Study aim: To find out the effects of hydrotherapy versus land based exercises on pain and grip strength in osteoarthritis of hand Design: Parallel study groups, 68 sample size, phase 2, randomized, single center Settings and conduct: Study setting is Aziz Bhatti Shaheed Hospital Gujrat, Pakistan

: Department of Physical Therapy, Safi Hospital, Faisalabad, Pakistan. Participants/Inclusion and exclusion

Study aim: The aim of this study is to determine the effects of muscle energy technique and dry needling of active trigger points of quadrats lumborum in low back 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: participants, healthcare providers (Physicians, nurses, etc.) who care for participants during the trial, data collectors, outcome assessors, and with lessor importance Data Safety and Monitoring Board and manuscript writers. Participants/Inclusion and exclusion criteria: INCLUSION CRITERIA: 1. Subjects between 18 to 60 year of age 2. Both gender (Male & Female) 3. Participants have mechanical lower back pain of at least two-months duration, initial MODI Score: 30%-60% 4. Participants have an active trigger point in quadratus lumborum muscle according to Travell and Simons diagnostic critaria EXCLUSION CRITERIA: 1. Anticoagulation or bleeding disorders. 2. Acute muscle trauma. 3. Local or systemic infections 4. Lumbar disc herniation 5. Spinal deformities 6. Any spinal surgery history 7. Any participant taking anticoagulation medication Intervention groups: Muscle Energy Technique (Post isometric relaxation) Dry Neeedling Main outcome variables: Numeric Pain Rating Scale (NPRS) Modified Oswestry disability index (MODI) Pain Pressure Algometer

of physical therapy, Dar-ul-Shifa campus, Islamabad Pakistan. Participants were kept blinded, they

Unit of Jinnah Hospital Lahore, Pakistan. Ethics Committee approval was taken from Ethical review

Study aim: To determine the effect of sciatic nerve mobilization in the management of patients with lumbar radicular pain. Design: Single blind, Single Centre, parallel assignment Randomized Controlled Trial. Settings and conduct: The study was conducted at out Patient Physiotherapy Department of Syeda Khatoon-e-Jannat Trust Hospital Faisalabad. only outcome assessor was blind in this study. Participants/Inclusion and exclusion criteria: Patients with Age 25 -55 years from both genders with Positive Laseague sign or straight leg raise test, Unilateral leg pain radiation and more than 2 month's history were included, while patients with Infection –Tuberculosis, Inflammation around the lumbar spine, Tumors around the back, Lumbar instability/ Subluxation/ Fracture/ Spondylolisthesis, Osteoporosis, Joint hyper mobility, any red flag signs and Inability to comply with the study protocol due to cognitive impairment were excluded from study. Intervention groups: Those patient who met eligibility criteria, were randomly allocated into two groups by using lottery method: Group A and Group B. Group A: Experimental Group consisting of 40 patients. They performed 2 sets of 10 repetitions of each exercise 3 times/week for 2 weeks. Sciatic nerve mobilization was applied in appropriate position as per standard procedure. Group B: Control Group contained 40 patients and was administered conventional physiotherapy treatment only. Main outcome variables: Pain measured by numeric pain rating scale (NPRS), Modified Oswestry Disability Index and ROM by Inclinometer.

Study aim: To check and compare the comparative effects of kaltenborn mobilization versus maitland mobilization on pain and functional status in patients with patellofemoral pain syndrome Design: It will be a single blinded Randomized Clinical trial. A total of 40 participants will be recruited according to the criteria. Lottery method will be used for the recruitment of patients in two equal groups. Settings and conduct: The study will be conducted in Allied hospital Faisalabad and Physiotherapy clinics Faisalabad. Participants/Inclusion and exclusion criteria: Age range between 25-55 years Possible isolated pain to the anterior knee when the examiner applies pressure on the upper part of the patella while the patient engages in an isometric contraction of the quadriceps muscle. The test is also deemed positive if the patient is unable to maintain the contraction for more than two seconds. Have a history of patellofemoral pain syndrome, with symptoms persisting for at least the past 30. Participants must report pain during weight-bearing activities such as squatting, stair climbing, or prolonged sitting with bent knees. All participants must provide informed consent before enrollment in the study. Patients with structural abnormalities of the knee, such as valgus or varus deformities.Individuals with significant sprains, strains, or tears in the muscles, ligaments, or tendons around the knee . Patients with any recent fractures of the femur, tibia, fibula, or patella Individuals who have experienced a patellar dislocation .Patella Alta: Patients diagnosed with patella alta, where the patella is positioned higher than normal . Intervention groups: The patient in Group A will receive Kaltenborn Mobilization. The patients enrolled in group B will receive Maitland Mobilization . Main outcome variables: Patellofemoral pain syndrome ; knee pain

