THE THERAPIST (Journal of Therapies & Rehabilitation Sciences)

Current Political & Economic Turmoil & Healthcare Provision

Ghulam Saqulain — Fri, 30 Jun 2023 00:00:00 +0000

Pakistan is doing well in achieving some Sustainable Development Goals (SDGs). However, Pakistan is left behind in meeting SDG 3 goal which is related to its Population’s health and wellbeing, which seem to be an impossible target in near future due to the current political turmoil and economic crisis, which is a huge challenge for the healthcare system. Unexpectedly following Pakistan’s 2010 devolution of health to provinces instead of an improvement in provision of healthcare, low capacity of institutions, week central and provincial- coordination and increased interference by elites impeded any significant improvement in health sector [1]. The economic crunch has hit the healthcare sector very badly, affecting the medical supply lines since it relies mostly on imported raw medical supplies to manufacture medicines, and imports of complicated surgical equipment, including cardiac, orthopedic and cochlear implants essentially required for saving lives and for catering to the physical as well as communicational disabilities [2]. Hence, with Pakistan’s fragile economy marred with precarious conditions including widespread floods of 2022 and extremism has brought the country’s economy to a record low level, affecting all activities of life including healthcare provision to the masses [3]. Pakistani health professionals’ competency is also at stake and low salaries are driving these professionals to opt for more than one job at a time and unfortunately compelling professionals to leave the country for better future [4]. The political turmoil and economic crunch have also resulted in inflation resulting in a record price hike affecting daily life; and raising crime rate which has also impact tourism, including medical tourism which has improved healthcare provision and income generation in some neighboring countries like India, UAE etc [5]. This also demands accreditation of medical institutions of the country with Joint Commission International (JCI) and other such international accreditation agencies to enhance healthcare quality and provision of standard healthcare. The current crisis has also multiplied many folds because of outbreaks of diseases in the flood affected areas, which are already marred with health issues like malnutrition and outbreak of infections like hepatitis, typhoid, paratyphoid and tuberculosis etc. Even in emergency and war situations, healthcare takes precedence, hence it is high time for the authorities and the government to mitigate the issues facing healthcare in the country by increasing budget allocation, systematic clinical and community healthcare provision, enhancing coordination of provincial and federal health authorities, hiring of medical and allied staff to fill the vacant positions, attractive salaries for this essentially required community, enhancing collaboration with World Health Organization, UNICEF and other international agencies, getting accreditation of medical institutions to enhance medical tourism and policy level decisions for sustainable healthcare policy. These steps will enhance quality of healthcare provision, retaining of highly skilled medical and paramedical manpower in the country and result in better provision of healthcare.

Trend of Snakebite Cases and their Management at Holy Family Hospital Rawalpindi During 2022

Shazia Zeb, Rizwana Shahid, Farzana Fatima — Fri, 30 Jun 2023 00:00:00 +0000

Snakebite is a neglected public health problem of tropical and subtropical regions globally. Millions of cases are reported annually worldwide and about half of them are bitten by poisonous snakes. Objectives: To determine trend of snakebite cases and their management at Holy Family Hospital during 2022. Methods: A retrospective hospital-record based study was done to identify the trend of snakebite cases reported at Holy Family Hospital Rawalpindi during 2022. The data was gathered from hospital administrators pertaining to age, gender, residential address, types of snakebite and treatment given. Data were analyzed by SPSS software version 25.0 and MS Excel 2016. Descriptive statistics were computed. Independent sample t-test was applied to measure statistically significant gender-based difference in mean age of the snake bite victims. P < 0.05 was considered significant. Results: Of the 90 snakebite cases, 64.1% were males. Mean age of the victims was 34.7 ±14.8 years. Difference in mean age of male and female victims was statistically insignificant (P > 0.67). Majority (33%) was resident of Rawalpindi, followed by 22% and 12.3% from Attock and Azad Jammu & Kashmir respectively. Peak of the cases was during July and August. As most (91.1%) of them were bitten by vasculotoxic snakes, so out of 1,117 anti-snake venom ampules about 93.1% were administered to those cases. None of the cases succumbed to snakebite. Conclusions: Snakebite has frequently been reported among residents of Rawalpindi and its neighbouring areas during summer season. The victims were promptly treated for their survival.

