: Multicentric. Pakistan. Retina clinic of a tertiary care dedicated eye care setup. The person assessing the

Study aim: To find out comparative effect of Buteyko Breathing Technique and Lotorp Method among COPD patients Design: 40 participants will be recruited. Two parallel groups, double blinded, randomized clinical trial with pre and post assessment. Settings and conduct: Pulmonary Ward Gulab Devi Educational Complex Participants/Inclusion and exclusion criteria: Inclusion Criteria Patients between age group of 40-65 years. Patients of both genders. Patients with mild or moderate COPD according to the GOLD criteria Exclusion Criteria: Patients with restrictive lung disease. Patients with any infection. Patients having uncontrolled asthma. Pregnant women. Risk of pneumothorax Low resting oxygen saturation(13) Unstable conditions, active infections and neurological condition Patients who cannot comply this technique Intervention groups: Group A: It will be treated by Buteyko Breathing Technique Group B: It will be treated with Lotorp Method Main outcome variables: Dyspnea measured using Modified Medical Research Council (MMRC) scale, Chest Expansion measured using Measuring tape, Pulmonary Function Tests using Diagnostic Spirometer and St George Respiratory Questionnaire

Study aim: To determine Combined Effects of diaphragmatic breathing and Thoracic Kinesio Taping on Pulmonary functions, dyspnea, Thoracoabdominal mobility and quality of life in mild to moderate COPD Chronic Obstructive Pulmonary Disease patients . Design: Two parallel group ,single blinded ,Randomized Controlled Trial with pre and post assessment Settings and conduct: Pulmonology ward : Ittefaq hospital Lahore Participants/Inclusion and exclusion criteria: Inclusion Criteria: ●Mild to moderate level COPD patients ●Both male and female gender ●Age between 40-60 years ●Vitally stable patient ●Individuals with no prior experience with thoracic Kinesio taping Exclusion Criteria: ● Participants with unstable medical conditions (e.g., cardiovascular instability) ● Individuals with cognitive impairments ●Pregnant women ● Participants with known allergies to tape ● Participants with known respiratory conditions other than COPD ● Diabetic patients Intervention groups: Thoracic Kinesio Taping along with diaphragmatic breathing Main outcome variables: • Dyspnea 12 Questionnaire will be used to assess change in Dyspnea • Digital Spirometer will be used to assess Pulmonary functions changes • St. George's Respiratory Questionnaire for COPD pauients (SGRQ-C) will be used to assess quality of life

peri-urban Rawalpindi, Pakistan. Design: Two-arm parallel-group cluster randomized controlled trial (...) and conduct: Public primary schools in the peri-urban areas of Rawalpindi District, Pakistan. Schools

Rangoonwala Trust, Karachi, Pakistan Participants/Inclusion and exclusion criteria: participant of age 60

Study aim: The aim of this study is to investigate the effectiveness of progressive resistance strengthening training on body mass index, quality of life and functional capacity in the overweight and obese knee osteoarthritis patients. Design: Study will be single-blinded randomized controlled design Settings and conduct: Study will be conducted at the Teaching Bay of Rehmatul-Lil-Alameen Postgraduate institute of cardiology, Punjab Employees Social Security Institution. The principle investigator will not be blinded. The participants receiving the intervention will be blinded by simply not informing them of their treatment allocation. Participants/Inclusion and exclusion criteria: The inclusion criteria will be: (1) Overweight and obese knee osteoarthritis patients having osteoarthritis of one or both knees (2) Osteoarthritis grading scale of 2-mild or 3-moderate according to Kellgren and Lawrence radiographic scale (3) Symptoms of osteoarthritis for more than three months (5) Residing in the Urban community of Lahore . Exclusion criteria will be one or more of the following: (1) Flat feet (2) Knee surgery (3) Corticosteroid injection of knee (4) Spinal deformities (5) Cardiac problem or (6) Hormonal problem Intervention groups: Intervention groups will be Rehabilitation Protocol Group and the Control Group. The patients in the Rehabilitation Protocol Group will perform the progressive resistance strengthening training in non-weight bearing sitting and lying positions following the instructions of daily care for duration of 12-weeks. The patients in the Control Group will follow the instructions of daily care for duration of 12-weeks. Main outcome variables: Primary outcome measures will be body mass index and quality of life. Secondary outcome measure will be the functional capacity.

