Study aim: To compare the effectiveness of lacosamide versus placebo in reducing neuropathic pain in patients with diabetic peripheral neuropathy. Design: Randomized, double-blind, placebo-controlled, parallel-group clinical trial Settings and conduct: Conducted at the Department of Medicine, Nishtar Hospital Multan, after ethical approval. Patients enrolled consecutively, treated and followed for 12 weeks with 4-weekly assessments. Participants/Inclusion and exclusion criteria: Inclusion Criteria: Age 20–60 years, either gender, Diabetes mellitus >5 years, VAS pain score >4, Informed consent given, Exclusion Criteria: Cardiovascular disease, Renal impairment or liver enzymes >2× normal, Pregnant or breastfeeding, Using other neuropathic pain medications (e.g., TCAs, lidocaine patch, mexiletine, tramadol, opioids, AEDs, NSAIDs) Intervention groups: Intervention group: Participants will receive Lacosamide (C13H18N2O3) tablets manufactured by Zakfas Pharmaceuticals Private Limited, orally. Dose will begin at 100 mg once daily, increased weekly by 100 mg to a maximum of 400 mg/day (200 mg twice daily) by week 4. This dose will be maintained for 12 weeks. Tablets will be provided in sealed identical packaging to ensure blinding. Follow-up will occur every 4 weeks. Control group: Participants will receive placebo tablets identical in appearance and schedule to the intervention group. Placebo will be manufactured by Zakfas Pharmaceuticals Privat Limited.Placebo contains inactive ingredients only and will be administered orally for 12 weeks using the same titration schedule to maintain blinding. Follow-ups will occur every 4 weeks. Main outcome variables: Main Outcome Variable: Mean pain score after 12 weeks, measured using Visual Analogue Scale (VAS).

Study aim: To compare the efficacy of intralesional triamcinolone acetonide and cryotherapy vs intralesional triamcinolone acetonide alone in treatment of keloid. Design: Pragmatic ,community based ,parallel group ,not blinded ,randomized controlled trial consisting 64 patients divided in two group 32 in each group Settings and conduct: This study will be conducted in the outpatient clinic of Dermatology PNS Shifa Hospital,Karachi, and will involve patients with keloid. Participants/Inclusion and exclusion criteria: Inclusion criteria: Either gender, Having single or multiple keloids of size not more than 10 cm in the largest diameter. Patient between 12 to 60 years of age, Willing to sign informed consent Patients with infected keloid. Exclusion criteria: Co- existing inflammatory skin diseases. Unrealistic expectation or with psychiatric illnesses, Pre- existing bleeding disorders, Renal and hepatic disease. Lactating or Pregnant women. Immunodeficient patients. Diseases that react adversely to cold (Raynaud's disease, cryoglobulinemia ,cold urticaria ) and with wound healing abnormalities Intervention groups: 64 Patients group A 32 will be received intralesional steroid and cryotherapy group B will received intralesional steroid alone Main outcome variables: Change in vascularity , height ,pigmentation and pliability of scar in both groups. Overall treatment efficacy comparison between the group A (steroid with cryotherapy ) and the group B (steroid only).

Study aim: Aim of the study is to use comma shaped incision for impacted mandibular third molars rather than traditional ward incision because comma incision is expected to be associated with lesser incidence of postoperative pain, swelling and trismus. Design: A concealed, randomized, blinded controlled clinical trial with a parallel group design of 100 patients, enrolled between 3rd October 2018 to 2nd April 2019 ,and followed for 6 months Settings and conduct: Non-probability, Consecutive sampling done in dept of Oral and Maxillofacial Surgery, AFID Rawalpindi. Participants/Inclusion and exclusion criteria: Inclusion Criteria: Patients with fully impacted lower third molars; Patients having physical status 1 according to ASA classification. Exclusion Criteria: Pregnant women, nursing mothers; Patients with non-localized odontogenic infection; Tooth associated with pathologies, Patients on radiotherapy, chemotherapy, bisphosphonates, bone diseases Intervention groups: Intervention group 1: Surgical removal of impacted mandibular third molar using comma-shaped incision. Intervention group 2: Surgical removal of impacted mandibular third molar using traditional ward incision. Main outcome variables: Pain; swelling; trismus.

