Study aim: The objective of this study is to compare methods of forced air warming combined with warm intravenous fluid administration versus forced air warming alone in preventing hypothermia and shivering associated with spinal anesthesia for elective caesarian section. Design: A preventive, double blinded, randomized controlled clinical trial with a parallel group design of 390 patients, enrolled between January 2023 and July 2023 and a single center study. Settings and conduct: Core temperature in both groups was recorded using a standard Braun Infrared Thermoscan5 thermometer (IRT 6500) by a resident anesthetist in the operating room unaware of the study protocol being double blind. Participants/Inclusion and exclusion criteria: included all ASA-I and II female patients presenting for elective caesarian with a gestational age of 37 or more weeks under spinal anesthesia. Excluded patients with pre-maturity, caesarian converted to general anesthesia following spinal administration, patients with fever, cardiac or respiratory disease, patients with PIH (pregnancy induced hypertension) or gestational diabetes mellites and patients unwilling to be included in the study. Intervention groups: The patients were randomized into Group FWI (forced warming with warm IV fluid) and FWA (forced warming alone). Main outcome variables: Core body temperature measured in degrees Celsius between Group FWI and Group FWA was 37.34±0.17 degrees Celsius versus 37.34±0.16 degrees Celsius measured pre-spinal administration (p=0.922). It was 36.85±0.09 degrees Celsius versus 36.12±0.10 degrees Celsius 30 minutes after spinal during the procedure between both groups (p<0.001) and was36.84±0.09 degrees Celsius versus 36.11±0.10 degrees Celsius measured 60 minutes in the procedure between both groups (p<0.001)

Study aim: In instances of 1st and 2nd grade degenerative lumbar spondylolisthesis treated with transpedicular fixation with or without interbody fusion via lumbar cage, the goal of this study is to assess the short-term clinical and outcome outcomes of two surgical procedures. Design: Randomized, superiority, parallel group trial with blinded outcome assessment. Randomization was centralized and computerized with concealed randomization sequence carried out at an external site, sample size 28. Settings and conduct: A trial was conducted at Afridi medical complex, Peshawar. In the Randomized Controlled Trial (RCT), outcome assessors were blinded through a meticulous process where they were kept unaware of participants' assigned interventions. Participants/Inclusion and exclusion criteria: Inclusion criteria: 1st and 2nd grade degenerative lumbar spondylolisthesis patients and patients who would consent to participate under ethical conditions Exclusion criteria: 1) Patients with additional lumbar spondylolisthesis types; 2) Patients with additional lumbar degenerative spondylolisthesis grades (3rd and 4th grades); 3) Patients with additional spine pathology (lumbar fracture, disc prolapse) Intervention groups: Group A: Participants randomized to group, undergoing transpedicular fixation with Fusion, will receive bilateral transpedicular fixation using pedicle screws, coupled with interbody fusion employing autograft or suitable bone substitute. This will be complemented by posterior stabilization using rods and cross-links. Group B: Group B, designated for Transpedicular Fixation Alone, will involve bilateral transpedicular fixation with pedicle screws without interbody fusion, followed by posterior stabilization using rods and cross-links. Main outcome variables: The Oswestry Disability Index (ODI) and Visual Analogue Score (VAS)

Study aim: To assess the influence of muscle energy technique with and without the application of a sacroiliac belt on pain levels, muscle strength, and the overall quality of life in individuals with sacroiliac joint dysfunction. Design: In an upcoming nine-month randomized control trial at Begum Akhtar Rukhsana Memorial Welfare Trust Hospital in Lahore, 48 participants will be conveniently sampled. Settings and conduct: Setting: Begum Akhtar Rukhsana Memorial trust Hospital, Lahore. Participants in the trial will be blinded, unaware of their group assignments or the nature of interventions, to minimize potential biases in behavior and reporting. Participants/Inclusion and exclusion criteria: Inclusion Criteria: Participants aged 30 to 50 years of both genders; Individuals with persistent pain in the lower back, gluteal, and groin regions, and lower extremity pain lasting between four weeks and one year; Participants testing positive on pain provocation tests. Exclusion Criteria: Pregnant females; Individuals with health issues hindering exercise, such as SLE, Multiple Sclerosis, and Chronic Fatigue Syndrome; Those with osteoporosis affecting the pelvic and spine region, inflammatory pathologies (Ankylosing Spondylitis, Osteoarthritis Hip, Degenerative Arthritis), a history of hip fracture, or any spinal surgery. Intervention groups: The study will allocate participants into experimental (MET with SI Belt) and control (MET only) groups, Main outcome variables: SF-36, NPRS, and MMT to assess quality of life, pain, and muscle strength, respectively.