Study aim: To investigate the effectiveness of EEG-based neurofeedback (NFB) treatment versus current treatments for the improvement in symptoms among OCD patient Design: Randomised, parallel group, superiority trial with four arms. Sample size: 80 OCD patients. Randomisation: Centralised and computerised using random number generator software. Settings and conduct: The trial will be conducted in the Psychiatry Unit at Lady Reading Hospital, Peshawar. Participants/Inclusion and exclusion criteria: Inclusion Criteria: 1. OCD patients diagnosed according to DSM-V criteria. 2. Age range: 18–40 years. Exclusion Criteria: 1. Neurological conditions such as stroke, head injury, epilepsy, or dementia. 2. Severe medical conditions (e.g., hepatic or renal failure). 3. History of psycho-surgery or neurosurgical procedures. 4. Substance abuse or drug dependence. 5. Psychiatric comorbidities including schizophrenia, psychosis, or delusional disorders. Intervention groups: There will be four intervention groups with equal participants (n=20 each), randomly assigned: Group A: Treatment as usual (psychopharmacological treatment only). Group B: Mindfulness-Based Cognitive Behavioral Therapy (MBCT) + psychopharmacological treatment. Group C: EEG-based Neurofeedback (NFB) + psychopharmacological treatment. Group D: Combined MBCT and NFB treatment. All participants, except Group A, will undergo 12 weekly sessions of therapy (MBCT: 50 mins; NFB: 30 mins + prep time). Main outcome variables: Primary Outcome: 1. Reduction in OCD symptom severity, assessed using the Yale Brown Obsessive Compulsive Scale (YBOCS). Secondary Outcomes: 1. Levels of depression, anxiety, and stress (DASS-21). 2. Insight and belief delusionality (Brown Assessment of Belief Scale). 3. Childhood trauma severity (MACE). 4. Biomarker levels (IL-6, IL-Iβ, C-reactive protein).

Study aim: This study aimed to compare the effects of a comprehensive corrective exercise program with and without soft tissue massage therapy on pain, functional mobility, and quality of life in patients with office syndrome. Design: Two arm parallel individual randomized trial with blinded outcome assessment Settings and conduct: This randomized clinical trial (RCT) will be carried out in the Department of Physical Therapy and will be completed within nine months of receiving approval. Based on VAS outcomes, the computed sample size will be 34 participants per group (28 + a 20% dropout buffer), with a 95% significant level and 80% power Participants/Inclusion and exclusion criteria: Participants of age 18-55, both male and female, with at least one myofascial trigger point on the trapezius muscle, and who had worked in an office or on a laptop for over a year and reported using a laptop for more than three hours daily will be selected. The study will be excluded patients with a history of motor vehicle accidents, inflammatory disorders such as rheumatoid arthritis, and cervical or lumbar radiculopathies with or without neurological deficits. Patients with spine degeneration, those who had undergone myofascial pain therapy within the previous month , individuals with recent fractures or dislocations and pregnancy will also excluded. Intervention groups: Those who met the eligibility criteria will be complete consent forms to participate. The lottery method will be used for randomization, with participants’ names picked to determine whether they will assigned to Group A (Comprehensive Corrective Exercise Program [CCEP] with Soft Tissue Massage [STM]) or Group B. Main outcome variables: Pain using Visual Analogue Scale Functional Disability using Brief Inventory Pain Quality of life using WHOQOL-BREF

