International Health Review

Prevalence of Down Syndrome and its Relationship with Maternal Age in Tehsil Kabal, District Swat, Pakistan

Fayaz Khan — 2025-12-29

Down Syndrome (DS) is the most common chromosomal disorder, with a well-established link to advanced maternal age. However, robust epidemiological data on DS is lacking in many regions of Pakistan. This study aimed to determine the prevalence of DS and its association with maternal age in Tehsil Kabal, Pakistan. A community-based cross-sectional survey was conducted from December 2021 to May 2022 across all 14 wards in Tehsil Kabal. Data was collected via door-to-door visits using a structured questionnaire. Verbal informed consent was obtained from all participants. The informed consent was acquired orally since the research was based on a low-risk survey and most of the participants belonged to groups with low signature practices. The project was approved by the faculty and the department that supervised the research. Suspected cases were identified based on standard phenotypic features. Out of an estimated population of 390,000 (excluding children under 4), 114 individuals with DS were identified, yielding a prevalence of 0.03% (approximately 1 in 3,400 live births or 3 per 10,000). A strong association with maternal age was found: 56% of affected children were born to mothers aged 31-40, 29% to mothers aged 21-30, and 15% to mothers aged 41-50. A significant male predominance was observed (78% male vs. 22% female). Nearly, half (47%) of the identified individuals were aged 11-20 years. The prevalence of DS in Tehsil Kabal was observed to be lower than global averages but confirmed maternal age as a significant risk factor. The high male-to-female ratio and low survival into adulthood highlighted potential sociocultural and healthcare factors affecting the DS population in this region, warranting further study.

Prevalence of Common Haematological Abnormalities Identified in Routine CBC Reports from a Local Pathology Laboratory in Mandi Bahauddin, Pakistan

Alina Riaz — 2025-12-17

The Complete Blood Count (CBC) is an affordable and widely accessible test that plays a crucial role in identifying a variety of blood-related disorders. Understanding how often these abnormalities are observed and how they differ across demographic groups would help shape effective and focused public health strategies. The current research used standard CBC test results from a local laboratory in Mandi Bahauddin (Punjab, Pakistan) to examine the laboratory variations among different demographic groups and assessed the frequency of particular blood disorders. In this cross-sectional retrospective study, 1017 CBC reports of patients of various ages and both genders were received. The blood abnormalities were defined with standard diagnosis criteria, and their occurrence rates were analyzed. The information was also stratified by age (0-20, 41-60 and 21-40 years) and gender. The description statistics were applied to the analysis. Over half (55.5%) of the reports showed at least one abnormality and 44.5% were normal. Iron deficiency was the most frequent diagnosis, followed by normocytic anemia (7.3%) and leucocytosis (8.5%). It was observed that more women were affected by Iron Deficiency Anemia (IDA) (79.5%) and megaloblastic anemia (82.4%) as compared to men. It is highly common in young adults (68.0%) between the age of 21–40 years, IDA was more prevalent than other population groups. Pancytopenia was found to be rare (1.5%) and occurred in all age groups. Iron deficiency was the leading haematological abnormality in the study subjects, especially in women of child bearing age. Even with the CBC test, early assessment is still possible. To reduce the impact of anemia and other blood disorders on the community, it is necessary to implement focused nutritional programs and public-health initiatives.

Gender Differences in Step and Stride Length among Physiotherapy Students at Holy Family Hospital, Rawalpindi

Syed Ali Hussain — 2025-12-21

Notable gender dimorphism in anatomy shows effects that extend beyond morphology to functional dynamics. Gait, as a major locomotor activity, can demonstrate these differences, especially in such parameters as step length and stride length. To determine whether perceived differences are statistically significant, the current study aims to quantitatively investigate and compare these gait parameters in both male and female participants in order to determine their mutual variability. A group of 50 healthy undergraduate students (13 males and 37 females) was selected based on a pre-determined inclusion criteria. This study was conducted in the Physiotherapy Department of the Holy Family Hospital, Rawalpindi, Pakistan. A small setup was created within the department. The complete procedure and one familiarity trial were performed before the actual data collection. All the participants were told to walk a 10-meter marked distance at a self-paced, comfortable walk. The total number of steps taken from the start to the end point of the 10-meter track were carefully noted down, enabling the computation of the mean step length and stride length. The data was analysed with the help of IBM SPSS (version 17.0). The analysis showed a significant difference between the two groups. The mean step length taken by men was 27.39 ± 1.74 inches, which is larger as compared to the mean step length of women, that is, 25.80 ± 2.31 inches. Stride length also varied, with the mean length for men being 54.79 ± 3.49, as compared to women with the mean length of 51.61 ± 4.62. Further, independent samples t-test established statistically significant differences in both step and stride length (p > 0.05). These findings empirically support the notion that gender is an important predictor of gait dynamics. The male subjects were found to have a longer step and stride length when walking, as compared to their female counterparts, in this cohort. The results underline the need to include biological differences, causing gender differences in ergonomics, rehabilitation, and sports science.

Unravelling the Impact of Hypoxia, Reactive Oxygen Species, and Necrosis in Skeletal Muscles

Farwa Munir — 2025-11-15

Skeletal muscle mass is strongly linked to stressors like ischemia and reactive oxygen species (ROS), both of which are regulated by oxygen availability and redox homeostasis. Intermittent ischemia and reperfusion cause a burst of reactive oxygen species, destruction of mitochondrial integrity, and inflammatory/necrotic pathways The objective of this review is to summarise existing data on the mechanistic interaction between hypoxia, ROS generation, and necrosis in skeletal muscle, as well as the role of these mechanisms in contributing to ischemia-reperfusion injury, metabolic disruption and dysfunction of skeletal muscle in the long term. The keywords examined in the literature search were skeletal muscle, hypoxia, reactive oxygen species, ischemia-reperfusion, mitochondria, and necrosis using PubMed, Scopus, and Web of Science. Articles published in English between 1990 and 2023 were peer reviewed and included, while conference abstracts, non-scientific reports, and duplicate records were excluded. The evidence suggests that hypoxia changes the use of substrates in the mitochondrion, stabilises the hypoxia-inducible factors and preconditions the muscle fibres to oxidative damage. The overproduction of ROS during reperfusion further increases the activity of inflammatory signalling, like NF-kB, calcium overload, and apoptotic and necrotic cell death. These teamed disruptions are what cause structural disintegration, dysfunctional contractional performance and retarded recuperation. An improved insight into these interrelated processes identifies prospects in therapeutic approaches such as antioxidants, enzymatic inhibition, gene-based treatment, cytokine therapy, and cell-derived exosomes- to alleviate ROS-related damage and promote muscle recovery.