Study aim: The aim of this study was to investigate the impact of nutritional counselling on the quality of life of patients who have undergone Sleeve Gastrectomy. Design: Randomized Control Trial (RCT) was performed utilized a simple random sampling using lottery method. The study compared the quality of life of post-op patients that have undergone sleeve gastrectomy and who received nutritional counselling with those who did not receive any counselling. Settings and conduct: The study was conducted in the General Surgery Department at Ammar Medical Complex Lahore and had a duration of 6 months. Participants/Inclusion and exclusion criteria: Inclusion criteria: The study's inclusion criteria included male and female patients aged between 18 to 60 years who have undergone bariatric surgery within 6 months, with no prior bariatric surgery, fractures or limb issues, and no coexisting diseases that affect limb function. This criteria helped in reducing confounding variables Exclusion criteria: Patients under the age of 18 or older than 60, those with a history of bariatric surgery that lasted longer than six months, those with limb fractures, pregnant women with a history of bariatric surgery, those taking antidepressants, and those who refused to adhere to the study's protocol were all excluded from the study. These requirements helped to accurately represent the study's target group and to reduce any potential confounding variables that might have had a detrimental impact on the study's findings. Intervention groups: A crucial component of sleeve gastrectomy is nutritional counselling, which assists patients in adjusting to dietary changes and achieving the best possible results in terms of weight loss and health Main outcome variables: effectiveness of nutritional counselling

Study aim: To compare the effects of post isometric relaxation and bruegger’s exercises on pain, Range of motion and disability in patients with mechanical neck pain . Design: It will Single blinded randomized clinical trial with parallel group design. 24 Participants will be allocated to two groups equally by random computer number generator Settings and conduct: It will be conducted at Arif memorial teaching hospital. Outcome assessor will be kept blind. Participants/Inclusion and exclusion criteria: Inclusion criteria: Both male and female patients age ranged from 20-40 years and suffering from Mechanical neck pain for at least three months Exclusion criteria: any orthopedic or neurological condition surgery in the cervical spine or shoulder Patients having Inflammation, malignancy and metabolic disorder will be excluded Patients with neck pain radiating into arms and upper extremity will be excluded from this study Neck pain associated with headache and facial pain, recent surgery, Vertebrobasiliar insufficiency (VBI) positive will be exclusion criteria: History of recent trauma and fractures of cervical spine will be excluded Intervention groups: Group A: Post isometric relaxation: Total 20 sessions will be given to each patient in 4 weeks with 3 sessions per week Group B: Bruegger’s exercise: Total 20 sessions will be given to each patient in 4 weeks with 3 sessions per week Baseline Treatment: Baseline treatment will be given as common treatment to both groups. It include Hot pack for 10-15 minutes Main outcome variables: Pain: Numeric Pain Rating Scale (NPRS) ROM: Universal Goniometer Disability: Neck Disability Index (NDI)

Study aim: To Compare the effects of post isometric relaxation and strain-counterstrain technique on pain, Range of motion and functional activities among individuals with gastrocnemius tightness. Design: Single blinded randomized clinical trial with parallel assignment of 44 participants to two groups equally. Settings and conduct: The study will be conducted at Arif Memorial Teaching Hospital. Outcome assessor will be kept blind. Participants/Inclusion and exclusion criteria: Inclusion Criteria: Participants from age group of 18-40 who present with gastrocnemius tightness. Patients with positive silfverskiold test. Exclusion Criteria: Systemic disease causing musculoskeletal issue. Any other type of connection tissue disorder. With history of neurological disorder. Having recent lower limb or spine fracture causing change in gait pattern. Intervention groups: Group A: Participants of group A received exercise post isometric relaxation exercise, 3 times a week for 4 weeks. Group B: Participants of group B received strain-counterstain technique, 3 times a week for 4 weeks. Main outcome variables: Pain: The intensity of pain will be measured by the numeric pain rating scale [NPRS]. Range of motion: ROM will be measured using a Universal Goniometer. Functional activities: Functional activities will be examined by foot functional index.

