Vol 14 Issue 1 April 2026-September 2026

Abstract: Adherence to anti-hypertensive treatment is essential for controlling hypertension and preventing complications such as stroke, heart failure, and kidney disease. However, poor adherence remains a significant challenge in many low-resource settings. This study assessed factors associated with adherence to anti-hypertensive treatment among hypertensive patients in the Kabgayi Hospital catchment area, Rwanda. A descriptive cross-sectional study was conducted among 418 hypertensive patients selected through consecutive sampling. Data were collected using a structured questionnaire and analyzed using SPSS version 23.0. Descriptive statistics, Chi-square tests, and logistic regression were used to determine factors associated with adherence. The findings revealed low adherence levels, with only 14.6% of participants demonstrating high medication adherence, while 51.4% exhibited low adherence and 45.0% reported missing at least one dose within the previous two weeks. Financial constraints (62.2%) and out-of-pocket expenditures for medicines due to stock-outs at health facilities significantly reduced adherence (AOR = 0.52, p = 0.002; AOR = 0.55, p = 0.018), whereas health insurance positively influenced adherence (AOR = 1.70, p = 0.025). Healthcare system factors, including shorter waiting times, consistent medication availability, accessibility of health facilities, and patient satisfaction, significantly improved adherence (AOR = 1.65–2.50, p < 0.05). Patient education, understanding of treatment consequences, and motivation were also significant predictors, with motivation showing the strongest association (AOR = 2.80, p < 0.001). The study concludes that adherence remains suboptimal and recommends strengthening medication availability, financial protection mechanisms, patient education, and motivational support to improve treatment outcomes among hypertensive patients.

Keywords: Hypertension, treatment adherence, anti-hypertensive medication, healthcare accessibility, patient motivation, Rwanda.

Title: FACTORS ASSOCIATED WITH ADHERENCE TO ANTI-HYPERTENSIVE TREATMENTS IN KABGAYI HOSPITAL, RWANDA

Author: Kayitesi Antoinette, Dr. Michael Habtu, Dr. Amos Habimana

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

Vol. 14, Issue 1, April 2026 - September 2026

Page No: 198-213

Research Publish Journals

Website: www.researchpublish.com

Published Date: 12-June-2026

Abstract: Anemia in pregnancy remains a major public health challenge globally, especially in low- and middle-income countries such as Rwanda, where maternal nutritional deficiencies and limited healthcare access persist. This study aimed to determine the prevalence of anemia among pregnant females of reproductive age attending Remera Health Center in Gasabo District, Rwanda. A descriptive cross-sectional design was employed, targeting 224 pregnant women selected through systematic random sampling. Data were collected using structured questionnaires and complemented by a review of medical records. Quantitative data were analysed using SPSS version 30. The findings revealed that 25.89% of the respondents were anemic, with microcytic hypochromic anemia identified as the predominant type. The highest prevalence was observed among women aged 30–34 years (24%), while the lowest occurred among those aged 40–44 years (14%). Married women represented 53% of the anemic cases, suggesting that socio-economic and household factors may play a key role in influencing nutritional outcomes during pregnancy. The study concludes that anemia continues to pose a significant public health concern among pregnant women in the study area. It recommends strengthening antenatal care services, enhancing screening and nutritional counseling, and promoting adherence to iron and folic acid supplementation as effective strategies to reduce anemia prevalence and improve maternal health outcomes.

Keywords: Anemia, Pregnancy, Prevalence, Iron Deficiency, Public Health, Remera Health Center, Rwanda.

Title: Prevalence of Anemia among Pregnant Females of Reproductive Age Attending Remera Health Center in Gasabo District, Rwanda

Author: Veuillemier Marie Ange, Mizero Olivier, Mourice Silali

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

Vol. 14, Issue 1, April 2026 - September 2026

Page No: 193-197

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Website: www.researchpublish.com

Published Date: 11-June-2026

Abstract: This narrative review evaluates axillary de-escalation in early breast cancer in the context of molecular oncology. While surgical burden has reduced, systemic therapy and radiotherapy have increased, suggesting a shift rather than true de-escalation.

Keywords: Breast cancer; Axillary surgery; De-escalation; Genomics; Molecular subtypes.

