Study aim: To compare the effects of Cyriax Manual Therapy versus Mulligan Technique on Clinical and Functional Outcomes in patient with Lateral Epicondylitis. Design: Parallel group, double blinded, randomized controlled trial Settings and conduct: The study would be double blinded as the participant and assessors of the study would be kept blind of the treatment group to which the patient will be allocated. The data will be collected from Physiotherapy Department, Gosha E Shifa Hospital, Lahore Participants/Inclusion and exclusion criteria: Inclusion criteria: A Diagnosed Male and Female cases referred from Gosha E Shifa Hospital having age of 20 to 50 year are included in this study. Exclusion Criteria: the patient having any surgery or trauma of Elbow, Steroid injection for lateral epicondylitis, any Skin hypersensitivity or any Congenital deformity, Any Infection like Osteomyelitis, Ulcers, open wound or pathology of Shoulder Joint will be excluded. Intervention groups: Group A participant will receive routine physical therapy as 10 minute TENS, 10 minute strengthening exercise of Extensor carpi longus,, 10 minute deep Friction Massage and Mill’s manipulation. Group B will receive Movement with Mobilization will applied on elbow in supine position, shoulder positioned as internal rotation, forearm pronation and elbow extension with 10 repetitions for 6 seconds with 15 seconds duration of rest, with routine physical therapy as 10 minute TENS, 10 minute strengthening exercise of Extensor carpi longus. Main outcome variables: pain intensity, hand grip and functional activity

Study aim: To compare the effect of Mulligan’s mobilization with movement and Muscle energy technique to decrease pain, disability and increase ROM in patients of adhesive capsulitis. Design: Parallel group, single blinded, randomized controlled trial Settings and conduct: OPD Physiotherapy department Mayo Hospital, Lahore. Participants/Inclusion and exclusion criteria: Inclusion Criteria  Subject having stage 2 of frozen shoulder  Age group 30-70years  Subject with bilateral/unilateral adhesive capsulitis  Both males and females  Subject who willing to participate Exclusion Criteria:  Malignancy  Patients was excluded if they exhibited  Subjects with Neuromuscular disorders  Conditions that contraindicated to manual therapy.  Any participant who was unable to return for follow up treatment or evaluation.  Any participant who received treatment concurrent to the research. Intervention groups: All the participant who came to physiotherapy department was considered and screened for adhesive capsulitis stage 2 with having a restriction of movements. 70 patients were allotted in two groups i.e.; group A(MWM) and group B(MET) via lottery method, 35 in each group. Consider the inclusion and exclusion criteria before concerning them in study. Both groups were received the conventional therapy, which was remain same throughout the study. Patient in A group was treated with Mulligan’s mobilization and in B group with muscle energy technique. Dosage:- Totally, 6 repetitions of the technique were performed during a single treatment session. The period between each repetition was no longer than 60s.  Duration: - Three session/week (alternative days) and treatment last for 3 weeks. Main outcome variables: • assessing the intensity of pain via using Numeric pain scale • range of motion was measure by Goniometer • and functional disability was measured by SPADI tool

Study aim: Study aims is to highlight the effectiveness of Neuromuscular re-education (NMR) and Postural training as potential treatment for symptoms related to overuse of mobile phones. Design: Design: Randomized, superiority, parallel group trial with blinded outcome assessment. sample size 30, single center. Settings and conduct: SETTING: Study was conducted at Bashir Institute of Health Sciences, Department of Physical Therapy. Participants/Inclusion and exclusion criteria: Participants: Thirty student participants Inclusion criteria: •Mild to moderate symptoms on Disabilities of the Arm, Shoulder and Hand (DASH) score. •Excessive use of smart phone device up to more than 3 hours daily. •Complains of pains and muscular fatigue mostly in upper extremity. •Have headache complain during prolong neck bending. Exclusion criteria: •History of traumatic injuries. •Surgical interventions of the neck or upper limbs. •Medical conditions (Diabetic neuropathy, sensory deficits). •Chronic diseases such as rheumatoid Arthritis, osteoarthritis, and other connective tissue disorders. Intervention groups: •For experimental group the regimen (Neuromuscular re-education & postural training) was of 30 mins, 3 days / week for 4 weeks. •For placebo group the regimen (hot packs only) was of 10 mins, 3 days/ week for 4 weeks. Main outcome variables: 1) Disabilities of the Arm, Shoulder and Hand (DASH) score 2) Visual Analogue Scale (VAS) scale 3) Manual Muscle Testing (MMT) scale 0-5