Study aim: To compare the opioid-sparing effect of intraoperative intravenous ibuprofen versus placebo in patients undergoing laparoscopic cholecystectomy, in terms of postoperative opioid consumption, pain scores, and requirement for rescue analgesia. Design: A single-center, randomized, placebo-controlled, parallel-group trial with blinded outcome assessment involving 60 patients (30 in each group). Settings and conduct: The study will be conducted in the Department of Anesthesia, National Hospital & Medical Center Lahore. Patients will be randomized into two groups by using the closed envelope method: the ibuprofen group (n = 30) and the control group (n = 30). The randomization will be blinded to all assessors Participants/Inclusion and exclusion criteria: Inclusion Criteria Age 18–65 years ASA physical status I–II Patients scheduled for laparoscopic cholecystectomy Exclusion Criteria Chronic use of NSAIDs or opioids Intraoperative discontinuation of study protocol for any reason Known contraindication or hypersensitivity to study drugs (ibuprofen/tramadol) Intervention groups: Intervention Group 1: The ibuprofen group (n = 30) will receive 400 mg (100 ml) of intravenous ibuprofen over 20 minutes, 20 minutes before extubation. Control Group: The control group (n = 30) will receive 100 ml of normal saline intravenously over 20 minutes, 20 minutes before extubation. Main outcome variables: Total postoperative opioid consumption (tramadol dose in mg) within 24 hours after laparoscopic cholecystectomy. Postoperative pain scores using Visual Analogue Scale (VAS) at 2-hour intervals for up to 12 hours. Time to first rescue analgesia. Requirement for rescue analgesia (yes/no). Total dose of rescue analgesia administered.

Study aim: This study was designed to compare the outcomes of SPG block administered via transmucosal and transcoronoid approaches in patients with autonomic cephalalgia Design: prospective quasi-experimental comparative study Settings and conduct: Department of Pain Medicine, CMH Rawalpindi over a period of six months Participants/Inclusion and exclusion criteria: Inclusion Criteria Patients aged 18–65 years with a clinical diagnosis of trigeminal autonomic cephalalgia were included. Eligible participants were those with inadequate response to at least six months of standard oral pharmacotherapy (including amitriptyline, duloxetine, venlafaxine, pregabalin or gabapentin) and who reported moderate to severe pain intensity (defined as a Numeric Rating Scale - NRS score greater than 6). Only patients without evidence of secondary headache disorders or underlying dental or palatal pathology were enrolled. Exclusion Criteria Individuals with identifiable dental or palatal abnormalities contributing to facial pain, patients with secondary headache etiologies such as intracranial tumors or hemorrhage, patients with structural abnormalities including cleft lip/ palate or nasal septal defects, history of trauma or surgical intervention, patients with significant coagulopathy, hepatic or renal dysfunction, as well as those with a history of malignancy, were excluded from the study. Intervention groups: Group A underwent sphenopalatine ganglion (SPG) block via the transmucosal approach, whereas Group B received the block through fluoroscopy guided transcoronoid approach. Main outcome variables: The primary outcome was the mean change in NRS score from baseline to one month.

Study aim: The aim of this study is to evaluate the lipid profile level changes assessed by total serum cholesterol (TC), serum low density lipoproteins (LDLs), serum triglycerides (TGs) and serum high density lipoproteins (HDLs) after six months of levothyroxine therapy in patients with presenting with sub-clinical hypothyroidism. Design: Pragmatic research, quasi experimental study, carried out at the Department of Medicine, Combined Military Hospital, Hyderabad from August 2025 – January 2026 Settings and conduct: After approval from the Institutional Ethical Review Committee, CMH Hyderabad, the study was conducted in the institute, ensuring strict confidentiality and data protection according to institutional and international guidelines. Simple random sampling was used to recruit a total of 90 adult patients aged 18–65 years diagnosed with mild SCH (sub-clinical hypothyroidism) (TSH 4.49–10 mIU/L) or moderate SCH (TSH >10 mIU/L) with normal T3 and T4 levels. They were screened through laboratory-verified thyroid profiles. Participants/Inclusion and exclusion criteria: Inclusion criteria: all patients aged 18-65 years of age diagnosed with sub-clinical hypothyroidism (mild and moderate) as per the WHO definition criteria furnished in the methodology and planned for levothyroxine therapy for six months. Exclusion criteria: patients already on thyroid replacement therapy, Overt hypothyroidism or Hyperthyroidism, Pregnancy or lactation, use of medications significantly known to affect thyroid function or lipid metabolism ( e.g amiodarone, statins) Intervention groups: All patients received the same levothyroxine regimen of 1.6 mcg/kg/day. Main outcome variables: Primary variables studied were mean change in serum lipid levels assessed by total serum cholesterol, serum low density lipoproteins, serum triglycerides and serum high density lipoproteins.