Study aim: To investigate whether controlled decompression therapy reduces the incidence of comorbidities and enhances recovery in traumatic brain injury patients Design: A two arm parallel group randomised trial with blinded postoperative care and outcome assessment on a total sample of 52 participants. Settings and conduct: The study was conducted at the neurosurgery unit, Afridi Medical Complex. Patients with elevated ICP underwent therapeutic hypothermia for 7–10 days. ICP was regularly checked with an ICP sensor, which was normally taken out around a week following surgery. Every two hours, the ICP and vital signs were monitored and noted. If the patients were stable at 1, 24, and 72 hours following the procedure, the cranial CT data were routinely evaluated. The outcome assessor during the process will be blinded. Participants/Inclusion and exclusion criteria: Inclusion criteria: Patients with TBI between the ages of 18 and 75 who gave informed permission and had a Glasgow Coma Scale (GCS) score between 3 and 8 at admission were eligible. Exclusion criteria: Exclusion criteria included the following: initial need for bilateral craniotomy; preoperative GCS score of 3 with no improvement after treatment in the emergency room; presentation without attenuated respiration Intervention groups: Experimental group: Standard surgical techniques were used to achieve a rapid craniotomy. The fast removal of the hematoma and brain contusion tissue was the main objective of the procedure. Control Group: The best option was a brain tissue monitor, followed by a ventricular intracranial pressure monitor. The dura was completely opened, and the hematoma or brain contusion tissue was then removed when the ICP was less than 10 mmHg and there were no visible evidence of bulging brain tissue. Main outcome variables: The Extended Glasgow Outcome Scale (GOSE)

Study aim: The aim of this study is to check the combined effects of inspiratory muscle training and expiratory muscle training through the breather device vs diaphragmatic breathing on the pulmonary function and severity of the disease in patients with pneumonia Design: parallel group, randomized clinical trial Settings and conduct: research will be conducted in Gulab Devi Chest Hospital Lahore in which subjects will be randomly allocated to both group through lottery method Participants/Inclusion and exclusion criteria: Inclusion Criteria • Adults aged 35-55 years • Both gender male and female • Patients having stage 2 to 4 according to pneumonia severity index • Participants willing to be the part of the research Exclusion Criteria • Participant with acute heart disease (Heart Failure) and acute coronary artery disease • Participants with other respiratory condition (Asthma, COPD) • Participants with the diseases leading to the impairment of respiratory muscle (Mysthenia Gravis) Intervention groups: Intervention Group (IMT and EMT combined through the breather device) 3d/week for upto 3 weeks through the breather device by starting with 15% maximum inspiratory and expiratory resistance. At the starting of intervention Pt will perform 5-6 diaphragmatic breathing in upright position. The patient will be asked to inhale deeply and then hold for 2-3 second and breathe out through the device with the 3 sets with each set including 8 repetitions of IMT and 8 repetitions of EMT in same cycle with diaphragmatic breathing between each set. Control group (Diaphragmatic breathing) The group B will be the control group that will receive baseline treatment of diaphragmatic breathing alone. Main outcome variables: Pulmonary function and severity of Pneumonia

Study aim: To compare the effects of Gong’s Mobilization and Mobilization with Movement on pain, range of motion and functional disability in patients with adhesive capsulitis. Design: This study will be a Randomized Clinical Trial, parallel-group, triple blinded Settings and conduct: The trial would be conducted in Allied Hospital Faisalabad. It would be triple blinded, as the patients, assessor and the analyzer would be blinded Participants/Inclusion and exclusion criteria: INCLUSION CRITERIA • Male & female patients • Age group 40 to 60 years • Subjects clinically diagnosed with grade 2 adhesive capsulitis. • Painful and limited active and passive glenohumeral ROM >25% in a capsular pattern • Pain in the shoulder for at least 3 months. EXCLUSION CRITERIA • History of surgery on affected shoulder. • History of fracture around shoulder complex. • History of pain or disorders of the cervical spine, elbow, wrist, or hand. • History of any other pathological conditions involving the shoulder History of neurological deficits limiting shoulder during activities of daily living Intervention groups: Group A will be given Gongs Mobilization along with ultrasonic therapy. Group B will be given Mobilization with Movement technique along with ultrasonic therapy. For common treatment, both the groups will receive Ultrasound with a dosage of 1 MHz in frequency, at continuous mode and 1.5 W/ cm2 of intensity for 10 minutes of treatment. Codman Pendulum Exercise will be taught as home plan for both groups as a common treatment.Total intervention protocol will be given for four weeks of duration, 3 sessions per week with total 12 sessions. Outcomes will be assessed at baseline, at the end of 2 week (6th session) and at the end of 4th week (12th session) Main outcome variables: Pain Disability Range of Motion