Study aim: The aim of the present study was to assess the efficacy L. Plantarum 299v against in local population suffering from IBS with improved study design and larger sample size. Design: This was a double blind placebo-controlled study, conducted for six (6) months Randomization was started by lottery method and then patients were alternatively allotted to either of the two groups. All the patients received probiotics (L. Plantarum 299v) or placebo for four (4) weeks and had three follow up visits after the baseline investigation. The baseline and the first follow up after two weeks were carried out. Settings and conduct: The patients were recruited through the outpatient clinic of Gastroenterology and Hepatology Department of the Lady Reading Hospital, Peshawar Participants/Inclusion and exclusion criteria: All the adult patients of either gender fulfilling the Rome III criteria for IBS, willing to participate and committed for follow up throughout the study period were enrolled in the study. The patients having history of major abdominal surgery, organic intestinal disease or chronic infectious disease like HIV or tuberculosis were excluded from the study. The pregnant and the female breastfeeding their babies or anyone with current use of antibiotics were also not included in the study population. Intervention groups: The study drug containing 5x1010 cfu of L.Plantarum 299v and the placebo containing micro-crystalline cellulose powder, both were packed in the similar packing by the manufacturers (Genetex Pharma PVT Limited). The study drug was labeled A and the placebo as B. Both groups were treated with therir respective medicine/placebo. It was disclosed at the end of the study. Main outcome variables: This randomized trail failed to show any significant improvement in the IBS symptoms by the use of L. Plantarum as compared to placebo.

Study aim: To compare the effectiveness subtalar mobilization with mulligan technique on pain and functional limitations versus conventional physiotherapy in patients with Planter Fasciitis Design: Two arm parallel group randomised trial with blinded postoperative care and outcome assessment Settings and conduct: The data was collected from Prime Care Hospital, Faisalabad. The patients were divided into two groups by using card allocation method. In group-A patients were treated with subtalar mobilization with Mulligan Technique and in group-B patients were treated with Convention physiotherapy treatment that were include a session of therapeutic Ultrasound for 10 minutes. Patients in both the groups received rigid tapping as standard treatment. Each Patient receives two treatment sessions per week with maximum eight treatment sessions over the period of 3 weeks. Participants/Inclusion and exclusion criteria: Enclusion Criteria Age 30–60 years. Patients of both Genders Main presenting complaint of Heel & Foot pain Limitation of Range of Motion at ankle joint due to heel pain Pain allocated at the bottom of heel and produced by pressure Pain in the morning at first steps or after prolonged non-weight bearing Exclusion criteria History of trauma, acute and chronic pathology Patients with any Systemic Illness (e.g. Rheumatism)• Fracture below knee during the last year Prior foot surgeries Intervention groups: n group-A patients were treated with subtalar mobilization with Mulligan Technique and rigid tapping as standard treatment. Each Patient receives two treatment sessions per week with maximum 6 treatment sessions over the period of 3 weeks. Main outcome variables: Outcomes were measured by Visual Analogue Scale and Foot & Ankle Disability Index at baseline, after 1st and 2nd week and at the end of the treatment.

Study aim: To determine the effectiveness of routine physical therapy with and without motor relearning program on balance and upright mobility in subacute stroke patients. Design: Single blinded Randomized controlled clinical trial Settings and conduct: Shaikh Zayed Hospital, Lahore Participants/Inclusion and exclusion criteria: Inclusion criteria: sub-acute stroke patients diagnosed by neuro physician; Age between 20-50 years; Both male and female; The first time stroke; being able to follow simple instructions; being able to rise from a chair without or with assistive devices. Non-inclusion criteria: having other neurological disorders; suffering from moderate to severe spasticity; having a musculoskeletal disorder of lower limbs; Presence of an unstable medical condition such as severe hypertension, convulsion and complete sensory loss of an upper limb. Intervention groups: Intervention group: receiving routine physical therapy along with motor relearning training in sit to stand component. Sit to stand training consists of 100 repetition (10 sets of 10 repetition each), 5 days a week for four weeks. Control group: will receive the routine physical therapy treatment that will include stretching exercises, strengthening the lower and upper extremities balance training, and gait training 5 days a week for 4 weeks. Main outcome variables: Berg Balance Scale; Time Up & Go Test

