Study aim: To assess the Efficacy and Safety of Empagliflozin in patients with Metabolic Associated Steatotic Liver Disease. Design: The study was a phase 4, single-center, single-blinded, randomized controlled trial. It enrolled a total of 46 participants. Settings and conduct: Conducted at the Department of Medicine and Gastroenterology, Mayo Hospital Lahore. Identical placebo tablets matching empagliflozin 10 mg in size, shape, color, and packaging will be used to maintain blinding integrity. All medications will be dispensed in coded, identical blister packs labeled without revealing treatment allocation. All participants will receive standardized instructions for medication intake and possibility of mild side effects to avoid differentiating between groups and perception bias. Participants/Inclusion and exclusion criteria: Inclusion criteria: Patients having age between 30-65 years, both male and female, having -MASLD receiving Empagliflozin therapy after giving consent along with standard therapy. Exclusion criteria: Patients having HCV, HBV, those having tumor of liver. Patients that are unable to understand local languages. Non cooperative patients, critical cases (ICU admitted, mechanical ventilation, coma patient, GCS score less than 10) are excluded from the study. Intervention groups: Patients will be randomly administered with empagliflozin 10 mg once daily orally for six months without modifying existing treatment for MASLD. The placebo/control group in the empagliflozin study received standard MASLD therapy along with a daily oral placebo tablet identical in appearance to empagliflozin. Main outcome variables: Efficacy of Empagliflozin: Measured by the Fibrosis-4 (FIB-4) Index score, which assesses liver fibrosis progression. Safety of Empagliflozin: Assessed through the SF-36 (Short Form-36 Health Survey), which measures the physical and mental health of the patients.

Study aim: To compare the Effectiveness of dry cupping therapy with and without thoracic mobilization among low back pain patients: Design: Randomized Clinical Trials (RCT). Settings and conduct: 4.2: Settings: Lahore Physiotherapy and Rehabilitation Center, Bahria International Hospital, (Lahore). 4.3: Study Duration: Within nine months of the synopsis being approved, the study will be finished. Participants/Inclusion and exclusion criteria: Inclusion Criteria: ● 18–59 years of age (40) ● Both male and female (40) ● If the participant is having pain in the spine for the duration of more than 3 months but not radiating to the leg (28) ● Any participant who has complain of pain on a scale of 3 to 8 (moderate to severe) according to the NPRS (28) 4.6.2: Exclusion Criteria: ● If any participants has planned any flights for the next two months (28) ● Already treated with cupping therapy. (28) ● If any individual is receiving physical therapy interventions (41) ● Any individual with psychological or neurological disorders ● Any individual who are at risk of falls or having visual or auditory discrepancies ● Any participant who can’t receive cupping therapy (e.g. open wound, skin infections) (41) ● Any individual with disorders of spine or spinal cord (e.g. fractures, infection or tumors) (40) ● Sacroiliac joint dysfunctioning Intervention groups: Participants were randomly allocated into two groups (Group A: Dry cupping therapy group with mobilization, Group B: Dry cupping therapy without mobilization). Both groups received routine physical therapy which includes 15 minutes of heat therapy. Main outcome variables: 1. Pain (Numeric Pain Rating Scale) 2. Physical Function (Oswestry Low Back Pain Disability Index Questionnaire) 3. Quality of Life (WHOQOL-BREF)

Study aim: This study aims to formulate a topical diclofenac potassium gel and evaluate its effectiveness in managing primary dysmenorrhea. It also seeks to compare the pain-relieving effects of the gel alone versus in combination with Transcutaneous Electrical Nerve Stimulation (TENS) to determine the potential benefit of combined therapy. Design: Pragmatic, community based, parallel group, double blinded, randomized controlled trial. Total 376 patients will be enrolled. Patients who met our inclusion criteria will be randomized into two groups. Settings and conduct: The trial will be held at Muhammad Physical Therapy & Rehabilitation Center, Multan. It is single-blinded, with participants unaware of their group. Treatments will be in identical boxes, and codes kept by the principal investigator. Participants/Inclusion and exclusion criteria: Inclusion Criteria Woman (18-45 years), Female diagnosed with primary or secondary dysmenorrhea, Regular menstrual cycles (21-35days), Females, Moderate to severe menstrual pain, Intervention was physiotherapy techniques (electro-physical agents, massage, exercise). Exclusion Criteria Pregnancy Females with bleeding disorders, Breast feeding, Uterine fibroids, Adenomyosis , Endometriosis, Pelvic inflammatory disease, Menstrual disorder Intervention groups: Group A will receive 6% diclofenac potassium gel plus TENS, while Group B will use the gel alone. Both groups will apply 2–4 grams of gel 2–4 times daily for up to three days. Group A will also get Transcutaneous Electrical Nerve Stimulation (80–100 Hz, 20–30 minutes, 2–3 times daily) to enhance pain relief. Main outcome variables: range of motion, joint stiffness, independency and quality of life