Study aim: To determine the comparative effects of strain counterstain and post-isometric relaxation techniques on pain, range of motion and functional disability in patients with upper cross syndrome. Design: This study will be Randomized Clinical Trial, parallel-group, triple blinded Settings and conduct: The Trial would be conducted in District Headquarters DHQ Hospital OKARA City Participants/Inclusion and exclusion criteria: inclusion criteria ⦁ Individuals with chronic neck pain from > 6 weeks ⦁ Both male and female gender ⦁ Age from 20-40 years ⦁ Neck Pain on > 3 on numerical pain rating scale ⦁ Individuals diagnosed with craniovertebral angle less than 50cm ⦁ Occiput to wall distance greater then 2cm exclusion criteria ⦁ Subjects who will have signs of recent surgery ⦁ Whiplash injury or open wounds ⦁ Cervical spine pathologies like radiculopathies disc herniation, spondylolisthesis, sensory changes in neck region ⦁ Any neurological defect Intervention groups: Group A will receive strain counterstain technique; the position of ease will be produced through positioning the muscle in relaxed/ shortened position, ease will be defined as where a reduction in pain at least 70% then, pressure is applied to Trp and it will be held for 90-120 seconds with 3-5 repetitions per treatment session ( three session per week for 3 weeks). Group B will receive post-isometric relaxation technique with 3-5 muscle contraction at sub maximal pain-free effort (20% of available strength) with 5-7 seconds for 5 repetitions per treatment session (three sessions per week for 3 weeks). Main outcome variables: Pain; Range of motion; Functional disability

Study aim: To determine the effects of Sustained Natural Apophyseal Glides with and without thoracic postural correction techniques on mechanical neck pain Design: The study design will be a Randomized Controlled Trial with a parallel group design of 28 patients. Settings and conduct: The study setting will be International Therapy Services ITS Clinic, Lahore. The sample would be taken by using a non-probability convenience sampling technique. Participants/Inclusion and exclusion criteria: Inclusion Criteria: • Individuals having localized pain or stiffness in the spine or both combined b/w C3 to C7 without upper limbs radiculopathy • Patients with chronic neck pain >3 months • Pain reported on NPRS score ˃3 in the neck region with a limited or painful range Exclusion Criteria: • Tuberculosis, carcinoma, heart disease, osteoporosis. • Neural disorders • Any trauma or localized infection in the neck region, cervical stenosis, metabolic diseases in bone and joint. • Hyper flexibility • Open sores • Ongoing radiotherapy, chemotherapy, steroid therapy, or anticoagulants. • Allergy to hot pack • Patients with a history of surgery in the cervical spine region within a year Intervention groups: Group A will receive combination of a sustained facet glide with movement applied at the facet joints between cervical C3 to C7. Group B will receive sustained natural apophyseal glides same as group A along thoracic postural correction technique. Thoracic postural correction technique includes active as well as therapist-facilitated stretches. Main outcome variables: Pain, Range of Motion and Disability