Study aim: To determine the effects of clubbell and plyometric exercises on shoulder pain, range of motion and performance in bowlers Design: RANDOMIZED CONTROLLED TRIAL Settings and conduct: 1. Pakistan Sports Board 2. Aleem Dar Cricket Academy 3. Shoaib Akhtar Cricket Academy Participants/Inclusion and

Study aim: The aim of the study is to find the compare the effects of electrical stimulation with and without motor re-learning programme on spasticity and upper limb function in stroke patients Design: Two arm parallel group randomized trial , single blind , of 62 stroke patients Settings and conduct: Sir Ganga Ram Hospital Participants/Inclusion and exclusion criteria: Inclusion criteria was as follows: • Aged between 25-65 years • Both Male and females • Stroke Onset ≥3 months • Ischemia Stroke • Patients with limb spasticity equal to 2 or less than 2 on modified Ashworth scale • Patients with English reading and writing skills Exclusion Criteria: • Patients with visual and auditory defects • Patients with severe shoulder or wrist pain • Patients with upper limb fractures/dislocations • Contraindication to Electrical stimulation such as skin allergy Intervention groups: Both groups will receive electrical stimulation for 15 minutes with hot pack and the Stretching of muscles will be performed at the end. The sessions will be last 60 minutes five days a week for an 8-week period. Electrical stimulation will be used to stimulate flexion and extension of wrist and elbow. In Group A participants will receive electrical stimulation with motor relearning programme which consist of 4 steps as Step 1: Analysis of Task Step 2: Practice of missing component Step 3: Practice of Task Step 4: Transference of training In Group B Electrical stimulation without motor re-learning programme will be given. This protocol will be as including different exercises like Wrist flexion and extension, Finger flexion and extension, Forearm supination and pronation, tapping table top with all fingers, Opening of all fingers and Counting with fingers. These exercises which can be performed for 5-10 repetitions depending on patient's capacity. Main outcome variables: Spasticity Upper limb function neurological function

Study aim: To evaluate the effectiveness of lower limb strength training and aerobic exercises in combination with lifestyle modification on strength, aerobic fitness and quality of life in patients with type II diabetes Design: Parallel group randomized clinical trial and Randomization will be achieved through computer generated random allocation software. Settings and conduct: District Head Quarter (DHQ) teaching Hospital Faisalabad, Tehsil Headquarter Hospital Gojra, AL Barkat Hospital Gojra, Hajra Tufail Hospital, Gojra. Patients and outcome assessor will be blinded. It will be assessor and participant who will be blinded about the type of intervention. Treatment will be given by principal /investigator. Participants/Inclusion and exclusion criteria: Inclusion criteria: Both male and female patients, Age: 40 to 60 years, Patient with diabetes type II diagnosed by physician Exclusion criteria: Unsafe blood pressure, Mental retardation, Any recent surgery (cardiac, musculoskeletal and neurological) ,Fracture ,Limb amputation and joint replacement ,Central nervous system dysfunction (stroke, Parkinson disease) Intervention groups: The intervention group will include lower limb strength training, aerobic exercises, and a lifestyle modification program. Session duration will be 45 minutes, thrice a week, and 24 sessions over 8 weeks. The interventions of the control group will include lower limb strength training, aerobic exercises, and unguided lifestyle instructions. Session duration will be 45 minutes, thrice a week and 24 sessions over 8 weeks. Main outcome variables: Strength, Aerobic fitness, Quality of life

and conduct: Pakistan Institute of Medical Sciences Islamabad. Physiotherapy department. Participants

: The data was collected from Volleyball athletes in Pakistan Sports Board, Lahore. Participants