Study aim: The aim of this study is to evaluate and compare the postoperative analgesic efficacy of bupivacaine alone versus a combination of bupivacaine and tramadol when used for local anesthesia in patients undergoing minor surgical procedures at a tertiary care hospital in Karachi. This research seeks to assess the mean postoperative pain following minor surgical procedures, as well as the need for rescue analgesia, in both groups, in order to determine whether the addition of tramadol provides superior pain control or not. Design: Parallel group, single blinded, randomized controlled trial. Settings and conduct: The study was conducted at the Surgical Unit 4 of Jinnah Postgraduate Medical Center and was a single blinded study where the patients were unaware of which group they have been assigned to Participants/Inclusion and exclusion criteria: INCLUSION CRITERIA: All patients undergoing elective procedure under local anesthesia Either gender. Age 18-60 years. EXCLUSION CRITERIA: Procedures Under general anesthesia. Diabetic patients, assessed by history and clinically and HbA1c >6.5% Patients with metastatic disease, assessed by history, clinically and by imaging. Patients who are I/V opioid abusers will be excluded. Intervention groups: In Group A (bupivacaine) patients received 0.5 ml/kg of 0.25% plain bupivacaine at the surgical site, while Group B (bupivacaine with tramadol) patient received 0.5 ml/kg of 0.25% bupivacaine in combination with 1 mg/kg of tramadol. Main outcome variables: Mean postoperative pain score using a visual analogue scale

Study aim: To Compare the Effects of Rocabado’s approach versus Jaw and Stick Exercises on Pain, ROM and Disability among patients with Temporomandibular Joint Dysfunction Design: It will Single blinded randomized clinical trial with parallel group design. 23 Participants will be allocated to two groups equally by random computer number generator Settings and conduct: It will be conducted at Rashid Latif Dental Hospital. Outcome assessor will be kept blind. Participants/Inclusion and exclusion criteria: Inclusion Criteria: • Both male and female patients between age 20-60 years. Patients with mild to moderate TMJ dysfunction (according to Fonseca Questionnaire) • Patients with jaw pain and limited jaw range of motion, and limited mouth opening and associated joint pain • Patients with TMJ clicking sounds Exclusion Criteria: • Patients with a history of significant trauma of fractures to the jaw or temporomandibular joint, Patients with a history of systemic rheumatic diseases affecting the temporomandibular joint. Patients with severe TMJ dysfunction with recent oral surgeries were excluded Intervention groups: Group A: will receive Rocabado approach with baseline treatment. Group A will receive Rocabado’s approach consisting 6 exercises six times a day twice per week for four weeks. Group B: will receive Jaw and Stick Exercise with baseline treatment. Group B will receive Jaw and stick exercises with the frequency of 2 sets and 6 repetitions twice a day two times per week for four weeks Main outcome variables: Pain: Numeric Pain Rating Scale (NPRS) ROM: Universal Goniometer Disability: Temporomandibular disorder (TMD) disability index questionnaire

Study aim: To determine the combined effects of pelvic floor activation exercises and Benson relaxation technique on pain, urinary incontinence and functional ability among postcesarean patients. Design: It will Single blinded randomized clinical trial with parallel group design. 30 Participants will be allocated to two groups equally. Settings and conduct: Arif Memorial Teaching Hospital Participants/Inclusion and exclusion criteria: Inclusion Criteria • Women aged 20 to 42 at 7 to 14 weeks after delivery or cesarean section Experiencing pain in the pelvic region post-cesarean section. • Patient's BMI did not surpass 30 kg/m2 primiparous and mild-degree SUI • Presented with symptoms of urinary incontinence. • Patients who were not currently undergoing any other specific pelvic floor rehabilitation program. Exclusion Criteria • Individuals with cognitive impairments or communication difficulties that may hinder participation in the study. • Patients with active infections or complications related to the cesarean section incision site. • Patients with severe medical conditions that may limit their ability to perform the prescribed exercises or relaxation techniques. Patients undergoing treatment for pelvic floor issues with interventions that may interfere with the study outcomes. presence of hypertension, diabetes, genital prolapse, and smoking. Intervention groups: Group A will receive Pelvic floor activation exercises with Benson relaxation technique. Pelvic floor activation exercises will be performed for 4 weeks and five times in a week. Group B will receive Pelvic floor activation exercises only. Benson relaxation technique will be performed for 4 weeks and five times in a week. Main outcome variables: Pain: Numeric pain rating scale Urinary incontinence: International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form Functional ability: Functional Independence Measure