Study aim: Aim of this study will be to determine the effects of Mulligan Mobilization with movement and concentric eccentric exercises on Pain, ROM, Functional Disability in patients with lateral epicondylitis. Design: Parallel group randomized clinical trial and Randomization will be achieved through computer generated random number table. Settings and conduct: Prime Care Hospital Faisalabad. It will be assessor who will be blinded about the type of intervention. Participants/Inclusion and exclusion criteria: Inclusion Criteria: Age: 25- 55 years, Gender: Both male and female, Patients who have pain for at least 3 month or more duration, Tenderness on palpation over the lateral epicondyle of humerus, Participants with positive cozen test. Exclusion criteria: Dysfunction in the shoulder, neck and thoracic region , Cervical radiculopathy, Corticosteroid injection within 3 months, Participants who had received any conservative treatment in the 4 weeks before entering the study, Previous surgery to the elbow region, Any fracture to the elbow, Soft tissue injury to the elbow region. Intervention groups: Intervention group A will receive Mulligan mobilization with movement after conservative treatment. Conservative treatment will be given in form of ultrasound and Tens followed by Mobilization technique for total 36 times, 12 repetitions with short period of rest. Duration of session will be 35 to 45 mints, 3 times a week ,12 sessions over 4 weeks. Intervention group B will receive eccentric-concentric exercise after the conservative treatment. Conservative treatment will be given in form of ultrasound and followed by Eccentric-concentric exercise for 3 set of 15 repetitions with rest period of 1 min in between sets. Duration of session will be 35 to 45 mints, 3 times a week ,12 sessions over 4 weeks Main outcome variables: Pain Range of motion Functional disability

conduct: Outpatient Physical Therapy Department of Safi Hospital, Faisalabad, Pakistan. It will be

Study aim: To evaluate clinical efficacy of Dapagliflozin in association with genetic polymorphism and its plasma levels in patients with CHFrEF in Pakistani population Design: Randomized Controlled Trial Settings and conduct: Department of Pharmacology & Therapeutics, Army Medical College, National University of Medical Sciences (NUMS), Rawalpindi Participants/Inclusion and exclusion criteria: 1) INCLUSION CRITERIA Pakistani patients of 18 years and above, males and females Diagnosed symptomatic heart failure (NYHA class 1–IV) Ejection fraction (EF) ≤ 40% on imaging study within last 12 months prior to enrolment Patient on stable GDMT of heart failure for ≥4 weeks Both diabetic and non-diabetic patients 2) EXCLUSION CRITERIA Type-1 diabetics or patients having any history of DKA Patients having eGFR ≤ 25 ml/ min/ 1.73 m2 as per (CKD-EPI formula), systolic blood pressure (SBP) < 95 mmHg Patients having MI, unstable angina, stroke, acute heart failure (HF) or any hospitalization due to acute HF <4 weeks preceding enrolment Patients undergoing PCI /CABG or valvular replacement, any previous transplantation of heart or infixing of ventricular assistance device (VAD), implantation of Cardiac resynchronization therapy (CRT) within 3 months preceding enrolment or any plan to undergo after randomization Intervention groups: Include Dapagliflozin in addition to GDMT. Main outcome variables: BIOCHEMICAL TESTS: Serum uric acid and creatinine,Urine R/E and P/C ratio,HbA1c at day 0 and after intervention at 12th week. Echocardiography & eGFR will be calculated at day 0 and 12th week. Plasma levels of Dapagliflozin will be determined by High Performance Liquid Chromatography (HPLC) Improvement in symptoms and QoL will be ascertained by KCCQ questionnaire & NYHA classification.

Study aim: The aim of this study is to evaluate the effect of ACBT exercises on airway clearance in COVID-19 patients and to fill the research gap for both studies that will help patients in future to deal with post COVID complications more conveniently with cost effective procedures. Design: 100 covid-19 patients from both ICU and indoor were taken. ACBT treatment was applied. No placebo effect was used. Non randomized, no biasness and not blinded. Settings and conduct: study was conducted in ICU and indoor wards of different hospitals with proper use of PPE-protective personal equipment's. Participants/Inclusion and exclusion criteria: Inclusion criteria: Patients having the age range from 30-60 were selected. Patients who were admitted to ICU or COVID indoor patients were included. Patients who were conscious were selected for this study. Exclusion criteria: Individuals below age 30, without COVID or with other comorbidities were prohibited from our review. Patients with decreased awareness and conscious level were not included in the assortment criteria. Patients admitted to CCU were excluded Intervention groups: A total of 100 patients were recruited including both males and females. They were taken for the application of active cycles of breathing techniques in different Indoors and ICU units from multiple hospitals in Lahore city. Prior to exercise subjects were evaluated with the help of a standardized questionnaire i.e. Interventions Evaluation on COVID-19 patients-Questionnaire. After getting the active cycles of breathing techniques patients were again evaluated with the Interventions Evaluation on COVID-19 patients-Questionnaire. All registered subjects were informed of the study protocol. Main outcome variables: Oxygen saturation, Breathing rate, Forced expiratory volume, Body temperature, heart rate and blood pressure were important variables because they fluctuate differently in both gender

