Study aim: 1) To determine the effects of Active Release and Post isometric Relaxation Techniques on pain and functional performance in patients with chronic lateral epicondylitis. 2) To determine the effects of Active Release and Post isometric Relaxation Techniques on grip strength in patients with chronic lateral epicondylitis. Design: 1. Single blinded Randomized clinical trial. 2. Outcomes Assessor (single blinded). 3. Clinical diagnosed with lateral epicondylitis by orthopedic surgeon. Settings and conduct: Settings: Sialkot medical complex hospital. Conduct: OPD of related hospital (physiotherapy department). Single blinded: A clinical trial in which outcomes assessor is blinded. An expert medical officer is working as outcomes assessor. Assessor has taken a Pre and Post treatment evaluation. Participants/Inclusion and exclusion criteria: Inclusion criteria: • Subject with unilateral epicondylitis. • Age group between 25-45 years with pain of atleast 6 weeks. • Both genders (males and females). Exclusion criteria: • History of cervical radiculopathy. • History of peripheral nerve involvement. • History of previous surgery of elbow. Intervention groups: Techniques apply containing active release technique with conventional treatment (pulse ultrasound for 5 minutes) for lateral epicondylitis and Post isometric relaxation (METS) with conventional protocol for lateral epicondylitis patient. Main outcome variables: Outcome variables: Pain by NPRS tool. Grip strength by Dynamometer. Functional performance by PRTEE scale

Study aim: To find the effects of tendon gliding exercises and neurodynamic techniques on two point discrimination in patients with carpal tunnel syndrome (CTS). Design: Two groups, Single blinded, Randomized Controlled Trial. Settings and conduct: Riphah College of Rehabilitation & Allied Health Sciences Fatima Memorial Hospital Participants/Inclusion and exclusion criteria: Inclusion criteria Age 20-40 years Gender both male and female Numbness and tingling in the area of the median nerve Positive Phalen’s test Positive Tinel’s sign Pain in the wrist area Exclusion Criteria Prior surgical treatment for carpal tunnel syndrome Tendon sheath inflammation Rheumatoid disease Past trauma to the wrist Intervention groups: Intervention group A Tendon Gliding Exercises, Intervention group B Neurodynamic Technique Main outcome variables: Two Point Discrimination, Boston Carpal Tunnel Questionnaire (BCTQ), Disability of Arm, Shoulder and Hand Questionnaire (DASH)

Study aim: To assess the efficacy of topical urea in combination with oral terrbinafine for the treatment of childhood dermatophytosis Design: Randamized control trial Settings and conduct: Lady reading hospital,Department of pediatrics Participants/Inclusion and exclusion criteria: inclusion criteria:patient with superficial dermatophytosis between age 2-14 years exclusion criteria: Intervention groups: 1.using terbinafine alone 2.using terbinafine along with topical urea Main outcome variables: 1. Clinical cure 2.prevention of chronicity and recurrence

Bahawalpur Pakistan with randomization of participants by lottery method keeping the participants blinded for

Study aim: The objective of this study is to compare the conventional measurement of neck extension versus ultrasound guided distance measured from skin to epiglottis (DSE) as sole predictors in determining difficult airway and laryngoscopy. Design: 150 patients (minimum sample size 139 as per WHO calculator) were included in the study as per the inclusion criteria furnished . The method of sampling was non-probability consecutive via lottery method. Settings and conduct: Maximum angle for neck extension in was measured with the patient sitting while keeping the head erect with mouth wide open and then asked to extend the head maximally while the anesthetist measured the angle traversed by the occlusal surface of the upper teeth. . In Group E, linear probe using ultrasound guidance was used to measure the distance from skin to epiglottis in the sniffing position with the patient lying supine . To remove bias, the anesthetist performing pre-operative airway assessment were different to those confirming through Cormack Lehane scoring. Participants/Inclusion and exclusion criteria: Inclusion criteria included all ASA I and II patients aged 20-40 years presenting to the anesthesia department after pre-anesthesia assessment for subsequent elective surgeries under general anesthesia Exclusion criteria excluded patients with patients with a history of burns or trauma to the airways, patient with a history of tracheostomy or lower airway surgeries and patients unwilling to be included in the study. Intervention groups: All the patients included in the study were divided into two groups, Group N, undergoing neck extension as sole predictor and Group E, using DSE by USG as a sole predictor for difficulty airway. Main outcome variables: Comparison of sensitivity and specificity showed a sensitivity of 76.9% in Group N versus 88.4% in Group E (DSE). Specificity showed 69.4% in Group N versus 87.5% in Group E.