Study aim: To determine the effect of eltrombopag olamine on platelet recovery time and bleeding complications in patients of dengue fever Design: It is a single-center randomized, double-blind, controlled clinical trial with a parallel group design of 50 patients. Settings and conduct: This single-center clinical trial will be conducted at the Isolated Dengue Ward of Pak Emirates Military Hospital Rawalpindi. Patients will be randomized using online computer-generated numbers to either a control or intervention group after consent. The manual platelets count, serum albumin, serum ferritin, and lipid profile will be measured at the time of admission and 7 days after intervention, the intervention group will be given oral Tab eltrombopag 25 mg once daily for 03 days while the control group will be oral tablet of glucose for same duration. Participants/Inclusion and exclusion criteria: Adult patients with dengue fever and thrombocytopenia. Patients with malaria co-infection and severe dengue will be excluded Intervention groups: The patients in the intervention group will be given Tab eltrombopag 25 mg once daily for 03 days. The control group will receive routine and conservative medical care along with oral tablets of Glucose for 3 days once daily. Main outcome variables: 1. The primary outcome will be platelet recovery time and incidence of bleeding complications amongst the groups. 2. The secondary outcome will be changes in inflammatory markers. Both of the outcomes will be measured on the 7th day after intervention.

Study aim: To evaluate and compare the efficacy of 5% cysteamine cream and 4% hydroquinone cream in reducing melasma severity Design: Study Design: Double-blind, Randomized Controlled trial Study Setting: Combined Military Hospital,Quetta Study Duration: 6 months Sample Size: The sample size for this study was calculated using the WHO calculator and following parameters :- Level of significance (α) :5 % Power of the test (1-β) :90 % Anticipated Population Proportion 1 (P1): 0.249 Anticipated Population Proportion 1(P2): 0.38 9 Sample size (n): 228 Sampling Technique: Non probability consecutive sampling Settings and conduct: Combined Military Hospital Quetta Participants in cysteamine group will be instructed to apply a pea-sized amount of the assigned cream to the affected areas once daily at night as per following procedure :- 15 minutes for 1st 15 days. Subsequently, add 1 minute in 15 minutes everyday till 30th day. Continue to apply cream for 30 minutes for next 2 months. Participants in the hydroquinone group will apply thin layer over night for next 3 months. Patients will be assessed after every month for melasma according to MASI score.Picture will be captured at each visit for visual documentation and analysis. Participants/Inclusion and exclusion criteria: Inclusion Criteria: mild to moderate melasma (MASI score 4-24). Patients with epidermal and dermal hyperpigmentation. Patients with Fitzpatrick skin types III to V . Exclusion Criteria:Lactating and pregnant mother Chronic underlying skin condition Patient allergic to cysteamine and hydroquinone Intervention groups: Melasma: An acquired pigmentary disorder characterized by hyperpigmented patches on sun-exposed areas of the skin. MASI Score: A validated measure used to quantify the severity of melasma, based on the area, darkness, and homogeneity of pigmentation. Main outcome variables: Change in MASI score from baseline

Study aim: The Purpose Of This Study Will Be To Evaluate The Efficacy Of Weight Bearing Exercises With And Without Kinesio Taping In Improving The Clinical Outcomes In PFPS Patients. Design: Randomized, Blinded And Every Individual Participant Of PFPS is Involved in The Study. sample size: 48 Settings and conduct: Hospital Settings include the following: 1- Allied Hospital Faisalabad 2- Aziz Fatima hospital Faisalabad 3- Madina teaching hospital Faisalabad 4- Health 360 5- Awais Bin inam Clinic Participants/Inclusion and exclusion criteria: Inclusion criteria: Both Genders; age 15-30 years; PFPS undiagnosed patients; anterior knee pain and retro patellar pain; presence of pain on palpation; 3 of pain more than 6 weeks. Exclusion criteria: history of knee injury and surgery; patient with meniscal injury; surgery recent injury; knee cap dislocation; patellar instability; knee effusion Intervention groups: 2 groups Intervention group A (weight bearing exercises with Kinesio Taping) Intervention group B (weight Bearing Exercises only) Both groups included in inclusion and exclusion criteria. Both groups are experiencing knee pain and decrease knee function and Range of motion. Diagnosed both groups with the help of Kujula score and Goniometer, and assess level of pain through Visual analogue scale. Main outcome variables: Visual analogue scale (for measuring Pain) it consist of 1 to 10 numbers. Kujula Score (for knee pain and Function) have several questions to ask from patients Goniometer (for Range of motion)