Study aim: To compare the effect of routine physical therapy with routine physical therapy and low intensity pulsed ultrasound on clinical and radiological outcomes in patients with early stage lumbar spondylolysis. Design: A concealed, randomized, blinded, controlled clinical trial with a parallel group design of 34 patients, enrolled between May 2020 and November 2020, and followed for one year Settings and conduct: The list of diagnosed cases will be obtained from the department of orthopedics, patients will be randomly selected and will be approached by principal investigator after informed consent taken and their approval and ethical approval they will be included in the study. The principal investigator will be known to the type of treatment but the assessor here will be kept blinded by labeling treatment A and treatment B to either group. Participants/Inclusion and exclusion criteria: Inclusion Criteria: Age: 20-40 years, Both Gender, Married living with their spouse as Oswestry Low Back Pain Disability Questionnaire is consisted of a part based on sexual activity, Diagnosed cases of early stage spondylolysis on x-ray and Symptomatic low-back pain since more than 4 weeks. Exclusion Criteria: History of neurological or autonomic deficits, History of other fracture or bony abnormalities, History of rheumatic disease, History of other spinal problems, History of post-menopausal female, History of osteoporosis, History of osteopenia Intervention groups: Group A: will receive the routine physical therapy alone. Group B: will receive the routine physical therapy and low intensity pulsed ultrasound. Main outcome variables: Pain, Quality of Life, Muscle Strength, Functional Disability and X-ray findings

Study aim: To find the effects of muscle energy technique and static stretching of piriformis and iliopsoas in reducing pain and improvement in pain free sitting in patients with coccydynia. Design: Two parallel group , single blinded, randomized clinical trial with pre and post assessment Settings and conduct: Al-Khumeinie Trust hospital, lahore, Investigator will be blinded. Participants/Inclusion and exclusion criteria: Inclusion criteria • Age group of 18 to 40 years • Pain on palpation at coccyx region. • Unable to sit pain free. Exclusion criteria • Pregnancy • History of recent trauma/fall or fracture • Vaginitis, cystitis, salpinities. Urinary tract infections, • Red flags like: fever, night sweats, malaise etc. • Rectal abscess • Patients with cysts or tumor in lumber area and pelvic • Previous surgical interventions involving lumbar spine and pelvic region Intervention groups: Muscle energy technique of (METs) of Piriformis and iliopsoas. Static stretching of Piriformis and iliopsoas. Main outcome variables: Pain by NPRS Daily and work-leisure activities, anxiety-depression, and social interest of the patients' lives by Dallas Pain Questionnaire (DPQ)

Study aim: The aim of this prospective observational study is to evaluate the effect of Dapagliflozin oral tablets in reduction HbA1C and body weight after 6 months in Type II Diabetes Mellitus Patients. Design: Single arm, Open Label, Post Marketing Interventional Trial Settings and conduct: Medicine Department of Bahawal Victoria Hospital, Bahawalpur. and Diabetes department of Laiq Rafique Foundation, Multan. Patients meeting the eligibility criteria will be included after written informed consent. The decision to start treatment will be made by the Investigators as per clinical practice. Planned no. of patients for this specific study is n=400. Patients will be prescribed Dapagliflozin as per physician discretion. Planned study duration is 24 weeks for a single patient. Through HbA1C, body weight determination patients’ response to therapy would be gauged. Patients' follow-up visits would be at Week 02, 04, 12 & 24. Participants/Inclusion and exclusion criteria: Inclusion Criteria: • Male & Female (Non-pregnant) Patients ≥ 18 years of age with type II Diabetes Mellitus. • Type II diabetes mellitus patients having controlled diabetes HbA1C 7-10 % or uncontrolled diabetes (HbA1C 10-12%). • Patients having BMI of > 25 kg/m2. • Not Hypersensitive to Dapagliflozin or any of ingredients. Exclusion criteria: • Male & Female Type I Diabetes patients. • Patients having complaints of urinary tract infections, genital infections • Patients with e GFR < 60 mL/min/1.73 m². • Pregnant Females. • Patients with end stage renal disease, or going through dialysis. • Suspected Ketoacidosis patients. Intervention groups: Intervention group: Dapagliflozin 5 or 10 mg as Per Investigator Discretion Main outcome variables: 1. Reduction in HbA1c from baseline observed at week 12 and 24 after initiation of therapy. 2. Reduction in Body weight from baseline observed at week 2, 4, 12 & 24 after initiation of therapy.

Study aim: • To identify the Effect of Sustained Natural Apophyseal Glide With And Without Neurodynamics In The Management Of Patient With Cervical Radiculopathy. Design: Interventional study Randomized Clinical Trial Non propability convience sampling techenique Settings and conduct: Sample size will be 44 individuals (22 each group) Conducted in time duration of 6 months Participants/Inclusion and exclusion criteria: Inclusion Criteria 1. Patients having Age 22-40 years 2. Both genders 3. Patient availability and cooperation during treatment 4. Patients with positive result of following tests:Spurling test,ULNT-1,neck distraction and ipsilateral cervical rotation test. Exclusion Criteria 1. Patients having negative one of the following tests:Spurling test,ULNT-1,neck distraction and ipsilateral cervical rotation test. 2. Patients with accessory Systemic Musculoskeletal Dysfunction 3. Patients having symptoms of Vertebral Artery Insufficiency. 4. Patients not willing to participate or to follow up treatment plan. Intervention groups: There will be two groups of equal number of individuals diagnosed with cervical radiculopathy after confirmation of Manual tests. Group A Control group will receive Sustained Natural Apophyseal Glide only. Patients in this group will receive a baseline treatment that is heating pad for 15 minutes before the treatment. Group B. This group will receive Sustained Natural Apophyseal Glide along with Neurodynamics. Patients in this group will receive a baseline treatment that is heating pad for 15 minutes before the treatment. Main outcome variables: Correcting Cervical Radiculopathy