Study aim: The aims are to compare the effectiveness of butler’s neural mobilization with SNAG mulligan’s mobilization to manage pain, disability and SLR ranges associated with subacute and chronic LBP Design: Single blind, parallel assigned, multicentered, randomized clinical trial will be conducted on 52 participants (2 groups with 26 each) with diagnosed LBP disc herniation Settings and conduct: Allied hospital and ProHealth rehab and medical center Participants are kept anonymous for conducting the single blind trails Participants/Inclusion and exclusion criteria: Low back pain diagnosed with non-contained disc herniation with radiation to lower extremity of age 35-55 year of both genders, having pain from 6 weeks, patients who are not on analgesics, unilateral SLR is positive in between 35 and 70 degrees will be included. Patients of cauda equina, saddle anesthesia, bowel and bladder symptoms, cancer, infection or inflammatory disease, bladder, kidney, uterus issues, injury, other severe medical or psychiatric illness pregnancy, history of any recent surgery, spinal surgery or artificial disc and LBP due to fracture, spine structural deformities like scoliosis, spinal fusion or osseous stenosis, patients on any other medical or therapeutic intervention within last 3 months, patient who are unable to participate in study due to any abnormality or refusal for consent will be excluded. Intervention groups: Group A: Baseline treatment will be TENS and hot pack, and then butler neural mobilization will be applied. Group B: Baseline treatment will be same as group A and then SNAG mullligan mobilization will be applied. Main outcome variables: Low back pain and disability Straight leg raise

Study aim: To evaluate the combined effect of Kinesio tape and MWM on lateral ankle sprain. Design: Randomized clinical design Settings and conduct: The study will done on patients of the acute, the sub acute stage of grade I, II lateral ankle sprain and patients will selected from Al-Fateh Sports Complex Faisalabad and DHQ hospital Faisalabad. participants after fullfilling the inclusion and exclusion creteria participants will selected for study and then divided into two groups. Participants/Inclusion and exclusion criteria: Inclusion criteria: • Unilateral lateral ankle sprain, Grade II and grade I lateral ankle sprain (Kim, et al., 2018),Positive anterior drawer test (Kim, et al., 2018), Positive talar tilt test, Age of patient 15 to 30 years, Both male and female (b) Exclusion criteria: • Fracture in distal end of tibia and fibula (Kim, et al., 2018). Open wound at ankle joint (Hudson, et al., 2017). Sprain more than 72 hours.Patients having loss of ankle function by <5 degree (Shin, et al., 2020). Sensory loss at the ankle due to neurological issue (Kim, et al., 2018). Patients having skin diseases,Grade III ankle sprain. Intervention groups: . Then patients will randomly assigned in the two groups, Experimental group (group A) and the control (group B). The Experimental group receives 3 sets of 10 MWM repetitions in one treatment session and 30 sec of rest in each set and KT tapping 3 sessions a week for 4 weeks. Control B received KT tapping 3 sessions a week for 4 weeks. Pre and Post intervention patients conditions will assess by the NRS, DPA- scale and the PSFS scale. Main outcome variables: NRS Numeric rating scale for pain. Patient specific functional scale (PSFS) for functional activity status.3 Disablement in physically active scale (DPA scale):This scale is used to gather data about disablement in four dimensions impairment,

Study aim: To determine the effectiveness of low level laser therapy for treatment of cervical pain in patients with trigger point of upper trapezius muscle. Design: Single Blind , parallel , Randomized Controlled Trial Settings and conduct: This Randomized Controlled Trial ,Double Blind ,Parallel study will be conducted at University of Lahore Teaching Hospital Participants/Inclusion and exclusion criteria: Inclusion : Patients diagnosed with active upper trapezius trigger point. •Both Male and female •Age ranges from 18 to 55 Exclusion : Participants having contraindications for LASER e.g. Pregnancy, Tumors, Implants, Pacemaker, •Past History of fracture of shoulder joint or cervical spine •Whiplash injury •Comorbid medical diagnosis e.g. osteoarthritis •Psychiatric illness (e.g., schizophrenia or substance abuse) •Irritable skin around the area of treatment Intervention groups: Patients of group-A will receive conventional physical therapy along with low level laser therapy ( LLLT with Omega Class IIIB Laser therapy unit with pen probe.) While patients of group B, will receive conventional physical therapy only. Main outcome variables: Neck pain , Neck Range of Motion and Neck Disability Indexes

Study aim: To determine the effects of gluteus medius muscle strengthening and lumbar stabilization exercise in chronic nonspecific low back pain with gluteus medius weakness. Design: A concealed, randomized, double-blinded, clinical trial with a parallel-group design of 18 patients Settings and conduct: Subjects from Madina University and Teaching Hospital, Faisalabad will be considered. Subjects and assessors are blinded. Participants/Inclusion and exclusion criteria: Inclusion  Females  Age 18 to 35 years  Having non-specific LBP, defined as pain anywhere from the inferior rib margin to the gluteal fold, for more than 3 months  Less than four out of five gluteus medius muscle strength on manual muscle testing  Numeric Pain Rating score 5 points or higher  Low back pain disability indices 20% or higher Exclusion  A prior history of thoracolumbar or pelvis fracture  Thoracic, abdominal or lumbar spine surgery  Radiculopathy, neurogenic claudication  Primary or secondary spinal tumors  Pregnancy Intervention groups: Baseline treatment will be given to both groups with Infrared for 10 minutes. One group will receive Lumbar stabilization exercises and other group will receive gluteus medius strengthening protocol. Main outcome variables: The primary outcome will be self-reported pain. Secondary outcomes will be low back pain-related disability.