Objective: The objective of the study is to establish the bioequivalence of a commercial product of Dinoprostone 3mg vaginal tablet against reference product and to establish the safety of Kleen enema while use in pregnancy before induction. Inclusion Criteria: pregnant women at or near term gestation (≥ 37 weeks) with a medical or obstetrical indication for the induction of labor; Age: 18-35 years; singleton pregnancy with cephalic presentation; parity ≤ 3; intact membrane; bishop score less than or equal to 4; fetal reactive non-stress test. Exclusion Criteria: neuropathy; renal impairment; liver disease; diabetes; hypertension & CV disease; placenta previa; placental abruption; vasa previa; active herpes genitalia; spontaneous labour; fetal death in-utero; where oxytocic drugs are contraindicated or where prolong contractions of uterus are considered inappropriate. Kleen enema will not be administered if subject is with diarrhoea & vomiting. Study population: pregnant women with an indication for induction of labor at term pregnancy. Sample Size: total 90 subjects & PP-population is minimum 70. Intervention: test product “A” is Dinoprostone 3mg vaginal tablet manufactured by Nabiqasim Industries (Pvt) Ltd; Reference product “B” Dinoprostone 3mg vaginal tablet (Prostin-E2) ; Test product “C” is Kleen enema manufactured by Nabiqasim Industries (Pvt) Ltd. Primary outcomes: An increase of 3 in bishop score; attainment of bishop score of 6 or more; or vaginal delivery occurring within 12 hours of dosing was considered as treatment success.; number & nature of adverse events occurring after kleen enema dosing but before induction with dinoprostone. Secondary outcomes: maternal, fetal and neonatal adverse events.

Study aim: The basic purpose of this study is to assess the effectiveness of upper limb exercise along with diaphragmatic breathing with or without lower limb exercise in COVID-19 survivors Design: Single blinded, randomized, total sample size is 176 and each groups contain 88 participants by lottery method. Settings and conduct: conducted at khawaja farid hospital Participants/Inclusion and exclusion criteria: Inclusion Criteria: Aged 35 and 60 years; male and female; COVID-19 survivors discharged from the hospital six weeks ago (diagnosed with COVID-19, respiratory illness) Exclusion Criteria: having any of the following symptoms in the last 14 days: fever; new or worsening respiratory symptoms; > 38.2 degrees Celsius (e.g., cough, dyspnea); Pregnant Females; Refusal to give consent approval. Intervention groups: group A received upper limb exercise along diaphragmatic breathing while group B received upper limb exercise along diaphragmatic breathing with or without lower limb exercise in COVID-19 survivors Main outcome variables: Respiratory function, exertion, quality of life

Study aim: The aim of the study was to assess the potential of the drug nebivolol on the cardiorespiratory parameters against exercise-induced stress and its related complications. Design: 200 patients were randomized into the control group(100) and treatment group(100) by simple randomization. It was a single-blinded randomized controlled trial. In this study participants will be completely blinded about intervention protocol. Settings and conduct: Muhammad physical therapy and rehabilitation center, KAIMS institute, Times university 200 patients were randomized into the control group(100) and treatment group(100) by simple randomization. It was a single-blinded randomized controlled trial. In this study, participants will be completely blinded by the intervention protocol. Participants/Inclusion and exclusion criteria: Inclusion Criteria: 18-25 years of age, mentally and physically fit, healthy individuals. Exclusion criteria: lactating mother, pregnant females, surgery, trauma Intervention groups: Group 1 was an exercise group that performed only stress-induced exercises Group 2 was the medicine group that performed the stress-induced exercises with the medicine Main outcome variables: Blood pressure, Respiration rate, Heart rate, Oxygen saturation, Temperature, Quality of life, and endurance

Study aim: To compare the effect of planter vibrator versus Transcutaneous Electrical Nerve Stimulation on life independence. Design: Two arms Parallel group randomized trial Settings and conduct: The study setting was the District medical and Rehabilitation complex charsadda and Shifa Rehab and Research Center Peshawar. It was the single-blinded and Only the researcher doing the study knows which treatment or intervention the participant is receiving. Participants/Inclusion and exclusion criteria: Inclusion criteria: Patients with diagnosed stroke; Stroke patients having issues of balance dysfunction who stands for at least 20 seconds independently; Patient score minimum from 2 on Ashworth scale. Exclusion criteria: Patient under the influence of any sedatives; Any other pathological conditions; Malignancy; Multiple sclerosis; Vestibular dysfunction; Suffering from severe visual problem Intervention groups: Intervention group received plantar vibration for 10 min 3 sessions per week for 4 weeks along with the conventional therapy. In the Planter vibration protocol, the patient was either in a standing or sitting position with 90 degrees flexed knee and support with belts and a frame to avoid the risk of fall. The Control group received the same conventional physical therapy was given as for treatment group. Patients were also received electrical stimulation via TENS. TENS sessions were applied to the tibial nerve branch of the sciatic nerve of the affected limb on the plantar surface of the foot each one was lasting for 10 minutes with 110 Hz frequency 3 times a day. The patient has received 3 sessions per week for 4 weeks. Main outcome variables: Balance