Cardiology,Faisalabad,Punjab,Pakistan setting used for research purpose.Patients will be allocated in groups

Study aim: To determine the effects of dry needling combined with spinal manipulative therapy versus spinal manipulative therapy alone on pain, disability, lumbar range of motion (ROM) and muscle endurance in patients with non-specific chronic low back pain. Design: Two arm parallel group randomised trial with blinded outcome assessment Settings and conduct: Setting is Sindh Institute of Physical Medicine and Rehabilitation. Outcome assesor will be blinded to the treatment intervention. Participants/Inclusion and exclusion criteria: Patients diagnosed as having chronic nonspecific low back pain will be included in the study. Any serious spinal pathology will be excluded Intervention groups: After random allocation of the participants into two groups, experimental group will receive spinal manipulative therapy and dry needling while the control group will receive spinal manipulative therapy alone. Main outcome variables: Pain, lumbar range of motion, disability and lumbar muscle endurance

Study aim: To determine the efficacy of Platelet Rich Plasma (PRP) versus 5% topical minoxidil for the treatment of androgenetic alopecia Design: randomized control trial(RCT) parallel group,single blinded study 35 patients will be assign in each group,radomization will be done by lottery method,a single center study Settings and conduct: PNS Shifa karachi after approval from ethical committee,blinding is done for photographic examination,as mentioned earlier Participants/Inclusion and exclusion criteria: inclusion criteria Age 18 to 60 years.Patient Hamilton-Norwood grade ≥2 and ≤ 5 or Ludwig scale grade 1-2.Platelets count more than150, 000 /µl.Duration of androgebetic alopecia > 6 months.Patient has not taken any kind of medical treatment for hair loss or has not used treatment for more than 6 months duration. exclusion criteria Patients with alopecia other than AGA, such as telogen effluvium, alopecia areata, acquired cicatricial alopecia, or anagen effluvium.The patient on warfarin or heparin.The infective disease of the scalp.Patient who has taken any treatment for androgenetic alopecia History of thyroid disorder.Patients with hypersensitivity to minoxidil in past.Any infective skin disease.Pregnancy /lactation.Patient taking aspirin.Unrealistic expectation. Intervention groups: 30 ml of venous blood will be drawn into a tube containing citrate phosphate dextrose,it will be subjected to centrifugation by two spins to produce PRP .Calcium gluconate to PRP ratio used will be 1:9 this will be injected intradermally,each session 1 month apart. Participants of group B will be advised to apply topical 5% minoxidil 1 ml over dry scalp 12 hourly. Main outcome variables: hair pull test ,investigator 7 point score ,patient satisfaction score ,patient standardized hair growth questionnaire,photographic evaluation

