Study aim: The aim of this study is to compare the analgesic efficacy when intravenous lignocaine is used as adjuvant analgesia in burn patients during change of dressing under general anesthesia Design: Two arm single blinded parallel group randomized controlled trial Settings and conduct: This randomized controlled trial was carried out at the Department of Anesthesiology, Combined Military Hospital from Jan-Jun 2023. Participants were single blinded by using non-descript marked burettes one containing ligonicaine and one containing normal saline (placebo) prepared before the start of surgery. patients were not told about the preparation details. Participants/Inclusion and exclusion criteria: Inclusion criteria included all ASA status patients presenting to the operating room for change of dressing under general anesthesia for full thickness burns (extending all dermal layers including bone, tissues, and ligaments). Exclusion criteria included patients with metastatic disease, major cardiac or respiratory disease, low ejection fraction, post chemotherapy, pregnant females, patients with partial thickness burns and unwilling to be included in the study Intervention groups: The patients were divided into two groups after randomization in Group L (n=45) as the intravenous lignocaine group and Group A (n=45) as the non-adjuvant group without intravenous lignocaine. Main outcome variables: Primary variables measured were mean heart rate, systolic and diastolic blood pressure, and oxygen saturation 5 minutes post-intubation and 15 minutes into the procedure and median pain scores 1-hour post-extubation in the recovery on standardized Visual Analog Scale.

Study aim: Aim of this study is to explore the correlates (B.P, pulse rate, oxygen saturation, glucose level, lipid profile, temperature, respiration rate) of young adults with acute pneumonia of Multan that are associated with body mass index and cardiorespiratory and renal parameters health. Design: randomization single group desgin triple blinding study Settings and conduct: Ch. Pervaiz Elahi Institute of Cardiology Multan. Participants/Inclusion and exclusion criteria: Including criteria • Young adults • Age group of 18-30 • Acute pneumonia patient • Acute pneumonia patients from Multan • Good mental health Excluding criteria • Any type of physical disability • Acute pneumonia patients with active infection • Any type of mental disorder • Any type of major surgery • Older adults • Childs • Smear positive respiratory sample Intervention groups: We take three groups. Group A Group B Group C In Group A we take 18 participants .They perform forced expiratory technique exercises. In Group B we take 17 participants .They perform chest phyiotherapy exercises. In Group C we take 18 participants.They perform pursed lips breathing exercises. Main outcome variables: This study will investigate the correlation of cardiorespiratory fitness and renal parameters with body mass index and in young adults with acute pneumonia of Multan and also investigate the respiratory improvements. We will expect the positive and negative correlation.

Study aim: The purpose of the present study is find the association in integrated patient education and routine physical therapy in patient of sub acromial pain syndrome. Design: randomized control trial Settings and conduct: Muhmmad rehabilitation center multan Participants/Inclusion and exclusion criteria: • . Inclusion Criteria Both Male and Female • Age ≥40(9) • Primary complaint of shoulder with or without referral in the upper limb for ≥ 3 months • Shoulder pain provoked with resisted abduction and lateral rotation contraction • Limitation to the range of motion of glenohumeral joint in the comparison to the contralateral side Exclusion Criteria • Shoulder pain in the last 6 months. • Known systemic inflammatory disorder. • Cervical repeated movement testing affecting shoulder pain and range of movement. • Severe depressive symptoms, suicidal inclination or psychotic illness. Intervention groups: 2 group are included in which 1 group have 10 patients with light weight exercise and educate the routine physical activity and 2 group have 11 patients with mobilization and educate the routine physical activity Main outcome variables: We are expecting that the patient education and routine physical therapy decrease the sub acromial pain syndrome.