Study aim: The main aim of this study is to see the comparison between stretching of respiratory accessory muscles and ribs mobilisation to improve chest expansion, level of dyspnea and vital capacity in COPD patients Design: Two parallel groups: group A have stretching of respiratory accessory muscles and group B have ribs mobilization. Sample size is 50 which is collected from single center (Rabia Trust Hospital Faisalabad). Randomization will be through lottery method, single blinded study will be conducted in which only patient would be blinded. Settings and conduct: This study is conducted in Rabia Trust Hospital Faisalabad. Randomization is done by lottery method. Sealed envelope method is use for blinding of participant.. grouping of 2 envelopes showed to patient, once he selected one of them, he will be the part of that Two groups are made. Sealed envelope will made upon with allocation of participants in both groups can be possible without biasness Participants/Inclusion and exclusion criteria: Inclusion Criteria: Age: 30-55 years, Patients who are diagnosed with COPD according to GOLD, Patients with acute and moderate history of COPD, Both males and females, Haemodynamically stable patients who will be willing participate in the study. Exclusion Criteria: Patients having lung carcinoma and acute inflammatory condition, Patients having cardiac or neuromuscular disease, Patients having recent surgery history and recent chest injury, Patients having severe or very severe history of COPD, COVID-19 patients, Patients with broken ribs, bruised ribs, fractured ribs, Patients having Fibromyalgia, Patients with costochondritis, Patients with pleurisy. Intervention groups: Two groups Group A stretching of respiratory accessory muscles Group B ribs mobilization Main outcome variables: Xiphisteranl chest expansion, Perceived dyspnea, Vital capacity

Study aim: The purpose of this study was to find the comparative impact of exercises with navicular mobilization versus exercise alone in patients with flat foot. In flat foot, hence the foot is pronated so the mobilization has to be given in order to improve normal biomechanics of foot or to elevate the medial arch. There is paucity of literature on mid foot mobilization in patients having flat foot. So, a comparative effect of these treatments on the navicular height and foot posture index in patients with flat foot was done to find out which one was superior to the other. Design: Two arm parallel group randomised trial Settings and conduct: Rehman Medical Institute, Peshawar However, assessor, who will assess pre and post measurements, will be blinded. Participants/Inclusion and exclusion criteria: Inclusion Criteria: 1. Subjects aged between 18 to 30 years 2. Both males and females 3. Unilateral or bilateral involvement 4. Subjects having flexible flat feet with navicular drop test positive Exclusion Criteria: 1.History of fractures in the lower limb 2. Skin infections and wounds on the foot 4. Any neurological deficit 5. Peripheral vascular diseases. Intervention groups: Control Group (Group A): Resistive exercises using TheraBand of 12 repetitions and 3 sets. Resistive exercises will contain plantarflexion, inversion, flexion of big toe and abduction of big toe Experimental Group (Group B): Group B will be given talonavicular mobilization along with exercises. In talonavicular mobilization, a dorsal glide of 3 sets and 20 repetitions will be given to the navicular while stabilizing the talar neck. Resistive exercises using TheraBand will be given with 12 repetitions of 3 sets. Main outcome variables: Outcome measures will be used on baseline, 1st assessment (after 3 weeks) and 2nd assessment (after 6 weeks) using Foot Posture Index (FPI) and navicular drop test