Study aim: Evaluates the effectiveness of Mulligan techniques in reducing pain and improving mobility, strength, and function in cervical radiculopathy patients, with and without methylcobalamin. It also examines whether combining Mulligan techniques with methylcobalamin enhances nerve function recovery. Design: A comparative study with sample size 370, Randomly allocate the subjects into two groups. Intervention &control group Settings and conduct: Muhammad physical therapy clinic and rehabilitation center, Multan Participants/Inclusion and exclusion criteria: Inclusion criteria: Age 18–70y Uni-lateral upper-extremity pain, paresthesia, or numbness Loss of reflexes in the affected nerve root distribution Motor or sensory dysfunction (optional) Pain radiating to the arm cervical rotation range of motion less than 60 degrees Positive distraction test Positive Spurling's Exclusion criteria: Fractures Open wounds Patients with spinal cord compression Traumatic injuries Cancer Intervention groups: Patients will receive Mulligan traction and mobilization with methylcobalamin via phonophoresis for 12 sessions over 4 weeks (3 times per week). Manual traction will last 10 minutes (10 sec pull, 5 sec rest), and phonophoresis will be applied for 5-7 minutes per session using 0.8 MHz frequency, 1.5 W/cm² intensity, and continuous 2:1 mode. Main outcome variables: Immediate pain relief, improved mobility, and long-term nerve regeneration, reducing inflammation and promoting muscle and sensory recovery.

Study aim: This study aims to determine the effectiveness of intranasal desmopressin in reducing the risk of bleeding after insertion of tunneled dialysis catheters. Design: Two arm parallel group randomised trial without blinding Settings and conduct: This study would be conducted on patients with end stage renal disease requiring tunneled dialysis catheters for haemodialysis. Patients would be selected using consecutive sampling from the dialysis unit. All of them would be asked to give consent. Patients would be randomized into 2 groups using sequences generated online (and concealed as described above). Patients in the intervention arm would receive intranasal desmopressin, 1 puff in each nostril, 30 minutes before the procedure. This step would be omitted in the control group. Tunneled dialysis catheters would be inserted in the Dialysis Unit Procedure Room under ultrasound guidance. Fluoroscopic guidance is not available, and would thus not be used. All catheters would be inserted using Seldinger technique. Patients would be observed in the hospital for 24 hours after the procedure to record bleeding from exit site. Participants/Inclusion and exclusion criteria: We will include patients of either gender, aged 12 years or more, who require placement of tunneled dialysis catheters for maintenance haemodialysis. Exclusion criteria include uncontrolled blood pressure (>180/110 mmHg), previous catheter placement at the same time, coagulopathy, current use of anticoagulants and platelets count <50,000.ul. Intervention groups: Patients in the intervention arm would receive intranasal desmopressin. This would be a single dose of 1 puff in each nostril administered 30 minutes before the catheter placement. Main outcome variables: Primary outcome would be bleeding from the exit site. Secondary outcome would be the requirement of some intervention (chiefly purse string suture) in case of bleeding

Study aim: To compare outcomes in open hemorrhoidectomy versus ligasure hemorrhoidectomy. Design: Randomized Controlled Trial Settings and conduct: Department of Surgery, Allama Iqbal Teaching Hospital DG Khan. Participants/Inclusion and exclusion criteria: Inclusion Criteria: Patients aged 25 – 65 years of either gender, planned to undergo surgery for grade III or IV hemorrhoids. Exclusion Criteria: Patients with recurrent hemorrhoids, rectal carcinoma (medical record) and patients with thrombosis of hemorrhoids (on clinical examination) will be excluded. Intervention groups: This study has been planned to compare open versus ligasure hemorrhoidectomy (in terms of pain, bleeding, operative time, hospital stay, and urinary retention) in our local setting. Ligasure is considered safe procedure which does not need any special skill. However, Ligasure is an expensive device. Our study results will provide local evidence for surgeons to opt most beneficial surgical approach, keeping in view cost as well while dealing with patients having 3rd or 4th degree hemorrhoids. So, patients will get benefit of resuming their routine activities earlier and with ease. Main outcome variables: Operative time: Time in minutes from induction of anesthesia to extubation of endotracheal tube. Time will be recorded by nursing staff using a stopwatch. Intra-operative blood loss: Amount of blood (in ml) collected in graduated bottles and pre- weighted surgical sponge (1-gram increase = 1 ml). Pain will be graded 24-hours postoperatively using visual analogue scale 0 – 10, where 0 is no pain and 10 is worst bearable pain.