Correlation of Chronic Fatigue with Post-Traumatic Stress Disorder and Symptom Severity in COVID-19 Survivors: A Cross-Sectional Study

Hassan Sarwar, Anna Zaheer, Sahar Fatima, Sumaira Parveen — Fri, 30 Jun 2023 00:00:00 +0000

Corona virus (COVID-19) is an airborne contagious respiratory disease. Fatigue is much reported complain by post-COVID patients. COVID-19 had generated stress in a wide variety of patients can be termed as post-traumatic stress disorder. Objective: To find the correlation of chronic fatigue with post-traumatic stress disorder and symptom severity in COVID-19 survivors. Methods: The commencement of this study required the allowance from University of Lahore ethical committee. About 155 participants participated in this cross-sectional study who had been COVID-19 positive for once up till now, which had supportive evidence through reverse transcriptase polymerase chain reaction (RT-PCR) test. Only those participants got eligible for study who had survived COVID-19 infectious disease. The data were kept secured by negating any biasness. Results: From total of 155 COVID-19 survivors, 75 (48.39%) males and 80 (51.31%) females participated in study. Mean age was 29.32 ± 10.81. About 123 (79.35%) had symptomatic COVID-19. Majority of patients 79 (50.97%) self-categorized them as struggling with moderate symptoms during their quarantine period. About 114 (73.54%) self-perceived they accompanied fatigue after recovering from COVID-19.While 87 (56.13%) COVID-19 survivors had encountered high impact post-traumatic stress disorder. Conclusions: It was concluded that majority of COVID-19 survivors had moderate level of fatigue and high impact post-traumatic stress disorder. This was seen more commonly among females. This is an important finding which needs to be taken into consideration when making a treatment plan for patients

Neck Pain Among Occupational Bike Riders Wearing Helmet in Twin Cities: A Cross Sectional Survey

Fri, 30 Jun 2023 00:00:00 +0000

Neck pain is a pain, stress, and fatigue of the muscles in or around the spine beneath head. Sometimes this pain may continue from the neck region into the shoulders, arms and upper back. Bike riders wearing helmet are more prone to neck pain due to prolonged use of helmet. Objective: To find the frequency of neck pain in bike riders who wear helmet in Twin Cities. Methods: A descriptive cross-sectional survey was conducted among bike riders wearing helmet working with Careem, Bykea and InDriver considering non-probability convenient sampling. 227 participants were selected agreeing to inclusion and exclusion criteria. Data were collected from bike riders at different locations of Rawalpindi and Islamabad. Association of neck pain to the use of helmet and weight was observed in this study. Pain intensity was measured by Neck Pain and Disability Scale. Data were analyzed by using SPSS 26. Results: Out of 370 participants, 227 were helmet users, 149 (65.6%) had neck pain. 78 participants wearing helmet did not feel neck pain. Conclusions: This study concluded that there was 65.6% frequency of neck pain among bike riders wearing helmet in Twin Cities

Ascorbic Acid: A Potent Agent for Mitochondrial Damage Repair in H2O2 Treated Bone Marrow Mesenchymal Stromal Cells

Fri, 30 Jun 2023 00:00:00 +0000

Bone Marrow Mesenchymal stromal cells (BMSCs) have shown an encouraging promise for cell-based treatments and regenerative medicine applications. Reactive oxygen species (ROS) can damage mitochondria and are detrimental to BMSC cell viability. Ascorbic acid, or vitamin C, is a crucial ingredient that is frequently added to culture media as an antioxidant. Its role in the proliferation of BMSCs has already been studied. However, no research has been done on its effects on the ability of BMSC to regenerate mitochondrial damage. Objective: To analyze the recovery of mitochondrial damage by H₂O₂-induced oxidative stress with Ascorbic Acid. Methods: BMSCs were cultured and treated with H₂O₂in order to induce oxidative stress. The injured BMSCs were then treated with vitamin C and their regeneration and recovery from mitochondrial damage is investigated by cell viability assays, ELISA and gene expression profiling. Recovery from oxidative damage is checked through anti-oxidative enzymes. Results: Findings showed that supplementing with vitamin C greatly enhanced cell viability and proliferation. It significantly decreased the BMSC's generation of ROS brought on by H₂O₂. These results imply that Ascorbic Acid may enhance the rate of proliferation and reduces apoptosis by recovering the mitochondrial damage as evidenced by the down-regulation of BAX. Conclusions: H₂O₂ when given to BMSC could create oxidative stress which in turn damages these cells as evidenced by their decreased cell viability. Ascorbic acid was also observed to regenerate the cells from H₂O₂ injury with the help of increased cells’ viability and proliferation and decreased apoptosis.