Study aim: The aim of this study was to evaluate the long-term effects of proton pump inhibitors (PPIs) on electrolyte, mineral, and vitamin levels in patients requiring prolonged acid suppression therapy. Design: A quasi-experimental, parallel-group trial conducted at a single center with a target sample of 60 participants. Participants were randomly assigned in a 1:1 ratio using computerized balloting. Outcome assessment was not blinded, and follow-up was conducted over 12 months. Settings and conduct: The trial was conducted at the Department of Family Medicine, Pak Emirates Military Hospital (PEMH). It was a single-center study where participants were recruited from family medicine clinics. The trial was not blinded, and both participants and investigators were aware of the assigned treatments. The trial was carried out from January 2023 to March 2024, with participants followed for 12 months. Data was collected through clinical assessments, blood and stool samples, and interviews at baseline, 3, 6, and 12 months. Participants/Inclusion and exclusion criteria: Inclusion criteria: Adults (≥18 years) requiring long-term PPI therapy for GERD, chronic gastritis, or Zollinger-Ellison syndrome. Exclusion criteria: Patients with H. pylori-related peptic ulcers, malabsorption conditions, or pre-existing electrolyte/vitamin deficiencies needing treatment. Intervention groups: Participants in the intervention group received oral omeprazole (20–40 mg daily), while the control group received famotidine or sucralfate. Electrolyte, mineral, and vitamin levels were monitored at baseline and at 3, 6, and 12 months. Nutritional supplements were not allowed, and those lost to follow-up were excluded from analysis. Main outcome variables: The main outcome measures were changes in electrolyte, mineral, and vitamin levels, as well as treatment side effects and effectiveness.

Study aim: To compare the effectiveness of Silodosin and extracorporeal shock wave lithotripsy (ESWL) in patients admitted for management of lower ureteric stone. Design: Randomized Clinical Trial Settings and conduct: The trial was double-blind and commenced at the Urology department of LUMHS, Jamshoro from August 2023 to July 2024. Blinding maintenance was ensured by using envelopes/slips that indicate only the group allocation without revealing the intervention details, keeping trial participants, data collectors, and outcome assessors blinded; additionally, interventions were designed to appear identical where feasible, such as in color, consistency, or packaging. Participants/Inclusion and exclusion criteria: Inclusion criteria:Patients between the ages of 15-70 years, both gender, and having stone sizes 5-10mm in the lower ureteric region were included. Exclusion Criteria:Patients having a single functional kidney before treatment, previous ureteric surgery, ureteric stones bilaterally, stricture in the ureteric region, previous stone passage, using alpha-adrenergic receptor blockers, and pregnant women and patients who lost follow up were excluded. Intervention groups: Group A 8 mg capsule of Silodosin was given for 28 days and once daily and advised for urine collection and discontinuation of the medication upon passage of stone, with the time and date of passage recorded. Group B underwent ESWL Main outcome variables: Demographic and basekine data, including age, duration of symptoms, BMI, hypertensive status, and diabetes, were recorded. Baseline investigations, including a computed tomography (CT) scan of the kidneys, ureters, and bladder (KUB), were performed to measure the size of the stone. After 1 month of treatment, patients underwent computed tomography scans to detect any residual stones or fragments in the ureter. If stones were not found, the patient was classified as stone-free.

Study aim: To determine the effectiveness of topical application of 0.5% Timolol Maleate in chronic recalcitrant heel fissures Design: A Single-arm non randomized clinical trial with a group design of 150 patents enrolled between 06 June 2023 and 12 December 2023, and followed up for 1 month. Settings and conduct: The study will be conducted on patients reporting in dermatology out-patient-department of a Tertiary care hospital. Data will be collected on a pre-designed proforma. Patients' anonymity will be maintained by keeping their identity hidden, and a code will be generated for them. Confidentiality of the data will be maintained by restricting the data only to the first author or the direct author/s who will collect the data. Participants/Inclusion and exclusion criteria: Inclusion criteria: patients with chronic heel, plantar fissures. Ages between 18 to 75 years Both genders included Exclusion criteria: Patients taking oral beta blockers Known allergy to beta blockers Patients with chronic dermatosis affecting feet i.e. psoriasis, Reiter's syndrome, keratoderma etc. Intervention groups: Intervention group includes 150 patients having heel fissures, with no control group for comparison. All will be advised to apply 2-3 drops of Timolol Maleate 0.5% on heel fissures at bet time for 2 weeks, A follow-up will be requested after 2 weeks and 4 weeks of application. Main outcome variables: Quantitative Variables : age, humidity, room temperature, Measurement of Heel Fissures Qualitative variables, such as Gender, Diabetes, Acute or Chronic Diseases, Pre-existing Skin Condition, Hydra/Aqua Working Environment, Exposure to the chemical on routine basis, Regular use of closed foot ware, Prolong standing workstation and scaling variables such as Severity Scale of Skin, and Photographic Scaling of Heel