Study aim: To compare of the effectiveness of standard therapy with and without vitamin D supplementation in patients of Liver Cirrhosis. Design: Randomized controlled trial Settings and conduct: OPD of Gastroenterology department, Mayo hospital Lahore. Participants were blinded by using identical ampules, non-revealing labeling and method of injection. Participants/Inclusion and exclusion criteria: The study will include seventy-two male and female cirrhotic patients aged 30 to 60 years who will provide informed consent and will be receiving standard therapy. Patients with metastatic liver tumors, those unable to understand local languages, non-cooperative individuals, and critically ill cases — including those admitted to the ICU, on mechanical ventilation, in a coma, or with a Glasgow Coma Scale (GCS) score below 10 — will be excluded from the study. Additionally, patients who have received vitamin D treatment within the two months prior to recruitment will also be excluded. Intervention groups: Patients will be randomly supplemented with monthly single intramuscular dose of 200,000 IU cholecalciferol /vitamin D3 for 6 months (Vitamin D Group), and the second arm will receive a monthly single intramuscular dose of the placebo (ampule containing 1ml of normal saline 0.9%, that will be obtained from our colleagues in pharmacology department, for 6 months (Placebo Group) Main outcome variables: The Chronic Liver Disease Questionnaire (CLDQ) will be used to measure changes in quality of life. The raw scores of the participants will be transformed into scale scores, and for all scales, higher scores will indicate better functioning or QOL.

Study aim: To assess the Efficacy and Safety of Empagliflozin in patients with Metabolic Associated Steatotic Liver Disease. Design: The study was a phase 4, single-center, single-blinded, randomized controlled trial. It enrolled a total of 46 participants. Settings and conduct: Conducted at the Department of Medicine and Gastroenterology, Mayo Hospital Lahore. Identical placebo tablets matching empagliflozin 10 mg in size, shape, color, and packaging will be used to maintain blinding integrity. All medications will be dispensed in coded, identical blister packs labeled without revealing treatment allocation. All participants will receive standardized instructions for medication intake and possibility of mild side effects to avoid differentiating between groups and perception bias. Participants/Inclusion and exclusion criteria: Inclusion criteria: Patients having age between 30-65 years, both male and female, having -MASLD receiving Empagliflozin therapy after giving consent along with standard therapy. Exclusion criteria: Patients having HCV, HBV, those having tumor of liver. Patients that are unable to understand local languages. Non cooperative patients, critical cases (ICU admitted, mechanical ventilation, coma patient, GCS score less than 10) are excluded from the study. Intervention groups: Patients will be randomly administered with empagliflozin 10 mg once daily orally for six months without modifying existing treatment for MASLD. The placebo/control group in the empagliflozin study received standard MASLD therapy along with a daily oral placebo tablet identical in appearance to empagliflozin. Main outcome variables: Efficacy of Empagliflozin: Measured by the Fibrosis-4 (FIB-4) Index score, which assesses liver fibrosis progression. Safety of Empagliflozin: Assessed through the SF-36 (Short Form-36 Health Survey), which measures the physical and mental health of the patients.

Study aim: To compare the Effectiveness of dry cupping therapy with and without thoracic mobilization among low back pain patients: Design: Randomized Clinical Trials (RCT). Settings and conduct: 4.2: Settings: Lahore Physiotherapy and Rehabilitation Center, Bahria International Hospital, (Lahore). 4.3: Study Duration: Within nine months of the synopsis being approved, the study will be finished. Participants/Inclusion and exclusion criteria: Inclusion Criteria: ● 18–59 years of age (40) ● Both male and female (40) ● If the participant is having pain in the spine for the duration of more than 3 months but not radiating to the leg (28) ● Any participant who has complain of pain on a scale of 3 to 8 (moderate to severe) according to the NPRS (28) 4.6.2: Exclusion Criteria: ● If any participants has planned any flights for the next two months (28) ● Already treated with cupping therapy. (28) ● If any individual is receiving physical therapy interventions (41) ● Any individual with psychological or neurological disorders ● Any individual who are at risk of falls or having visual or auditory discrepancies ● Any participant who can’t receive cupping therapy (e.g. open wound, skin infections) (41) ● Any individual with disorders of spine or spinal cord (e.g. fractures, infection or tumors) (40) ● Sacroiliac joint dysfunctioning Intervention groups: Participants were randomly allocated into two groups (Group A: Dry cupping therapy group with mobilization, Group B: Dry cupping therapy without mobilization). Both groups received routine physical therapy which includes 15 minutes of heat therapy. Main outcome variables: 1. Pain (Numeric Pain Rating Scale) 2. Physical Function (Oswestry Low Back Pain Disability Index Questionnaire) 3. Quality of Life (WHOQOL-BREF)

