Study aim: To find out the effectiveness of McKenzie exercises compared to conventional physical therapy in patients with chronic non-specific neck pain. Design: Randomised, superiority, parallel group trial with blinded outcome assessment. Randomisation was centralised and computerised with concealed randomisation sequence carried out at an external site Settings and conduct: Physical therapy department of Hayatabad Medical Complex (HMC). Participants/Inclusion and exclusion criteria: Inclusion Criteria: • Male and female individuals • Age 18 to 65 years • Having localized chronic non-specific neck pain from ≥ 3 months Exclusion Criteria: • Cervical radiating pain • History of the neck surgery in the past 12 months • History of spinal cord lesion • Diagnosed cases of serious pathologies like infection, inflammation or malignancy Intervention groups: Control Group: The conventional physical therapy protocol will include active neck exercises, which consists of functional exercises, postural exercises, stretching, relaxation exercises and isometric neck exercises to increase strength or range of motion. Exercise therapy may also be preceded by massage (such as soft tissue release for 5 minutes), stretching, or physical therapy techniques like heat applications (such as hot pack for 10-15 minutes), interferential current, and transcutaneous electrical nerve stimulation (TENS) application. Experimental Group: The patient will be asked to keep their head as forward-facing as possible while moving it backward as much as they can. Making the movement as large as possible is crucial. After finishing, the patient goes back to their neutral rest position. Main outcome variables: Numerical Pain Rating Scale (NPRS) for neck pain, Copenhagen neck functional disability scale (CNFDS) to measure neck functional activity and goniometer to measure cervical ROM.

Study aim: To compare the efficacy of intralesional tranexamic acid and topical 4% hydroquinone in the treatment of melasma Design: Comparative prospective study Settings and conduct: Study was conducted at the Dermatology Department, Pak Emirates Military Hospital Rawalpindi, Pakistan from 16th

, Pakistan. Participants/Inclusion and exclusion criteria: Inclusion criteria: • Patients of both genders

: Faisalabad Institute of Cardiology, Faisalabad, Punjab, Pakistan. This setting is used to conduct the

Study aim: To compare the effects of Bowen therapy and tennis ball technique on pain and functional disability in patients with thoracic myofascial pain syndrome Design: This study will be Randomized Clinical Trial, parallel-group, triple blinded Settings and conduct: The trial would be conducted in District Headquarters Hospital Kasur. it would be triple blinded, as the patients, assessor and analyzer would be blinded. Participants/Inclusion and exclusion criteria: Inclusion criteria: Both male and female patients; Age group 18-40 years old; Only patients reporting pain on numeric pain rating scale above 4; Individuals fulfilling the criteria of five major(spontaneous pain, palpable taut band, localized sharp tenderness, referred pain, decreased ROM) and at least one out of three minor signs (pain on pressure, local twitch response (LTR), decrease in pain by muscle stretching) of myofascial pain syndrome will be included. Exclusion criteria: Patients with fibromyalgia; Individuals with any other deformity like scoliosis; Participant taking anti-inflammatory drugs will be excluded. Intervention groups: Intervention group: group A will receive Bowen therapy, the position of ease will be produced and then small moves at varying pressure will be applied. The treatment will include light, cross-fibre manoeuvres of muscle, tendon with no forceful manipulation. one session will take 15-20 minutes. Intervention group: group B will receive tennis ball technique, position of ease either standing or lying will be achieved, then placing a tennis ball between the body and the wall or floor, Rolling the ball across these areas for a short time will relax the knot. it will take 10 -15 minutes. Main outcome variables: Pain; Functional Disability