Exploring Trends and Barriers to Physical Activity in Adolescents/ School Going Children of Rawalpindi

Fri, 30 Jun 2023 00:00:00 +0000

Adolescent’s active participation in PA may reduce the risk of chronic non-communicable diseases (NCDs) in adulthood. Barriers to PA and the association among these barriers were examined. Objective: To explore barriers to PA in the adolescent of public school of Rawalpindi, Pakistan. Methods: A Descriptive cross-sectional design, multistage cluster sample of adolescents (N = 400) with 214 (53.5%) male and 186 (46.5%) females was conducted. Independent variables such as sociodemographic, (i.e., education, age, gender, socioeconomic level), the discernment of barriers which did not permit to take part in PA, (i.e., fear of harm, lack of time, resources, social support, energy, and motivation, inaccessibility of recreational sports near residence and lacking skills); and adolescent’s physical activity participation was evaluated using WHO tool, international physical activity questionnaire (IPAQ). To investigate the connection between perceived barriers and PA participation, multiple regression analysis was used. Results: Of the 400 adolescents females are more likely to perceive a lack of time as a barrier to engaging in PA [OR 2.17 (95% CI (1.45---3.23)]. In a similar vein, those from lower socioeconomic levels are more likely to perceive a lack of motivation. [OR 2.17 (95% CI (1.42---3.32]. Regarding poor /fair Self-perception of health have a high chance of perceiving scarcity of resource [OR 4.25 (95% CI (2.72---7.43)] were viewed as obstacles to PA. Conclusions: Low socioeconomic status, lack and standard of education, and self-perception of health are indicators of are indicators of potential obstacles to physical activity

Impact of Vigorous Exercise on Blood Serum Creatinine Concentration Among Students Athletes

Fri, 30 Jun 2023 00:00:00 +0000

Creatinine is a chemical compound left over from energy-producing processes in your Healthy kidneys that filter creatinine out of the blood. Creatinine exits your body as a waste product in urine. Objective: To examine the impact of vigorous-intensity exercises on serum creatinine concentration among student athletes. Methods: Participants were categorized as the control group (CG=n-15) and the experimental group (EG=n-15). Eight-week self-made vigorous intensity exercise protocol was applied on EG. 5 ml blood was collected from each subject, and similarly, serum creatinine concentration was assessed through a serum creatinine test in a biochemistry laboratory. The results (pre and post-test) were statistically tested by independent t-test, mean, and paired sample t-test as statistical tools. Results: A statistically significant difference was found in the Creatinine level between the pretest and posttest scores of EG (P < 0.05) after the treatment. No significant difference was observed in Creatinine level in CG's pretest and posttest scores (P > 0.05). Conclusions: The study shows a considerable difference in the pre and post-test of the subjects of CG and EG, and thus it is shown that vigorous exercise has a positive impact on kidney functions, particularly on creatinine

Prevalence of Low Back Pain among Physiotherapists Working in Clinics and Hospitals of Islamabad