Study aim: This study aimed to compare the efficacy of probiotic and antibiotic combination therapy with antibiotic therapy alone to prevent the recurrence of bacterial vaginosis. Design: Parallel-arm, Randomized controlled trial Settings and conduct: Gynecological Department of Nishtar Hospital, Multan, Participants/Inclusion and exclusion criteria: Women 18-45 years old having bacterial vaginosis diagnosed according to Amsel's criteria (at least three of the following BV symptoms: Greyish white, thin, homogenous vaginal discharge, vaginal pH >4.5, positive amine test findings, and presence of clue cells (>20%) in a wet smear observed under microscopy, all cured with metronidazole, were enrolled. Patients with a history of allergy against the study drug, pregnant, lactating, menopausal women, history of bleeding from the genital tract of unknown aetiology, women with malignancy of the reproductive tract or any co-morbid condition like AIDS, diabetes, psychiatric illness, or currently using any contraceptive method, and patients using another oral or vaginal probiotic at the time of assessment or receiving antibiotic therapy for another reason were excluded. Intervention groups: In Group A, probiotics (Lactobacillus plantarum PBS067, Lactobacillus rhamnosus LRH020, and Bifidobacterium animalis lactis BL050) were administered once a day for 14 days following antibiotic treatment (Tab Metronidazole 400mg TDS for seven days). A post-antibiotic therapy placebo (dextrose-filled pill) was administered to Group B (n = 52). Main outcome variables: Recurrence of bacterial vaginosis

Study aim: To evaluate the therapeutic outcomes of dry needling coupled with intramuscular stimulation in patients with fibromyalgia syndrome. Design: A concealed, randomized, blinded, controlled trial with a parallel group design of 78 patients Settings and conduct: Physical Therapy Department, University of Lahore Teaching Hospital, Lahore Participants/Inclusion and exclusion criteria: Inclusion Criteria Both male and female patients; Age over 18 years and under 60 years; Pre diagnosed patients with FMS referred through consultant; Manifesting chronic widespread musculoskeletal pain symptoms; Presence of active trigger points, as confirmed by physical examination; No contraindications to dry needling or IMS. Exclusion Criteria Pregnancy or breastfeeding; Use of any medications that could interfere with the study results e.g. muscle relaxants, opioids within the past 48 hours; Previous treatment with dry needling or IMS within the past 6 months; Presence of any other conditions that could interfere with the study results e.g. cancer, infection; Intervention groups: Group A: This group will be given dry needling and conventional treatment. The sterile stainless steel 0.25*25mm to 0.25*50mm (Hua long) acupuncture needle will be inserted. CPT will consist of Application of hot pack for 10 minutes, TENS(typical, 100 Hz) for 20 mins at the affected region. Isometric exercise, Range of Motion, Stretching and strengthening exercise of affected region. Therapy will be provided for one session per week for four weeks. Group B: This group will be given dry needling and IMS will be applied for 15 minutes (low frequency parameters (2 Hz) and a pulse width of 120 μs).Conventional physical therapy will be given as of Group A. Main outcome variables: Numeric Pain Rating Scale; Pain pressure threshold; algometer; Quality of sleep; Anxiety depression; Fatigue scale

Study aim: The aim of study is to manage psychological distress to improve quality of life, self-efficacy and emotional intelligence of school teachers by using cognitive behavioral therapy Design: This phase of the study will be based on Randomized Control Trial with Pre and Post test design with 187 subjects, enrolled between February 2024 to June 2024. Settings and conduct: The independent variable of the study will be cognitive behavioral therapy while the dependent variable will be psychological distress, quality of life, self-efficacy and emotional intelligence. There will be two groups. One group will be experimental group which will receive treatment and the other will be control group which will not receive any treatment. Nature of the treatment will be brief cognitive behavioral therapy. Participants/Inclusion and exclusion criteria: Inclusion criteria: Female school teachers employed in government and private schools in the Layyah district, employed for at least one year, females who will score high in psychological distress scale. Exclusion criteria: Male school teachers, who will be unwilling to participate in the CBT intervention, females who will score low in psychological distress scale. Intervention groups: Participants in the Experimental group will receive 8 sessions of culturally adapted Cognitive behavioral therapy. Each session will be comprised on 120 minutes once in a week. However Control group will be kept passive and will not receive any treatment during experiment. Main outcome variables: Level of psychological distress.