Study aim: The aim of this study was to evaluate the comparative effectiveness of upper thoracic sustained stretch mobilization and posterior shoulder stretch glide for management of SIS symptoms severity such as shoulder pain, disability, range of motion and thoracic kyphosis angle. Design: A double blinded randomized clinical trial Settings and conduct: a study conducted at; Bakhtawar Amin Trust and Hospital Multan Faiz hospital Multan Outcome assesor and data analyzer will be unaware of intervention recieved by particular subject/ group Participants/Inclusion and exclusion criteria: Inclusion criteria: (1) Potentially willing patients diagnosed with subacromial impingement syndrome (SIS) (2) Both male and female, of age 25-45 years (3) Patients with thoracic kyphosis >40o (4) At least three positive physical tests from followings Neer impingement test, Hawkins kneddy test, Drop arm test, relocation test and apprehension test will be included. (5) Patients often had painful arc between 70° and 120° pain on forced movement above the head. Exclusion criteria: Patients with following conditions will be excluded (1) History of rotator cuff tear, shoulder and cervicothoracic surgery. (2) Patients of scapulothoracic dysfunction, sensory/ motor deficit and adhesive capsulitis. (3) Osteoporosis, fracture and dislocation.(4) Presence of thoracic scoliosis on Adam’s forward bend test. Intervention groups: Group A- Upper thoracic (T1-T4) centrally posterio-anterior sustained stretch mobilization Group B- Postrior shoulder sustained stretch glide Main outcome variables: shoulder pain, physical disability, range of motion and thoracic kyphosis angle are outcome measures.

Study aim: To evaluate the therapeutic effects of intra-vitreal injection Bevacizumab combined with Diclofenac-Na versus intra-vitreal Bevacizumab alone in the treatment of naïve diabetic macular edema. Design: Prospective, randomized, parallel group, interventional clinical practice trial Settings and conduct: Eye dept. Nowshera Medical College/ Qazi Hussain Ahmad Medical Complex, Nowshera. The trial was non-blinded, prospective interventional study started from Sept. 2020 till March 2021. Participants/Inclusion and exclusion criteria: The ‘ETDRS’ criteria was utilized for enrollment of treatment naïve eyes of DME, defined as any hard exudates/dot blot hemorrhages, retinal thickening/edema within 500µm from the center of the fovea or involving the very center, examined clinically on fundoscopy Exclusions included: 1) Any history of prior retinal laser therapy 2) History of prior intravitreal injections any type (3) Any intra-ocular procedure done within last 6 months 4) Rubeosis irides 5) Any glaucomatous eye damage 6) evidence of ischemic maculopathy, defined as an enlarged foveal avascular zone (FAZ) ≥ 1500µm; 7) Best corrected VA of ≥ 6/12 or ≤ 6/120; 8) significant media opacity precluding fundus view 9) Associated morbid conditions like, monocularity, pregnancy, diabetic nephropathy grade 3 and HbA1c ≥ 10. Intervention groups: INTRAVITREAL DICLOFENAC PLUS BEVACIZUMAB (IV-B/D) VERSUS BEVACIZUMAB (IV-B) ALONE Main outcome variables: Primary outcome variable was Visual acuity in Log MAR Secondary outcome variable was Central sub-field thickness of Macula Tertiary variable was Intra-ocular pressure (IOP)

Study aim: To determine the effectiveness of flossing techniques on pain and range of motion in patients with patellofemoral pain syndrome Design: It will be a two arm parallel Randomized trial with outcome assessor being blinded Settings and conduct: Data will be collected from outpatient department of REX clinic Lahore Participants/Inclusion and exclusion criteria: Inclusion Criteria: (1)Patients with age 14-40 will be included (2)Diagnosed patients with patellofemoral pain syndrome having three months history of pain (3) patients with positive clinical patellar test Exclusion Criteria: Patients with history of knee Osteoarthritis, fracture of knee joint, malignancy will not be included in the trial Intervention groups: Group A will receive Routine physical therapy which involves standing hamstring stretch, quadriceps stretch, side lying leg lift, Quads sets, straight leg raise, step up, wall squats and stabilization exercises Group B will receive flossing exercises along with routine physical therapy. Floss band which is stretchable will be used for this purpose. Main outcome variables: Pain, functional disability and range of motion