, Karachi. 2. Country: Pakistan. 3. Tertiary care hospital. Participants/Inclusion and exclusion criteria

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

hospital in Punjab, Pakistan over period of 6 months from April, 2023 to October, 2023. The sample size was

Study aim: To find the comparative effects of Transcutaneous Electrical nerve stimulation and labor exercises on pain, duration and behavioral response of primigravida women. Design: Study design was randomized control trial Settings and conduct: Study Setting was Gynecological Department, Social Security Hospital, Multan Road, Lahore. Participants/Inclusion and exclusion criteria: Inclusion criteria encompassed females aged 20-35, primigravida women at 38 to 40 weeks' gestation, experiencing the first stage of labor with cervical dilation between 3 to 4 centimeters. Exclusion criteria included females with uterine issues, cervical cerclage, hypertension, urinary incontinence, or diagnosed psychological issues. Intervention groups: Both groups received transcutaneous electrical nerve stimulation as conventional therapy. Group A received TENS along with labor exercises, while Group B received TENS without labor exercises. Main outcome variables: Pain, Duration and behavioral response

Study aim: The main aim of this study is to determine the effects of mechanical cervical traction with and without sustained natural apophyseal glides (SNAGs) on pain, functional disability and quality of life among patients with mechanical neck pain. Design: It will be single blinded study, in which the accessor will be unaware of the treatment group. Settings and conduct: The data will be collected from the University of Lahore Teaching Hospital. The study population will be consisted of patients with mechanical neck pain. Participants/Inclusion and exclusion criteria: Inclusion criteria: •Both male and female academic staff of University of Lahore. •Patients with NPRS score between 3 and 6 for more than three months. •Patients with screen time greater than 6 hours per day. Exclusion criteria: •Degenerative diseases ( inflammatory arthritis, osteoporosis, osteoarthritis) •Recent weight loss and history of tumor around neck. •Patient taking anticoagulants. •History of neck trauma due to RTA, fall or other accidents. •Recent fracture or dislocation. •Previous surgery of cervical and upper thoracic spine. •Pregnant females. Intervention groups: Intervention Group A: Mechanical cervical traction with SNAGS and routine physical therapy to check how it influence the pain, functional disability and quality of life. Group B: mechanical cervical traction and routine physical therapy will be provided to the patients Main outcome variables: Numeric Pain Rating Scale for Pain Neck Disability Index for Functional Disability Short Form -36 for Quality of Life.

Study aim: To evaluate the effects of METS and Deep friction massage along with Static Stretching of Extesnsor carpi Radialis brevis in patients with lateral epicondylitis. Design: Pragmatic, community based, parallel group, double binding, randomised clinical trial the calculated sample size is 24. After adding 20% dropout ratio, it becomes 30. Settings and conduct: Conduct randomized clinical trial blinding Double blinding was used as patient and assessor was blind, i.e, patient was unware of which treatment was applied to them and assessor was also unware during assessment which treatment was provided to that subject. Participants/Inclusion and exclusion criteria: Patients with pain in extension of wrist with resistance Patients having pain with passive wrist flexion with the elbow extension Tenderness on palpation on elbow Moderate level of pain (4/10) Age b/w 25 to 50 years Positive Cozen’s Test Exclusion Criteria Neurological Deficit Previous trauma to the elbow region History of recent surgery in cervical region, upper limb or heart related surgery Dislocation of elbow in pervious 3months Diagnosed degenerative disease Intervention groups: Subjects in Group A received MET Group B was treated two times a week for four weeks with deep transverse friction massage at the tendon origin for 15 minutes. Main outcome variables: Pain, Wrist grip, Functional limitation

