Background: The increasing prevalence of physical inactivity, declining fitness, and rising childhood obesity highlight the importance of physical literacy (PL), as a foundational component for fostering lifelong health and active lifestyle. This recognition necessitates the development of effective tools for PL assessment that are applicable across diverse cultural landscapes. Aim: This study aimed to translate the Canadian Assessment of Physical Literacy-2 (CAPL-2) into Urdu and adapt it for the Pakistani cultural context, to assess PL among children aged 8–12 years in Pakistan. Method: The Urdu version of CAPL-2 was administered among 1,360 children aged 8–12 from 87 higher secondary schools across three divisions in South Punjab province, Pakistan. Statistical analysis includes test-retest reliability and construct validity, employing confirmatory factor analysis to evaluate the tool’s performance both overall and within specific subdomains. Results: The Urdu version of CAPL-2 demonstrated strong content validity, with a Content Validity Ratio of 0.89. Confirmatory factor analysis supported the four-factor structure proposed by the original developers, evidenced by excellent model fit indices (GFI = 0.984, CFI = 0.979, TLI = 0.969, RMSEA = 0.041). High internal consistency was observed across all domains (α = 0.988 to 0.995), with significant correlations among most, excluding the Knowledge and Understanding domains. Notably, gender and age significantly influenced performance, with boys generally scoring higher than girls, with few exceptions. Conclusion: This study marks a significant step in the cross-cultural adaptation of PL assessment tools, successfully validating the CAPL-2 Urdu version for the Pakistani context for the first time. The findings affirm the tool’s suitability for assessing PL among Pakistani children, evidencing its validity and reliability across the Pakistani population.

Purpose: Patient satisfaction can be used to assess the quality of services provided at pharmacies. Our aim was to determine the level of patient satisfaction with pharmacy services and related factors at community pharmacies located in Punjab, Pakistan. Methods: A questionnaire-based cross-sectional study was conducted from May 2021 to July 2021 by administering the questionnaire to the patients using stratified random sampling method. Survey instrument comprised 4 sections including demographics, satisfaction towards provision of facilities, the provision of information, their accessibility to patients, the relationship between pharmacists and patients and the continuity of care provided. Categorical data were represented by percentages. Descriptive statistics were calculated for satisfaction scores. Simple and multiple logistic regression models were used to find the odds ratios. A p-value of less than 0.05 was considered statistically significant. Results: Response rate of the survey was 92%. Only 30% of patients agreed that the pharmacist was available for counseling on their visit. About 52% agreed that the counseling time provided by pharmacist was enough. Most of the pharmacy patients (61%) trusted the pharmacist regarding any query about medicine and were satisfied with the way the pharmacist resolved issues. Mean satisfaction score of the pharmacy patients was 45.75 with a range of 25 (highly satisfied) to 66 (highly dissatisfied). Conclusion: The provision of community pharmacy services to patients was not satisfactory. Furthermore, the absence of pharmacist in the pharmacy and the lack of provision for counseling time raised concerns.

Obesity, hypertension (HTN) and type 2 diabetes (T2D) are among the multifactorial disorders that occur at higher prevalence in a population. This study aims to assess the health-related quality of life (HRQoL) of patients with obesity, HTN and T2D individually and in the form of multimorbidity. A questionnaire-based cross-sectional study was conducted among the patients in 15 private clinics of Punjab, Pakistan. A stratified random sampling technique was used to collect the data from patients with obesity, HTN and T2D or their comorbidity. A total of 1350 patients responded by completing the questionnaire. The HRQoL of these patients was assessed using the EQ-5D-5L questionnaire (a standardized instrument for measuring generic health status). Statistical analysis was performed using chi-square test, Mann-Whitney U test, and Kruskal-Wallis test. Multivariate linear regression model was used to model the visual analogue scale (VAS) score. In total, 15% of patients had combined obesity, HTN and T2D; 16.5% had HTN and T2D; 13.5% had obesity and HTN and 12.8% had obesity and T2D. Only 15.8% of patients had obesity, 14.3% had HTN, and 12% had T2D. Mann Whitney-U test gave the statistically significant (p = <0.001) HRQoL VAS score55.1 (±23.2) of patients with the obesity. HRQoL VAS scores of patients with obesity were found to be higher when compared to patients with both T2D 49.8 (±15.4) and HTN 48.2 (±21). Diagnosis of one, two and three diseases showed significant results in VAS with all variables including gender (p = 0.004), educational level (p = <0.001), marital status (p<0.001), residence (p = <0.001), financial situation (p = <0.001) and monthly income (p = <0.001). The most frequently observed extremely problematic dimension was anxiety/ depression (47%) and the self-care (10%) was the least affected. Patient HRQoL is decreased by T2D, HTN, and obesity. The impact of these diseases coexisting is more detrimental to HRQoL.