Study aim: To evaluate the efficacy of zinc supplementation compared to a placebo in augmenting standard therapy for the management of bronchiolitis in pediatric patients. Design: Single blind randomized controlled trial Settings and conduct: The study was conducted in the patients admitted in Children hospital and university of child health sciences Participants/Inclusion and exclusion criteria: Inclusion criteria Children with age group 2 - 23 months having and Clinical signs & symptoms of acute bronchiolitis were included Exclusion criteria Children with use of mechanical ventilation in neonates or History of prematurity, Recent use of antibiotic, Congenital heart and lung disease, Down syndrome, Respiratory failure signs, Immunodeficiency, Previous wheezing episodes history, Family history of allergies and/or asthma, Metabolic or neurological diseases, Zinc intake during the previous one month were excluded Intervention groups: One group received 1% zinc sulphate (20mg/5ml) orally (0.5 cc/kg in children with age below one year and 5cc (20 mg) in children with age above 1 year). Other group received placebo treatment (5%-100% glucose water and oral flavoring). General appearance, smell, color and taste of the Zinc and placebo syrups was similar. Main outcome variables: Patients were evaluated for the clinical sign & symptoms including wheezing, rhinorrhea, cyanosis, subcostal and intercostal retraction, tachypnea, fever and nasal flaring. pre-designed Performa was sued to record findings.

Study aim: Comparison of efficacy of infrared heat therapy with cryotherapy as an adjunct to meglumine antimoniate in treatment of cutaneous leishmaniasis Design: Clinical trial which is a parallel group,double blind, randomised, phase 3 trial Settings and conduct: Dermatology department Combined military hospital Quetta Participants/Inclusion and exclusion criteria: Inclusion criteria includes 18 years or older, diagnosis confirmed with biopsy and smear ,caused by leishmania species amenable to treatment with meglumine Exclusion criteria involves individuals with comorbidities, pregnant women, abnormal ECG, allergy to antimonials, compromised immune system, diffuse or visceral leishmaniasis, Intervention groups: Patient,researcher and outcome assessor studying three groups ,group 1,group 2 and group 3.Group 1 receiving infrared heat therapy twice a week 2 cycles of 10 mins session with gap of 2 minutesand meglumine antimoniate group 2 receiving cryotherapy twice a week with cryogun/cotton wisp applied on lesion unless appears white and meglumine antimoniate and group 3 receiving meglumine antimoniate alone Main outcome variables: Clinical response

Study aim: To compare the efficacy of balloon tamponade versus Sengstaken-Blakemore tube in patients with primary PPH. Design: Open label, randomized controlled trial. Settings and conduct: Gynecology and Obstetrics Department, Bahawal Victoria Hospital, Bahawalpur, Pakistan Participants/Inclusion

Study aim: To compare the safety and efficacy of oral and subcutaneous routes of administration of methotrexate in patients with severe psoriasis Design: Total 60 patients will be randomized by lottery method into two equal groups with 30 patients in each group (sample size calculated by WHO sample size calculator) Settings and conduct: National University of Medica Sciences in collaboration wit dermatology department of PEMH Participants/Inclusion and exclusion criteria: inclusion criteria 1. Both gender, aged between 18 and 65 years 2. Severe psoriasis PGA score of 4 exclusion criteria 1. Pregnant or lactating women 2. Any respiratory, cardiac, GI, hepatic, or renal illness 3. Patients on biologics Intervention groups: intervention group 1 :will receive oral Methotrexate (10 mg up to 25 mg) weekly. intervention group 2 :will receive subcutaneous Methotrexate (10 mg up to 25 mg) weekly Main outcome variables: PGA score Adverse effects including number of episodes of vomiting and diarrhea laboratory investigation for Hb level, serum ALT, serum AST, urea and creatinine levels.