Study aim: Effects of Robotic hand training device on upper limb motor functions, dexterity, and grip strength in chronic stroke patients in Pakistan Design: A concealed, randomized, single blinded, sham controlled clinical trial with a parallel group design of 38 patients, enrolled between August

Study aim: Our study aims to study the analgesic efficacy of the nebulized form ketamine with intravenous paracetamol versus paracetamol alone for post-operative analgesia in pediatric cases undergoing general anesthesia for elective tonsillectomy as a day care procedure. Design: Prospective Study, parallel group, double blind study, non probability consecutive sampling Settings and conduct: a double-blind method was used to prevent bias. Participants in group K received intravenous paracetamol 10 mg/kg with nebulized ketamine 2 mg/kg diluted in 5 ml given over 5 minutes 15 minutes before induction whereas group P received intravenous paracetamol 15 mg/kg with nebulization with 5 ml normal saline as placebo 15 minutes before the procedure. The anesthetist preparing the solutions was given sealed non-descript bottles with the nebulizing preparations and the trainee in the operating room did not know of the drug in the nebulizer while also unaware of the study protocol. Participants/Inclusion and exclusion criteria: Inclusion criteria included all ASA-I and II male and female pediatric patients aged 7-12 years coming to the pre-anesthesia clinic for elective tonsillectomy as a day care procedure. Exclusion criteria included patients with any co-morbidity requiring admission, history of upper or lower respiratory tract infection in the last 2 weeks, major cardiovascular abnormalities, un co-operative patients and patients unwilling to be included in the study. Intervention groups: Patients were divided into two groups K and P with group P to receive intravenous paracetamol 10 mg/kg pre-operatively while group K to receive pre-operative intravenous paracetamol at 10 mg/kg along with nebulized ketamine at 2 mg/kg 15 minutes before induction. Main outcome variables: Post-operative median pain scores were calculated in the recovery

Study aim: The main aim of this study is to compare the post-operative analgesic efficacy of thoracic epidural block when compared with erector spinae plane block in patients post-thoracotomies Design: Randomized controlled trial. Method of randomization was non-probability consecutive by lottery method. Settings and conduct: Patients were randomized into two groups thoracic epidural block (Group T) and erector spinae group (Group E) an informed written consent was taken .Standard monitoring was attached in both groups . After securing IV line and preparing patient patient in Group T were placed in sitting position and 18G tuohy needle was passed for catheter in T3-6 epidural space .In Erector Spinae Group patoent were placed in semi lateral position and block was performed as per NYSORA guidelines and 20G catheter placed in situ for infusion in next 24 person ours. Participants/Inclusion and exclusion criteria: Inclusion Criteria included all male and female patients between ages 25-75 years presenting in the operating room for elective thoracotomies. Exclusion Criteria included patients with metastatic disease, major cardiac or respiratory disease, low ejection fraction, post chemotherapy, allergy to lignocaine or bupivacaine, patients with advanced polytrauma causing hemodynamic instability, patients with oxygen saturation less than 92 percent after supplemental oxygen or patients unwilling to be included in the trial. Intervention groups: Patients were divided into two interventional groups thoracic epidural block group (Group T) (n=20) and erector spinae block group (Group E) (n=20). Main outcome variables: Mean time to first dose analgesia Total dose of intravenous analgesia needed in 24 hours Median pain scores at 1,3,6,12 and 24 hours Patient satisfaction Score for pain relief in 24 hours