Fri, 30 Jun 2023 00:00:00 +0000

Lower back pain (LBP) is a prevailing musculoskeletal condition that affects nearly all individuals at certain point in their lives. Although the majority of individuals with LBP experience temporary pain or disability and rapidly resume normal activities regardless of treatment, a small percentage develop chronic pain and disability. Among those with long-term pain and disability, few return to normal activities after experiencing LBP for more than one year. Despite the lack of discrimination based on gender, race, or work environment, certain professionals, such as physiotherapists, are at a heightened risk of developing LBP. Objective: To determine the prevalence of lower back pain among physiotherapists working in clinics and hospitals of Islamabad. Methods: A descriptive cross-sectional study was performed using demographic data, visual analogue scale (VAS) and OSWESTRY low back disability questionnaire to determine the prevalence of lower back pain among physical therapists working in clinics and hospitals of Islamabad. The study participants were physiotherapists working in Islamabad with age between 23 to 35 years. Data were analyzed by SPSS version-25. Results: A total of 50 physiotherapists participated in the study. Results showed that out of 50 participants, 50% had moderate amount of pain following the mild pain that was 44% and 6% showed no pain measured through Visual analogue pain scale. Conclusions: The present study concludes that low back pain is prevalent among physiotherapists working in clinics and hospitals of Islamabad.

Impact of Endurance Exercises on Knocked Knees as a General Health Concern

Fri, 30 Jun 2023 00:00:00 +0000

Knocked knees are a problem in children and adults, making it challenging to walk or run and causing knee pain. In this problem, the knees gradient inward while the ankles remain spaced apart. Objective: To analyse the impact of endurance exercises on knocked knees as a general health concern. Methods: The study participants were randomly selected from the department of sports science and physical education, University of Punjab, Pakistan. Subjects were categorized as a control group (CG) and an experiential group (EG). Each group was comprised of twenty subjects. All the subjects were informed about the risk and benefits of participation in the study. Thus, written informed consent was taken from each subject. In addition, Ethical approval (293/SPS) was also obtained from the University of the Punjab, Lahore, Pakistan. Results: The mean and standard deviation during the pre-test were 50.60±2.35, and the mean and standard deviation during the post-test was 53.05±2.33. The t value was 1.788, and Sig was .96. Therefore, the table shows no significant difference in CG in knee-knocking before and after training sessions imposed upon EG. The mean and standard deviation of EG during the pre-test was 50.00±2.07, and the mean and standard deviation of EG during the post-test was 58.35±2.20. The t value was 17.376, and Sig was .000. Therefore, there was a significant difference during pre- and post-test EG analysis in knee-knocking. Conclusion: Based on the analysis, the researcher concluded that exercise has a vital role in rehabilitating the knocked knee.

Knowledge, Attitudes and Interest of Evidence Based Practice among Physical Therapist Working in Pakistan

Fri, 30 Jun 2023 00:00:00 +0000

Evidence-Based Practice (EBP) is an approach that integrates the best available research evidence with clinical expertise and patient values to guide clinical decision-making. Objectives: To determine the knowledge, attitudes and interests towards Evidence-Based Practice (EBP) among physiotherapists in Pakistan. Methods: We surveyed 302 physical therapists working in Government and private settings in Pakistan via an online survey. The survey questionnaire encompassed four sections: (1) respondent characteristics; (2) knowledge of the principles of EBP as well as attitudes, interests, use and perceived efficacy of EBP. Data were analyzed using the SPSS version-23. Results: Overall 85% perceived EBP study is useful and necessary in PT clinical practice and 83% of respondents believed the importance of literature discoveries in regular practice and in improving the worth of patient care. Moreover, 77% showed interests to incorporate evidence increasingly in regular practice and 82% of participants were interested in seeking and enhancing proficiency to implement EBP in practice. Conclusions: Majority of physical therapists took part in this study held positive attitudes towards the role of EBP. Most participants were interested in incorporating their perceived roles in practice as a means of honing their skills

Awareness of Dietary Habits and Balanced Lifestyle Among Physical Therapy Students

Rabia Fauz, Umme Hani, Sana Batool, Maham Javaid — Fri, 30 Jun 2023 00:00:00 +0000