Title: Axillary Surgery De-escalation in Early Breast Cancer: Are We Truly De-escalating or Simply Shifting to Another Treatment Modality?

Author: Dr. Richa Rani, Dr. Saurabh Patel

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

Vol. 14, Issue 1, April 2026 - September 2026

Page No: 190-192

Research Publish Journals

Website: www.researchpublish.com

Published Date: 06-June-2026

Abstract: Background: Electronic waste or e-waste is a big problem that is getting worse every day. This is because new technology is coming out all the time and people are buying more electronic devices. When we throw away these devices in the way it is very bad for the earth and our health. This is because they have things like lead and mercury inside them. We do not know much about how people deal with e-waste at home. We also do not know what people, in communities think about e-waste or what stops them from getting rid of it. Electronic waste is still an issue.

Objectives: To assess the knowledge and practices regarding e-waste management in urban households

Methods: A community-based cross-sectional study was conducted among urban households in the field practice area using a pretested semi-structured questionnaire. People above 18 years of residing in the field area were recruited by simple random sampling .Information regarding socio-demographic characteristics, knowledge about e-waste, disposal practices, awareness of health and environmental risks was collected. Data were analyzed using descriptive and inferential statistics.

Results: The study evaluated awareness levels, disposal behaviors, and challenges related to e-waste management among urban residents. Majority of the participants demonstrated moderate knowledge (53.3%) and moderate practices(78.6%) of e- waste management.

Conclusion: Strengthening public awareness, improving accessibility to e-waste collection centers, and implementing incentive-based recycling programs may enhance responsible e-waste disposal practices among urban households.

Keywords: Electronic waste, electronic devices, recycling programs.

Title: Knowledge and Practices of E-Waste Management in Urban Households: A Cross-Sectional Study

Author: Dr. Malai Ammal, Aparna, Aravindhan, Dr. Arun Murugan

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

Vol. 14, Issue 1, April 2026 - September 2026

Page No: 184-189

Research Publish Journals

Website: www.researchpublish.com

Published Date: 05-June-2026

Abstract: Tuberculosis (TB) remains one of the leading infectious causes of morbidity and mortality worldwide. Beyond pulmonary manifestations, TB is associated with metabolic disturbances that may contribute to disease severity and treatment outcomes. Electrolyte abnormalities and alterations in membrane potential have been reported among pulmonary tuberculosis patients, but their clinical significance remains inadequately characterized.

Keywords: Pulmonary tuberculosis, Electrolytes, Membrane potential, Sodium, Potassium, Calcium, Hyponatremia, Hypokalemia.

Title: Electrolyte Disturbances and Membrane Potential Alterations in Newly Diagnosed and Treated Pulmonary Tuberculosis Patients in Imo State

Author: Ekenyem Kierian, Azuike Chioma Gladys, Chiamaka Stella Umelo Onuoha, Nwaigwe Chidera, Ayozie Paschal Chibuzor

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

Vol. 14, Issue 1, April 2026 - September 2026

Page No: 180-183

Research Publish Journals

Website: www.researchpublish.com

Published Date: 04-June-2026

Abstract: The global healthcare sector accounts for approximately 4.4–8.5% of national greenhouse gas emissions, making it a significant contributor to climate change. Yet, the sector’s internal commitment to environmental sustainability remains inconsistent and under-researched, particularly in terms of frontline workforce awareness and institutional infrastructure. This cross-sectional survey study examines the knowledge, attitudes, and institutional readiness of healthcare professionals (n=312) across multiple healthcare settings regarding sustainable healthcare practices, including green energy adoption, waste reduction, sustainable procurement, and carbon footprint management. Data were collected using a validated 28-item structured questionnaire administered online between January and March 2024. Results revealed that 67.3% of respondents acknowledged the environmental impact of healthcare delivery, yet only 38.5% reported that their institution had a formal sustainability policy in place. A significant positive correlation (r=0.61, p<0.001) was found between professional education level and sustainability awareness scores. Key barriers identified included lack of training (74.4%), absence of institutional frameworks (61.2%), and cost concerns (57.1%). The study underscores an urgent need for embedding environmental sustainability curricula in health professional education and operationalizing institutional sustainability frameworks in hospitals globally.