Study aim: Aim of the study is to explore the effects of massage therapy with and without aerobic exercises on glucose, blood pressure and diabetic peripheral neuropathy Design: 94 Patients will be randomized into treatment group(47) and control group(47) by lottery method. It is a single blinded randomized controlled trail. In this study patients will be completely blinded about intervention protocol Settings and conduct: Muhammad physical therapy clinic and rehabilitation cenetr, Al khaliq hospital, Multicare physical therapy clinic Multan Participants/Inclusion and exclusion criteria: Patients with diabetic peripheral neuropathy and hypertension will be included in this study. Patients with angina, stroke, myocardial infarctio, acute illness and any fracture of the lower limb will be excluded from this study Intervention groups: Group 1 will be treatment group in which patients receive massage therapy with aerobic exercises(cycling and walking) and group 2 will be control group in which patients receive massage therapy alone. Main outcome variables: Blood pressure, glucose level and neuropathic pain

Study aim: To compare the effectiveness of motor imagery technique along with conventional therapy and conventional therapy alone on pain intensity, range of motion and physical function in patients who underwent total knee replacement. 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: Rehman medical institute, Peshawar Due to nature of study blinding the researcher/therapist and subjects will not be feasible. However, the assessor, who will compare pre and post scores will be blinded. Participants/Inclusion and exclusion criteria: INCLUSION CRITERIA: 1. Age group 45-75 years 2. Males & females 3. Patients who had undergone unilateral total knee replacement EXCLUSION CRITERIA: 1. Uncontrolled hypertension and Uncontrolled diabetes mellitus 2. A history of any neurological disorder, multiple sclerosis, Parkinson’s disease 3. Patients with rheumatoid arthritis or active cancer 4. Previous history of deep veinous thrombosis Intervention groups: Experimental Group (Group A): This group will be same as control group (as having conventional physical therapy) but with addition of the motor imagery techniques session. Each session will be of 30 minutes per day for five days per week. The treatment will be provided for three days during hospitalization and two weeks after discharge. Control Group (Group B): This group will comprise of conventional therapy for the participants. Conventional therapies include CPM (continuous passive machine), Icing and physical exercises. Main outcome variables: Tools to be used are numeric rating scale for pain intensity, western ontario mcmaster universities osteoarthritis index (WOMAC) for physical function and Goniometer for range of motion.

Study aim: To evaluate the efficacy of dapagliflozin in diabetic and non diabetic patients with acute heart failure Design: Prospective randomized control study Settings and conduct: Pharmacology department of public sector hospital, National University of medical sciences in collaboration with cardiology deprtment of a public sector hospital. Participants/Inclusion and exclusion criteria: Inclusion Criteria: 1. Male/Female patients 18 years and above 2. Diagnosis of acute decompensated heart failure made on admission 3. Left ventricular Ejection fraction ≤ 40% Any two of the following signs and symptoms a) Dyspnea at rest or minimal exertion b) Peripheral edema c) Ascites d) 5-pound weight gain (rapid) e) Signs of congestion on X-ray 4. eGFR ≥ 30ml/min Exclusion Criteria: 1. Cardiogenic shock 2. urgent hospitalization for acute heart failure primarily triggered by pulmonary embolism, cerebrovascular accident, or acute myocardial infarction (AMI) 3. Current hospitalization for acute heart failure not caused primarily by intravascular volume overload; Type 1 Diabetes mellitus 4. History of Diabetic ketoacidosis 5. History of hepatic impairment 6. Known allergy to SGLT 2 inhibitors 7. women pregnant or breast feeding Intervention groups: Control and study Groups The control group will be prescribed with conventional treatment for acute heart failure the study group will be prescribed with Dapagliflozin as add on therapy to the conventional treatment for Acute heart failure Main outcome variables: 1. Effect of dapagliflozin in causing pulmonary decongestion. 2. Effect of dapagliflozin in improving quality of life assessed by KCCQ 3. Effect of dapagliflozin on eGFR

Study aim: To determine the effectiveness of muscle energy techniques versus manipulation in sacroiliac joint dysfunction in postpartum female Design: A concealed, experimental, blinded, randomized clinical trial with a control group design of 22 patients enrolled between June 2022 and September 2022 and followed for 4 months. Settings and conduct: This trial will be conducted at Physical Therapy & Rehablitation Ward of Chaudhary Akram Teaching Hospital (Teaching Hospital Associated with Azra Naheed Medical College ,The Superior University ,Lahore) Participants/Inclusion and exclusion criteria: Inclusion Criteria Low back pain within six weeks If they had anterior or posterior innominate dysfunctions and their levels of current pain were at least three by visual analog scale (VAS) positive gaenslen test subjects were included in this study age between 20-55 years. Exclusion Criteria The patient having a hip fracture. The subjects had a neurological deficit. Prolapsed intervertebral disc with or without radiculopathy True limb length discrepancy Intervention groups: Group A:The patients of the group were given 10 minutes of the warm-up session using a hot pack. Afterward, they came in for a muscle energy technique (METS) session.This protocol will be given to the patient for 8 weeks (4 times per week) Group B While Patients in group B were also given 10 minutes of the warm-up session using a hot pack. Later, they came in for a manipulation session. Then, at the end of the session, both groups (A&B) received pelvic stability exercises. This protocol will be given to the patient for 8 weeks (4 times per week) Main outcome variables: Pain will be measure visual analog scale and functional ability will be calculated by using Modified Oswestry disability scale