Obesity has now-a-days became global epidemic and the fifth leading cause of death. A strong relation has been observed between obesity and mortality among the general population Objective: To observe the nutritional status of the food intake in physical therapy students to make a guideline to modify the dietary habits. Methods: A cross-sectional study conducted in January 2022 to June 2022 among the students at Dow University of Health Sciences (DUHS), Karachi. The minimum sample size was calculated as 75. A self-designed questionnaire was used to collect data from the students. IBM SPSS Version-26 was used for data analysis. Results: The average weight and height of the students was 52.8 ± 9.5 SD (kg) and 5.34 ± 0.27 SD (feet). The BMI was measured as (height)² / weight. The mean BMI calculated was 20.4 ± 3.4 SD. Based on the BMI, the frequency of overweight students was 13 (8.2%) and obese were 2 (1.3%). Remaining 52 (32.9%) were under- weight. The majority of students i.e., 82.2% reported that they eat two to three meals per day. Consumption of fruits and vegetables was least common. Less than one-fourth of the students said that they intake fruits on regularly. Snack consumption other than regular meals was about 21.5% among students. Conclusions: Students were found to have normal weight. The current study indicates that most of the students were well aware and concerned of obesity and over-weight and they tried to maintain their body weight by controlling diet.

Perception of Oncology Patients toward the Quality of Life and Rehabilitation

Fri, 30 Jun 2023 00:00:00 +0000

Cancer is a worldwide pandemic disease 1 in 8 deaths is due to cancer globally. The major parameter used for the evaluation of cancer treatment is quality of life. Objective: To find out the perception of oncology patients towards the quality of life and rehabilitation. Methods: This study was a cross-sectional survey conducted in two tertiary care hospitals and one medical center in Karachi. Non-probability purposive sampling technique was used for sampling. Ethical approval was prior obtained from Parent Institute. Data were analyzed by SPSS version-23.0. Result: A total of 255 survey forms were filled out by oncology patients. Mostly158 (62.0%) patients lie between the ages of 20-49 years. There were 117 (45.9%) males and 138 (54.1%) females. Change in quality of life with time related to post-diagnosis. Those who were diagnosed < 5 years rated mean overall physical health as 5.46 ± 1.7, > 10 years rated 4.39 ± 1.8, and 5-10 years rated 4.22 ± 1.5. Satisfaction of patients regarding physical therapy sessions <5 years of post-diagnosed responded mean satisfaction level was 7.33 ± 2.494, 5.00 ± 1.633 of >10 years patients, and 6.08 ± 1.714 of 5 to 10 years post diagnosed patients. Improvement in QOL after physical therapy sessions <5 years diagnosed patients responded mean QOL as 7.39 ± 2.367, >10 years of patients responded 5.70 ± 2.032, and 5 to 10 years patients responded 6.45 ± 1.670. Conclusions: This study concluded that the perception of oncology patients regarding rehabilitation to maintain their quality of life is significant.

Emotional Lability and Perceived Social Support in Association with Psychological Well-Being Among University Students: An Exploratory Analysis

Salbia Abbas, Tayyaba Dar, Nadia Mir, Komal Shafique, Tatheera Zainab — Fri, 30 Jun 2023 00:00:00 +0000

The Current study examined correlation among emotional lability, perceived social support and psychological well-being of university students. Methods: Cross sectional study with quantitative method was used in the current study. Sample comprised of 300 university students from various backgrounds was recruited through random probability sampling technique. For assessment self-developed demographic sheet with standardized scales Affective Lability Scale, Multi-Dimensional Scale of Perceived Social Support, and Ryff’s Psychological Well-Being Scale 42-Items Version were administered. For analysis both descriptive and inferential statistics were used. Results: Results revealed that perceived social support had a positive relationship with psychological well-being(r=0.49**), which means that with increase in social support, psychological well-being begun to improve. Moreover, PSS had negative relationship with emotional lability (r= -0.52**), indicating that emotional instability decreases with the increase of PSS. Furthermore, results of regression analysis explored that PSS is significant predictor of EL and PWB among university students. Mean score test results indicates that EL and PWB are affected by PSS. Hence, a significant relationship exists between perceived social support and PWB and EL. Conclusions: To conclude it is stated that perceived social support presented role as a moderator in predicting the relationship between emotional lability and psychological well-being.

