, 30 Nov 2025 00:00:00 +0000

Background: Pediatric obstructive sleep apnea (OSA) is commonly managed with adenotonsillectomy (AT), which has shown substantial benefit in symptom reduction and quality-of-life improvement. Despite this, limited evidence exists from low- to middle-income countries incorporating polysomnographic, cognitive, and behavioral assessments. Objective: To compare the effects of AT versus watchful waiting on OSA symptoms, quality of life, and cognitive and behavioral performance in children with moderate OSA. Methods: This randomized trial was conducted at Kaleem Hospital, Lahore, involving 40 children aged 5–10 years with moderate OSA (AHI 10–30 episodes/h) and adenotonsillar hypertrophy. Participants were assigned to AT or watchful waiting. Baseline and 12-month assessments included polysomnography, OSA-18, Child Behavior Checklist (CBCL), full-scale IQ, GIA, attention, verbal fluency, learning measures, executive function, and ADHD symptom scales. Assessors were blinded to group allocation. Analyses followed the intention-to-treat principle using t-tests and ANCOVA. Results: AT produced significantly greater reductions in AHI (-12.0 ± 4.5 vs. -4.0 ± 3.8 episodes/h; P < 0.001) and ODI (-23.9 ± 5.5 vs. -7.7 ± 4.4; P < 0.001). Polysomnographic normalization occurred in 75% of AT patients versus 20% of controls (P = 0.001). Improvements were also larger in OSA-18 (-10.0 ± 5.0 vs. -3.2 ± 4.2; P < 0.001) and CBCL scores (-8.5 ± 4.0 vs. -2.2 ± 3.5; P = 0.001). AT markedly enhanced cognitive outcomes, including IQ (+10.8 ± 4.5 vs. +1.2 ± 3.8; P < 0.001), and reduced inattention and hyperactivity symptoms (both -21%; P < 0.003). Conclusion: AT yields significantly greater improvements than watchful waiting in polysomnographic indices, symptoms, quality of life, cognition, and behavioral functioning in children with moderate OSA.

Prevalence of Musculoskeletal Disorders and Associated Factors Among Remote Computer Workers: A Cross-Sectional Online Survey

Muhammad Zeeshan, Naveed Anwar — Sun, 30 Nov 2025 00:00:00 +0000

Background: The rapid shift to remote work during the COVID-19 pandemic has heightened concerns about musculoskeletal disorders (MSD) among computer users, driven by poor ergonomic setups and prolonged sedentary behavior. This study assesses the prevalence of MSD and associated risk factors in remote computer workers using an online cross-sectional survey. Methods: An anonymous online survey was distributed to remote computer workers via social media and professional networks. Participants (n=56) reported socio-demographic data, work characteristics, and MSD using a modified Nordic Musculoskeletal Questionnaire. Descriptive statistics summarized prevalence, while chi-square tests and odds ratios (OR) with 95% confidence intervals (CI) evaluated associations. Results: Of the 56 participants (mean age 31.4 ± 6.2 years; 53.6% male), 69.6% reported at least one MSD in the past 12 months. The most affected regions were the neck (58.9%), lower back (55.4%), and shoulders (53.6%). Significant associations included female gender (OR 4.21, 95% CI 1.16–15.23), lack of dedicated workspace (OR 4.43, 95% CI 1.10–17.91), and physical activity <150 min/week (OR 3.64, 95% CI 1.10–11.97) (all p<0.05). Conclusion: MSD prevalence is high among remote computer workers, with modifiable risk factors highlighting the need for ergonomic interventions. Online surveys prove feasible for such assessments.

Prevalence & Risk Factors of Non-Alcohol Fatty Liver Disease (NAFLD) in Urban & Rural Communities of Pakistan

Sidra Afzal, Faiza Amjad, Muhammad Laeeq, Laj Khan — Sun, 30 Nov 2025 00:00:00 +0000

Background: The rising condition of non-alcoholic fatty liver disease (NAFLD) has been widely observed in South Asia due to the increasing trends of urbanization and lifestyle factors because of metabolic disturbances. Objective: To identify the prevalence of NAFLD risk factors, along with metabolic and sociodemographic and lifestyle factors, in the adult population of Pakistan’s urban and rural settings. Methods: This study was carried out using a cross-sectional approach involving 108 adults who attended the general hospital of Sialkot in Pakistan. The study used a structured questionnaire to gather information regarding the sociodemographic factors of the participants. Anthropometric measurements were also done. NAFLD was also identified using the criterion of the absence of severe alcohol consumption along with the absence of chronic liver diseases alongside the criterion of the detection of hepatic steatosis through ultrasonography. Statistical computation was carried out using the software package SPSS version 25. Results: The prevalence of NAFLD was 48.1%. The prevalence of NAFLD was higher in the urban group than the rural group (56.3% vs. 36.4%; p=0.042). In the NAFLD group, there were higher levels of BMI, waist measurement, ALT levels, AST levels, and triglyceride levels, along with lower levels of HDL. Conclusion: NAFLD has been found to be prevalent within this dual non-rural community of Pakistani patients and has been found to be strongly linked to obesity, diabetes, and a sedentary lifestyle.