Study aim: To compare efficacy of Titanium Screw and Gutta Percha Sticks for obturation of Mental Foramen after Mental Nerve Neurectomy Design: Single Blinded Randomized Controlled Trial Settings and conduct: Oral and Maxillofacial Surgery Department of AFID, Pakistan Participants/Inclusion and exclusion

Study aim: To explore lidocaine infusion can be used as anesthetic adjuvant Design: Interventional, prospective, double-blind randomized study Settings and conduct: This study after approval by our Institutional ethical Review Committee will be carried out in POF Hospital Wah Cantt. Participants/Inclusion and exclusion criteria: Inclusion • ASA I and II 18-60y Exclusion • ASA, III, IV, V &, and VI • Abnormal LFT/RFT Intervention groups: Lidocaine infusion 2ml bolus dose & the continous infusiion @ 8 drops / min till closure of incision. Main outcome variables: L-6, IL-8 Inflammatory markers Mobilization after surgery VAS

Study aim: The objective of this research was to assess the effectiveness of oral promethazine in comparison to intranasal midazolam in terms of its sedative and anxiolytic effects prior to anesthesia in children. Design: Single center two arm parallel group randomized control trial of 100 participants with pre operative care and outcome assessment Settings and conduct: This is a non- blinded randomized control trial done at department of anaesthesiology, Combined Military Hospital Rawalpindi, after approval from the ethical board committee Participants/Inclusion and exclusion criteria: Children between ages 2-6 years, of either gender, undergoing elective surgery were included in the present study. Children with respiratory issues, known allergies, and required intravenous anesthesia were excluded from the present study. Intervention groups: Two intervention groups: group M, which received intranasal midazolam at a dosage of 0.3 mg/kg, administered 30 minutes before the start of general anesthesia induction, and group P, which received oral promethazine syrup at a dosage of 1 mg/kg, administered 90 minutes before the start of general anesthesia induction. Main outcome variables: The assessment of the patient's sedation and emotional levels will be conducted using a five-point sedation scale and a four-point emotional scale. The study also includes the examination of heart rate, respiratory rate, and oxygen saturation % to assess the effect of intervention.

Centre of Pak Emirates Military Hospital, Rawalpindi , Punjab, Pakistan. Patients have been blinded and

Study aim: To compare the clinical outcomes and analgesic efficacy in patient’s post-thoracotomy treated with extra pleural paravertebral block (PVB) versus thoracic epidural anesthesia (TEA) Design: A prospective, two-arm, parallel-group, non-randomized clinical trial comparing extra pleural paravertebral block and thoracic epidural block for post-thoracotomy pain. Participants will be allocated to either group without randomization. No blinding will be performed. sample size 140 Participants. Settings and conduct: This quasi-experimental study was carried out at the Department of Anesthesiology, Combined Military Hospital, Rawalpindi from Jan-Jun 2024. Participants/Inclusion and exclusion criteria: Inclusion Criteria: ASA-II and III male and female patients between ages 25-65 years presenting in the pre-anesthesia clinic planned for an elective diagnostic and/or therapeutic thoracotomy. Exclusion Criteria: Patients with metastatic disease, major cardiac or respiratory disease, low ejection fraction, post chemotherapy, allergy to lignocaine and/or bupivacaine, unwilling to be included in the study, infection at site of block, coagulation disorders, ineffective regional block, and failure to perform block after three consecutive attempts by a consultant pain specialist Intervention groups: The patients were divided into Group A (n=70) to receive Paravertebral block (PVB) and Group B (n=70) to receive thoracic epidural anesthesia (TEA) Main outcome variables: Primary variables studied were median Visual Analogue Scale Score for first 24 hours after 6 hour intervals and mean dose of added rescue analgesia (Intavenous Nalbuphine 0.15 mg/kg) required once pain scores reached above 5 on the Visual Analogue Scal scale for all patients.