Study aim: The study aims to contribute to understanding of the relationship between Mindfulness based stress reduction and academic stress and efficacy of Mindfulness based stress reduction on academic stress for academic benefits . Design: The randomized control trial comprises pre test and post test with a follow up period. Settings and conduct: 160 academic stress students will be selected by purposive sampling technique and were randomly assigned in experimental and control group. The data will analyzed by SPSS through ANCOVA. Participants/Inclusion and exclusion criteria: 1) Academic stress which student has.18 to 30 years. A willingness to commit to 2.5 hours of MBSR at the identified times for a period of 8 consecutive. Scores of academic stress moderate levels on the perceived academic scale. Individuals will be excluded if they will not attend at least 2 sessions of MBSR. Moreover those who will be suffering from other medical and mental issues they will engage in any other health program. Intervention groups: An eight week training in Mindfulness Based Stress Reduction consisting of 2.5 hours of instruction per week and 45 minutes per day of home practice. The course will utilize the materials from palousemindfulness.com (permission has been sought and received from the site owner), which include video and written materials. Mindfulness practices include mindful eating, body scans, focused breathing and gentle yoga poses. These are conducted during the sessions and in home practice tasks. The palousemindfulness course is designed to be self-directed. Maximum group numbers will be 10 per group. Main outcome variables: Mindfulness, Academic Stress, Academic Achievement, Academic Self-efficacy, Academic Resilience, Academic Burnout and Suicidal Ideation.

Study aim: The aim of study will be to compare the effects of Myofascial release technique with Cognitive Behavior Therapy on Pain, Craniovertebral angle, Neck Disability in university students with chronic neck pain and forward head posture Design: Parallel group randomized clinical trial and Randomization will be achieved through computer generated random number table. Settings and conduct: Safi Hospital. It will be assessor who will be blinded about the type of intervention. Treatment will be given by principal /investigator Participants/Inclusion and exclusion criteria: Inclusion Criteria: Age group: 18-28 Years, Gender Group: Both male and female participants, Individuals with Craniovertebral angle <53, Individuals having grade 2 neck pain according to KNGF Guidelines. Exclusion Criteria: Past history of shoulder and spine surgery, Congenital problems, Fibromyalgia, Myopathy, Cervical Radiculopathy, Trigger point injections, Any recent accidents Intervention groups: Interventional Group: (Group A) will receive a hot pack for 5 minutes, followed by a 10-minute myofascial release technique. After that, they will perform isometric exercises consisting of six movements, holding each movement for 10 seconds, repeating every five times with a 5-second rest between them. Cognitive behavior therapy will be administered for 20 minutes, utilizing visual aids in the form of videos, images, animations, simple pamphlets, and text. Control Group: (Group B) will receive a hot pack for 5 minutes, followed by a 10-minute myofascial release technique. After that, they will perform isometric exercises consisting of six movements, holding each movement for 10 seconds, repeating every five times with a 5-second rest between them. Then, the patients will be provided with a Reference Guide on Ergonomics and Design, which they will read for 20 minutes. Main outcome variables: Pain Craniovertebral angle Neck disability

clinical Trial Settings and conduct: Riphah Rehabilitation Centre Lahore Pakistan Participants/Inclusion

Institute Hospital Karachi Pakistan. Participants/Inclusion and exclusion criteria: Inclusion Criteria

Study aim: To determine the comparative effect of resistance and aerobic training in pre frail to moderately frail patients for improving quality of recovery in post coronary artery bypass grafting surgery patients Design: Non Randomized, quasi experimental design of 46 patients were enrolled. Two arm parallel group with non blinded outcome assessment Settings and conduct: The setting was Faisalabad Institute of Cardiology Faisalabad and the trial was quasi experimental study and factorial design was used. Participants/Inclusion and exclusion criteria: The participants were selected on the basis of age 40 -65 years, both male and female were included, patient with double and triple vessel coronary artery disease were also included and patients who were mildly to moderately frail and had a Clinical Frailty Scale of 4-6 before surgery at the hospital setting and the participants were excluded on the basis of patient with unstable or recently unstable cardiac syndrome, prehabilitation is contraindicated in cases where a patient cannot follow study protocols due to cognitive impairment, patients who were severely frail (CSF 7-9) and a lack of consistency in attending prehabilitation treatments. Intervention groups: Intervention group 1: After giving participants the baseline treatment. Group 1 recieved aerobic training including walking for 10-15 minutes and stepping 8-12 repetitions. Intervention group 2: After giving participants the baseline treatment. Group 2 recieved resistance training including shoulder overhead press, biceps curl, hamstrings curl and knee lift 10-15 repetitions. Main outcome variables: Clinical Frailty Scale Quality of recovery WHO Disability Assessment Score 2.0