Study aim: This study aims to formulate a topical diclofenac potassium gel and evaluate its effectiveness in managing primary dysmenorrhea. It also seeks to compare the pain-relieving effects of the gel alone versus in combination with Transcutaneous Electrical Nerve Stimulation (TENS) to determine the potential benefit of combined therapy. Design: Pragmatic, community based, parallel group, double blinded, randomized controlled trial. Total 376 patients will be enrolled. Patients who met our inclusion criteria will be randomized into two groups. Settings and conduct: The trial will be held at Muhammad Physical Therapy & Rehabilitation Center, Multan. It is single-blinded, with participants unaware of their group. Treatments will be in identical boxes, and codes kept by the principal investigator. Participants/Inclusion and exclusion criteria: Inclusion Criteria Woman (18-45 years), Female diagnosed with primary or secondary dysmenorrhea, Regular menstrual cycles (21-35days), Females, Moderate to severe menstrual pain, Intervention was physiotherapy techniques (electro-physical agents, massage, exercise). Exclusion Criteria Pregnancy Females with bleeding disorders, Breast feeding, Uterine fibroids, Adenomyosis , Endometriosis, Pelvic inflammatory disease, Menstrual disorder Intervention groups: Group A will receive 6% diclofenac potassium gel plus TENS, while Group B will use the gel alone. Both groups will apply 2–4 grams of gel 2–4 times daily for up to three days. Group A will also get Transcutaneous Electrical Nerve Stimulation (80–100 Hz, 20–30 minutes, 2–3 times daily) to enhance pain relief. Main outcome variables: range of motion, joint stiffness, independency and quality of life

Study aim: The aim of this study is to evaluate and compare the postoperative analgesic efficacy of bupivacaine alone versus a combination of bupivacaine and tramadol when used for local anesthesia in patients undergoing minor surgical procedures at a tertiary care hospital in Karachi. This research seeks to assess the mean postoperative pain following minor surgical procedures, as well as the need for rescue analgesia, in both groups, in order to determine whether the addition of tramadol provides superior pain control or not. Design: Parallel group, single blinded, randomized controlled trial. Settings and conduct: The study was conducted at the Surgical Unit 4 of Jinnah Postgraduate Medical Center and was a single blinded study where the patients were unaware of which group they have been assigned to Participants/Inclusion and exclusion criteria: INCLUSION CRITERIA: All patients undergoing elective procedure under local anesthesia Either gender. Age 18-60 years. EXCLUSION CRITERIA: Procedures Under general anesthesia. Diabetic patients, assessed by history and clinically and HbA1c >6.5% Patients with metastatic disease, assessed by history, clinically and by imaging. Patients who are I/V opioid abusers will be excluded. Intervention groups: In Group A (bupivacaine) patients received 0.5 ml/kg of 0.25% plain bupivacaine at the surgical site, while Group B (bupivacaine with tramadol) patient received 0.5 ml/kg of 0.25% bupivacaine in combination with 1 mg/kg of tramadol. Main outcome variables: Mean postoperative pain score using a visual analogue scale

Study aim: To Compare the Effects of Rocabado’s approach versus Jaw and Stick Exercises on Pain, ROM and Disability among patients with Temporomandibular Joint Dysfunction Design: It will Single blinded randomized clinical trial with parallel group design. 23 Participants will be allocated to two groups equally by random computer number generator Settings and conduct: It will be conducted at Rashid Latif Dental Hospital. Outcome assessor will be kept blind. Participants/Inclusion and exclusion criteria: Inclusion Criteria: • Both male and female patients between age 20-60 years. Patients with mild to moderate TMJ dysfunction (according to Fonseca Questionnaire) • Patients with jaw pain and limited jaw range of motion, and limited mouth opening and associated joint pain • Patients with TMJ clicking sounds Exclusion Criteria: • Patients with a history of significant trauma of fractures to the jaw or temporomandibular joint, Patients with a history of systemic rheumatic diseases affecting the temporomandibular joint. Patients with severe TMJ dysfunction with recent oral surgeries were excluded Intervention groups: Group A: will receive Rocabado approach with baseline treatment. Group A will receive Rocabado’s approach consisting 6 exercises six times a day twice per week for four weeks. Group B: will receive Jaw and Stick Exercise with baseline treatment. Group B will receive Jaw and stick exercises with the frequency of 2 sets and 6 repetitions twice a day two times per week for four weeks Main outcome variables: Pain: Numeric Pain Rating Scale (NPRS) ROM: Universal Goniometer Disability: Temporomandibular disorder (TMD) disability index questionnaire

