Chak 454

This clinical trial aims to compare the efficacy and safety of acetazolamide versus metolazone as adjunctive treatments to standard therapy in patients with acute decompensated heart failure (ADHF). ADHF is a life-threatening condition, and current treatments often involve loop diuretics to alleviate volume overload. This study will assess the added benefit of acetazolamide and metolazone in improving decongestion, reducing hospital stays, and preventing complications such as renal dysfunction or electrolyte imbalances. Participants will be randomized to receive either acetazolamide or metolazone in addition to standard diuretic therapy. The trial will evaluate primary outcomes including successful decongestion, in-hospital mortality, and length of hospital stay, with secondary outcomes focusing on renal function, electrolyte disturbances, and overall safety. The study is conducted at Bahawal Victoria Hospital, Bahawalpur, and aims to provide valuable insights into the management of ADHF, especially in the Pakistani population.

Researchers are investigating anterior pelvic tilt (APT), a common postural issue where the pelvis tilts too far forward, often causing increased lower back curvature and linked to non-specific low back pain (NSLBP). NSLBP affects many people worldwide and arises from factors like poor posture, muscle imbalances, and a sedentary lifestyle. Since APT contributes to NSLBP by altering spine alignment and increasing strain, understanding how to treat it effectively is important for reducing pain and improving quality of life. The trial compares four physiotherapy methods to treat APT and NSLBP: core stability exercises combined with electrotherapy; soft tissue release with manual therapy and stretching; postural correction exercises with contrast therapy; and a combination of electrotherapy with stretching and flexibility exercises. Participants will be randomly assigned to one of these groups and receive the respective treatments designed to strengthen muscles, improve posture, reduce pain, and increase flexibility. Participants will be adults aged 20 to 40 with confirmed APT and NSLBP. Their progress will be monitored through measures such as pelvic tilt angle using digital photography, pain levels rated on a numeric scale, quality of life questionnaires, and tests of lumbar spine motion and muscle strength. Assessments will occur at the start, mid-point, and immediately after the interventions to evaluate changes. The study aims to identify which therapy best improves pelvic alignment, reduces pain, and enhances function and well-being.

Researchers are evaluating how well intralesional 5 fluorouracil combined with cryotherapy works to treat keloids compared to intralesional 5 fluorouracil alone. The study also aims to understand the safety of both treatments and participant satisfaction with each approach. This randomized controlled trial includes 88 patients with symptomatic keloids, aged 18 to 50 years. The main questions are whether cryotherapy followed by intralesional 5 fluorouracil is more effective and how each treatment affects skin problems and patient satisfaction. Participants are randomly assigned to two groups. Group A receives cryotherapy at the keloid site using a mini-cryogun with liquid nitrogen, followed 30 minutes later by intralesional injections of 5 fluorouracil mixed with triamcinolone acetonide every three weeks, for four sessions total. Local anesthesia is given before cryotherapy. Group B receives only the intralesional injections with the same dosing schedule and pain management. Treatments are repeated every three weeks, with adjustments if large necrotic areas develop. During the 12-week treatment period, clinical assessments include measuring keloid severity using the DKS score and recording side effects such as pain, blistering, infection, and eschar formation. Participant satisfaction is measured with a seven-point patient global impression scale. A blinded dermatologist monitors safety, and outcomes are assessed at baseline and after 12 weeks of treatment.

Researchers are evaluating how well 5 fluorouracil (5FU) combined with micro-needling works to treat limited, stable vitiligo compared to strong topical steroids. This early phase 1 trial focuses on patients with vitiligo affecting less than 10% of their body surface area. The study aims to measure re-pigmentation in vitiligo patches, participant satisfaction, and skin side effects of both treatments. Participants will be randomly assigned to one of two treatment groups. Group A will receive micro-needling on the vitiligo patches every two weeks, with 0.5 ml or less of 5FU applied during each session for a total of six sessions over 12 weeks. Group B will apply 0.05% clobetasol propionate ointment twice daily to the affected areas for 12 weeks. The micro-needling involves using a device with 42 needles at specific depths and passes, followed by applying 5FU to enhance absorption. Participants will have their vitiligo patches assessed before treatment starts and after 12 weeks using the Vitiligo Area Scoring Index (VASI). Researchers will also measure participant satisfaction with treatment and monitor for side effects such as skin irritation or scarring. The study includes demographic and clinical data collection, photography, and safety monitoring throughout the treatment period.

Chronic Obstructive Pulmonary Disease (COPD) is a progressive lung condition that limits airflow and causes breathing difficulties. This research compares Benson's Relaxation Technique and Tai Chi to see how they affect breathing difficulty, physical endurance, and quality of life in people with COPD. The study focuses on patients aged 40 to 50 with moderate to severe COPD who are able to perform these exercises. Participants will be divided into two groups: one group will practice Benson's Relaxation Technique, and the other group will perform Tai Chi. Both treatments are done five days a week for 45 minutes each session over eight weeks. The relaxation technique involves breathing exercises aiming to reduce breathlessness and improve oxygen intake, while Tai Chi is a gentle exercise form used in pulmonary rehabilitation. During the study, researchers will assess participants' breathing difficulty using the Modified Borg Dyspnea Scale, measure physical endurance through the Six Minute Walk Test, and evaluate lung function with a spirometer after eight weeks. Data will be collected at Bahawalpur Victoria Hospital and analyzed to understand which intervention better supports COPD management. Participants' safety and response to treatments will be monitored throughout the study.

Physical inactivity among school-age children is a growing concern worldwide, increasing risks for heart disease, obesity, and poor health. This research evaluates the effects of rope skipping on cardiopulmonary fitness in children aged 6 to 12. The study is a randomized control trial conducted in a school setting, aiming to measure improvements in heart rate, endurance, and lung function to support physical activity's role in children's health routines. The trial involves two groups: one practicing rope skipping for 50 minutes, three times a week, for 8 weeks, including warm-up and cool-down sessions; and a control group participating in self-directed free play without supervision. The intervention's intensity and accessibility make it suitable for school environments. Cardiopulmonary fitness will be assessed before and after the 8-week period using the Borg rating scale, talk test of perceived exertion, and the 20 meter shuttle run test. Participants will be monitored throughout the 8 weeks, with evaluations of endurance, heart rate recovery, and lung function before and after the intervention. Researchers will analyze these measures to determine the impact of rope skipping compared to regular physical education activities. The study seeks to demonstrate significant improvements in cardiopulmonary parameters among children practicing rope skipping, promoting heart and lung health.