Study aim: To compare the effect rooming-in practices and vaginal birth versus cesarean delivery on the quality of early mother–infant bonding during the immediate postpartum period Design: quasi-experimental design Settings and conduct: PNS HAFEEZ Participants/Inclusion and exclusion criteria: Inclusion criteria: Primigravida aged 18 to 40 years, with a single, full-term pregnancy (38–42 weeks of gestation), classified as American Society of Anesthesiologists (ASA) physical status II planned for vaginal delivery . Exclusion criteria: Women were excluded who had multiple gestation (twins or triplets), known major fetal anomalies or a history of significant psychiatric illness Intervention groups: Group-VD (vaginal delivery) Group-CD (cesarean delivey) Main outcome variables: PBQ SCORE

Study aim: The study aims to Compare the effects of the Active Release Technique and Muscle Energy Technique On Low Back Pain, Range of Motion, and Balance caused by psoas syndrome among office workers. Design: A single-blinded randomized controlled trial, conducted on 80 patients, equally divided into two groups, single centered study Settings and conduct: Family clinic in Lahore. single-blinded study (patient will be blinded to the recruited group) Participants/Inclusion and exclusion criteria: Inclusion criteria: both gender; age 25-53 years, Low Back Pain for more than 3 months. Exclusion criteria: history of trauma; systemic diseases; fractures; congenital diseases; dislocation. Intervention groups: Patients with low back pain caused by psoas muscle will be selected from both genders. VAS will be used to measure low back pain. Goniometer will be used to measure the range of motion, and a berg balance scale will be used to measure balance. Group A: will receive routine physical therapy for low back pain i.e; hot packs, tens therapeutic ultrasonic, with spine isometrics, rolling technique, along with active release technique. Each session would be of 40-45 minutes 5 times a week for 3 weeks to 6 weeks. Group B: will receive routine physical therapy for low back pain i.e; hot packs, tens therapeutic ultrasonic, with spine isometrics, rolling technique, along with muscle energy technique. Each session would be of 40-45 minutes 5 times a week for 3 weeks to 6 weeks. Main outcome variables: 1. Pain intensity 2. Range of motion 3. Berg balance scale

Study aim: To evaluate the efficacy of high dose solumedrol in patients with severely hypoxemic COVID-19 infection. Design: This is a single-center, double-blinded, randomized, and controlled parallel groups study. Each group will include a total of 30 patients. Patients will be grouped in a randomized manner via a concealed method Settings and conduct: All patients admitted in the intensive care with severe COVID-19 infection will be randomly assigned to any of the arms in a blinded manner. The ICU nurse and the patient will be blinded. The injection will be administered in 100 ml saline which will be numbered. Participants/Inclusion and exclusion criteria: Inclusion criteria: 1. written informed consent 2. Subjects age > 18 years at the time of signing the Informed Consent Form. 4. individuals with severeCOVID-19 symptoms according to Berlin Criteria 6. Hospitalized patients and on Mechanical Ventilation Patients requiring FiO2 of 0.5 or more and a PEEP of 5 mmHg or more exclusion Criteria: 1. Pregnant females 2. Patients with HIV infection., or active tuberculosis, or a history of treatment for pulmonary tuberculosis 4. Patients with a CrCl of less than 30 ml/minute, an ejection fraction of 30% or less, or advanced liver disease 7. Patients allergic to methylprednisolone Intervention groups: Group 1: Patients will receive standard of care and 1000 mg methylprednisolone for three consecutive days after randomization Group 2: patients will receive standard of care and a placebo medicine. Standard of care: This will include oxygen therapy, ventilatory support, antiviral drugs (remdesivir), antibiotics, fluids, PPIs, and anticoagulants. Main outcome variables: The primary outcome will be assessed based on in-hospital mortality. The secondary outcome will be assessed based on the: 1. duration of hospital stay 2. Improvement in lung mechanics, inflammatory markers, and incidence of infections

private sector teaching hospital in Pakistan. Randomized sampling technique was used for data collection