Study aim: The objective of this study is to compare the effects of modified otago exercises and Action observation therapy on balance and postural stability in sub-acute stroke Design: Randomized Clinical Trial, Single blinded study Settings and conduct: This study will be conducted in Society hospital Lahore single blinded study , Participant will be blinded Participants/Inclusion and exclusion criteria: Inclusion criteria: patients should be diagnosed with stroke; both male and female. Participant’s Age will be between 45 to 60 years patients should be able to walk at least 10 meters. Patients should be able to understand and follow instruction, mini mental status examination (MMSE)>24. Exclusion criteria: If patient has any other neurologic disease other than stroke Any auditory or visual deficit that can affect data collection of this study Patient having any abnormality in the vestibular System. Patients having any other orthopedic conditions Intervention groups: Group A: Experimental group (n=19) Group A will be treated by modified otago exercise program and Conventional physical therapy. A session of 40 minutes for 6 weeks including 3 sessions per week will be given to each patient. 10 minutes of conventional treatment will be given to every participant and then 30 minutes of modified otago exercise program. Experimental group (n=19) Group B will be treated by Action Observation Therapy and Conventional physical therapy 40 minutes session will be given 3 times per week for 6 weeks. Prior to Action observation therapy patient will receive session of conventional physical therapy of 10 minutes. Main outcome variables: Balance Postural stability

Study aim: Comparison of efficacy of intramuscular meglumine antimoniate plus oral allopurinol with intramuscular meglumine antimoniate alone in treatment of cutaneous leishmaniasis Design: Clinical trial which is parallel group, double blind, randomized, phase 3 trial. Settings and conduct: Dermatology Department Combined military hospital Quetta Participants/Inclusion and exclusion criteria: Inclusion criteria:All patients with biopsy proven leishmaniasis plus has lesion(s) located in sites not compatible with local treatment for example on or around eyes lesions in which scaring would be disfiguring like on face lesions that will have difficulting in healing like on lower limb or lesion ≥4 cm lesion with sporotrichoid spread Exclusion criteria:patients allergic to antimonials pregnant and breast feeding women patients having mucosal, mucocutaneous or visceral leishmaniasis Patients with comorbidity (diabetes, hypertension,chronic liver disease,chronic kidney disease) and/or immunosuppression Patients with baseline ECG abnormalities/ Intervention groups: Intervention group A: Patients were given drug via Intramuscular route injection meglumine antimoniate plus oral allopurinol. Intramuscular meglumine antimoniate was given in dose of 15mg/kg intramuscular if volume of injection exceeds 10ml as per body weight then it should be divided into two doses in each buttock nd oral allopurinol was given 15mg/kg in the form of tablets Intervention group B: Patients were given drug via Intramuscular route meglumine antimoniate 15mg/kg if the volume of injection exceeds 10 ml, it should be divided into two doses: one in each buttock or thigh. Main outcome variables: Clinical/treatment response

Study aim: The objectives are to enhance gaze stability through the application of gaze stabilization exercises and Cawthorne Cooksey exercises also to study and compare the effect of Gaze stabilization exercises and Cawthorne Cooksey exercises on Craniovertebral angle and Vestibular ocular reflex. Design: Simple random sampling is a statistical method used to gather data from a population. In simple random sampling, each member of the population has an equal chance of being selected to be part of the sample. This method ensures that the sample is representative of the entire population and helps reduce bias in the results. Simple random sampling can be conducted using various techniques such as random number generators, random drawing methods, or randomization software. Settings and conduct: The University of Faisalabad. participants were blinded Participants/Inclusion and exclusion criteria: Inclusion criteria • Participants willing to give consent • IT students • Both genders • Age: 19-25 years • Screen time 6-8 hours • VOR(+) • Craniovertebral angle 50° -53° • Thoracic angle 30° -50° Exclusion criteria • Uncooperative participants • No other neurological disorder • History of ear infection • History of migraine • History of dizziness, vertigo • Subjects with history of head injury • Subjects with ADHD Intervention groups: Group A The participants of experimental group A will perform Gaze stabilization exercises as treatment approach for 3 weeks, 3 sessions per week and 3 times a day. Group B The participants of experimental group B will perform Cawthorne Cooksey exercises as a treatment protocol for 1 minute thrice a day (total 3 minutes per day) on alternate days for 3 weeks, 3 sessions per week and 3 times a day. Main outcome variables: Goniometer Inclinometer