Study aim: To compare the outcomes of ultrasound guided dry needling in addition to conventional physical therapy on patellar tendonitis, tendon thickness, tendon width, fibrillar echo-pattern and echogenicity of patellar tendon in patients with jumper’s knee. Design: parallel group, single blinded, randomized controlled trial Settings and conduct: The institute of physical therapy, The university of Lahore Participants/Inclusion and exclusion criteria: inclusion criteria: Athletes with medical diagnosis of Jumper’s knee. Aged between 18 to 45 years. Both genders. A score below 80 on the Victorian Institute of Sports Assessment for PT (VISA-P) questionnaire. Pain provocation on Single leg decline squat test as a score >0 on the NRS. Exclusion Criteria: Knee surgery within the previous 6 months. Chronic knee joint diseases. Corticosteroid injection in the patellar tendon within the last 1 month. Contraindications for needling. Presence of calcification. Use of analgesics for last 48 hours. Any other concomitant treatment for jumper’s knee. Intervention groups: (Experimental group); it will receive ultrasound guided dry needling(three needle insertions lasting 3 seconds each and the number of times the needle will pass through the tendon will range from 15 to 30 passes, depending on the size of the tendon abnormality) in addition to routine physical therapy.(An exercise program will consist of stretching and strengthening exercises of quadricep & hamstring: mini-squats, seated knee extensions, lunges, and lateral steps (3 sets, 15 reps each) & therapeutic modalities) and activity modifications. control group will receive same routine physical therapy intervention as of group A Main outcome variables: Visual analogue scale, Victorian Institute of Sport Assessment Patellar(VISA-P) Score, The Knee Injury and Osteoarthritis Outcome Score (KOOS), Lysholm score , Sonographic tendon assessment

urban area of Lahore Pakistan and measurements will be assessed at the Teaching Bay of Rehmatul-Lil

Study aim: To compare the effects of visual scanning exercises on balance, gait and activities of daily livings in patients with post stroke eye movement disorders. Design: Double blinded Randomized controlled clinical trial Settings and conduct: Out patient department of Physical Therapy Department, University of Lahore Teaching Hospital, Lahore Participants/Inclusion and exclusion criteria: Inclusion Criteria: Patients who suffered with eye-movement disorder either an ischemic or hemorrhagic stroke • Clinically diagnosed by a neurologist • Information on the type of stroke will be obtained from the patients’ medical records • Both male and female patients between the age group of 19–60 years • Minimum score of 7 on Mini-Mental State Examination • Patients in the sub-acute stage after the stroke and able to follow instructions and have the capacity to provide informed consent Exclusion Criteria: • Repeated stroke • Severe dementia, identified by applying the MMSE • History of an organic disorder or major psychiatric impairment • Disability or other comorbid disease such as cancer or amputation that will limit or prevent assessment of the patients • Participation in other interventional or pharmacological studies which can affect the results of this study • Patients with vestibular problems who have positive dix-hallpike test • Patients with facial palsy • Patients with ophthalmological problems before stroke onset • Patients suffering from balance problems as a result of muscular problem Intervention groups: The patients will be randomly divided into experimental and control group. 32 patients in each group. Experimental group will receive visual scanning exercises along with task-specific approach while control group will receive task-specific approach alone. Main outcome variables: 1. Berg Balance Scale 2. The Dynamic Gait Index 3. Barthel index scale

Study aim: To determine the effect of Whole Body Vibration on functional performance and balance in chronic stroke patients. Design: Single Blind, randomized controlled clinical trial Settings and conduct: This randomized clinical trial was performed in the Department of Physical Therapy Lahore General Hospital Lahore. Outcome Assessor has been blinded and he was not aware of the allocated group of the participants. Participants/Inclusion and exclusion criteria: Participants of both of the genders aging from 40 to 75 years having a single stroke more than six months ago. Intervention groups: Routine Physiotherapy Group received Strengthening Exercises, Stretching Exercises, Gait Training and Balancing Exercises. WBV Group received routine physiotherapy treatment plus WBV session for 2 weeks. During the intervention, subjects were positioned on the platform in a standing position and both knees extended[0 degrees as the anatomic position] to keep an upright position with even weight distribution on both feet. The time course included 5 bouts of 2 minutes of vibration with a 1-minute rest interval between every two steps making the total time duration of 15 minutes with a frequency of 20-30Hz and a vibration amplitude of 3-6mm for 6 days per week for 2 weeks. The vertical type of vibratory stimulus was used. Main outcome variables: The primary outcomes of the study were the improvement in Stair Negotiation Time and Obstacle Clearance measurements. [Obstacle height that patient can clear without tripping] Secondary outcome measures were the improvement in Self-Selected Walking Speed, Balance Score according to BBS, Muscle Tone according to Modified Ashworth Scale Score, Timed Up and Go Test Score and Timed 10-Meter Walk Test Score.