Study aim: • The purpose of the study is to evaluate the effects of manually applied percussions as opposed to mechanically applied percussions Design: The research will use a prospective randomized control trial as a study design. a study design in which participants are randomly assigned to either an experimental or control group. A hypothesis may be tested to see which variables are most likely to be significant explanatory factors. Settings and conduct: These investigations will be carried out in pediatric general ward and pediatric intensive care unit in Memon Medical Institute Hospital Karachi. Participants/Inclusion and exclusion criteria: Inclusion criteria: • Children who will admit with symptoms of lower respiratory tract infection • Pneumonia patients of age 3months-15 years • Pneumonia patients who are confined to a hospital bed for an extended period of time. Exclusion criteria: • Over fractures, spinal fusion, or osteoporotic bone. • Over tumor area. • If a patient has a pulmonary embolus. • If a patient has a condition in which hemorrhage could easily occur. • In recent neurosurgery, head down position is contraindicated. • If patients has a hyper-reactive airways(cystic fibrosis) and severe bronchospasm (asthma) though, not an absolute contraindication Intervention groups: The targeted population for this research will pediatrics population admitted under diagnosis of pneumonia in Memon Medical Institute Hospital. Main outcome variables: • There will be no significant effects of manual and mechanical percussions. • There will be no significant effects of chest physiotherapy of admitted peadiatrics patients. • There will be significant effects of manual and mechanical percussions. • There will be significant effects of chest physiotherapy of admitted peadiatric patients.

Faisalabad; City : Faisalabad, Pakistan; Study Population: Patients suffering with non-specific neck pain

Study aim: This study aims to compare the effects of blood flow restriction training and routine physical therapy on clinical and functional outcomes in patients with lateral epicondylitis. Design: Parallel groups randomized clinical trial with blinded outcome assessment Settings and conduct: This clinical trial is conducted at Wasim General & Orthopaedic Hospital Gojra. The patients in control group have received routine physical therapy treatment including application of TENS, moist heat pad and stretching exercises (06 reps with10 secs hold) and strengthening exercises (10 reps with 10 secs of resistance application). The patients in experimental group have received blood flow restriction resistance training in addition to routine physical therapy treatment. In this training, limb occlusion pressure (LOP) is measured of affected upper limb. BP cuff is applied at deltoid level to restrict the blood flow at 30% LOP and then patient is asked to perform resistance exercises in 04 sets with 30 reps in 1st set and 15 reps in other 03 sets. Each participant(of both group)has 03 session per week for 06 weeks. Only data assessor is blinded. Participants/Inclusion and exclusion criteria: Patients of both genders having diagnosed unilateral tennis elbow in 20-50 years of age are included in the study. Patients who received steroid injections for tennis elbow in last 06 months, patients having cardiovascular diseases, bleeding disorders, peripheral diseases, hypertension, hypotension, tumor, trauma, systematic or skin diseases are excluded from the study. Intervention groups: There are two intervention groups. The control group is receiving routine physical therapy treatment alone and experimental group is receiving blood flow restriction training along with routine physical therapy treatment. Main outcome variables: The study outcome variables are pain, range of motion, functional disability and quality of life.