Study aim: To determine the effectiveness of magnetotherapy and lumbar traction on sciatica patients. Design: This is a double-blind, randomized, two phase study. subjects will be randomized to 2 different treatments in a cross-over design. Settings and conduct: Johar medicare complex, lahore Green international University, Lahore Ali Fatima Hospital Lahore Participants/Inclusion and exclusion criteria: Inclusion criteria: Low back pain of 3 months duration or longer present at least 5 out of 7 days a week Age between 28-80 at the start of the study Men and women of all ethnicities Signs and symptoms of lumbar radiculopathy. Willingness to refrain from making changes in non-study medications taken for sciatica Patients with failed back syndrome. Pain level of at least 4/10 on average on a scale of 0 to 10 for the past month Pain not attributable to malignancy, inflammatory arthritis such as rheumatoid arthritis, or infection by previous examinations or by laboratory testing Patients' agreement to keeping a log of their pain level and documentation of compliance with wearing of back device. Patients' agreement not to make changes in pain medication type of dosing during the study. Women of reproductive age agreeing to undergo a pregnancy test at baseline. Exclusion criteria: Patients with pacemakers Patients with mechanical heart pumps Pregnancy or breast feeding Presence of pain of greater intensity in any other location than the low back or the leg Presence of active cancer History of spinal infection Patients s/p spinal fusion with spinal rods over the lower lumbar spine Intervention groups: group 1: magnetotherapy group 2: magnetotherapy with lumbar traction Main outcome variables: reduction of pain and numbness in low back and leg

Study aim: : To compare the efficacy of topical nepafenac 0.1 % and diclofenac 0.1% eye drops in reducing the aqueous cells in the anterior chamber in an uneventful post cataract surgery. Design: Sample size= 70 patients, Probability sampling by simple randomization (via computer-generated no.), parallel-group, non-blind, clinical practice trial Settings and conduct: The study was conducted an an Eye dept. of Nowshera Medical College Participants/Inclusion and exclusion criteria: Patients’ ≥ 50 yrs. Both males and females with visually significant senile-cataracts under-going phaco-emulsification with intra-ocular lens implantation were enrolled. Exclusion criteria were any past intra-ocular surgery, any history of any intra-ocular inflammatory diseases, traumatic globe injuries, corneal disorders impairing the view, any glaucomatous diseases of eye, pseudo-exfoliation, any retinal/macular abnormalities, such as macular edema due to other etiologies or epi-retinal membranes or any age-related maculopathy. Those not willing to follow the study protocols and requirements of follow up were also excluded. Those who were pre-diabetics and confirmed diabetics, with systemic autoimmune/inflammatory disorders or any history of allergic reaction to the study drugs or other NSAIDs were also expelled. Oral steroids or NSAIDs intake was prohibited for the participants throughout the trial duration. Patients with eventful phaco surgery such as posterior-capsular tear, vitreous-prolapse or post-operative fibrinous reactions were not recruited for the study. Intervention groups: Topical Diclofenac 0.1% (TD) Topical Nepafenac 0.1% (TN) Main outcome variables: BCVA (visual acuity) converted into Log MAR; CMT measured in microns by SD-OCT; Mean AC cells