Keywords: Sustainable healthcare, green hospitals, carbon footprint, healthcare waste management, environmental sustainability, health professional awareness, green practices.

Title: Greening the Healing: Assessing Healthcare Professionals’ Awareness, Attitudes, and Institutional Readiness toward Sustainable Healthcare Practices: A Cross-Sectional Survey Study

Author: Dr. Aashish Raj Kakuri

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

Vol. 14, Issue 1, April 2026 - September 2026

Page No: 173-179

Research Publish Journals

Website: www.researchpublish.com

Published Date: 03-June-2026

Abstract: Background: Family is a group of people related by blood, emotions, marriage, adoptions. Family is where our roots take hold and from there, we grow. Family play an important role in shaping an individual’s personality, values and behaviour. In India, the joint family system has been in existence since ancient times. However, with the passage of time, the joint family system has disintegrated, giving rise to the nuclear family system. The nuclear family is a biological phenomenon of private human society. It not an adaptive form in an evolutionary series of human development nor a functional aspect of industrial aspect. Rather it a practically human time in social space. Nuclear family is the unit of husband - wife and parents - children. Whereas joint family is nothing but an extension of nuclear family in which the spouse was not separated after their marriage due various reasons.

Objective: To make a comparative study of the various aspects of psychological factors e.g., happiness, cheerful, etc among the members of nuclear and joint family and to promote a positive mental health among the members.

Conclusion: We concluded that studying the psychological well-being of the nuclear and joint families helps finding differences in social support, communication, and their stress levels and enhancers. It can provide a vision into the effects of family structure and their roles playing on mental health, which may inform interference and support systems for individuals in different family setups. In joint families, the people can provide emotional support, develops communication around everyone, and shared responsibilities, which leads to a strong social network. Nuclear families, provides more privacy, allowing for better /quality individual decision-making and reduced conflicts among the family members.

Keywords: Joint family, nuclear family, responsibilities, psychological wellbeing, mental health, emotional support, privacy.

Title: A Comparative Study on psychological well-being among nuclear and joint families in urban population, Chennai

Author: Karna Palanisamy S, Jagadeeshwari D

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

Vol. 14, Issue 1, April 2026 - September 2026

Page No: 164-172

Research Publish Journals

Website: www.researchpublish.com

Published Date: 03-June-2026

Abstract: Background: Soil-transmitted helminths (STHs) remain a leading cause of morbidity among school-aged children in sub-Saharan Africa. Rwanda has implemented national mass drug administration (MDA) programmes, yet persistent hotspots remain. Mudende Sector, Rubavu District a high-altitude, predominantly rural area bordering the Democratic Republic of the Congo with documented WASH infrastructure deficits  has never been characterised by sector-specific STH data. This study aimed to determine the prevalence, infection intensity, and independent risk factors for STH infection among school-aged children in this setting.

Methods: A retrospective cross-sectional analysis was conducted using secondary data from a community survey carried out by the Rwanda Biomedical Center (RBC) in 2023. All 1,093 school-aged children (aged 5–14 years) with complete stool examination results and household WASH data were included. Infection was diagnosed using the duplicate Kato-Katz technique; intensity was classified per WHO criteria. Bivariate chi-square analysis and multivariate logistic regression identified independent predictors of STH infection (significance threshold p < 0.05).

Results: Overall STH prevalence was 95.3% (n = 1,042). Ascaris lumbricoides (86.0%) and Trichuris trichiura (85.9%) were the predominant species; hookworm was rare (0.5%). Dual Ascaris–Trichuris co-infections affected 76.7% of children. Moderate-intensity infections predominated for both Ascaris (85.1%) and Trichuris (83.4%). In multivariate analysis, only two variables independently predicted infection: absence of a household handwashing facility (adjusted odds ratio [aOR] = 6.57; 95% confidence interval [CI]: 1.77–19.8; p = 0.002) and reliance on unimproved water sources (aOR = 3.20; 95% CI: 1.23–7.32; p = 0.009). Gender, age, parental education and literacy, religion, latrine cleanliness, and knowledge-attitude-practice scores were not independently significant.