Study aim: To compare the effects of myofascial release and Bowen therapy on pain, range of motion, disability and posture (craniovertebral angle, rounded shoulder angle) in patients with text neck syndrome: Design: Randomized clinical trial, single blinded study, two parallel groups with 32 patients from University Of Lahore Teaching Hospital Lahore Settings and conduct: The trial will be conducted at University Of Lahore Teaching Hospital Lahore. The participant will be blinded by concealment of the technique that will be used on the participant. Participants/Inclusion and exclusion criteria: INCLUSION CRITERIA: Both male and female patients, 18-35 years of age, Using smartphones>2 hours a day patient having neck pain which is increased by sustained posture and feeling of stiffness on turning the head and neck after long usages, NPRS > 3, NDI ≥10, Craniovertebral angle<50°, Rounded shoulder angle>52°, Neck pain lasting more than 3 months EXCLUSION CRITERIA: Patients with any spinal infection or inflammatory disorder, Neck surgery or trauma or Malignancy, Torticollis, Scoliosis, Pregnancy, Diagnosed cases of disc prolapse, Stenosis, or Herniation, Spondylolisthesis, Osteoporosis, Those with current use of any medication or physical therapy treatment Intervention groups: Group A: Myofascial release will be given to group A along with conventional therapy Group B: Bowen therapy will be given to group B along with conventional therapy Main outcome variables: Pain intensity, Neck disability, Cervical ROM, Postural assessment

& Maxillofacial Surgery Department at Armed Forces Institute of Dentistry, Rawalpindi, Pakistan Participants

Study aim: To compare the effects of core stability with and without stretching exercises on pain and functional disability in non-specific low back pain. Design: The study was a Randomized controlled trial. Randomization was done through drawing a number. Settings and conduct: Study was conducted at layyah city hospital of govt college university Faisalabad layyah campus. The study population was consisted of patients with non specific with low back pain. The study was single blinded. The participants didn't know while they were receiving experimental or conventional treatment. Participants/Inclusion and exclusion criteria: Inclusion Criteria: Age 25 – 65 years; Both genders; Non-specific low back pain for at least 3 months ; Pain intensity of 3 or higher based on Numeric Pain Rating Scale (NPRS). Non-inclusion Criteria: History of spinal surgery; History of ankylosing spondylitis or rheumatoid arthritis; History of spondylolisthesis or spondylolysis; History of spinal or pelvic fracture; History of spinal inflammation or tumor; History of osteoporosis; Continuous use of pain medications; History of respiratory or heart disease; History of stroke. Intervention groups: Intervention group: participants performed core stabilization exercises with stretching for 30 min, 3 times/week, for 6 weeks. Control group: they performed core stabilization exercises i.e abdominal hollowing, straight leg raise from prone, supine extension bridge and prone bridge, for 20 minutes 3 times a week. Main outcome variables: Pain; Disabilty

Study aim: The aim of the study is compare the effect of Alfredson vs Silbernagel eccentric protocol on clinical outcomes in Amateur players with Achilles tendinopathy 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 18-40 years, Both male and female with Grade 1, Grade 2 – Tendinopathy (grade 1 represents a normal tendon; grade 2 an enlarged tendon) and Clinical diagnosis of Achilles tendinopathy. Arc test, Thompson test, RLH test are diagnostic tests are included. Achilles tendon rupture, History of invasive intervention for AT on more painful side, Diagnosed systemic inflammatory conditions (e.g. rheumatoid arthritis, ankylosing spondylitis),Any other lower limb pathology are excluded. Intervention groups: 72 patients will be randomly divided into control and experimental groups. The control group will receive Alfredson eccentric protocol while the experimental group will receive Silbernagel eccentric protocol. Main outcome variables: Pain, Quality of life

Study aim: The aim of the study is to compare the effects of Motor Relearning program and Action Observation therapy on balance and gait in chronic stroke patients. Design: study design is Randomized control trial Settings and conduct: DHQ hospital sahiwal Participants/Inclusion and exclusion criteria: • Those who were diagnosed with cerebral hemorrhage and cerebral infarction based on computed tomography or magnetic resonance imaging. • Both male and female • Patients age 50-70 years • Chronic stroke patients (after 6 months of first stroke) • Medically stable patients having a single stroke • No visual field defects • No abnormality in the vestibular organs • A score greater than 24-30 in mini-mental test • Patients that will be able to fulfill and comprehend the command. • 2–4 muscle power in the affected side (Medical Research Council-MRC Muscle scale 2–4) exclusion criteria: • Patients with orthopedic diseases (such as contracture) in the trunk and both lower extremity. • History of fall in last 6 months • A history of other neurological diseases or disorders (Multiple Sclerosis, Parkinson’s) • Manual muscle testing below grade II • Those who are receiving other related therapy through the study, which may affect the efficacy of this study; • Those with any contraindications to start rehabilitation (i.e. severe uncontrolled hypertension, uncontrolled diabetes or unstable angina) Intervention groups: Group A will receive intervention Motor Relearning Program with conventional treatment and Group B will receive Action Observation Therapy with conventional treatment. All participants will receive interventions for 35-40 minutes per session, three times a week, for eight weeks. Main outcome variables: Balance and Gait