Study aim: To determine the combined effects of pelvic floor activation exercises and Benson relaxation technique on pain, urinary incontinence and functional ability among postcesarean patients. Design: It will Single blinded randomized clinical trial with parallel group design. 30 Participants will be allocated to two groups equally. Settings and conduct: Arif Memorial Teaching Hospital Participants/Inclusion and exclusion criteria: Inclusion Criteria • Women aged 20 to 42 at 7 to 14 weeks after delivery or cesarean section Experiencing pain in the pelvic region post-cesarean section. • Patient's BMI did not surpass 30 kg/m2 primiparous and mild-degree SUI • Presented with symptoms of urinary incontinence. • Patients who were not currently undergoing any other specific pelvic floor rehabilitation program. Exclusion Criteria • Individuals with cognitive impairments or communication difficulties that may hinder participation in the study. • Patients with active infections or complications related to the cesarean section incision site. • Patients with severe medical conditions that may limit their ability to perform the prescribed exercises or relaxation techniques. Patients undergoing treatment for pelvic floor issues with interventions that may interfere with the study outcomes. presence of hypertension, diabetes, genital prolapse, and smoking. Intervention groups: Group A will receive Pelvic floor activation exercises with Benson relaxation technique. Pelvic floor activation exercises will be performed for 4 weeks and five times in a week. Group B will receive Pelvic floor activation exercises only. Benson relaxation technique will be performed for 4 weeks and five times in a week. Main outcome variables: Pain: Numeric pain rating scale Urinary incontinence: International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form Functional ability: Functional Independence Measure

Study aim: To determine the effect of eltrombopag olamine on platelet recovery time and bleeding complications in patients of dengue fever Design: It is a single-center randomized, double-blind, controlled clinical trial with a parallel group design of 50 patients. Settings and conduct: This single-center clinical trial will be conducted at the Isolated Dengue Ward of Pak Emirates Military Hospital Rawalpindi. Patients will be randomized using online computer-generated numbers to either a control or intervention group after consent. The manual platelets count, serum albumin, serum ferritin, and lipid profile will be measured at the time of admission and 7 days after intervention, the intervention group will be given oral Tab eltrombopag 25 mg once daily for 03 days while the control group will be oral tablet of glucose for same duration. Participants/Inclusion and exclusion criteria: Adult patients with dengue fever and thrombocytopenia. Patients with malaria co-infection and severe dengue will be excluded Intervention groups: The patients in the intervention group will be given Tab eltrombopag 25 mg once daily for 03 days. The control group will receive routine and conservative medical care along with oral tablets of Glucose for 3 days once daily. Main outcome variables: 1. The primary outcome will be platelet recovery time and incidence of bleeding complications amongst the groups. 2. The secondary outcome will be changes in inflammatory markers. Both of the outcomes will be measured on the 7th day after intervention.

Study aim: To evaluate and compare the efficacy of 5% cysteamine cream and 4% hydroquinone cream in reducing melasma severity Design: Study Design: Double-blind, Randomized Controlled trial Study Setting: Combined Military Hospital,Quetta Study Duration: 6 months Sample Size: The sample size for this study was calculated using the WHO calculator and following parameters :- Level of significance (α) :5 % Power of the test (1-β) :90 % Anticipated Population Proportion 1 (P1): 0.249 Anticipated Population Proportion 1(P2): 0.38 9 Sample size (n): 228 Sampling Technique: Non probability consecutive sampling Settings and conduct: Combined Military Hospital Quetta Participants in cysteamine group will be instructed to apply a pea-sized amount of the assigned cream to the affected areas once daily at night as per following procedure :- 15 minutes for 1st 15 days. Subsequently, add 1 minute in 15 minutes everyday till 30th day. Continue to apply cream for 30 minutes for next 2 months. Participants in the hydroquinone group will apply thin layer over night for next 3 months. Patients will be assessed after every month for melasma according to MASI score.Picture will be captured at each visit for visual documentation and analysis. Participants/Inclusion and exclusion criteria: Inclusion Criteria: mild to moderate melasma (MASI score 4-24). Patients with epidermal and dermal hyperpigmentation. Patients with Fitzpatrick skin types III to V . Exclusion Criteria:Lactating and pregnant mother Chronic underlying skin condition Patient allergic to cysteamine and hydroquinone Intervention groups: Melasma: An acquired pigmentary disorder characterized by hyperpigmented patches on sun-exposed areas of the skin. MASI Score: A validated measure used to quantify the severity of melasma, based on the area, darkness, and homogeneity of pigmentation. Main outcome variables: Change in MASI score from baseline