Study aim: This study evaluates the comparative effects of camphor and clove oil massage with and without Mulligan Traction in cervical radiculopathy, focusing on pain relief, mobility improvement, and the therapeutic benefits of the oils in reducing inflammation, pain, and supporting nerve health. Design: A comparative study with sample size 370, Randomly allocate the subjects into two groups. Intervention &control group Settings and conduct: Muhammad physical therapy clinic and rehabilitation center, Both outcome assessors and data analyser will be blinded to group assignments to minimize bias in treatment delivery and outcome measurement. Participants/Inclusion and exclusion criteria: Inclusion criteria: Age 18–70y Uni-lateral upper-extremity pain, paresthesia, or numbness Loss of reflexes in the affected nerve root distribution Motor or sensory dysfunction (optional) Pain radiating to the arm cervical rotation range of motion less than 60 degrees Positive distraction test Positive Spurling's Exclusion criteria: Fractures Open wounds Patients with spinal cord compression Traumatic injuries Cancer Intervention groups: Patients will receive Mulligan traction and mobilization with clove oil, menthol, via massage. Manual traction will last 10 minutes, with 10-second pulls and 5-second rests. Treatment will occur 3 times a week for 4 weeks, totaling 12 sessions. Mulligan SMWAM will be performed with 10-30 repetitions, and SNAG mobilizations will be applied. Clove oil, and menthol will be topically applied daily for 4 weeks, with each session lasting 5-6 minutes. Main outcome variables: Immediate pain relief, mobility, and long-term nerve regeneration, inflammation and promoting muscle and sensory recovery.

Study aim: To determine the individual effects of aerobic training and circuit training and comparison of these two on balance and disease severity in ataxic patients. Design: Randomized clinical trial, parallel group, single-blinded study. Settings and conduct: The setting of this study is Allied Hospital, Faisalabad. It is a single blinded study in which participants will be blinded. They will be allocated into the groups through online randomization generator. Participants/Inclusion and exclusion criteria: Inclusion Criteria • Participants ranging from 30-65 years of age were included in this study (mid adulthood). • Scale for Assessment and Rating of Ataxia (SARA) sitting sub-score was less than or equal to 1 (patients are able to sit and use a stationary exercise bike). • Both genders were included in this study. • Hemodynamically stable patients. • Patient fall on stage “3 and 4” of Ataxia staging scale. • Patients were able to walk independently with or without assistive device for at least 5 minutes (as a minimum criteria). Exclusion Criteria • Patient suffering from recent surgery of low back or lower limb. • Patient encountered any recent musculoskeletal injury (fracture, dislocation, soft tissue injury). • Patients suffering from heart problems/diseases. • Patients who were unable to exercise. • Medically unstable patients. • Uncooperative patients Intervention groups: Group 1is Aerobic training group (30 minutes on stationary cycling) Group 2 is Circuit training group (Stretching of calf and hams (30 sec hold/5 rep), bridging (1 set/5 rep), sit to stand (1 set/5 rep 30 seconds standing in each rep), stationary cycling (5 minute) and walk on parallel bars (5 minute) Main outcome variables: • Disease severity of ataxic patients is the primary outcome of this study. • Balance is the secondary outcome of this study.

Study aim: Our study aims to assess the predictive validity of the HACOR score in our demographic area for diagnosing non-invasive ventilation (NIV) failure in patients diagnosed with type-1 respiratory failure assessed after one hour of NIV therapy irrespective of the cause of respiratory failure. Design: Prospective, single center, single blinded, interventional study Settings and conduct: HACOR score to be assessed by the consultant on duty one hour before and after being on CPAP therapy blinded to the study protocol Participants/Inclusion and exclusion criteria: Inclusion criteria included patients with Pa02/FiO2 levels < 300 mmHg and PaCO2 levels less than 45 mmHg with PaO2 and PaCO2 (calculated by ABG (arterial blood gas) analysis) at room air or not maintaining ratio at low oxygenation therapy after administration of oxygen at FiO2 of 0.30 Exclusion criteria included patients with severe cardiorespiratory compromise, critical patients on vasopressor support, patients with poor lung compliance unable to breath in CPAP, intubated patients or those intubated less than 1 hour of CPAP, patients with a previous failed CPAP trial or on HFNO (high flow nasal oxygenation) in the last 72 hours, patients non-compliant on CPAP despite sedation and patients not willing to be included in the study. Intervention groups: One interventional group studies for the HACOR score and its predictive validity for NIV failure before and after one hour on CPAP therapy Main outcome variables: Primary variables studied were success and failure of CPAP therapy and accuracy of prediction of the HACOR score for NIV failure after 1 hour of therapy.