Study aim: The objectives are to enhance gaze stability through the application of gaze stabilization exercises and Cawthorne Cooksey exercises also to study and compare the effect of Gaze stabilization exercises and Cawthorne Cooksey exercises on Thoracic angle and Cervical ranges. Design: Simple random sampling. Settings and conduct: The University of Faisalabad. Participants/Inclusion and exclusion criteria: Inclusion criteria • Participants willing to give consent • IT students • Both genders • Age: 19-25 years • Screen time 6-8 hours • VOR(+) • Craniovertebral angle 50° -53° • Thoracic angle 30° -50° Exclusion criteria • Uncooperative participants • No other neurological disorder • History of ear infection • History of migraine • History of dizziness, vertigo • Subjects with history of head injury • Subjects with ADHD Intervention groups: Group A: The participants of experimental group A will perform Gaze stabilization exercises as treatment approach for 3 weeks, 3 sessions per week and 3 times a day. Group B: The participants of experimental group B will perform Cawthorne Cooksey exercises as a treatment protocol for 1 minute thrice a day (total 3 minutes per day) on alternate days for 3 weeks, 3 sessions per week and 3 times a day. Main outcome variables: Goniometer Inclinometer

Study aim: To investigate the effects of ischemic conditioning along with bimanual task training to improve skill learning in children with unilateral cerebral palsy Design: consecutive sampling Settings and conduct: The Children Hospital & institute of child health Faisalabad Participants/Inclusion and exclusion criteria: Children diagnosed with Unilateral Cerebral palsy UCP. Children with age: 8-16 years. Children having Manual Ability Classification System (MACS) levels I – III. Children having ability to complete a stack of three cups in 1 min. Mainstream in school. Children with other developmental disabilities such as Autism, attention deficit hyperactivity disorder, developmental coordination disorders. Children with absent active motor threshold. Children with known cardiorespiratory, vascular and metabolic disorders. Children with neoplasm and hydrocephalus. Children who are currently receiving or received other adjunct therapies such as RTMs and TDs in the past 6 months. Children with active seizures or seizures within last two years and currently on anti-seizures medication. Children with metal implants and incompatible medical devices. Intervention groups: After taking informed consent from participants fulfilling the inclusion criteria, they will be randomized into two groups (Group A and Group B). Group A will receive Ischemic conditioning with 20 mmHg and bimanual task training of 15 repetitions each, for 6 consecutive days. Group B will receive only ischemic conditioning with 25 mmHg for 5 consecutive days. Main outcome variables: Movement Time Measure of bimanual coordination Goal Synchronization Total Task Duration

Study aim: To investigate the effect of virtual reality on trunk control in children with developmental delays Design: randomized controlled trial , single blind, parallel group Settings and conduct: The children hospital Faisalabad Participants/Inclusion and exclusion criteria: • Willing to give consent. • Both gender male/female • Age limit 3-8 years (11) • Able to follow visual and verbal commands (16) • Gross motor function level II-IV (11) • Those with an appropriate cognitive level to understand a VR exercise program • Inability to follow instructions • Other Neurological disorders (polio, epilepsy, seizures, trumatic brain injury) • Malgnanices and Infectious disorders ( encephalitis, meningitis, malignancy, tumors ) • Patients having musculoskeletal problems ( fracture, congenital hip dysplesia) • Spastic CP with Ashworth scale 2 + • Any surgery within last 6 months • A diagnosis of Autism or attention deficit disorders • Psychiatric disorder Intervention groups: Group A receives baseline treatment utilizing neurodevelopmental treatment (NDT) principles, focusing on trunk control through three stages of exercises: initial stage for dynamic co-activation, second stage for weight shift facilitation, and third stage for trunk rotation induction. Group B, the study group, undergoes 24 sessions of baseline treatment combined with immersive virtual reality (VR) protocol over 8 weeks. Sessions last 30 minutes, with 15 minutes of NDT followed by 15 minutes of playing VR games targeting trunk control and gross motor function. Games involve dynamic adaptations for head and trunk movements to promote engagement and motor learning. Main outcome variables: The trunk control measurement scale