Background. Physical literacy is vital for addressing children’s health issues such as childhood obesity, physical inactivity, and sedentary behavior. However, there is a lack of research on PL assessment in Pakistan. This study is aimed at translating and cross-culturally adapting the Canadian Assessment of Physical Literacy-2 (CAPL-2) tool and establishing its validity and reliability in the Pakistani population. Methods. The CAPL-2 was translated to Urdu employing the translation and back translation method. A cross-sectional study involving 350 school children (8-12 years) from Multan, South Punjab, evaluated the CAPL-2U version’s reliability. Results. Expert consensus and pilot testing successfully achieved translation, cross-cultural adaptation, face and content validity. The CAPL-2U demonstrated excellent reliability and internal consistency across the domains. Specifically, daily behavior domain had an internal consistency of and test-retest reliability of . Knowledge and understanding domain showed internal consistency ranging from to 0.986 and test-retest reliability of to 0.986. The motivation and confidence domain had an internal consistency of to 0.997 and test-retest reliability of to 0.993. The correlation between test-retest results for knowledge and understanding and motivation and confidence domains was to 0.973. However, two items in the motivation and confidence domain showed discrepancies in test-retest outcomes. Conclusion. The study confirms the successful translation and adaptation of the CAPL-2 questionnaire for use in Urdu and Pakistani contexts. The findings endorse the tool’s reliability and suitability for assessing physical literacy in Pakistan’s children aged 8-12.

Objective: Rheumatic heart disease (RHD) is a major health problem in the world, particularly in developing countries. This study aimed to predict mitral regurgitation (MR) and mitral stenosis (MS) RHD among children with RHD.Methodology: Data was collected from the Pediatric Cardiology Department at Chaudhry Pervaiz Elahi Institute of Cardiology Multan, Pakistan from March to October 2019. A sample of 561 children aged 4–14 years, who were diagnosed with RHD of either MR or MS, were recruited from the hospital’s outpatient department. The presence of multivariate outliers was detected, and different machine learning methods, including subset logistic regression, subset logistic regression after deletion, stepwise winsorized logistic regression, robust logistic regression, subset deep neural network, and random forest models were compared using the area under receiver operating characteristics (ROC) curve, sensitivity, and specificity. Parsimony was also considered in model selection.Results: Out of 561 patients in this study, 75.94% had RHD MR and 24.06% had RHD MS. The average age of study participants was 9.19 ± 2.45 years and of them 55.43% were male. Among the male participants, 58.6 and 45.2% had MR and MS, respectively; and among female participants, those were 70.4 and 29.6%, respectively. Subset logistic regression after deletion appeared as competitive with a discrimination power of 90.1% [95% CI 0.818–0.983]. The sensitivity and specificity of this model were 85.1 and 70.6%.Conclusion: The best predictive model was subset logistic regression after deletion. The predicted method will be used in the decision-making process, which helps early diagnosis of the disease and leads to prevention. The study findings provide the proper guideline for earlier diagnosis of the RHD MR and MS cases among children with RHD in Pakistan.