Study aim: To determine the effects of mobile application, dexteria fine motor skills on hand dexterity and grip strength in chronic stroke patients. Design: Randomized controlled trial Settings and conduct: • Jinnah Hospital Lahore(JHL) • Ittefaq trust hospital Lahore Participants/Inclusion and exclusion criteria: Inclusion criteria Age: 40 to 60 years both male and female • Six months to 2 years post stroke • Participants must be able to open and close their fingers (even only 2 cm of movement) • Before stroke there must be fully functional hand • Normal or intact vision where as exclusion criteria is • Neurological disorders other than stroke for example multiple sclerosis or Parkinson disease. • Upper extremities acute orthopedic conditions. • Any cardiopulmonary complications • Medically unstable patients. Intervention groups: Conventional hand therapy group: The control group received conventional hand function rehabilitation therapy including, strengthening exercises which consist of palm down wrist flexion exercise, dexterity( shifting exercise) and fine motor skills(nine peg hole exercise) this protocol is given for 30-60 minutes session with 10 minutes of rest duration, 3 times per week for one month. Dexteria App therapy Group: The experimental group received an additional mobile application therapy including , dexterity fine motor skills, bowling game, scribble game and peglight game in addition to the conventional therapy for hand function. This protocol is given for 30-60 minutes session with 10 minutes of rest duration, 3 times per week for one month. Main outcome variables: • The Nine Hole Peg Test (NHPT) • Fugl-Meyer Motor assessment (FMA) • The Box & Block Test (BBT) • hand dynamometer

Study aim: In order to investigate the effect of different frequencies of TENS in urinary incontinence the current study was planned as no such study was done in not only Pakistan but Asia. The study will investigates the effect of TENS at two frequencies among patients post-stroke urinary symptoms

Muhammad Physiotherapy and Rehabilitation Center, Multan, Pakistan. After approval obtained from the

Study aim: 1. To check efficacy of active segmental stretching and 30-minute walking on pain reduction. 2. To check life’s quality in fibromyalgia patients. Design: A parallel group, single blinded, randomized controlled trial conducted on 62 females diagnosed with fibromyalgia between August to November 2022 with a 6 week follow up. Settings and conduct: This study was conducted in orthopedic department of Aziz Bhatti THQ hospital, Gujrat Data analyser is only blinded in our study because he does not know which and how interventional exercises were performed by patients. Participants/Inclusion and exclusion criteria: Inclusion: Female from 20 to 65 year old diagnosed with fibromyalgia in outpatient/inpatient clinics or by America College of Rheumatology Criteria in general population. Exclusion: Joint disorders (Grade 4 arthritis, hip or knee arthroplasty, rheumatoid arthritis) that can cause hindrance in the exercise program. Respiratory diseases or cardiovascular diseases (heart failure, cardiac pacemaker, uncontrolled arterial hypertension) that would prevent physical exercise. Pregnant and post-partum women. Intervention groups: Active segmental stretching group: Participants undergone through a 6-week supervised exercise program involving active segmental stretching of muscles mostly involving large muscles (paravertebral, gluteus, quadricep, hip abductor, latissmus dorsi, pectoral, trapezius and calf stretches). Each exercise was held for 30 seconDS 30- minute walking group: participants only undergo 30 min of brisk walk in bouts of 15 minute with no other specific exercises or Each intervention was done thrice a week for first three weeks and four time per week for the next three weeks Main outcome variables: Fibromyalgia impact questionnaire-revised (FIQR) for symptoms and impact of Fibromyalgia Numeric pain rating scale for pain SF-12 for quality of life

Settings and conduct: Department of gastroenterology tertiary care hospital Rawalpindi Pakistan

will be conducted at Muhammad Physiotherapy and Rehabilitation Center, Multan, Pakistan. After approval

Lahore, Pakistan. Participants/Inclusion and exclusion criteria: Inclusion criteria: male and female(40

Study aim: To determine the efficacy of thalidomide in the treatment of transfusion dependent thalassemia. Design: Randomized Controlled Trial, single group study of 55 patients with non blinded outcome assessment. Non probability convenience sampling. Settings and conduct: This study will be conducted at Department of Pediatrics, Sheikh Zayed Medical College/Hospital, Rahim Yar Khan. This study will be conducted after approval from Ethical Review Board (ERB) of Sheikh Zayed Hospital and University of Health Sciences, Lahore. Participants/Inclusion and exclusion criteria: inclusion criteria: thalassemia patients aged 2- 15 years Exclusion criteria: Patient with liver, renal, cardiac, pulmonary, neurological deficits or thrombotic episodes. Intervention groups: Patients diagnosed with beta thalassemia diagnosed according to clinical characteristics and hemoglobin electrophoresis were included in this study according to the selection criteria. At the time of treatment the patients will interviewed and tested for pre-treatment variables which include hemoglobin levels, transfusion rate. All the patients will then be given 2-5mg/kg thalidomide for 6 months as prescribed by the consultant and these variables will be tested again. Response rate will be tested on the basis of operational definition. The principal investigator will follow up with all the patients and see post-treatment results. Main outcome variables: This study will help us determine if we can use thalidomide in the treatment of beta thalassemia patients for reduction of transfusion, increase Hemoglobin level and response rate.