Study aim: To determine the effect of neurological music therapy on cognitive function, emotional well being and quality of life among older adults with mild cognitive impairment. Design: randomization simple random sampling technique with lottery method, parallel group Settings and conduct: allied hospital Faisalabad Participants/Inclusion and exclusion criteria: Both Male and female Presence of MCI (Montreal Cognitive Assessment score < 26) Being able to walk safely A low level of physical activity assessed by means of a physical activity questionnaire. Age 60-80 years En Older adults with visual impairment and those with hearing problems History of cardiovascular disease Presence of neurological disorder ( Parkinson's disease, multiple sclerosis ) Patients having Serious motor deficits Patient having difficulty in moving and communicating Left-handed or ambidextrous Patient having diagnosis of severe cognitive impairment such as dementia. Presence of depression Intervention groups: The MMT group participated in a multi task MMT program consisting of exercise therapy with music and use of the Naruko clapper. The STT group participated in exercise sessions that involved the same movements as those in the MMT group. However, in these sessions, the instructor (single task) counted out the movements without accompanying background music or the Naruko clapper. Main outcome variables: • Cognitive function • Physical Function • Quality of life

Study aim: The present study is aimed at recording the average intensity of pain experienced by the patients after root canal procedure through rotary devices which are not used in common practice by the dentists in our community and comparing it with older techniques such as manual hand files which are more commonly used. Design: In this non blinded randomized control trial subjects were divided into two interventional groups by lottery method. There were 30 subjects in each. The patients were asked to mark their pain on a Numeric pain intensity scale at 6-, 12-, 24- and 48- hour postoperative intervals. Settings and conduct: Out-patients in the department of Operative dentistry, Rehman College of Dentistry, Peshawar Participants/Inclusion and exclusion criteria: The inclusion criteria were patients of both gender of age between 20 to 50`years, incisors and canines with irreversible pulpitis, periodontally sound tooth, with no systemic diseases, no radiographic changes on periapical radiograph and restorable teeth. Excluded were subjects who had taken pain medication 12 hours prior to the treatment. Subjects unable to understand the consent and the procedure itself. Intervention groups: In the manual instrumentation group the cleaning and shaping of the root canals was done by NiTi K-files. In the rotary instrumentation group cleaning and shaping of the root canals was done by HyflexNiTi rotary system. In order to keep equal apical diameter, the final apical preparation in both groups was kept similar.. The patients were asked to mark their pain on a Numeric pain intensity scale at 6-, 12-, 24- and 48- hour postoperative intervals. Main outcome variables: Pain perceived by the subject at given time post operative intervals.

Study aim: Aim of the study is to assess the efficacy of intravenous cyclophosphamide as compared to oral cyclophosphamide in the treatment of primary membranous nephropathy. Secondary objective is to document side effects of both regimens Design: Two arm parallel unblinded, Randomized control trial. Sample size is 58. 29 patient in each group. Randomization will be done by lottery method. It will be a singe center study. Settings and conduct: Indoor and out patient department of Nephrology department of Jinnah hospital. It will be non blinded study. Participants/Inclusion and exclusion criteria: Inclusion Criteria: 1. Serum Anti-Phospho Lipase A2 Receptor positive or IgG4 positivity on Immunofluorescence. 2. Biopsy–proven Idiopathic Membranous Nephropathy high risk group (Spot Urine protein/ spot urine creatinine Ratio more than 8g/g). 3. Biopsy –proven Idiopathic Membranous Nephropathy, moderate risk group that has failed to respond to conservative therapy for 6 months. Exclusion Criteria: 1. Patients with clinical, histologic, or serologic evidence of secondary Membranous Nephropathy. 2. Active or ongoing infection/ Recent infection. 3. Allergy or contraindication to cyclophosphamide. Intervention groups: Patients will be assigned into two groups randomly. Non probability / consecutive sampling technique will be used. One group will be given intravenous cyclophosphamide, 500mg/m2 on 2, 4 and 6 months and steroid on 1, 3 and 5 month as per modified ponticelli regimen. Control group will be given oral cyclophosphamide 2 mg/kg/day on 2, 4 and 6 months and steroids on 1,3 and 5 months as per modified ponticelli regimen. Main outcome variables: Spot urinary protein: creatinine ratio. Serum creatinine. Side effects like anemia, thrombocytopenia, leucopenia, any infection or hospitalization and malignancy.