Study aim: To compare clinical parameters and post-operative recovery when using dexmedetomidine versus propofol after induction with sevoflurane in children undergoing elective diagnostic MRI (magnetic resonance imaging). Design: Randomized controlled trial Settings and conduct: This randomized controlled trial was carried out at the Department of Anesthesia, Combined Military Hospital Rawalpindi from Jan 2023-Jun 2023 Participants/Inclusion and exclusion criteria: Inclusion criteria: included all children aged 1-12 years of age presenting to the pre-anesthesia clinic for diagnostic MRI. Exclusion criteria: included patients <1 and >18 years, children with congenital heart disease or other congenital anomalies of major organs, children with known allergy to propofol or dexmedetomidine, children with major cardiac or respiratory disease, history of general anesthesia in the last 8 weeks, children with respiratory tract infections and children requiring intubation during the procedure for any indication required. Intervention groups: Inhalational induction with Sevoflurane 1.0 MAC (minimum alveolar concentration) was carried out and weight and age-appropriate i-gel (Laryngeal mask airway) was inserted to secure the airway. Maintenance of anesthesia was then carried out with IV Propofol and IV Dexmedetomidine in respective groups. Sevoflurane was then shut off and maintenance doses of both drugs were started. Patients in Group P (IV Propofol) received a maintenance infusion of 100 mcg/kg/min whereas patients in Group D (IV Dexmedetomidine) received a dose of 1 mcg/kg/hour titrated in an infusion pump till the time of completion of the procedure. Main outcome variables: heart rate, mean arterial pressure, and respiratory rate recorded every 5 minutes during the maintenance of anesthesia till the end of the procedure.

Study aim: Our study aims to use dexmedetomidine in reduction of emergence delirium in children undergoing elective adenotonsillectomy after general anesthesia. Design: This quasi experimental study was carried out at the Department of Anesthesiology, Combined Military Hospital from Jun-Dec 2023. A total of 90 patients (WHO minimum sample size 28) were included in the study keeping the confidence interval at 95%, power of test at 80%, with the proportion of children experiencing emergence delirium with per-operative dexmedetomidine infusion compared to placebo at 26% versus 60.8%10. Settings and conduct: Double blinding where study group, resident and accessor were unaware. Participants/Inclusion and exclusion criteria: Inclusion criteria included all ASA-I and II pediatric patients aged 6-12 years of age presenting in the pre-anesthesia clinic requiring general anesthesia fitness for elective adenotonsillectomy. Exclusion criteria included patients with congenital anomalies, history if ICU admission in the last 3 months, advanced cardiac or respiratory disease, patients on anti-psychotics or mood stabilizers, allergic to dexmedetomidine and patients or their parents unwilling to be included in the study. Intervention groups: Patients were divided into two groups as per the inclusion criteria and sampling technique specified. After being divided into two groups, Group D (n=45) to receive per-operative intravenous infusion of dexmedetomidine at 0.3 mcg/kg dilutes in 50 ml of normal saline over 5 minutes and Group P (n=45) to receive the placebo dosing of 50 ml normal saline over 5 minutes. Main outcome variables: Primary variables studies were the total incidence of emergence delirium between both groups, median PAED (pediatric assessment emergence delirium) score . Secondary variables measured were mean time to discharge and total dose of analgesia required post-operatively.