Conclusions: STH infections are hyper-endemic in Mudende Sector a prevalence that has not declined despite years of national MDA and are driven entirely by structural deficits in WASH infrastructure rather than individual behavioral or demographic factors. High STH knowledge coexisting with near-universal infection demonstrates that awareness cannot substitute for physical infrastructure in hyper-endemic settings. Mudende Sector should be formally designated a priority hotspot within Rwanda's national NTD control programme, with deworming frequency increased to at least three rounds per year and investment in household handwashing facilities and safe water access accelerated through multi-sectoral collaboration.

Keywords: soil-transmitted helminths; Ascaris lumbricoides; Trichuris trichiura; Rwanda; school-aged children; WASH; handwashing; hyper-endemic; Kato-Katz; neglected tropical diseases.

Title: Prevalence, Intensity and Factors Associated with Soil Transmitted Helminths among School Aged Children in Mudende Sector, Rubavu District, 2023

Author: Uwayezu Leonard, Amanuel Kidane Andegiorgish

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

Vol. 14, Issue 1, April 2026 - September 2026

Page No: 153-163

Research Publish Journals

Website: www.researchpublish.com

Published Date: 01-June-2026

Abstract: Background: For neurosurgery patients on antiplatelet or anticoagulation, there is a critical balance to be struck between the risks of bleeding and thromboembolic complications. A crucial distinction must be made, as the effects of even a small amount of over-bleeding are irreversible and fatal.

Key Findings: Aspirin can safely be continued for certain types of cranial or spinal procedures. P2Y12 inhibitors will need to be discontinued 5-10 days before operation. For Warfarin patients, the goal is an INR <1.4, and bridging is only recommended in extreme situations of thrombotic risk. All DOACs should be discontinued 48-72 hours before procedure, but emergency reversal is available if necessary (idarucizumab and andexanet alfa). Routine bridging anticoagulation should generally not be utilized.

Conclusion: Multidisciplinary, individualized decision making is necessary in each perioperative neurosurgical case; by accounting for the risks of bleeding from specific procedures versus individual thrombotic risks to a specific patient, one can provide adequate care. This review aims to offer a systematic evidence based approach to such a dilemma.

Keywords: anticoagulants; antiplatelet; neurosurgery; perioperative management; intracranial haemorrhage; bridging anticoagulation; DOAC reversal.

Title: Perioperative Management of Antiplatelet and Anticoagulant Therapy in Neurosurgical Patients: A Practical Review with Evidence-Based Flow Chart

Author: Dr. Rathikinda Srinivasulu, Dr Saurabh Patel

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

Vol. 14, Issue 1, April 2026 - September 2026

Page No: 145-152

Research Publish Journals

Website: www.researchpublish.com

Published Date: 01-June-2026

Abstract: Background: Postpartum weight retention is a major contributor to the long term obesity and related health problems in women, Despite being a critical period for health promotion, postpartum phase is often neglected in routine maternal care. Addressing lifestyle practices, mental health, sociocultural factors through comprehensive postpartum interventions can improve maternal health outcomes and long term well being.

Objectives: This study aims to estimate the prevalence of postpartum weight retention and assess its association with lifestyle, psychosocial, dietary, sociodemographic factors as well as weight management interventions among postpartum women in Chennai.

Methods: A cross-sectional study was conducted among 100 women, 6 months to 1 year postpartum, attending primary health centres in Chennai between June and August 2025. Data were collected using a pretested semi-structured questionnaire covering sociodemographic details, obstetric history, sleep, diet, physical activity, psychosocial perceptions, and weight loss intentions. Anthropometric measurements were obtained, and associations were analysed using Chi-square and Fisher’s exact tests.

Results: The prevalence of PPWR was high (79%). Significant associations were observed with shorter sleep duration, household and childcare responsibilities, mismatched family eating habits, limited dietary awareness, bodyweight perception, and occupation. Weight loss intentions were strongly influenced by confidence, media exposure, social comparison, physical activity, dietary efforts, and motivation to initiate lifestyle changes.

Conclusion: Postpartum weight retention is common and influenced by modifiable behavioural and psychosocial factors. The postpartum period is a key opportunity for preventing long term obesity and cardiometabolic risk by integrating structured lifestyle and psychosocial counselling into routine maternal care.