Study aim: The objective of this study is to compare the analgesic efficacy of intra-articular facet joint block versus transforaminal epidural injection in patients with lumbar radiculopathy. Design: A non blinded randomized controlled trial; single-center study with two intervention groups carried out from June 2023 to November 2023 Settings and conduct: The study was conducted in Anesthesia department of Combined Military Hospital Rawalpindi Participants/Inclusion and exclusion criteria: Inclusion criteria included all male and female patients between ages 30-60 years presenting in the pain clinic after confirmation of lumbar radiculopathy diagnosed by standard MRI imaging studies. Exclusion criteria included patients with debilitating cardiac or respiratory disease, tumors of the spine with or without metastatic disease, patients with known allergy to lignocaine, bupivacaine or steroids, patients with a regional block done for pain in the last one year. Intervention groups: The patients were divided into the facet-joint group (Group F) and the epidural group (Group E) Main outcome variables: Main variables were pain relief after each block and assessed on visual analog score , numerical rating scale and Oswestry disability index.

Study aim: The aim of this study is to investigate the effectiveness of interferential current therapy on pain, edema, range of motion (ROM), basic functional mobility and knee stiffness in the early postoperative rehabilitation in total knee arthroplasty. Design: Randomized Controlled Trial,After the synopsis is approved, the project will be conducted with in nine months,Non Probability Sampling Technique Sample Selection: Settings and conduct: Study Setting: Bahria International Hospital, Lahore Binding: The trial will be single-blinded because the assessor will not know which group will get treatment. Assessment: Baseline and post-treatment information will be analyzed from each participant to determine the effectiveness of each treatment. After the week of treatment, a follow-up assessment will be conducted, and all results compared during treatment. A comparison of the pre-and post-treatment ranges also will be performed. Participants/Inclusion and exclusion criteria: 52 Participants included. Both male and female patients. Age between 45 to 65 years. Participants who has undergone total knee arthroplasty for the first time Patients who are not exposed to IFC treatment pre-operatively. Exclusion criteria: Patients with causes as: Infections, Deep Vein thrombosis(DVT), Cancer and Epilepsy. Bone and joint diseases or serious diseases affecting organ function. Any patient with pacemaker or any electrical stimulator device Intervention groups: The experimental group used Interferential current therapy (IFC) in addition to conventional rehabilitation protocol. The control group received conventional rehabilitation training for the treatment of TKA. The same therapist will be employed to conduct each treatment for 20 minutes, twice a day, 3 times a week, for total of 1 week Main outcome variables: Outcome measures: Clinical and physical outcomes (Pain, Edema,ROM and Basic Functional Mobility)

Study aim: Assessing the Epley’s maneuver effects on reducing craniovertebral angle (less than 50-53 degrees) in patients having posterior canalithiasis due to forward head posture, vertigo after positive Dix-Hallpike maneuver Design: Randomized clinical trial Settings and conduct: The settings are The University of Faisalabad Participants/Inclusion and exclusion criteria: Inclusion criteria: Both male and female genders; reduced craniovertebral angle that is less than 50-53 degrees; computer/ laptop users; individuals with forward head posture; IT students of final year (The University of Faisalabad) Individuals with neck pain; positive Dix-Hallpike maneuver. Exclusion criteria: CVA (cerebrovascular accident); vestibular migraine; cervical spondylosis; history of fracture; upper cross syndrome; already diagnosed with Benign paroxysmal positional vertigo; other musculoskeletal conditions; other neurological conditions; mentally or emotionally unstable; brain tumor, hypertension. Intervention groups: interventional group: Epley’s maneuver control group: gaze stabilization exercises Main outcome variables: Dizziness handicap inventory, Visual Vertigo Analogue Scale.

Study aim: This study will guide the researchers to do more work on rhythmic initiation and rhythmic stabilization. It will guide the researchers to explore the effects of rhythmic initiation and rhythmic stabilization and decreases the facial weakness and increases the muscular movement. It will help them to identify the treatment techniques to improve the facial muscles, symmetry and its movement. Design: Randomized clinical trials with 32 participants of bells palsy and included by random allocation. Parallel group with blinded outcome assessment Settings and conduct: Mujahid hospital, Shahid Ahmed heera's health clinic, Allied hospital, Rubina Memorial, Faisal Hospital. Participants/Inclusion and exclusion criteria: Inclusion Criteria: Both gender, Age of 20-40 years, Acute onset 1-3 weeks, Bell’s palsy diagnosed with House Brackmann grading index Grade3,4, Steroids intake, Facial asymmetry with facial disability index. Exclusion Criteria: Patient having psychological problems, Patient having Neurological deficits, Patient having Stroke, Patient having Multiple Sclerosis, Facial palsy , Patient having Bilateral facial paralysis. Intervention groups: Patient was divided into two groups, group A and group B. In group A, Rhythmic initiation along with kabat patterns was applied on patient 12 sessions over 4 weeks, 3 times/weeks, 10-15 min and other group is group B, Rhythmic stabilization along with kabat patterns was applied on patient 12 sessions over 4 weeks, 3 times /weeks, 10-15min. Pre and post assessment were taken before and after intervention, then compare the readings to check the effect of both techniques and its effects of neuroplasticity on bell’s palsy. After 1 month follow up was taken. Main outcome variables: Facial asymmetry and muscular weakness