Study aim: To compare the combine effect of cervical isometric with shoulder isometric exercises on pain, function and forward head posture in patients with cervical spondylosis. To find the correlation of factors affecting on pain, function and their management in the patients with cervical spondylosis Design: A community based, single blind, parallel group, randomized controlled trial Settings and conduct: Study conducted in Water and Power Development Authority teaching Hospital Lahore the trial is single blind, the participants and data analyzed were blinded they did not know, they belong to which group either experimental and control group Participants/Inclusion and exclusion criteria: Both male and female, 30-60 years, Diagnosed patients by orthopedic surgeons, No previous surgical /steroidal history in last six months, Patients having symptoms of radiculopathy Exclusion Criteria: Pregnant women, History of previous cervical surgery, Vertebral compression fracture, History of malignancy, Rheumatoid disorder and other systemic problems, Any infectious disease like osteomyelitis, tuberculosis, ankylosing spondylitis etc. Intervention groups: Group A (experimental) was received cervical isometric exercises with shoulder isometric exercises. Group B (control) was received cervical isometric exercises without shoulder isometric exercises. Main outcome variables: Compare the combine effect of cervical isometric with shoulder isometric exercises on pain, function and forward head posture and correlation with factors

Study aim: To analyze the comparative effects of integrated neuromuscular inhibition technique and active release technique in patients with upper trapezius myofascial trigger points. Design: Two arm parallel group Randomized trial with participant blinded. Randomization was centralised and computerised with concealed randomization sequence carried out through a randomization software. Settings and conduct: The trial is conducted in Riphah International university Faisalabad Campus. Subjects are chosen according to inclusion criteria. Subjects are blinded as the don't know their treatment protocol and group. Participants/Inclusion and exclusion criteria: Inclusion criteria: Participants aged between 20 to 35 years; Work/sedentary activity of 5 hours per day; Minimum of 4 months of neck pain due to trigger points; Decreased cervical lateral flexion and rotation Exclusion criteria: History of whiplash injury, fracture or other congenital disorders; Cervical radiculopathy, radiculitis or myelopathy or vascular syndromes; Degenerative conditions of cervical spine e.g., spondylosis; Any deformity of cervical and thoracic spine or scapular deformity; Participant received any treatment of neck in past 3 months; VAS score >7 Intervention groups: Group A: Integrated neuromuscular inhibition technique. Intermittent Ischemic compression for 15 seconds, Strain-Counterstrain for 20-30 seconds, Muscle Energy Technique in which isometric contraction held for 7-10 seconds and stretch held for 30 seconds (3-5 repetitions) Group B: Active Release Technique - 3 sets with 10 repetitions Main outcome variables: Neck pain; Cervical lateral flexion and rotation; Neck disability

Study aim: To compare the effects of Vestibular Rehabilitation Therapy and Task-Oriented Circuit Training on Gait, Balance and fear of falling in Elderly Population. Design: Randomized Clinical Trial Settings and conduct: Allied Hospital Faisalabad- Old Age Shelter Home Faisalabad Participants/Inclusion and exclusion criteria: Inclusion criteria: age of participants 60 y/o or more; have fallen at least once in the last 12 months; taking more than 15 s in the timed up-and-go (TUG) test; both genders; identified as medium fall risk on BBS (21-40)/56. Exclusion criteria: balance disorders(neurologic, vestibular, etc.); organic conditions. Intervention groups: Task-Oriented Circuit Training: The protocol will included: Sit to stand, Stand up and walk (6 m),Walking over inclined surface (3 m), Step, Taking an object from the ground while walking (6 m), Slalom (6 m),Climb and descend stairs, Touch different point marked a semicircle on a mirror with the feet, Reaching to object while standing, Standing on a movable platform Vestibular Rehabilitation Therapy: Head movement: backward and forward bending, turning from right to left, Balancing on a mat and swiveling eyes, Standing on a sports mat, walking on the spot, and rotating the head on both sides, Alternately shift weight toward one limb while maintaining partial weight bearing on the other, keeping the sight on a fixed target object. Repeated for the opposite side, Standing on foam with closed eyes and rotating the head on both sides, Forward and backward walking with a side-to-side head turn, Sitting on a ball with feet on foam, eyes closed, and bouncing slightly while turning the head from side to side, Marching in place. The sessions will be 20 to 30 minutes; 3 days per week for 6 weeks. Main outcome variables: Timed Up-and-Go (TUG) Test; Dynamic Gait Index; Falls Efficacy Scale-International(FES-I)