Keywords: Postpartum weight retention (PPWR); Maternal health; Psychosocial determinants; Dietary behaviours; Physical activity; Body image perception; Urban primary health centres; Public health intervention; Obesity prevention; Cardiometabolic risk.

Title: Postpartum Weight Retention and Weight Loss Intentions among Women Attending an Urban Primary Health Centre in Chennai: A Cross-Sectional Study

Author: M.H.Akshaya, N.Alagusankar, Dr. Sathishkumar, Dr.Arunmurugan

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

Vol. 14, Issue 1, April 2026 - September 2026

Page No: 138-144

Research Publish Journals

Website: www.researchpublish.com

Published Date: 01-June-2026

Abstract: Introduction: Neonatal mortality remains a critical public health challenge in Rwanda, where neonates account for 44% of all under-five deaths and the Northern Province reports a neonatal mortality rate (NMR) of 22 deaths per 1,000 live births. Despite national progress in maternal and child health, facility-specific predictors of neonatal mortality in Gicumbi District have not been previously published. This study aimed to determine the prevalence and independent predictors of neonatal mortality at Byumba Level II Teaching Hospital.

Methods: A retrospective cross-sectional study was conducted at Byumba Level II Teaching Hospital, Northern Province, Rwanda. A total of 234 neonatal records (from a systematically sampled frame of 239) were reviewed for the period April to September 2023. Data were extracted using a validated structured tool (reliability coefficient 0.92; content validity index [CVI] 0.78). Bivariate chi-square analysis identified variables significantly associated with neonatal mortality (p < 0.05), which were entered into multivariate binary logistic regression to calculate adjusted odds ratios (aOR) with 95% confidence intervals (CI), controlling for potential confounders.

Results: The prevalence of neonatal mortality was 6.7% (16/239). Most mothers (95.3%) were enrolled in Mutuelle de Santé health insurance, yet 57.1% attended only 1–3 antenatal care (ANC) visits. Remarkably, 61.6% of neonates had very low birth weight (≤1,500 g). Multivariate analysis identified five independent predictors of neonatal mortality: inadequate ANC attendance of 1–3 visits versus ≥4 (aOR = 3.806; 95% CI: 1.203–12.046; p = 0.019); placenta abruption (aOR = 7.719; 95% CI: 1.260–47.326; p = 0.047); home birth compared to hospital delivery (aOR = 21.283; 95% CI: 1.718–263.628; p = 0.017); respiratory distress (aOR = 3.886; 95% CI: 1.091–13.834; p = 0.036); and congenital anomalies (aOR = 5.538; 95% CI: 1.121–27.350; p = 0.023). Marital status, maternal age, neonatal gender, and birth weight category were not independently significant.

Conclusion: Neonatal mortality at Byumba Level II Teaching Hospital is predominantly driven by modifiable factors. Targeted interventions to increase ANC attendance beyond four visits, eliminate home births among high-risk pregnancies, and strengthen neonatal respiratory care and congenital anomaly management are urgent priorities. These findings fill a critical evidence gap for Northern Province Rwanda and provide a foundation for district-level programme planning aligned with Rwanda's Sustainable Development Goal 3.2 targets.

Keywords: Neonatal mortality; Rwanda; Antenatal care; Home birth; Respiratory distress; Congenital anomalies; Sub-Saharan Africa.

Title: Prevalence and Predictors of Neonatal Mortality at Byumba Level II Teaching Hospital, Northern Rwanda: A Retrospective Cross-Sectional Study

Author: Claudine Ingabire, Charles NSANZABERA

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

Vol. 14, Issue 1, April 2026 - September 2026

Page No: 128-137

Research Publish Journals

Website: www.researchpublish.com

Published Date: 29-May-2026

Abstract: Background: Diabetes mellitus is a growing global health challenge strongly associated with obesity. While both elevated fasting blood sugar (FBS) and increased Body Mass Index (BMI) are independently linked to type 2 diabetes mellitus, evidence regarding a direct relationship between BMI and FBS remains inconsistent. Urban elite populations, characterized by affluence, sedentary lifestyles, and dietary transitions, may exhibit unique metabolic patterns. This study assessed the relationship between BMI and FBS among an adult urban elite population in Onitsha, Nigeria.