Study aim: The study aims to assess the comparative effect of METs and (muscle energy techniques) with and without scapular mobilization in patients with adhesive capsulitis. This study will help to highlight various physiological effects for managing adhesive capsulitis. To study the effect of Muscle Energy Technique on pain in patient with adhesive capsulitis. Design: Pragmatic, community based, parallel group, double blinded, randomized controlled trial. Total 377 patients will be enrolled. Patients who met our inclusion criteria will be randomized into two groups. Settings and conduct: Muhammad physical therapy & rehabilitation center Multan Participants/Inclusion and exclusion criteria: Inclusion: 1. Age range (e.g 30-60 y) 2. Patients who have completed their conservative treatment for a minimum of 6 Week 3. Patients with pain and Restricted range of motion in the affected shoulder joint 5. Patients who can understand exercise programe 6. Both genders Exclusion: 1. Patients with any other pathological disease related to the shoulder 2. Patients with neurological and rheumatological disorders 3. Patients with systemic diseases affecting the musculoskeletal system 4. Patients who may be limited in their capacity to exercise due to cardiovascular, respiratory, or metabolic issues 5. Pregnant or breastfeeding ladies 6. Fractures/dislocations 7. History of acute trauma or previous surgery in the affected shoulder 8. Patients treated with corticoid injection in the affected shoulder in the last 12 months (25, 26). Intervention groups: Group A 188 (who will receive METs with combination of scapular mobilization) and Group B 188 (who will receive METs without scapular mobilization). Main outcome variables: joint range of motion, joint stiffness, adhesions, independency and quality of life in adhesive capsulitis patients.

Study aim: TO STUDY EFFICACY OF MILTEFOSINE AND ALLOPURINOL IN COMBINATION VERSUS MILTEFOSINE ALONE IN CUTANEOUS LEISHMANIASIS Design: Clinical trial which is parallel group, double blind, randomized, phase 3 trial Settings and conduct: Dermatology Department, CMH Quetta Participants/Inclusion and exclusion criteria: Inclusion criteria Patients of both genders, aged 18-65 years with biopsy-proven cutaneous leishmaniasis. Plus • Positive LD bodies smear on Giemsa stain • Lesions in sites not responding to local treatment or meeting WHO guidelines • Multiple lesions on body • Lesions on lower legs, over a joint, mucosa or cartilage • Lesions located on sites not compatible with local treatment • Lesions that are potentially disfiguring or disabling (i.e. on face, fingers or toes) Exclusion criteria • People with comorbidity(diabetes, hypertension, chronic liver diseases, chronic kidney disease) and or immunocompromised • Allergy to Allopurinol,miltefosine and previous history of drug reactions to any drug. • Has lesions that are limited in size (papules, nodules or ulcerated nodules) • The lesion is already self-curing • Patients enrolled in other research protocols • Pregnant and breast feeding women • Those who refused to accept the diagnostic procedures • Children under 12 years of age Intervention groups: Group A: Receives miltefosine (2.5 mg/kg) plus a placebo.(wt > 45 kg = 50 mg x TDS, < 45 kg 50mg x BID, max dose 150 mg /day) for 28 days. Group B: Receives miltefosine and allopurinol (20mg/kg) Main outcome variables: Clinical Response

Study aim: The aim of the study is to compare the effects of Whole-body vibration and PNF(proprioceptive neuromuscular facilitation) techniques on pain, sensorimotor functions and balance in diabetic peripheral neuropathy Design: Two arm parallel group randomised trial with single blinded trial with 36 participants with diabetic pheripheral neuropathy,group A recieve Whole-body vibration and grouo B recieve PNF(proprioceptive neuromuscular facilitation) technique after pre and post outcome assessment , enrolled between july 2024 to december 2024. Settings and conduct: This study was conducted at Al-Shifa clinic Ahmed pur east from july 2024 to December 2024'. Participants/Inclusion and exclusion criteria: Inclusion criteria: HbA1c level should be >154ml/dL, Age beteeen 45 to 60, both male and femle participants, presence of sensorimoter dysfunction like pain and numbness,persisted pain for 4-6 weeks,Exclusion criteria: diabetic ulcers, high surgical risks,participants with cardiac conditions, neuropathic symptoms other than included in the study. Intervention groups: Group A recieves Whole-body vibration technique by standing on a vibratory platform to get vibrational stimulation. Group B recieves PNF(proprioceptive neuromuscular facilitation) techniques where the participants' limbs are moved through diagonal patterns to achieve the desired gaol. this intervention is designed for three times a week for eight weeks Main outcome variables: primary outcome variable: pain intensity measure with Numeric pain rating scale, secondary outcome variable: sensorimotor functions measured using the Leeds Assessment of neuropathic Symptoms and Signs (LANSS) scale balance measured with Berg Balance scale (BBS)