Study aim: The study objective is to investigate the effectiveness of LLRPw-mHeath on physical disability and exercise adherence among knee osteoarthritis patients who are overweight and obese. Design: A parallel group, single blinded randomized control trial. Sixty participants will be randomly divided into three groups by computer generated numbers. It is a single centered. Settings and conduct: Study will be conducted at the Teaching Bay of Rehmatul-Lil-Alameene Post Graduate Institute of Cardiology. Participants are blinded in this study. Afetr randomization only one group will be called for their intervention in order to secure the blinding process. Participants/Inclusion and exclusion criteria: Inclusion criteria Overweight and obese Knee OA patients; Both males and females; Aged between 45 to 60 years; Living in urban area of Punjab, Lahore. Non-inclusion criteria: Rheumatoid arthritis; Flat feet; Spinal deformities; Surgery or injections of knee/s of any cause; System lupus erythematosus (SLE). Intervention groups: Intervention group 1 (LLRPw-mHeath): The researcher will teach the lower limb rehabilitation protocol by using mHealth and instructions of daily care and will advice them to carry out three times a week for 12-weeks at their houses. The researcher will send the reminder with the mHealth in the form of periodic manual WhatsApp messages two times a day for three days a week for 12 weeks. Intervention group 2 (LLRPwo-mHealth): The researcher will teach the lower limb rehabilitation protocol and instructions of daily care and will advice them to carry out three times a week for 12-weeks at their houses. Control group: The researcher will teach the instructions of daily care to the control group keeping in mind the ethical consideration of patients. Main outcome variables: Physical disability; Exercise adherence

public school and its branches in Faisalabad, Pakistan and the study duration will be 12 months

Study aim: The purpose of this study is to assess and contrast how well Proprioceptive neuromuscular facilitation stretching and joint mobilization can enhance joint mobility and quality of life in individuals with knee osteoarthritis. Design: Randomised, superiority, parallel group trial with blinded outcome assessment on 48 participants. Randomisation was centralised and computerised with concealed randomisation sequence carried out at an external site Settings and conduct: A randomized, parallel-group, superiority trial with blinded outcome assessment. Participants (n=48) will be randomly assigned using a sealed envelope method into two intervention groups. This is a single-center study conducted at District Headquarter Hospital Bannu over a duration of four weeks. Participants/Inclusion and exclusion criteria: INCLUSION: Individuals aged between 40 to 75 years diagnosed with knee osteoarthritis based on clinical and radiographic criteria. Participants with a Kellgren-Lawrence grade II–III classification of knee OA. EXCLUSION: OA patients who have received intra articular injections. Those with neurological disorders affecting lower limb function. Intervention groups: Control Group (Joint Mobilization - Group B) Participants will receive Maitland joint mobilization (Grade III-IV), including anterior-posterior glides and patellar mobilization, to reduce stiffness and improve mobility. Sessions will be **three times per week for four weeks, progressing in intensity with weight-bearing mobilization. Experimental Group (PNF Stretching - Group A) Participants will undergo PNF stretching using the hold-relax technique for knee flexors and extensors, with progressive increases in hold duration and integration with functional movements. Sessions will be three times per week for four weeks. Both groups will have a 5–10 minute warm-up and cool-down in each session. Main outcome variables: Quality of life

, Central Park Medical College, Lahore, Pakistan Participants/Inclusion and exclusion criteria: Inclusion