Study aim: The objective of this study is to investigate the effectiveness of Proprioceptive paradigm in addition to strength training program on pain, functional disability, and cervical proprioception in the treatment of Cervical Radiculopathy patients. Design: Parallel group Randomised Control trial with double blinded study. Settings and conduct: Physical Therapy Department of Allama Iqbal Teaching Hospital D. G. Khan, Outpatient Clinics. Participants/Inclusion and exclusion criteria: Inclusion Criteria: Age between 30-55 years. Both male and females are included. Patients with pain or numbness of one or both arms. Duration of symptoms is from more than 3 months. Exclusion Criteria: Past fracture or surgery in cervical spine. Deformity of the spine. Inflammatory rheumatologic disease. Intervention groups: Group A (Experimental group) patients were received proprioception training paradigm (eye head coupling based rehabilitation program) described by Revel M in the cervical region along with myofascial release or soft tissue release for 20 minutes as well as a strength training program for 10 minutes and patients in group B (Control group) were received only the same specific strength training program for 30 minutes. Main outcome variables: 1. Pain 2. Functional Disability 3. Cervical Proprioception (ROM) Treatment outcomes such as pain, disability and proprioception were determined from the following scales: scores of Neck Pain from VAS and Scores for functional disability from Neck Disability Index (NDI) as a self-reported measure while for Proprioception Head Position Accuracy, a laser beam device/ Laser Pointer device (LPD) was used

fall. The study will conducted in Combined Military Hospital, Bahawalpur, Pakistan Participants

Pulmonology Department, Sheikh Zayed Medical College, Rahim Yar Khan, Pakistan. Eligible hospitalized adults

Hospital, Lahore, Pakistan. 16 individuals will b equally divided into 2 groups that are selected by

Study aim: To compare the effects of manual therapy with and without shockwave therapy on lumber disc herniation in patients with sacroiliac joint dysfunction Design: Two arm parallel group randomized trial with single blind about outcome assessment Settings and conduct: This study will be conducted at University of Lahore teaching hospital .This study will be a single blinded study in which assessor was kept blinded. Participants/Inclusion and exclusion criteria: Inclusion Criteria • Participants aged ≥ 18 years • Both male and female patients • Chronic low back pain lasting over 3 months • Pain localized in unilateral sacroiliac joint • Presence of muscle spasm around the sacroiliac joint • Limited activity of lower limbs and inability to sit for extended periods • Positive findings on pelvic compression and separation tests, the "4" test, and one-foot standing test Exclusion Criteria: • Patients experiencing pain in the waist and legs from alternative etiologies • Pregnant individuals • Individuals with tuberculosis affecting the sacroiliac joint or spine • Participants with inflammatory conditions such as ankylosing spondylitis • Individuals with sacroiliac joint sprain characterized by symmetrical bone marks and no abnormalities observed in X-ray images Intervention groups: All the screened and willing participants will be randomly allocated to two groups (Group A: Shockwave therapy with routine physical therapy group, Group B: Comparative Group / Manual therapy with routine physical therapy) by lottery method. Main outcome variables: Pain , Disability and Quality of life

Study aim: To determine the effects of thoracolumbar myofascial release and Graston technique on pain, range of motion, and disability among chronic low back pain patients. Design: Randomized, parallel group trial with blinded outcome assessment. Randomization was centralized and computerized with concealed randomization sequence carried out at an external site between sample size of 72 patients. All the screened and willing participants will be randomly allocated to two groups by lottery method. This study will be a single-blinded study in which the assessor will be kept blinded Settings and conduct: Department of Physical Therapy, University of Lahore Teaching Hospital, Defense Road, Lahore. Participants/Inclusion and exclusion criteria: Inclusion Criteria will be patients aged between 35 and 50 years both males and females with low back pain for more than 3 months in a year, having a 4 score on the Visual Analogue Scale and the prone position must be pain-free for the patients ; Exclusion Criteria will include patients with history of fracture, tumor, and infections, if had undergone any spine-related surgery between Th 12 and S1, had radiating pain in the legs, and had pacemakers or pregnancy. Intervention groups: All the screened and willing participants will be randomly allocated to two groups by lottery method. This study will be a single-blinded study in which the assessor will be kept blinded. Group A participants will be received Myofascial release technique and Group B participants will be received Graston technique with routine physical therapy. Both groups will be received routine physical therapy which included 15 minutes of electrical muscle stimulation (application of Transcutaneous Electrical Nerve Stimulation (TENS) for 10 minutes (pulse width: 50-100 µs and frequency: 60-120 Hz) at bearable intensity along with heating pad at the same time covering the lumbosacral and gluteal region in a prone position.) with heat therapy. The intervention groups will be received three sessions per week for 8th week of follow-up. Main outcome variables: Pain, ROM (range of motion), Disability