Association Between Allergic Rhinitis and Sleep Disorders in Pediatric and Adult Populations in Pakistan

Hafiza Shahbnum Noor, Rifat, Rida Noor — Sun, 30 Nov 2025 00:00:00 +0000

Background: Allergic rhinitis (AR) is a prevalent chronic inflammatory condition of the upper airways that heavily impacts the quality of sleep because of nasal obstruction, inflammation of the nasal mucosa, and alteration in the upper airway flow. As the burden of AR rises in the Pakistani population, there remains a scarcity of information regarding disturbed sleep in the pediatric and adult AR patient groups according to the patient's age. Objectives: To identify the intensity and factors of sleep disorders in pediatric and adult patients who suffer from physician-verified AR in Pakistan. Methods: This was a cross-sectional study involving 124 participants: 62 children and adults each with AR according to ARIA guidelines. Sleep problems were assessed using standardized scales: the Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale (ESS), and the Insomnia Severity Index (ISI). Sleep breathing problems were screened by the Pediatric Sleep Questionnaire in the pediatric group and symptom reports in the adult group. Comparisons of groups were done using the χ² test, the t-test, and the odds ratio at the 95% confidence level. Results: Sleep problems existed in high proportions in both the pediatric and adult groups: 80.6% in the pediatric group and 85.5% in the adult group. Difficulty in initiating sleep existed predominantly in the adult group (59.7% vs. 45.2%), although OSA existed predominantly in the pediatric group (12.9% vs. 3.2%).In both groups, the average value of the PSQI score exceeded the cut-off value of 8.5. In addition, both groups experienced excessive daytime somnolence and disrupted sleep. Conclusion: The co-occurrence of disturbed sleep is evident across the spectrum of AR in Pakistan, especially within the pediatric population, who are at risk of OSA. The incorporation of the management of disturbed sleep in the treatment of AR could be beneficial.

Prevalence of Hearing Loss and Associated Risk Factors Among Factory Workers in Urban Pakistan

Farwa Shahid, Hafiz Muhammad Asad Ullah, Zarrar Ahmed, Umrah Khan — Sun, 30 Nov 2025 00:00:00 +0000

Background: Noise-induced hearing loss in the occupational setting remains a prevalent and preventable cause of disabling illness in the global industrial workforce, especially in developing nations. However, there has been scarce data available from the Pakistani industry that mainly involves selected sectors without a substantiated statistical analysis of the interaction of the duration of exposure to the intensity of the sound along with the pattern of extended work schedules and hearing protection practices. Objective: To determine the point prevalence of hearing impairment as evident from the audiogram and its interassociation factors in the selected group of workers of the Sheikhupura factory region of Pakistan. Methods: An analytical type of cross-sectional study involving a selected group of 135 workers from the Sheikhupura region of the Pakistan industry was carried out. Detailed interviews were conducted with the participants, measuring the sound intensity in their respective departments, examining the workers through audiograms, and collecting data on their work schedules and hearing protection practices. Results: The point prevalence of the selected group of workers of the Sheikhupura region of the Pakistan industry suffering from the said condition was revealed to be approximately one in three at 30.4% (41/135 [95% CI: 22.6–38.1%]). Approximately eight out of ten of the said hearing losses were bilateral at 80.5%. Workers aged above 10 years had approximately thrice the chances of suffering from hearing problems in the investigated group at an odds ratio of 3.06 [95% CI: 1.43–6.55], individuals exposed to sound above 95 dB had approximately thrice the chances at an odds of 3.18 [95% CI: 1.48–6.79], workers who worked extended hours above the scheduled eight hours had approximately thrice the chances of suffering from the said ailments at an odds of 3.17 [95% CI: 1.48–6.79], irregular users of hearing protection practices had approximately four times the chances of the said ailment at an odds of 4.14 [95% CI: 1.59–10.8], and smokers had approximately twice the chances of suffering from the said ailment at an odds of 2.19 [95% CI: 1.00–4.77]. Conclusion: Approximately one out of three workers of the selected region of the Pakistan industry was suffering from the said ailment due to the above-stated numerous factors.

Food Habits and their Relationship to the Incidence of Non-Alcoholic Fatty Liver Disease in Various Social Classes in Pakistan

Anum Hammed, Laiba Khan, Amna Ali — Sun, 30 Nov 2025 00:00:00 +0000

Background: The prevalence of non-alcoholic fatty liver disease (NAFLD) has been rising at a rapid pace in the context of Pakistan due to lifestyle changes and increasing metabolic risk factors. International research has already identified Western-type food habits to be a consistent risk factor for NAFLD. However, no study in Pakistan has investigated variations based on socioeconomic factors. Objectives To evaluate the relationship of empirically identified dietary patterns to NAFLD and ascertain the existence of differences in these relationships based on socioeconomic groups in the city of Lahore. Methods: A case–control study was performed at Mansoora Hospital, recruiting 60 NAFLD patients proven by ultrasound scan and 60 controls. Food habits were recorded through a semiquantitative food-frequency questionnaire. Principal components analysis was used to extract large dietary factors. Logistic regression models estimated the odds of NAFLD according to the tertiles of each factor's adherence, adjusted for various factors. The role of SES was explored considering interaction with jointly defined education-income groups. Results: A high Western dietary pattern was positively related to the odds of NAFLD (adjusted OR: 2.94; 95% CI: 1.20-7.19; p trend=0.011), and the protective effect of the prudent dietary pattern was evident (adjusted OR: 0.28; 95% CI: 0.11-0.70; p trend=0.003). The effect of the Western pattern was maximal in the Conclusion: The Western dietary pattern confers a high risk of NAFLD, which increases substantially in higher socioeconomic groups. Stratified dietary treatment trials are greatly needed.