Study aim: The Purpose Of This Study Will Be To Evaluate The Efficacy Of Weight Bearing Exercises With And Without Kinesio Taping In Improving The Clinical Outcomes In PFPS Patients. Design: Randomized, Blinded And Every Individual Participant Of PFPS is Involved in The Study. sample size: 48 Settings and conduct: Hospital Settings include the following: 1- Allied Hospital Faisalabad 2- Aziz Fatima hospital Faisalabad 3- Madina teaching hospital Faisalabad 4- Health 360 5- Awais Bin inam Clinic Participants/Inclusion and exclusion criteria: Inclusion criteria: Both Genders; age 15-30 years; PFPS undiagnosed patients; anterior knee pain and retro patellar pain; presence of pain on palpation; 3 of pain more than 6 weeks. Exclusion criteria: history of knee injury and surgery; patient with meniscal injury; surgery recent injury; knee cap dislocation; patellar instability; knee effusion Intervention groups: 2 groups Intervention group A (weight bearing exercises with Kinesio Taping) Intervention group B (weight Bearing Exercises only) Both groups included in inclusion and exclusion criteria. Both groups are experiencing knee pain and decrease knee function and Range of motion. Diagnosed both groups with the help of Kujula score and Goniometer, and assess level of pain through Visual analogue scale. Main outcome variables: Visual analogue scale (for measuring Pain) it consist of 1 to 10 numbers. Kujula Score (for knee pain and Function) have several questions to ask from patients Goniometer (for Range of motion)

Study aim: Evaluates the effectiveness of Mulligan techniques in reducing pain and improving mobility, strength, and function in cervical radiculopathy patients, with and without methylcobalamin. It also examines whether combining Mulligan techniques with methylcobalamin enhances nerve function recovery. Design: A comparative study with sample size 370, Randomly allocate the subjects into two groups. Intervention &control group Settings and conduct: Muhammad physical therapy clinic and rehabilitation center, Multan Participants/Inclusion and exclusion criteria: Inclusion criteria: Age 18–70y Uni-lateral upper-extremity pain, paresthesia, or numbness Loss of reflexes in the affected nerve root distribution Motor or sensory dysfunction (optional) Pain radiating to the arm cervical rotation range of motion less than 60 degrees Positive distraction test Positive Spurling's Exclusion criteria: Fractures Open wounds Patients with spinal cord compression Traumatic injuries Cancer Intervention groups: Patients will receive Mulligan traction and mobilization with methylcobalamin via phonophoresis for 12 sessions over 4 weeks (3 times per week). Manual traction will last 10 minutes (10 sec pull, 5 sec rest), and phonophoresis will be applied for 5-7 minutes per session using 0.8 MHz frequency, 1.5 W/cm² intensity, and continuous 2:1 mode. Main outcome variables: Immediate pain relief, improved mobility, and long-term nerve regeneration, reducing inflammation and promoting muscle and sensory recovery.

Study aim: This study aims to determine the effectiveness of intranasal desmopressin in reducing the risk of bleeding after insertion of tunneled dialysis catheters. Design: Two arm parallel group randomised trial without blinding Settings and conduct: This study would be conducted on patients with end stage renal disease requiring tunneled dialysis catheters for haemodialysis. Patients would be selected using consecutive sampling from the dialysis unit. All of them would be asked to give consent. Patients would be randomized into 2 groups using sequences generated online (and concealed as described above). Patients in the intervention arm would receive intranasal desmopressin, 1 puff in each nostril, 30 minutes before the procedure. This step would be omitted in the control group. Tunneled dialysis catheters would be inserted in the Dialysis Unit Procedure Room under ultrasound guidance. Fluoroscopic guidance is not available, and would thus not be used. All catheters would be inserted using Seldinger technique. Patients would be observed in the hospital for 24 hours after the procedure to record bleeding from exit site. Participants/Inclusion and exclusion criteria: We will include patients of either gender, aged 12 years or more, who require placement of tunneled dialysis catheters for maintenance haemodialysis. Exclusion criteria include uncontrolled blood pressure (>180/110 mmHg), previous catheter placement at the same time, coagulopathy, current use of anticoagulants and platelets count <50,000.ul. Intervention groups: Patients in the intervention arm would receive intranasal desmopressin. This would be a single dose of 1 puff in each nostril administered 30 minutes before the catheter placement. Main outcome variables: Primary outcome would be bleeding from the exit site. Secondary outcome would be the requirement of some intervention (chiefly purse string suture) in case of bleeding