Study aim: To check the comparative effects of Mulligan two leg rotations and bend leg raise techniques in pain intensity and hamstring dynamics in subjects with chronic low back pain. Secondary objective was to compare the disability in patients with chronic low back pain. Design: Single blind, parallel assigned, bi-center, randomized clinical trial that will be done on 34 patients with history of pain for more than 12 weeks. Patients will be assigned by using the lottery method of simple random sampling. Settings and conduct: Hussain memorial hospital Lahore and The Physiotherapy Clinic of The University of Lahore. Participants/Inclusion and exclusion criteria: Patients with age from 20 to 45 years. Both male and female were included. Subjects with pain above 3 on numeric pain rating scale. Pain more than 12 weeks. Score more than 30% and less than 65% on the Modified Oswestry disability questionnaire. Subjects not willing to participate. Patients with Sciatica pain.. Fracture of the Lumber, pelvic and all the spinal regions. Slipping of vertebra or complete tears of intervertebral disc. Recent history of trauma within six months. Patients with Surgical History. Radiating pain to the legs and buttocks. Spinal pathologies i.e. degenrative changes, spinal T.B, discitis, Osteoporosis and neoplasm. Disc herniation at any spinal region. Females with Pregnancy. Intervention groups: Group A: Warmup before the treatment will be given as baseline treatment. Mulligan two leg rotation technique will be applied. Group B: As a baseline treatment warmup before the treatment will be done by the use of hot pack. Then the bend leg raise technique will be applied. Main outcome variables: Pain intensity, Hamstring Flexibility on both sides and disability

Study aim: To see the efficacy of the psychological factor, i.e. craving, uncontrolled aggression, and impulsivity in MBRP in comparison with TAU in Amphetamine type stimulant(ATS) users. To find out enhancing the effect of the psychological factor, i.e. coping, quality of life, and self-efficacy in MBRP in comparison with TAU in ATS users. Design: This randomized control trial comprises pre-test and post-test with a follow-up period. Participants will be assigned to either MBRP + TAU or TAU, with repeated assessments at baseline, mid-treatment, post-treatment (after 8 weeks)and follow up. Settings and conduct: 90 amphetamine-type stimulants users who are receiving inpatient treatment (approximately 60 to 90 days) beyond the period of detoxification and could complete the program were selected by convenient sampling and were randomly assigned into two groups (MBRP and TAU). The data were analyzed by SPSS-15 using the Multivariate Analysis of Covariance (MANCOVA). Participants/Inclusion and exclusion criteria: Inclusion: who have completed detoxification, age 18-40 years; referred by a psychiatrist (diagnosis of stimulant use disorder) based on DSM-V; medical detoxification from any substances. Exclusion: The absence of over two sessions; are suffering from severe medical and neuropsychiatric complications or any psychotic illness; already completed any mindfulness-based programme. Intervention groups: The experimental group will complete 8 sessions (each session is 120 minutes) of Mindfulness-based relapse prevention for the experimental group. While the control group will receive standard 12 steps relapse prevention program for 8 weeks. Main outcome variables: The variables in this research are Quality Of Life, self efficacy, coping.craving, aggression, impulsivity, and Relapse Prevention.

Institute of Child Health Multan, Pakistan Settings and conduct: This open label randomized control trial (...) Multan, Pakistan from November 2020 to October 2023. Total 320 infants (160 each group) will be included

, Peshawar Pakistan. The patients will be recruited in three groups i.e. Group A, Group B and Group C by

Teaching Hospital, Lady Reading Hospital, Peshawar Pakistan. The outcome assessor had been kept blind

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.

tertiary care hospital in Jhelum, Pakistan. A total of 158 eligible participants will be randomized equally