Study aim: To find out the effectiveness of Piriformis stretch and muscle activation exercise among patients with Piriformis syndrome. Design: The design of this study is Randomized, parallel clinical trial. Randomization is done by Lottery method. In this method the researcher gives each participant of the trial a number. Researchers draw numbers from the box randomly to allocate participants in two groups. Settings and conduct: The study is conducted at Arif Memorial Teachning Hospital. in this trial participants are blinded through concealment to avoid baisness. Participants/Inclusion and exclusion criteria: Inclusion criteria: suffering from Piriformis syndrome; both male and female; being at the age between 20 and 50 years. Non-inclusion criteria: The condition be a complication of hip surgery or fracture Intervention groups: Intervention group: All the patients of this group will be treated by Piriformis stretch. Control group: All the patients of this group will be treated by muscle activation exercise. Main outcome variables: Pain intensity; Low back Disability

Study aim: To compare the efficacy of Kinesio Taping after Mandibular 3rd Molar Extraction in terms of Post Op Swelling And Trismus Design: A simple randomized controlled clinical trial with a parallel group design of 154 patients, enrolled between October 2023 and January 2024 and followed for one week after the enrollment of last patient. Settings and conduct: Trail will be performed in Oral and Maxillofacial Surgery Department of AFID. Two groups will be made by simple randomization of patients getting surgical removal of Mandibular third Molars. One group (intervention)will get K taping done post operatively un addition to normal post operative care and second group (control) will have usual post operative care. Participants/Inclusion and exclusion criteria: Inclusion Criteria Having physical status 1 according to ASA classification Surgical extraction in mandibular third molars. Teeth which score =/>5 on Pederson's difficulty index for removal of impacted third molars EXCLUSION CRITERIA Patients having beard or any other hindrance in application of K- TAPE Patient with odontogenic infection Patient with medications that can alter pain perception. Teeth which score <5 on Pederson's difficulty index for removal of impacted third molars Intervention groups: Kinesio Taping will be performed in one group after 3rd Molar Extraction and No intervention will be performed in other group after 3rd Molar Extraction Main outcome variables: Post Operative Swelling Post Operative Trismus

Study aim: To compare the direct and indirect sinus lifting techniques for maxillary bone augmentation in patients receiving Implants Design: Single Blinded Randomized Controlled Trial Settings and conduct: Trail will be performed in Oral and Maxillofacial Surgery Department of AFID. Two groups will be made by simple randomization of patients getting sinus lifting done for placement of Dental implants in the Maxillary Molar region . One group will get the sinus lifting done via Direct method and second group will get it done by Indirect method.Patients will be randomized by using lottery method and concealed lottery tickets will be used for the purpose of blinding. Participants/Inclusion and exclusion criteria: INCLUSION Having physical status 1 according to ASA classification Bone Height Less than 5mm in Maxillary Molar Region EXCLUSION Pregnant women, nursing mothers, smokers Patient with infection in Maxillary Molar Region Patients Having Sinus Pathology Patient with medications that can alter pain perception. Intervention groups: Direct Sinus Lifting will be performed in one group and indirect in Other for Augmentation of Vertical Bone Height Main outcome variables: Post Op Pain; Post Op Swelling; Gingival Swelling; Implant Stability; Patient's Compliance

Study aim: The aim of this study is to compare the per and post-operative analgesic efficacy and adverse effect profile of ultrasound guided paravertebral plane block versus epidural anesthesia in patients with bronchiectasis planned for partial pneumonectomy. Design: Parallel group, single center, interventional randomized controlled trial Settings and conduct: Done at Combined Military Hospital, Rawalpindi Participants/Inclusion and exclusion criteria: Inclusion criteria included all ASA-II and III patients between ages 60-70 years presenting in the thoracic surgical department for partial pneumectomy for bronchiectasis. Exclusion criteria included patients with major cardiac or respiratory disease, low ejection fraction, allergy to bupivacaine or nalbuphine, unwilling to be included in the study, infection at site of block, coagulation disorders or spine deformity or having contraindication to epidural insertion. Intervention groups: The patients will be divided into the paravertebral group (PVB) (n=45) and epidural group (n=45). The method of sampling was non-probability consecutive sampling via lottery method. Patients in the paravertebral group (PVB) were taken to the procedure room before starting the procedure. Paravertebral block was given in sitting position with the arms of the patient extended. Confirmation correct needle placement was done by deflection of the pleura downwards on injecting 2 mL of saline. Patient in the epidural group were prepped for procedure and 18 G epidural catheter after priming was inserted in the T8 vertebral space. Main outcome variables: Primary variables measured were per-operative analgesia requirement, patient satisfaction for pain relief 24 hours after surgery and 24- hour total dose of analgesia needed. Secondary variables observed were hypotension, nausea, shivering and respiratory depression.