Study aim: The aim of the study is to evaluate the safety and efficacy of carpal bone mobilization and median nerve mobilization in the treatment of carpal tunnel syndrome patient. Design: randomized clinical trial with parallel randomized control and treatment, single blinded groups, trial on 30 patients. randomization will be done using lottery method. Settings and conduct: In different medical hospital of Faisalabad. consecutively enroll 5-10 eligible patients who meet the eligibility criteria and sign the informed consent by themselves or their guardians. four hospital District Head Quarter Hospital Faisalabad, Medina teaching hospital Faisalabad, Chinot hospital Faisalabad ,Faisal hospital Faisalabad. Participants/Inclusion and exclusion criteria: Inclusion criteria:Included all patients with mild and moderate CTS.Positive phalen’s test and Tinel sign .EXclusion Criteria:Excluded a patient with Any congenital deformity.People with any kind of systematic diseases i.e. Rheumatoid Arthritis. Intervention groups: Patients allocated to group A were given carpal bone mobilization 3 times a week with hot pack and exercises. Furthermore, patients in the group B received median nerve mobilization 3 times a week plus exercises and hot pack. Main outcome variables: Boston Carpal Tunnel Syndrome Questionnaire(BCTQ) to measure symptom severity and function status of carpal tunnel syndrome patient. visual analogues scale(VAS) to measure pain carpal tunnel syndrome patient

Study aim: To compare the effects of Powerball in addition to routine physical therapy on pain, range of motion and functional disability in patients with scapular dyskinesis Design: Randomized Controlled Trial; single-blinded; on 44 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 at the Physiotherapy department THQ Khushab. The study will be single-blinded. The assessor will unaware of the treatment given to either group. Participants/Inclusion and exclusion criteria: Inclusion Criteria: Age of 25- 50 years. Both gender Pre-Diagnosed cases of scapular dyskinesis A score of greater than or equal to 4/10 on Numeric Rating Pain Scale (NRPS) All types of scapular dyskinesis Exclusion Criteria: Previous cervical spine or shoulder surgery Presence of a severe systemic disease (as Systemic lupus erythematous, Sickle cell disease) Participation in an exercise program for the scapular or shoulder muscles in the 6 months preceding the study Severe osteoporosis Whiplash injury/fracture Intervention groups: Group B: (Experimental Group) Group B will receive Powerball intervention along with same conventional physical therapy as given in group A. 3 sessions will be given on alternate days each week, for next 4 weeks. 5-10 minutes Powerball intervention will be given in each session. The overall treatment session for this group lasts for 35-40 minutes. Main outcome variables: pain, range of motion and functional disability

Study aim: To compare the effects of Post Isometric Relaxation Technique on Pain, Range of Motion and Quality Of Life in Patients with Gastrocnemius Trigger Points Design: Randomized Controlled Trial; single-blinded; on 40 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 at the Department of Physical Therapy DHQ Hospital Layyah. The study will be single-blinded. The assessor will unaware of the treatment given to either group. Participants/Inclusion and exclusion criteria: Inclusion Criteria: Age is between 25-55 years. Both gender 49 Long standing workers (at least 3-5 hours of standing work including 5- min seated rest breaks and a 30-min lunch break) Pre-diagnosed patients of calf pain NPRS scoring ≤ 4 The presence of at least one trigger point in unilateral gastrocnemius muscles. Jump sign positive. Exclusion Criteria: Analgesic intake in the past 48 hours Individuals who are already involved in any exercise program for lower extremity Had a previous history of lateral malleolar, bi malleolar or calcaneal fracture that would affect their gait pattern or strength of the gastrocnemius Current pregnancy Intervention groups: Experimental Physical Therapy Group (B): Group B will be given Post isometric Relaxation along with routine physical therapy including hot packs, range of motion exercises, static stretching, and strengthening exercises of the gastrocnemius muscle. This will be given up to three sessions per week. Post Isometric Relaxation, Static Stretching, and strengthening exercises will be provided in three repetitions per session. Each treatment session will have 40-45 minutes duration. Main outcome variables: pain, range of motion, and Quality of Life

Study aim: To compare the effectiveness of modified constraint-induced movement therapy with trunk restraint with bobath concept to improve upper extremity motor function and activities of daily livings in subacute stroke patients Design: Randomized Controlled Trial Settings and conduct: University of Lahore Teaching Hospital, Lahore Participants/Inclusion and exclusion criteria: • Patient with an episode of the first stroke between 2 to 12th week of the subacute stage. • Both genders, age lies 40-70 years. • Patient is able to perform a functional test of 20° wrist extension and 10° finger extension. • Patient had active range of motion of 45° or more of shoulder flexion, abduction, or scaption and had the capacity to sustain standing balance for 2 min • Patient had Mini-Mental State Exam score of greater than or equal to 7. Individuals will be excluded if they • s. Intervention groups: Group-A: Modified Constraint-Induced Movement Therapy with trunk restraint. The training was provided at the rehabilitation clinic during a 1-hour therapy session, 5 days per week, for 4 weeks (a total of 20 sessions). The training was based on repetitive and task-specific practice. Group-B: Bobath approach. This approach usually takes one hour per day during 20 sessions. The interventions will group into 5 major items: facilitated movement; mobilization; practicing an activity component; and/or whole task and teaching patients. Main outcome variables: Motor Assessment Scale and Barthel Index