Study aim: To evaluate the role of intermittent use of CPAP (continuous positive pressure ventilation) in hypoxemic patients with CVOID-19 infection requiring at least 10 liters of oxygen. Design: Two arms parallel-group open-labeled randomized clinical trial Settings and conduct: The trial will be conducted in the department of General Medicine in the specialized COVID isolation units. This is an open-labeled clinical trial conducted in patients with severe COVID pneumonia requiring oxygen supplementation of 10 liters or more. Participants/Inclusion and exclusion criteria: Inclusion Criteria: 1- Age between 18 to 70 years 2- COVID-19 confirmed patients on 10 liters of oxygen or more. Exclusion criteria: 1. Unco-operative patient 2. Pneumothorax 3. Surgical emphysema 4. GCS less than 13 5. Excessive respiratory secretions 6. Shock Intervention groups: One group (control) will receive the conventional treatment while patients in the intervention group will be put on intermittent CPAP therapy. These patients will be put on CPAP for two hours in the morning and two hours in the evening. Patients will be kept in the intervention group until their oxygen demand reaches 30 liters or more. Main outcome variables: The primary outcome will be assessed based on the in-hospital mortality. Secondary outcomes will include the duration of hospital stay, patients requiring mechanical ventilation, and patients requiring the use of continuous CPAP or BiPAP therapy.

Therapy and Rehabilitation Clinic, Lahore Pakistan. Patients and outcome assessors/data collectors were

Therapy department of City Hospital Jalal Pur Jattan, Gujrat, Pakistan Participants/Inclusion and

Pakistan sports Board, Lahore and Other local cricket clubs in Lahore. The evaluators who measure outcome

Study aim: The study aims to evaluate the short-term effects of Kinesio Taping on pain intensity and neck functional status using the Numerical Rating scale (NRS) and the Oswestry Neck Disability Index (ONDI). Design: A randomized controlled trial (RCT) with a parallel-group design will compare Kinesio Taping + standard care vs. standard care alone in 100 neck pain patients. Randomization will be concealed. Assessments will be conducted at 24 hours, 3 days, and 1 week post-intervention. Settings and conduct: The trial will be conducted in clinical settings. Participants will be randomly allocated to the intervention or control group. This is an open-label study; therefore, blinding will not be applied to participants, investigators, or outcome assessors. Participants/Inclusion and exclusion criteria: -Inclusion Criteria: Adults aged 18-70 years.Chronic neck pain.Trauma or injury to the neck or Cervical spine.Informed consent and participate in the study. -Exclusion Criteria: Recent surgery of neck.History of neck or cervical spine fractures.Presence of cancer in neck or cervical spine.Pregnant or breast feeding women.Skin allergies, open wounds and infections in neck area.Patients with inflammatory diseases(e.g Rheumatoid arthritis,Ankylosing Spondylitis). Neurological disorder and Neck trauma. Intervention groups: The intervention group will receive Kinesio Taping (K-tape) on the neck based on standard KT guidelines. Taping will be applied for three consecutive days and reapplied over one week. Physiotherapy, exercises, and NSAIDs will be provided as needed. Main outcome variables: Numeric pain rating scale(NRS) and Oswestry neck disability index(ONDI).

Study aim: The aim of this study is to explore the effect of Kabat exercises along with mirror therapy in Bell's palsy in improving facial movement and asymmetry Design: The 32-patient age range of 25–50 years was included in this study. In this randomized clinical trial, the non-probability purposive sampling technique (random allocation to groups by means of the lottery method) was used. Randomization was done into 2 groups (treatment group and control group. Settings and conduct: Faisal Hospital, Rubina memorial Hospital, Madinah teaching Hospital, Allied hospital Faisalabad, Mujahid Hospital, Shahid Ahmed heera’s Health Clinic Participants/Inclusion and exclusion criteria: Inclusion criteria: Both genders, Male and Female, Age of 25–50 years, Acute onset (1-3 weeks), BP diagnosed with HBGS (grades III and IV), Facial asymmetry checked with FDI. Exclusion criteria: Patient having psychological problems, Hypertensive patient, Neurological deficit, Sensory deficit, Stroke, MS. Intervention groups: In the treatment group intervention, Kabat exercise along with mirror therapy for 12 sessions over 4 weeks, 3 times per week, for 10-15 minutes. In the control group only Kabat exercise was given for 12 sessions over 4 weeks, 3 times/week for 10-15 minutes. Main outcome variables: Facial movement (like eye closing, blinking, lip closing smile) and asymmetry

: Physical therapy department of WAPDA Teaching Hospital Complex Lahore, and Pakistan Society for the Rehabilitation of the Disabled, Lahore, Punjab, Pakistan Participants/Inclusion and exclusion criteria