Study aim: The aim of this study is to compare analgesic efficacy and patient satisfaction when comparing the intercostal nerve block versus erector spinae block in patients presenting with traumatic multiple rib fractures. Design: Randomized controlled trial Single center randomized interventional study Settings and conduct: Conducted at Combined Military Hospital (CMH) Gujranwala Patients in Group E received intravenous 0.5% bupivacaine with 2% lignocaine diluted in distilled water to make a total volume of 20 ml given according to block guidelines under ultrasound guidance furnished by NYSORA. Patients in Group I received the similar titration of drug as 3 ml aliquots in each intercostal space under ultrasound guidance according to block guidelines furnished by NYSORA as well. Participants/Inclusion and exclusion criteria: Total 380 participants randomized into two groups of 190 each Inclusion criteria included all male and female patients between ages 25-55 years presenting in the operating room for pain relief with regional block with multiple rib fractures (>2 ribs) not requiring surgical intervention admitted for observation. Exclusion criteria included patients with metastatic disease, major cardiac or respiratory disease, low ejection fraction, post chemotherapy, allergy to lignocaine or bupivacaine, patients with advanced polytrauma causing hemodynamic instability, patients with oxygen saturation less than 92% after supplemental oxygen, patients with flail chest or pneumothorax and patients unwilling to be included in the study. Intervention groups: Group E: To receive erector spinae block Group I: To receive intercostal nerve block Main outcome variables: Primary variables measured were mean time to first rescue analgesia, total dose of intravenous analgesia needed in 24 hours and patient satisfaction for pain relief on the Likert scale 24 hours after intervention.

Study aim: Treatment efficacy of oral versus intravenous iron supplementation in improving the serum iron and hemoglobin status of patients with chronic kidney disease not on hemodialysis or erythropoietin Design: Single center, parallel group, randomized controlled interventional trial Settings and conduct: Department of Medicine, PEMH Rawalpindi Participants divided into the intravenous iron supplementation group (Group I) (n=105) and the oral iron supplementation group (Group O) (n=105). Participants/Inclusion and exclusion criteria: Inclusion criteria included all male and female patients over the age of 18 years not on hemodialysis or erythropoietin diagnosed as anemia with a baseline Hb of less than 13 g/dl in males and less than 12 g/dl in females with established chronic kidney disease with a GFR (glomerular filtration rate) of less than 60ml/min for more than 90 days assessed using the CKD-EPI equation and/or hyper albuminuria with urine albumin  30 mg in 24 hours or urine albumin to creatinine ratio (ACR)  30 mg/g. Exclusion criteria included patients on dialysis, erythropoietin or use of erythropoietin stimulating agents (ESAs) in the last 3 months, patients with advanced liver, cardiac or ESKD (end-stage kidney disease), drug allergies to iron and its supplemental form during therapy or previous known history or unwilling to be included in the study. Intervention groups: Intravenous iron group (Group I) (n=105) Oral iron group (Group O) (n=105) Main outcome variables: Primary variables observed were changes in the serum iron, Hb, transferrin and TIBC. Secondary variables observed were the adverse effect profile seen with both treatment regimes

Study aim: To compare the efficacy of buffered local anesthetic with non-buffered local anesthetic in terms of pain reduction and speed of onset of anesthesia. Design: It was a randomized, parallel group, double blinded, single center study including 100 patients in total. Settings and conduct: This randomized controlled trial was conducted at Armed Forces Institute of Dentistry in the outpatient department of Oral & Maxillofacial Surgery from March 2020 to Dec 2022. Participants/Inclusion and exclusion criteria: The physical condition of all patients was evaluated, and those with systemic diseases for which injections of lignocaine with adrenaline were contraindicated, were excluded from the study. Intervention groups: The study included a total of 140 TMD patients that were randomly assigned to two groups: Buffered Group (A) (n=50) and Non- Buffered Group or Control Group (B) (n=50). Buffered local anesthesia was made by adding 0.18 ml of 8.4% solution of sodium bicarbonate to a 1.8ml cartridge of 2% Lignocaine with adrenaline 1:100,000 leading to a 1:10 dilution. All procedures were done by a single maxillofacial surgeon, who was unaware of the type of LA given to the patient. Main outcome variables: Pain intensity was assessed using the Visual Analog Scale (VAS) and speed of onset of anesthesia measured in seconds from point of retrieval of the needle.