Study aim: To compare effects of Janda’s approach with Bruegger’s exercise on clinical outcome in patient with lower cross syndrome. Design: two arm parallel group randomized trial with single blinded and single center Settings and conduct: Physiotherapy department of Dr. Khalid Clinic Lahore Pakistan

National Medical center, Karachi, Pakistan. The patients were divided into 2 treatment groups; group 1 was

Study aim: To compare the effects of Semont and Epley’s maneuver in patients with Benign Paroxysmal Positional Vertigo (BPPV) using Patient Specific functional scale and Activity based Confidence (ABC) scale Design: Randomized Control Trial RCT, Single blind study Study groups: Epley's and Semont group Phase: N.A Sample size : 24 Randomization: In this study simple random sampling technique is used by sealed envelop method by using a computerized random number generator. The study is single blinded as participants is not aware of the intervention group they are placed in. Study center: Single center study Settings and conduct: Health care unit in Islamabad (ENT department) In this study simple random sampling technique is used by sealed envelop method by using a computerized random number generator. The study is single blinded as participants is not aware of the intervention group they are placed in. Participants/Inclusion and exclusion criteria: Inclusion criteria: • Diagnosed Benign paroxysmal positional vertigo • Patients with recurrent rotatory vertigo attacks proceeded by rapid and/or gravity-dependent head movements • Patients with active daily life activities between ages 20 to 65 years • Patients having positional dizziness Exclusion criteria: • Patients who have any neuromuscular comorbidity • Patients on any kind of drug or sedative during study • Patients with epilepsy or on epileptic drugs • Patient with highly impaired vision • Bilateral Benign paroxysmal positional vertigo Intervention groups: There are 2 groups . 1. Epley's Group 2. Semont Group Main outcome variables: 1. Patient specific functional scale to evaluate functional scale 2. Activity based confidence scale to evaluate confidence level

Study aim: To compare the effects of core muscles strengthening exercises with routine physical therapy on trunk balance and functional mobility in stroke patients. Design: Single blinded, Randomized controlled trial Settings and conduct: Mubarak Medical Complex Participants/Inclusion and exclusion criteria: Inclusion Criteria: 1) Patients who has the first on set of ischemic stroke.2)Age between 40-60 years. 3) Medically stable, understand and follow simple verbal instructions. 4) Both male and female with chronic stroke (6 months post stroke). 5) MMSE > 24 Exclusion Criteria: 1) Patients who could not communicate (severe aphasia). 2) Participants having neglect of paretic limb 3) Participants with severe spasticity (modified ash worth scale score >3). 4)Patient having visual and sensory deficit. 5)If patient had a neurological disease affecting balance other than stroke, such as cerebellar disease, Parkinson’s disease or vestibule disease. Intervention groups: All the participant who came to physiotherapy department was considered and screened for chronic phase of stroke.74 patients were allotted in two groups i.e.; group A(RPT) and group B(RPT+ Core strengthening exercises) via lottery method, 37 in each group. Consider the inclusion and exclusion criteria before concerning them in study. Both groups will receive the routine physical therapy. Patient in A group will be treated by routine physical therapy and in B group with routine physical therapy plus core strengthening exercises. Dosage:- 30 minutes RPT in both groups and core strengthening exercises with 7-10 repetitions for 15-20 minutes with adequate rest interval in experimental group.  Duration: - Four sessions/week (alternative days) and treatment last for 8 weeks. Main outcome variables: 1: Trunk Balance 2: Functional Mobility