Effects of Instrument-Assisted Compressive Versus Decompressive Myofascial Release in Patients with Non-Specific Low Back Pain

Fri, 30 Jun 2023 00:00:00 +0000

Non-specific low back pain, a common condition, affects vast majority of the population worldwide and can be treated with soft tissue mobilization either with compression or decompression. Objective: To compare the effects of instrument-assisted compressive versus decompressive myofascial release on pain intensity, lumbar range of motion, and disability in non-specific low back pain. Methods: This quasi-experimental study was conducted at Laeeque Rafiq Hospital from February 2023 to April 2023. Two groups were included: one received instrument-assisted compressive myofascial release (Ergon tool), and the other received decompressive myofascial release with dry cupping. The study followed the patients for three weeks, collecting measurements of pain intensity, lumbar flexion and extension range of motion (ROM), and disability scores of low back pain. Data analysis were performed using SPSS 21.0. Results: There were a total of 44 patients. 23 patients were assigned to the compressive myofascial release technique group and 21 patients to the decompressive myofascial release group. Pain severity and disability score in the decompressive myofascial release group reduced significantly compared to the compressive myofascial release group at the end of the third week and first week respectively (p-value=0.02 and p-value=0.05 respectively). Lumbar flexion and extension ROM improved significantly in the compressive release group as compared to the decompressive release group after 1^st and 2^nd week respectively (p-value=0.01 and p-value=0.04 respectively). Conclusions: Decompressive myofascial release reduces low back pain and disability, while compressive myofascial release improves lumbar range of motion.

Therapeutic Application of Cupping Therapy (Hijama): A Brief Review

Fri, 30 Jun 2023 00:00:00 +0000

Hijama is a form of Unani medicine that involves using heat or suction to partially vacuum a Hijama glass placed on the surface of the body in order to remove disease-causing material or divert it from the diseased area, return displaced organs to their proper positions, and encourage blood flow to the intrusion site. The cups used to administer hijama therapy gave the treatment its name. For sucking purposes, glass or wooden cupping glasses are employed, and a vacuum pump creates the suction. Hijama involves placing a cup to a specific area of the body and sucking blood from there. Hijama is a method of Istifragh that removes the disease's root cause.

Causes, Precautions and Management of Risk Factors Associated with Dehydration among Athletes