Methods: A cross‑sectional study was conducted among 96 consenting Knights and Ladies of the Anglican Communion, at Onitsha. Sociodemographic data, anthropometric measurements, blood pressure, and fasting blood sugar were obtained using standardized procedures. BMI was calculated from measured height and weight, and FBS was assessed using a Double G glucometer. Data were analyzed using SPSS version 27. Independent samples t‑tests compared mean values by gender, while Pearson’s correlation coefficient evaluated the relationship between BMI and FBS. Statistical significance was set at p < 0.05.

Results: Participants had a mean age of 61.35 ± 10.3 years; 54.2% were female. The mean BMI was 30.4 ± 3.87 kg/m², indicating obesity, and the mean FBS was 114.2 ± 29.71 mg/dl, reflecting impaired fasting glucose. Males had significantly higher FBS than females (123.7 vs. 106.19 mg/dl, p = .003), while females had significantly higher BMI (31.85 vs. 28.68 kg/m², p < .001). Pearson’s correlation analysis showed no significant relationship between BMI and FBS (r = –.095, p = .357).

Conclusion: Despite high levels of obesity and impaired fasting glucose in this urban elite population, BMI did not correlate with fasting blood sugar. These findings suggest that BMI alone may not be a reliable predictor of glycaemic status in older, socioeconomically advantaged adults. Measures of central obesity may offer better predictive value and should be prioritized in future research.

Keywords: Body Mass Index, Fasting Blood Sugar, type 2 Diabetes mellitus, urban population, obesity.

Title: A Cross-Sectional Analysis of Body Mass Index and Fasting Blood Sugar Levels among Urban Elite Adult Population

Author: Onyekwelu J, Njelita IA.

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

Vol. 14, Issue 1, April 2026 - September 2026

Page No: 121-127

Research Publish Journals

Website: www.researchpublish.com

Published Date: 14-May-2026

Abstract: Background: Postpartum women commonly experience upper back and periscapular pain due to hormonal changes, muscle weakness, and prolonged faulty postures during breastfeeding and infant care, leading to postural deviations, functional limitations, and reduced quality of life. However, evidence regarding the effectiveness of structured physiotherapy interventions such as GPR and MET in this population remains limited.

Objective: To determine the impact of Global Postural Re-education (GPR), Muscle Energy Technique (MET), and conventional therapy on pain, posture, functional ability, and quality of life in postpartum women with upper back and periscapular pain.

Methods: A total of 84 females aged 20 – 40 years with postpartum duration of 6 weeks to 12 months were selected using convenient sampling method. Participants were randomly divided into three groups; Group A received GPR, Group B received MET, and Group C received conventional management, including ergonomic counseling and posture education, with 28 participants each. Outcome measures included NPRS, MAPP-QOL, NDI, SPADI, and CVA. All groups received treatment sessions 3 times per week for a duration of 4 weeks.

Results: All three groups showed significant improvement in NPRS, MAPP-QOL, NDI, SPADI, and CVA after interventions (p < 0.001). Between-group analysis showed no significant differences in pain and quality of life outcomes. However, significant differences were observed in disability, shoulder function, and postural alignment (p < 0.001), with Group A demonstrating greater improvement.

Conclusion: All three interventions were effective in managing postpartum upper back and periscapular pain. However, GPR was more beneficial in improving functional ability and postural alignment.

Keywords: Postpartum women, Upper back pain, periscapular pain, Muscle energy technique, Global postural re-education, Quality of life.

Title: Effect of Global Postural Re-education Versus Muscle Energy Technique on Periscapular and Upper Back Pain Along with Quality of Life Among Postpartum Women: A Randomized Controlled Trial

Author: Jasmeen Kaur, Varinder Kaur

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

Vol. 14, Issue 1, April 2026 - September 2026

Page No: 109-120

Research Publish Journals

Website: www.researchpublish.com

Published Date: 12-May-2026

Abstract: Background: Knee osteoarthritis is a degenerative disorder affecting postmenopausal women, frequently resulting in pain, reduced muscle strength, stiffness and limitation in joint range of motion. Bilateral knee osteoarthritis presents with asymmetrical involvement between the left and right knee, leading to functional imbalance and altered gait mechanics. Multimodal physiotherapy interventions including manual therapy and therapeutic exercises are commonly used in the management. However, limited studies have investigated side-to-side differences in knee range of motion and muscle strength following multimodal physiotherapy interventions in postmenopausal women with bilateral knee osteoarthritis.