Study aim: To compare the impact of stretching exercises with and without kinesiotaping on pain levels, disability, and range of motion in shoulder flexion among dentists with rounded shoulders. Design: A double blinded, randomized clinical trial with sample size of 58 patients, enrolled between January 2024 & September 2024 Settings and conduct: Double blinded study conducted at physiotherapy OPD of Ibne Siena Hospital & Research Institute, Multan. patient and assessor are blind Participants/Inclusion and exclusion criteria: Inclusion criteria: 1)Patients with rounded shoulders diagnosed by physiotherapist. Calculate scapular index using formula (CP to SN)/(PLA to TS) *100 2) Both males and females 3) Age group 30-50 years 4) Patients with shoulder flexion limitation. 5) Patients with shoulder pain are included in the study 6) Dentists who treat more than 8 patients daily 7) Evidence of shoulder pain induced limitations in activities of daily life 8) Mobile Screen time should be less than 04 hours per day Exclusion criteria: 1) Individuals with frozen shoulder 2) Individuals with shoulder injury 3) Fracture or shoulder joint dislocation 4) Individuals with diabetic neuropathy 5) Neurological disorders like epilepsy or surgical procedures Intervention groups: Along with standard physical therapy kinesio-taping with approximately 50 to 60% stretch. 1st kinesiology tape applied from anterior aspect of acromion to spinous process of T10 vertebra. 2nd kinesiology tape was applied to same area with 50% overlay. Taping applied after every 3 days for 24 hours. Sessions given twice a week for 4 weeks lasting 30–40 minutes. Main outcome variables: Pain disability Shoulder flexion range

Study aim: To evaluate comparative effects of post isometric relaxation technique and straincounterstrain in patients with piriformis syndrome. Design: In the randomized clinical trial, participants were randomly assigned to either the Post-Isometric Relaxation or Strain Counter-Strain therapy groups, ensuring unbiased distribution. Both groups received standard conventional treatments, with each group getting its assigned therapy. This design improved the reliability and validity of the results. Settings and conduct: Participants were selected from Outdoor Patient Department of Allied hospital, National hospital Faisalabad Participants/Inclusion and exclusion criteria: Participants were eligible if they were aged 30-50 years, of either sex, with unilateral piriformis muscle involvement and positive FAIR and Beatty tests. Exclusion criteria included pregnancy, SIJ pain, lumbar radiculopathy, malignancy, previous hip, knee, or ankle surgery, pre-existing musculoskeletal abnormalities in the lumbar spine. Intervention groups: Both groups received 15 minutes of hot packs, 30-second piriformis stretches, and hip abductor strengthening. Group A received Post-Isometric Relaxation therapy with resisted piriformis contractions, while Group B had Strain Counter-Strain therapy with gentle pressure on the piriformis trigger point. Each additional therapy was given three times per session, three times a week, for four weeks. Main outcome variables: OUTCOME MEASURES A primary outcome measure was pain which was assessed by Numeric Pain Rating Scale (NPRS). Secondary outcome measures were hip abduction and internal rotation range of motion that was measured through universal goniometer and Lower Extremity Functional Status was assessed by Lower Extremity Functional Scale (LEFS).

Study aim: To determine the effect of deep transverse friction massage along with the nerve gliding exercises in the management of carpal tunnel syndrome patients Design: A Randomized Clinical Trial with two groups, not a blinded study of 3rd phase with 11 patients in each group, which is 22 in total Settings and conduct: Mujahid Hospital, Social Security Hospital, District Health Quarter Hospital Participants/Inclusion and exclusion criteria: positive Phalen's test, positive Tinel test, positive Duncan's test, both genders of patients with unilateral hand, age 20 to 40, moderate pain(4-7), No neurovascular surgery, No neurovascular condition of neck or upper limb, No neurological condition, No musculoskeletal problem of upper quadrant, No myofascial pain syndrome, No upper extremity trauma, No pain with orthopedic condition, No fracture, No post-traumatic stiffness, No osteoarthritis pain, Not pregnant, No diabetes mellitus Intervention groups: group A: TENS, Nerve gliding exercises, soft tissue massage Group B: TENS, nerve gliding exercises Main outcome variables: Pain, Wrist ROM, The Grip Strength, Functional Disability