Study aim: To compare outcomes in open hemorrhoidectomy versus ligasure hemorrhoidectomy. Design: Randomized Controlled Trial Settings and conduct: Department of Surgery, Allama Iqbal Teaching Hospital DG Khan. Participants/Inclusion and exclusion criteria: Inclusion Criteria: Patients aged 25 – 65 years of either gender, planned to undergo surgery for grade III or IV hemorrhoids. Exclusion Criteria: Patients with recurrent hemorrhoids, rectal carcinoma (medical record) and patients with thrombosis of hemorrhoids (on clinical examination) will be excluded. Intervention groups: This study has been planned to compare open versus ligasure hemorrhoidectomy (in terms of pain, bleeding, operative time, hospital stay, and urinary retention) in our local setting. Ligasure is considered safe procedure which does not need any special skill. However, Ligasure is an expensive device. Our study results will provide local evidence for surgeons to opt most beneficial surgical approach, keeping in view cost as well while dealing with patients having 3rd or 4th degree hemorrhoids. So, patients will get benefit of resuming their routine activities earlier and with ease. Main outcome variables: Operative time: Time in minutes from induction of anesthesia to extubation of endotracheal tube. Time will be recorded by nursing staff using a stopwatch. Intra-operative blood loss: Amount of blood (in ml) collected in graduated bottles and pre- weighted surgical sponge (1-gram increase = 1 ml). Pain will be graded 24-hours postoperatively using visual analogue scale 0 – 10, where 0 is no pain and 10 is worst bearable pain.

Study aim: This study evaluates the comparative effects of camphor and clove oil massage with and without Mulligan Traction in cervical radiculopathy, focusing on pain relief, mobility improvement, and the therapeutic benefits of the oils in reducing inflammation, pain, and supporting nerve health. Design: A comparative study with sample size 370, Randomly allocate the subjects into two groups. Intervention &control group Settings and conduct: Muhammad physical therapy clinic and rehabilitation center, Both outcome assessors and data analyser will be blinded to group assignments to minimize bias in treatment delivery and outcome measurement. Participants/Inclusion and exclusion criteria: Inclusion criteria: Age 18–70y Uni-lateral upper-extremity pain, paresthesia, or numbness Loss of reflexes in the affected nerve root distribution Motor or sensory dysfunction (optional) Pain radiating to the arm cervical rotation range of motion less than 60 degrees Positive distraction test Positive Spurling's Exclusion criteria: Fractures Open wounds Patients with spinal cord compression Traumatic injuries Cancer Intervention groups: Patients will receive Mulligan traction and mobilization with clove oil, menthol, via massage. Manual traction will last 10 minutes, with 10-second pulls and 5-second rests. Treatment will occur 3 times a week for 4 weeks, totaling 12 sessions. Mulligan SMWAM will be performed with 10-30 repetitions, and SNAG mobilizations will be applied. Clove oil, and menthol will be topically applied daily for 4 weeks, with each session lasting 5-6 minutes. Main outcome variables: Immediate pain relief, mobility, and long-term nerve regeneration, inflammation and promoting muscle and sensory recovery.

Study aim: To determine the individual effects of aerobic training and circuit training and comparison of these two on balance and disease severity in ataxic patients. Design: Randomized clinical trial, parallel group, single-blinded study. Settings and conduct: The setting of this study is Allied Hospital, Faisalabad. It is a single blinded study in which participants will be blinded. They will be allocated into the groups through online randomization generator. Participants/Inclusion and exclusion criteria: Inclusion Criteria • Participants ranging from 30-65 years of age were included in this study (mid adulthood). • Scale for Assessment and Rating of Ataxia (SARA) sitting sub-score was less than or equal to 1 (patients are able to sit and use a stationary exercise bike). • Both genders were included in this study. • Hemodynamically stable patients. • Patient fall on stage “3 and 4” of Ataxia staging scale. • Patients were able to walk independently with or without assistive device for at least 5 minutes (as a minimum criteria). Exclusion Criteria • Patient suffering from recent surgery of low back or lower limb. • Patient encountered any recent musculoskeletal injury (fracture, dislocation, soft tissue injury). • Patients suffering from heart problems/diseases. • Patients who were unable to exercise. • Medically unstable patients. • Uncooperative patients Intervention groups: Group 1is Aerobic training group (30 minutes on stationary cycling) Group 2 is Circuit training group (Stretching of calf and hams (30 sec hold/5 rep), bridging (1 set/5 rep), sit to stand (1 set/5 rep 30 seconds standing in each rep), stationary cycling (5 minute) and walk on parallel bars (5 minute) Main outcome variables: • Disease severity of ataxic patients is the primary outcome of this study. • Balance is the secondary outcome of this study.