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: 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

Study aim: To find the effectiveness of facilitated electric stimulation of two alternating patterns (abdominals cross hamstrings and lower back muscles cross quadriceps) on lower extremity pelvic tilts in stroke patients. Design: community based, parallel group, double blind, randomized controlled trial Settings and conduct: Allied hospital Faisalabad, Sahil hospital Faisalabad, Aziz Fatima hospital Faisalabad, Maqsooda Zia hospital Faisalabad Participants/Inclusion and exclusion criteria: Inclusion criteria • All men and women will be included in study. • Hemiplegic stroke patients will be included in study. 32 • Age between forty five to sixty years old will be included in study. • Patient with static and dynamic sitting balance will be included. • Patients with static standing balance will be included in this study. Exclusion criteria • All patients had imaging tests to rule out their diagnosis for stroke during the acute stage. • People who frequently have strokes. • People who have cerebellar, brain stem, or bilateral hemisphere lesions. • People who suffer from severe spasticity or cognitive impairment. • Patients with peripheral or orthopaedic neuropathy, substantial vision field defects, or hemi neglect issues were not included. Intervention groups: both groups are interventional. Group A Abdominals cross Hamstrings and additional conventional exercises 3 days per week with 30 minutes. Additional conventional exercises will include lower limb joint mobilizations (including hips, knees, ankles and feet), stretching of lower extremity, and ROMS. Group B Lower back cross Quads and additional conventional exercises 3 days per week with 30 minutes stimulation each session. Main outcome variables: Functional gait analysis Modified Ashworth scale Ranges of motion Pelvic tilts Carbon foot prints to measure cadence

Study aim: The objective of this study is to assess the synergistic effects of majoon-e-suranjaan with and without isometric exercises in rheumatoid arthritis patients. Design: Pragmatic, community based, parallel group, single blinded, randomised controlled trial. Total 100 patients will be enrolled. Patients who met our inclusion criteria randomised into two groups. Control group-A and treatment group-B Settings and conduct: At Muhammad Institute of Medical and Allied Sciences Multan after getting approval from institutional ethical committee. Participants/Inclusion and exclusion criteria: Inclusion criteria: Patients of all ages, diagnosed RA, of both gender, and patients with swelling in joints and pain. Exclusion criteria: Patients with vascular neoplasia, fibromyalgia, radiculopathy, neuropathy, tumor, joint fractures, and vestibular problems were excluded. Intervention groups: Control group A will be treated with majoon-e-suranjaan only while treatment group-B will be treated with isometric exercises and majoon-e-suranjaan. Dosage of 5 gm twice a day of majoon-e-suranjaan given after meal in the form of paste taken orally. The isometric exercises given to group B will be upper extremity resistive exercises, resistive hand training with the medicine ball, elbow, and shoulder resistive training by dumbbells. Lower extremity resistive exercises i-e resistive knee training by pressing soft rollers and ankle weights—upper extremity theraband strengthening exercises and lower extremity theraband strengthening exercises. Main outcome variables: Pain, stiffness and physical activities will be main outcome variables. And at the end patient dependency and range of motion will also be assessed. By using WOMAC and NPRS scale, pain stiffness and ADLs were the variables to be assessed. ESR will also be monitored. X-ray will also be done for the assessment of the joints with RA.

: Study setting is Department of Physical Therapy, DHQ Hospital Muzaffargarh, Punjab, Pakistan. The study