Study aim: The primary study aim of this study is to investigate the efficacy of an integrative treatment approach combining eccentric exercises with curcumin-enhanced ultrasound therapy for the management of knee tendinopathy. Design: Pragmatic, community based, parallel group, double blinded, randomised controlled trial. Total 90 patients will be enrolled. Patients who met our inclusion criteria randomised into two groups. Control group-A and treatment group-B Settings and conduct: At Muhammad Institute of Medical and Allied Sciences Multan after getting approval from institutional ethical committee Participants/Inclusion and exclusion criteria: Inclusion criteria: Participants between 18 to 60 years of age; patellar tendinopathy, confirmed by a qualified healthcare professional; chronic patellar tendinopathy symptoms for at least 3 months; moderate severity of symptoms; no active inflammatory conditions. Exclusion criteria: Individuals with acute (less than 3 months) patellar tendinopathy or other acute knee injuries; Participants with other significant knee conditions (e.g., patellofemoral pain syndrome, osteoarthritis, ligament injuries, or meniscal tears) that may confound the outcomes or interact with the treatments being tested; surgical interventions involving the patellar tendon or knee in the past 6 months; Individuals with uncontrolled systemic diseases, including rheumatoid arthritis, diabetes mellitus, or severe cardiovascular or neurological conditions that could affect tendon healing or physical activity. Intervention groups: Control group: Curcumin-aloe vera gel + ultrasound + eccentric exercises. Intervention group: Placebo aloe vera gel + ultrasound + eccentric exercises. Main outcome variables: Pain, Knee ROM, Muscle strength ,Tendon thickness , Quality of life ,CRP, ESR and Tendon function

Study aim: The objective of this study is to check comparative effects of post isometric relaxation technique and mulligan traction straight leg raise technique along with retro walking on pain, hamstrings flexibility, quadriceps strength in knee osteoarthritis pain. To check effects of hamstrings flexibility and quadriceps strength on knee range of motion and functional activity in knee osteoarthritic patients Design: Parallel group, Randomised trial Settings and conduct: Settings: Madina Teaching Hospital FSD, Physio Fixx Physiotherapy center Faisal Hospital, FSD, Revive Healthcare Clinic, FSD, Sarfraz Healthcare Clinic, FSD, InMotion Physiotherapy and Rehabilitation Clinic, FSD Participant, Care provider, investigator and outcome assessor will be blinded . Participants/Inclusion and exclusion criteria: Inclusion criteria: Knee pain with crepitus sound, Radiographically finding Grade II-III, Both genders having age 40-60, Morning stiffness <30 minutes, tight Hamstrings muscles, NPRS score of 5 or greater than 5 Exclusion criteria: Any history of trauma to the knee ligament, pathology, recent surgery or any neurological impairment, severe valgus or varus deformity, active infection or inflammation, unwilling participants Intervention groups: Baseline treatment: moist heat on hamstrings muscles, quadriceps isometrics by foam roller before treatment and retro walking at maximum pace for 5 minutes after treatment will be given to both groups A and B. Group A (Post isometric relaxation technique) will be treated with baseline treatment and PIR Technique. Repetition 3 to 4 times per day; three sessions per week on alternative days. Group B (Mulligan Traction Straight Leg raise technique) will be treated with baseline treatment and TSLR technique. Repetition 3 to 4 times per day, three sessions per week on alternative days. Main outcome variables: Pain, Knee Range of Motion, Functional Activity and Cadence

Study aim: The aim to the study is to compare the effectiveness of fractionated resurfacing carbon dioxide LASER and topical methotrexate with topical PUVASOL in cases of vitiligo effecting less than 10% body surface area. Design: Two arm parallel group randomized control trial with blinded outcome assessment by a neutral assessor Settings and conduct: The trial will be conducted in dermatology outpatient department of a tertiary care hospital.30 patients will be selected based on inclusion/exclusion criteria. They will be randomized into 2 groups of 15 by allocation concealed randomization in the form of selecting one of the 2 sealed envelopes. Patients and assessor will be blinded. Participants/Inclusion and exclusion criteria: Inclusion Criteria: Patients willing to participate in the study; of age group of 10 -70 years; Vitiligo involving less than or equal to 10% body surface area. Exclusion Criteria: Patients using or have used other treatments for vitiligo; Pregnant women or lactating women; segmental vitiligo; Patients on immunosuppressant medications; Patients having contraindication to methotrexate or PUVASOL. Intervention groups: For Group A, a 10,600-nm fractional carbon dioxide laser device will be used with a resurfacing mode followed by topical methotrexate application. 3 sessions will be done at 2weeks a part interval. Group B will be advised topical psoralen i.e. Methoxsalen .5% ointment is to be applied for 45 minutes on the vitiligous patch prior to sunlight exposure followed by photo exposure for 5 to 10 minutes. Patients will be examined monthly for 2 months. Main outcome variables: Clinical improvement: 1, < 25% minimal re-pigmentation; 2, 26–50% mild re-pigmentation; 3, 51–75% moderate re-pigmentation; 4, >75% excellent re-pigmentation. Patient satisfaction. 1. Unsatisfied, 2. Partially satisfied, 3. Completely satisfied.