Study aim: To find the effect of abdominal hypopressive exercise on pain intensity in primiparous female with sacroiliac hypermobility dysfunction To assess the effects of abdominal hypopressive exercise on functional activities of primiparous female with sacroiliac hypermobility dysfunction. To evaluate the effects of abdominal hypopressive exercise on sonographic change in transversus abdominus muscle thickness in primiparous female with sacroiliac hypermobility dysfunction To find the change in quality of life in primiparous female with sacroiliac hypermobility dysfunction Design: Randomized, single blinded, parallel group Settings and conduct: The Physical therapy department, ULTH, The University of Lahore It will be a single blinded trial in which the assessor will be kept blind. Assessor will be senior physiotherapist who will take measurements after giving consent to participate in the study. He will be blind, not confirmed about the group of intervention Participants/Inclusion and exclusion criteria: • Primiparous Female aged between 18-30 years • Patient with vaginal delivery • Within one year after post-partum • Unilateral sacroiliac dysfunction • Positive SI joint dysfunction test Exclusion Criteria: • Pregnancy • History of Cardiopulmonary Disease • History of Spondyloarthropathies Intervention groups: Abdominal hypopressive exercise group Conventional physical therapy Main outcome variables: Pain Intensity functional disability Muscle thickness changes

Study aim: To see the effects of PNF Hold Relax technique on scapular dyskinesis in patients with subacute stroke and to compare the effects of D1 and D2 flexion patterns of proprioceptive neuromuscular facilitation on pain, range of motion, disability and scapular asymmetry in patients with subacute stroke Design: Randomized Clinical Design was used. Both group taking same conservative treatment, with patterns of movement was changed in both groups. As "D1 flexion pattern" to one group and "D2 flexion pattern" to other group. Using " chit and draw" method as patient came according to chit treatment given to patient. Total 43 patient taking treatment, in which group A had 22 patient and group B had 21 patient. Settings and conduct: Ibn-e-Siena Hospital & Research Institute, Multan. Participants/Inclusion and exclusion criteria: Both male and female genders; age range between 40-60 years; stage of stroke attack with onset at least 5 months; patients developing unilateral scapular dyskinesis due to stroke assessed by lateral scapular slide test with type 1 scapular dyskinesia prominent infero-medial border of scapula. Exclusion criteria: patients with neurological deficit of the upper extremity; patients with any surgery of the upper extremity, active infections, hypermobility, calcification of the soft tissues, fragile skin patients with musculoskeletal injuries as upper limb fractures, dislocation, joint instability or any soft tissue injuries on affected side; other illnesses such supraspinatus, bicep tendinitis, fibromyalgia, frozen shoulder and arthritis that produced discomfort in the upper extremities; severe depression or other post-stroke symptoms. Intervention groups: There were two groups, Intervention group 1 was named D1 flexion group and Intervention group 2 named D2 flexion group. Main outcome variables: Shoulder ROM, Visual analogue scale; disability index

Study aim: The aim of the study is to compare the efficacy of ivabradine versus beta blockers in achieving heart rate control in patients with uncontrolled permanent atrial fibrillation and to assess their impact on various clinical parameters and safety outcomes over a specified duration. Design: Randomized Control Trial Settings and conduct: Study setting and conduct will be carried out at Pervaiz Ilahi Institute of Cardiology, Bahawalpur. Study will be single blinded as participants will not know which drug being given to them. Participants/Inclusion and exclusion criteria: Inclusion Criteria; It includes adults more than 18 years of age, fulfilling the criteria of permanent atrial fibrillation, resting heart rate more than 110/min, capable of providing informed consent and previous history of pulmonary vein ablation. Exclusion Criteria; It includes individuals allergic to drugs, decompensated heart failure, Patients of hypertrophic obstructive cardiomyopathy(HOCM), acute pericarditis or myocarditis or myocardial infarction, having conditions like end stage renal disease(ESRD) or liver failure, fever, hyperthyroidism, anemia, pregnant or lactating females, severe comorbidities or history of major surgery. Intervention groups: Two intervention group will be assigned. First group will be ivabradine group containing 30 participants. Other will be Beta blocker group of 30 participants. Main outcome variables: Main outcome variable is heart rate.