Study aim: This research aims to effects of hold relax and spencer muscle energy technique in patients with adhesive capsulitis Design: Two arm parallel group randomised trial with participant blinded. Randomisation was centralised and computerised with concealed randomisation sequence carried out at an external site Settings and conduct: The study will be conducted in Allied Hospital Faisalabad. Outcome assessor will be blind as the outcome assessor will be the therapist from the concerned hospital and researcher and outcome assessor will be a different person Participants/Inclusion and exclusion criteria: Inclusion Criteria: • age 30 above • both gender included • pain in the shoulder for at least 3 month • subjects were clinically diagnosed with grade 2 adhesive capsulitis.. Exclusion Criteria: • History of surgery on specified shoulder. • History of any other pathological condition involving the shoulder. Intervention groups: Both groups will receive baseline treatment protocol Movement with Mobilization in 3 sets and 15 repetitions each set and Ultrasonic Therapy for 10 minutes at 1.5 w/cm intensity and continuous mode. Group A will be given Spenser Muscle Energy Technique for 3 sets and 10 repetitions each set. Group B will be given Hold Relax Technique for 3 sets and 10 repetitions each set. Main outcome variables: Pain, Range of Motion in External Rotation, Range of Motion in Abduction, Range of Motion in Internal Rotation, Functional Disability,

Study aim: To evaluate the effects of the Active Release Technique and Positional Release Technique in female students with tightened calf muscles. Design: Randomized controlled trial design . Settings and conduct: The University of Faisalabad Government College University Faisalabad. Participants/Inclusion and exclusion criteria: Inclusion criteria • Age 20-30 years • Reduced ROM (ankle dorsiflexion) • Height of heel: 2” and above • Through flat palpation, one hypersensitive sore nodule within a perceptible tense band in the leg muscle Exclusion criteria • Lower limb musculoskeletal injury or surgery • Acute Cardio-Respiratory or Neurological disease • Medical or surgical complications • Fibromyalgia syndrome • Congenital deformity of the foot and ankle • Lower limb fracture • Diabetic neuropathy • Peripheral vascular disease Intervention groups: Subjects were divided into two groups by convenient sampling technique using the lottery method. Pre-treatment readings were taken from each subject for pain using NPRS, ROM (dorsiflexion and plantarflexion), and respectively. Treatment was given for a total of four weeks. 3 times each week for both groups. Ultrasound was used as the baseline treatment for both groups. Both groups received conventional Physiotherapy treatment which included stretching of both gastrocnemius and soleus muscles. Treatment Group A performed Active Release Therapy and Group B performed Positional Release Therapy Main outcome variables: Primary Outcome Measure: • Numerical pain rating scale Secondary Outcome Measure • Cadence • Dorsiflexion • Plantarflexion

Study aim: The aim of this study is to investigate the effectiveness of cognitive behavior therapy (CBT) on reducing feelings of shame/guilt, improving self-esteem, and decreasing suicidal ideation among women who are victims of violence. Design: Experimental Design (pre- and post test) Settings and conduct: Shelter home ,NGOs Participants/Inclusion and exclusion criteria: The terms inclusion and exclusion criteria relate to the makings that research participants must have to be considered for Participation and those that would rule them out. Women who meet the following criteria would be eligible to participate in research examining the effects of cognitive behavior therapy on shame/guilt, self-esteem, and suicidal thoughts among survivors of domestic abuse. Women, Participation in therapy, being over 18, having endured physical, sexual, or emotional abuse at some point of shame/guilt, low self-esteem, and suicidal ideation. While exclusion criteria refer to the characteristics that would disqualify someone from participating in the study, male and children, Intervention groups: Experimental Group Main outcome variables: Shame, guilt, low self-esteem, and suicidal ideation