Fri, 30 Jun 2023 00:00:00 +0000

Adequate intake of water is essential concerning the upkeep of body function. Water also hydrates discs between the vertebrae in the spine and foils tendons, ligaments, and muscles from becoming tight and stiff. Insufficient water intake may cause health problems, such as kidney stones and urinary tract infections (UTIs) in women, poor physical and psychological performance, improper salivary gland function, dehydration, etc. This commentary aims to unpin the facts about the causes, precautions, and management of risk factors associated with dehydration among athletes. Previous epidemiological studies have shown that exercise causes sweating and resultant loss of fluids, affecting an athlete physically and psychologically. In addition, previous studies have also demonstrated that dehydration negatively influences performance and causes high body temperature or glycogen use and the consequent reduction in muscle reserves. Likewise, the studies also showed that dehydration caused pain in joints and muscles, slowed the healing rate, and increased the chances of injuries. Based on the conclusion of previous studies, dehydration should be rehabilitated by fulfilling the fluid level in the body by consuming clean water, clear broths, ice pops and sports drinks. In severe conditions, oral rehydration therapy, intravenous (IV), is also suggested. The human body comprises 75% water inside cells, blood vessels and between the cells. Without water, living things cannot survive sufficient intake of water help the body to maintain its functions. Likewise, the body loses water throughout the day, as when we breathe, sweat, urinate, and defecate; the body restocks the water by drinking fluids. The body sometimes leads to a state of dehydration when intake is lower than consumption of the body, which causes headaches, lethargy, and constipation. Dehydration is a common problem concerned with fluid and electrolytes among the elderly. Frequently loss of water causes dehydration. Age-related changes in total body water, thirst perception, renal concentrating ability, and vasopressin effectiveness probably caused dehydration among the elderly. In addition, other health problems such as infection, high-protein tube feedings, cerebral vascular accidents, and medication-related hypodipsia are also associated with ageing and are particularly relevant for elderly patients. Proper patient treatment for dehydration depends upon the water deficiency assessment [1]. Dehydration is a state of the body when the body loses more fluids than intake [2, 3]. Insufficient water intake upsets the balance of minerals such as sugar and salt and thus affects the body's functions. Water makes up over two-thirds of the healthy human body. In addition to sweating, vomiting and diarrhea, diuretics (water pills) can result in increased urination, which causes body dehydration [4, 5]. Dehydration may be categorized into three types: hypotonic (primarily a loss of electrolytes such as sodium potassium chloride, calcium, magnesium, phosphate, and bicarbonate are electrolytes in blood and other body fluids that carry an electric charge, hypertonic (An imbalance between water and salt in the body it occurs when the body loses too much water while excessive or too much salt is in the fluid outside the cells) and isotonic (there is an equal loss of water and Sodium, commonly caused by vomiting and diarrhea) [6-9]. There are many reasons for dehydration, such as lack of time, avoiding safe drinking water, travelling, hiking or camping. In addition, diarrhea, vomiting, fever, excessive sweating and increased urination [10, 11]. Dry mouth, absence of tears while crying, sunken eyes and cheeks, no wet diapers for three hours etc., are the main signs & symptoms of dehydration. The main signs and symptoms include dry mouth and tongue, no tears when crying, no wet diapers for three hours, sunken eyes and cheeks, a sunken soft spot on top of the skull and littleness' or irritability [11]. Dehydration problem is commonly found among children. Intravenous (IV) therapy and oral rehydration therapy (ORT) are effective ways of treating dehydration [12]. Intravenous (IV) therapy is a method of managing fluids directly into veins. Thus these procedures enable different substances such as water, medication, blood, or nutrients to access the body quickly through the circulatory system [13]. Likewise, ORT is a method of managing fluids for preventing and preventing patients with diarrhea [14]. Likely it involves drinking water with modest amounts of sugar and salts, specifically Sodium and potassium. A nasogastric tube can also give oral rehydration therapy [15-18]. The nasogastric tube, also called the NG tube, is a medical tube that passes through the patient's nose; thus, for a limited duration, food substances and medications are delivered to the stomach or to draw the implications out [19-21]. The problem of dehydration is also found in players. The dehydration rate is low among the players in badminton despite of moderate sweat rate. Likewise, the badminton players were adequately hydrated during the game, and thus the dehydration attained was low. In addition, badminton did not cause fatigue and significantly increased the prevalence of proteinuria, leukocyturia and erythrocyturia [22]. Proteinuria, also known as albuminuria, is evaluated protein in the urea; it is not a disease that sometimes affects kidneys. A high protein level in urea means that the kidney's glomeruli filter is not working correctly, allowing too much protein to escape into the urine. When the glomeruli are damaged, the condition is called nephritis or glomerulonephritis. Other conditions can lead to nephritis, including hypertension, heart disease and diabetes, as well as different types of kidney disease [23, 24]. Leukocyturia (LU) indicates the presence of leukocytes in urine, and UL may be due to urinary infections or non-infectious factors. In some conditions, such as chronic renal failure, heart failure, and diabetes mellitus, bacteriuria (BU) without LU can be encountered [25]. Erythrocyturia indicates impaired renal function and strongly predicts poor renal outcomes in patients with known renal disease [26]. The problem of dehydration is found among players of aerobic and anaerobic activities [27, 28]. Dehydration negatively impacts cardiovascular stability, and psychological status did not significantly affect anaerobic performance [29, 30]. Muscle cramps are aching, spasmodic, and involuntary skeletal muscle contraction during and after exercise and have no causal metabolic, neurological, or endocrine pathology [31]. Nocturnal or cramps associated with metabolic abnormalities are not considered exercise-associated muscle cramps (EAMC). In addition, the problem of several types of cramps is considered linked with EAMC [32, 33]. Dehydration caused physical exertion. Change in body mass is associated with the volume and intensity of exercise, and thus, awareness among children about dehydration is also helpful in cognitive and physical performance [34]. Similarly, understanding a balanced diet and promising strategies for health is also essential for athletic performance; likewise, the intake of fluids also influences athletes' performance and recovery [35]. Physical training causes dehydration from consuming fewer water and mislaid through sweating, which affects an athlete physically and psychologically [36]. Exercise causes sweating and resultant loss of fluids, affecting an athlete physically and psychologically. In addition, previous studies have also demonstrated that dehydration negatively influences performance and causes high body temperature or glycogen use and the consequent reduction in muscle reserves [37].