Objective: To compare the effectiveness of Maitland Mobilisation combined with Isometric exercises and Dynamic Quadriceps and Maitland Mobilisation combined with Multiple-Angle Isometrics and Mini-squats on left and right knee range of motion and muscle strength in postmenopausal women with bilateral knee osteoarthritis.

Methods: Sixty postmenopausal women aged 40-60 years diagnosed with bilateral knee osteoarthritis (Kellgren Lawrence grade II-III) were randomly allocated into two groups. Group A received Maitland Mobilisation with Isometric exercises and Dynamic Quadriceps whereas Group B received Maitland Mobilisation with Multiple-Angle Isometrics and Mini-squats. Interventions were administered for three sessions per week for four weeks. Outcome measures included Range of Motion (Active and Passive) and Manual Muscle Testing (MMT).

Results: Both groups showed significant improvements in, increase in range of motion and muscle strength. However, the interventions used in Group B demonstrated comparatively greater improvement in both the outcome measures. Although improvements were observed bilaterally, the right knee demonstrated slightly better outcome in range of motion parameter as well as muscle strength improvements.

Conclusion: The study provides evidence regarding the effectiveness of multimodal physiotherapy interventions in improving side-specific knee range of motion and muscle strength in postmenopausal women with bilateral knee osteoarthritis. The findings guide clinicians to design targeted protocols for patients presenting with asymmetrical and bilateral involvement.

Keywords: Knee osteoarthritis, Postmenopausal Women, Maitland Mobilisation, Isometric Exercise, Multiple-Angle Isometrics.

Title: Effect of Multimodal Physiotherapy on Side-to-Side Differences in Knee Range of Motion and Strength in Postmenopausal Women with Bilateral Knee Osteoarthritis

Author: Sehajleen Kaur, Varinder Kaur

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

Vol. 14, Issue 1, April 2026 - September 2026

Page No: 99-108

Research Publish Journals

Website: www.researchpublish.com

Published Date: 11-May-2026

Abstract: Contemporary warfare is increasingly defined by artificial intelligence (AI), yet its implications for population health remain insufficiently theorized. Existing scholarship is fragmented across security, governance, and public health domains, with limited integration of the mechanisms through which technological warfare produces health outcomes. This study addresses this gap by advancing the Technological Warfare Disruption–Public Health (TWD–PH) framework (Bull, 2026) as a novel mid-range explanatory theory. Grounded in complex adaptive systems theory and the structural determinants of health, the framework conceptualizes AI-enabled warfare as a structural driver of population health outcomes through cascading system disruption. The TWD–PH framework identifies key constructs, including AI warfare capability, technological dominance and strategic asymmetry, health system vulnerability, cascading disruption, and population health outcomes, while incorporating ethical governance and regulatory oversight as moderating and mediating influences. Central to the theory is cascading disruption, defined as the nonlinear and amplifying failure of interconnected systems following an initial technological shock. The framework advances a set of theoretically grounded propositions (P1–P6) that explain how technological inputs propagate through health systems and infrastructure to produce emergent outcomes such as increased morbidity, mortality, displacement, and psychological trauma. By integrating technological, structural, and governance dimensions into a unified explanatory model, the TWD–PH framework extends existing literature beyond descriptive and governance-centered approaches. The theory contributes by introducing cascading disruption as a central mechanism, conceptualizing health system vulnerability as a dynamic mediating construct, and embedding governance within system-level interactions. These contributions provide a coherent foundation for future empirical testing and offer critical insights for policy development aimed at mitigating the public health consequences of AI-enabled conflict.

Keywords: Artificial intelligence warfare; theory development; population health; cascading disruption; health system vulnerability; technological asymmetry; complex adaptive systems; governance.

Title: Technological Warfare Disruption and Public Health (TWD–PH): A Systems-Based Framework for Cascading Health Impacts in AI-Enabled Conflict

Author: Dr. David Bull

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

Vol. 14, Issue 1, April 2026 - September 2026

Page No: 86-98

Research Publish Journals

Website: www.researchpublish.com

Published Date: 11-May-2026