Abstract INTRODUCTION There is a great interest in vitamin-D supplementation that has recently grown; as the scientific community has reported extra renal production of calcitriol by cells in nearly all body systems and the presence of vitamin-D binding receptors in different tissues5 as the 1-α hydroxylase enzyme has been found in parts of the body outside the kidney1. A recent study in hemodialysis patients showed that 1,25-dihydroxvitamin-D3 levels increased after supplementation with nutritional vitamin-D, suggesting that even in ESRD there is enough extra renal 1-α hydroxylase activity to influence serum levels there by showing a role for nutritional vitamin D in patients with kidney disease6 OBJECTIVES 1. To find the effect of oral cholecalciferol supplementation on Bone Mineral Metabolism (25 hydroxyvitamin D level, Alkaline Phosphatase, intact Parathyroid Hormone (iPTH), Calcium (Ca), Phosphorus (P), calcium phosphorus product(Ca x P)) and 2. To find the effects of its supplementation on marker of inflammation (C Reactive Protein, White blood cell count) and chronic musculoskeletal symptoms (visual analog scale). MATERIAL AND METHODS: Study Design: Double blind Randomized controlled trail. Settings: The study will be carried out in the Hemodialysis Unit, Shaikh Zayad Hospital Lahore. Duration of Study: 2 months. SAMPLE SIZE: 70 , 35 in each group The sample size of 35 was estimated by using 95% confidence level, 90% power of the test with expected iPTH level at baseline and at two months 295± 90 and 249± 80 respectively24. SAMPLING TECHNIQUE: Lottery method SAMPLE SELECTION: Inclusion criteria Age more than 18 years On hemodialysis thrice per week for more than 3 months Both the gender Patients who give informed consents Exclusion criteria The patients with history of active bleeding (melena, hematemesis, hematochezia). Patients who have taken cholecalceferol or ergocholicalciferol within two months period, Patients taking cinacalcet Iv Iron in 1 month prior to enrollment Blood transfusion 1 month prior to enrollment during the study Any diagnosed malignancy, tubercular infection, sarcoidosis, pregnancy Calcitriol or activated Vitamin D3 or erythropoietin dosage adjustment 1 month prior to enrollment Patients having corrected serum calcium>10.2 mg/dl or having serum phosphorus >6mg/dl OUTCOME VARIABLES Serum level of 25 hydroxyvitamin D level, Alkaline Phosphatase, intact Parathyroid Hormone (iPTH), Calcium (Ca), Phosphorus (P), calcium phosphorus product(Ca x P)C Reactive Protein, White blood cell count) and for Chronic musculoskeletal symptoms (visual analog scale).

and outcome assessor blinding. Study will be conducted in Mayo Hospital Lahore, Pakistan Participants

Study aim: To check the effects of virtual rehabilitation versus therapeutic exercises in improving the balance of the lower limb of post-stroke patients. Design: Randomized Control Trial Settings and conduct: Physiotherapy Department of Abdullah Hospital Lalamusa Participants/Inclusion and exclusion criteria: Inclusion Criteria: • Age: 35 – 55 years. • Potential participants with 3 months post-stroke lower limb movement difficulties. • Ability to stand up with or without assistive devices • Patients with stable vital signs Exclusion Criteria: • Subjects with severe hypertension. • Lower limb amputation. • Patients with a history of Deep venous thrombosis or Pulmonary embolism. • Auditory or visual dysfunction. • If the patient has severe receptive or expressive aphasia that affects the ability to communicate with or give consent. • Significant cognitive impairment such as the ability to follow two-level commands. Intervention groups: Experimental group played video games using X-box and Kinect connected to the laptop. This group performed training for 35-40 minutes, 3 days/week for a total of 6 weeks times duration. The repetitions will increase according to the performance of the patient. Games were started from the basic level and the level was increased according to the patient’s performance. The training was done under the supervision of a trained physiotherapist to avoid any hazards. Main outcome variables: Balance

Study aim: To see the effectiveness of Mulligan mobilization with movement and corrective exercises and corrective exercises alone in scapular dyskinesia to evaluate level of disability of the affected limb after scapular winging. Design: Pragmatic, parallel-group, single-blind, randomized clinical trial Settings and conduct: The trial is conducted in Allied, District headquarters, and Aziz Fatima hospitals, Faisalabad. Subjects are chosen according to inclusion criteria. Subjects are blinded as they don't know their treatment protocol and group. Participants/Inclusion and exclusion criteria: Inclusion criteria: Both male and female; aged 30-50 years; Patients diagnosed with distal radius fracture; Patients treated with closed reduction and plaster cast immobilization; Patients having distal radius fracture at least six weeks ago, after removal of the cast; Patients with scapular dyskinesis measured using lateral scapular slide test; Side to side difference of more than 1.5 cm considered significant. Exclusion criteria: Patients having complications after removal of the cast (e.g., compartment syndrome, Complex regional pain syndrome 1, carpal tunnel syndrome, wrist drop, neural or vascular issues, etc.); Patient having any shoulder pathology before fracture and after removal of the cast (e.g., shoulder pain, frozen shoulder, impingement syndrome, shoulder instability, bursitis, fracture, etc.); Patient having any radiculopathy or radiculitis; Patients having any neck problem (e.g., neck muscles spasm, wry neck, torticollis, etc.); Patient having any spine deformity (e.g., kyphosis, scoliosis, etc.). Intervention groups: Intervention group: Mulligan Mobilization with Movement for positional faults. Maintain the glide and 8-10 reps of arm elevation were performed in 1 set. Control group: corrective exercise. Main outcome variables: Distance of scapula from the spine.