Study aim: To compare the effects of electrical dry needling in addition to routine physiotherapy on pain, range of motion, and functional disability in patients with moderate e knee osteoarthritis. Design: Randomized clinical Trial. single-blinded, 92 samples, parallel groups, randomized by computer-generated method and further concealed envelop method used for allocation in the group. In the envelope, 1 will be code for the control group and 2 will be code for the experimental group. Settings and conduct: The study will be conducted by Physical Therapy Department of the UNIVERSITY OF LAHORE Teaching Hospital, Lahore Participants/Inclusion and exclusion criteria: Inclusion Criteria: • Age group 30-60 years. • Both male and female. • Patients with degenerated osteoarthritis. • Unilaterally, most painful knee will be treated. • Moderate osteoarthritis, Grade II and III. • Radiologically diagnosed knee osteoarthritis. • Chronic knee pain for more than three months. • Less than half an hour of morning stiffness. Exclusion Criteria: • Any previous trauma, fracture, subluxation, dislocation, surgery, or bony abnormalities around the knee joint in the past six months. • Cancer • Suppression of the immune system • Pregnancy • Recent infection • Any dermatological issues • Unexplained weight loss/gain • Dysfunction of bladder Intervention groups: Group (A) Initially, routine physical therapy exercises will be performed including hot pack for 10 minutes of duration, manual therapy including passive mobilization of knee joint, strengthening exercises & muscle stretching. Group (B) participants will receive Electrical Dry Needling with routine physical therapy exercises. Electrical Dry Needling for 10 minutes at frequency of 2 Hz , width of 100us and continuous biphasic waveform through 2 diagonal channels of 4 needles for 3 times a week. Main outcome variables: Pain, Range of motion and functional disability

Study aim: The aim of the study is to compare the effectiveness of SNAG and cervicoscapular strengthening on pain intensity, headache frequency and duration, and quality of life in patients with cervicogenic headache Design: Randomized, superiority, parallel-group trial with blinded outcome assessment. Randomization was centralized and computerized with computer-generated random numbers sequence carried out at an external site. Settings and conduct: participants, healthcare providers who care for participants during the trial, data collectors, outcome assessors, and with lesser importance data safety and monitoring board and manuscript writers. outcome assessor will the blind in the study. Participants/Inclusion and exclusion criteria: Participants will be added to the study if they are 18 to 45 of age, both male and female, have unilateral headaches without side shift, have positive flexion rotation test, have had headaches for 3 months for a minimum of once per week, and have pain intensity equal or less than 4 on numeric pain rating scale, participants will be excluded from the study if they are suffering from dizziness, any visual problem, or have a congenital problem of the cervical spine. Intervention groups: Group A: participants in this group will receive SNAG and cervicoscapular strengthening with a hot pack for 5 weeks with 3 sessions per week on alternate days. Group B: participants will receive cervicoscapular strengthening with a hot pack for 5 weeks with 3 sessions per week on alternate days. Main outcome variables: Numeric pain rating scale, Headache questionnaire sheet, Headache impact test-6.

Study aim: The aim of this study is to Compare effects of Kinesio taping with or without conventional physical therapy in obese women with pes planus. Design: A single blinded randomized controlled trial, conducted on 72 patients, equally divided into two groups, single centered study. Settings and conduct: The university of Lahore teaching hospital, single blinded study. Participants/Inclusion and exclusion criteria: Age of young adults (25-60) years having navicular drop with BMI Body mass index (BMI, kg/m2) above(<25) considering obese female are included and Skeletal or structural injury of lower extremities, Ankle sprain or surgery within 6 months, Any nervous system diseases or Any nervous system diseases are excluded. Intervention groups: 70 patients will be randomly divided into control and experimental groups. The control group will receive kinseio taping while the experimental group will receive kinesio taping along with conventional physical therapy. Main outcome variables: Navicular Drop, Foot Functionality.

Study aim: To determine the effects of strain counter-strain technique with and without dry needling on pain, range of motion, functional disability and quality of life in patients with sacroiliac joint dysfunction. Design: Randomized clinical trial, single blinded study, two parallel groups with 32 patients from Al syed Touqeer Altaf surgical Hospital Lahore Settings and conduct: The trial will be conducted at Al syed Touqeer Altaf surgical Hospital Lahore. Participants/Inclusion and exclusion criteria: Inclusion criteria: Patient of age 25-50 years, Both Male and female patients, patient having pain in lower back and buttocks from last 3 months, NPRS score greater than 4. Inclusion criteria: Acute injury or fracture of the lower limb and spine, previous major lumbar or hip surgery, Infection, pregnancy, Congenital spinal deformity, Malignancy Intervention groups: Group A:Strain counterstrain technique with dry needling will be given to group A along with conventional therapy Group B: Strain counterstrain technique will be given to group B along with conventional therapy Main outcome variables: Pain, Range of motion, functional disability, quality of life