Study aim: The study aims to evaluate the effects of gastrocnemius recession versus physiotherapy in chronic plantar fasciitis. Design: Parallel, 40 Sample size, Randomized Controlled Trial, single-blinded Settings and conduct: The trial will be conducted in the Physiotherapy Department of Punjab Social Security Health Management Company Hospital. Assessor will be completely blind to outcomes. Participants/Inclusion and exclusion criteria: Inclusion Criteria: Age 30-50 years individuals, Male and female both, Heel pain lasting > 3 months, Pain in the morning, Tenderness over medial plantar fascia insertion, Positive Silfverskiöld test Exclusion Criteria: Degenerative arthritis of the hindfoot joints, Systemic joint disease, Previous injury or surgery to the foot or ankle, Inoperable due to comorbidity Intervention groups: Group A. PHYSICAL THERAPY PHONOPHORESIS, STRETCHING, and MANUAL THERAPY were done on alternate days for 4 weeks. The calf muscle and/or plantar fascia–specific stretching will be used to provide pain relief and improvement in calf muscle flexibility 3 times a day (3 minutes) stretching time, for three months in-home plan. Group B. GASTROCNEMIUS RECESSION Patients randomized to surgery will be operated on with a proximal medial gastrocnemius recession (PMGR) as described by Barouk. Patients were instructed to continue the stretching exercises and fully weight-bear from the first postoperative day. If needed, the patients were allowed to use crutches during the first 2 weeks after surgery. Main outcome variables: numeric rating scale, Foot and Ankle Ability Measure (FAAM)Activities of Daily Living Subscale, ankle hindfoot scale, The Short Form–36 (SF-36)

Study aim: To find the effects of diaphragmatic stretch with and without rib cage mobilization on chest expansion, dyspnea and pulmonary function test in COPD patients. Design: 36 participants will be recruited. Two parallel groups, double blinded, randomized controlled trial with pre and post assessment. Settings and conduct: The study will be conducted in Pulmonology ward at Shalamar hospital Lahore. Participants and outcome assessor will be blinded. Participants/Inclusion and exclusion criteria: Inclusion Criteria: • Age group of 35-55 years • Both male and female • At least history of COPD from 1 year • Decrease FEV1/FEV ratio • History of smoking.(11) Exclusion Criteria: • Acute exacerbations of COPD • COPD diagnosed at severe stage • Patients with comorbidities • Patients with other life- threatening conditions • Patients who are vitally unstable. Intervention groups: Diaphragmatic stretch with and without rib cage mobilization. Diaphragmatic Stretch Technique with Rib Cage Mobilization: Group A will be treated with diaphragmatic stretch technique with rib cage mobilization. This treatment duration will be 10 minutes, once a day, 5 days per week for 2 weeks. Diaphragmatic Stretch Technique: Group B will be treated by diaphragmatic stretch technique only. This treatment duration will be 20 minutes, once a day, 5 days per week for 2 weeks. Main outcome variables: Dyspnea using Modified Medical Research Council Dyspnea Scale, Chest expansion using Measuring Tape, Pulmonary Function Test using Portable Spirometer.

Study aim: To compare the effects of whole-body vibration along with plyometric on agility,lower extremity function and gait in footballers Design: single-blinded Randomized control trial with 2 groups. A total of 30 participants will be recruited from a single center. The sample size was calculated using Gpower version 3.1.9.7. sealed enevelop method will be used to randomzied the participants in two euqal groups (as per the description of Randomization). Settings and conduct: would be condcuted in Young star football club Phalia . it would be sinlgle blinded study with assessor is blind, thecare provider wil not be blinded Participants/Inclusion and exclusion criteria: male Footballers with regular training from last 2 years with Age 18- 27 years would be included participant with Lower limb injury past six months, History of no chronic illness,Recent fracture, Cardiopulmonary issues would be excluded Intervention groups: Group A Whole body vibration therapy and plyometric group B plyometric training only Main outcome variables: Lower Extremity Function Agility Gait Kinematics: (walking speed, step length)