Chak 454

Researchers are evaluating the effectiveness and safety of acetazolamide versus metolazone when added to standard treatment in patients with acute decompensated heart failure ADHF. This condition is serious and often treated with loop diuretics to reduce excess fluid. The study aims to determine which adjunct therapy better improves fluid removal, shortens hospital stays, and reduces complications like kidney problems or electrolyte imbalances. The trial is focused on patients with ADHF, including those with preserved or reduced heart function. Participants will be randomly assigned to receive either acetazolamide at 500 mg daily or metolazone at 5 mg daily, both alongside standard intravenous loop diuretics furosemide 80 mg per day. These treatments are given orally for three days to assess their role in enhancing fluid removal. The trial compares these two adjunct therapies to see which is more effective and safe in managing fluid overload in ADHF. During the study, patients will be closely monitored for successful fluid removal after 72 hours of treatment, along with hospital stay duration and in-hospital mortality. Researchers will also watch kidney function, electrolyte levels, and any side effects. The study takes place at a hospital setting and involves routine clinical assessments, imaging to confirm fluid overload, and blood tests to measure heart failure markers. Total participation duration covers the initial treatment and hospital stay.

Anterior pelvic tilt APT is a common postural issue where the pelvis tilts forward excessively, often linked to increased lower back curve and non-specific low back pain NSLBP. NSLBP affects many people worldwide and results from factors like poor posture, muscle imbalances, and sedentary lifestyle. This research aims to compare different physiotherapy treatments for APT in people with NSLBP to find the best ways to reduce pain and improve function and quality of life. The study is a randomized controlled trial that divides participants into four groups receiving different treatments core stability exercises combined with electrotherapy, soft tissue release with manual therapy and stretching, postural correction exercises with contrast therapy hot and cold packs, and a control group receiving electrotherapy with stretching and flexibility exercises. Each treatment focuses on improving muscle balance, posture, and pain relief over a 4-week period. Participants will be adults aged 20 to 40 diagnosed with NSLBP and confirmed APT. They will undergo assessments at the start, middle, and end of the treatment, measuring pelvic tilt angle, pain levels using a numeric scale, quality of life questionnaires, and functional capacity including range of motion and muscle strength. The study also monitors balance and overall effects of the therapies to identify which intervention best helps improve symptoms and daily function.

This research aims to compare two treatments for keloid scars cryotherapy followed by intralesional 5 fluorouracil 5FU and intralesional 5 fluorouracil alone. It will assess how well cryotherapy combined with 5FU works compared to 5FU alone, participant satisfaction with these treatments, and any skin problems that may occur. The study is an early phase 1 randomized controlled trial involving 88 patients aged 18 to 50 years with symptomatic keloids. Participants will be randomly assigned to one of two groups. Group A will receive cryotherapy at the keloid site using liquid nitrogen spray with freeze-thaw cycles, followed 30 minutes later by an injection of 5FU mixed with triamcinolone acetonide. Group B will receive only the intralesional injection of 5FU combined with triamcinolone acetonide. Both treatments will be given every three weeks for a total of four sessions. Local anesthesia and oral painkillers will be used to manage pain. During the 12-week treatment period, researchers will assess keloid severity using the DKS score and record patient satisfaction with a seven-point improvement scale. Side effects such as severe pain, blistering, infection, and eschar formation will be monitored from the first hour after each injection. A blinded dermatologist will document side effects, and an independent observer will evaluate treatment outcomes. The studys total participation spans the 12 weeks of treatment with regular assessments.

Researchers are evaluating how well 5 fluorouracil 5FU combined with micro-needling works to treat limited stable vitiligo compared to the use of strong topical steroids. The study aims to find a cost-effective treatment for patients with less than 10% body surface area affected by vitiligo. It will also monitor participant satisfaction and safety issues related to both treatments. Participants will be randomly assigned to one of two groups. Group A will receive micro-needling with 5FU applied every two weeks for six sessions. The procedure involves numbing the skin, cleaning the lesion, using a micro-needling device, and applying up to 0.5 ml of 5FU per session, followed by a sterile dressing. Group B will apply 0.05% clobetasol propionate ointment twice daily for 12 weeks, using a measured amount according to the size of the vitiligo patches. Participants will be assessed at the start and after 12 weeks of treatment using the Vitiligo Area Scoring Index VASI to measure repigmentation. A blinded medical observer will evaluate pigment return and side effects like skin irritation or scarring. Patient satisfaction will also be recorded. Overall safety and efficacy will be monitored throughout the study, which lasts up to 6 months from enrollment to treatment completion.

Chronic Obstructive Pulmonary Disease COPD is a progressive lung condition that causes breathing difficulties, fatigue, and anxiety, impacting patients quality of life. Researchers are evaluating the effects of two non-drug methods, Bensons Relaxation Technique and Tai Chi, to see how they may help improve breathlessness, physical endurance, and overall well-being in people with moderate to severe COPD. This is a randomized clinical trial conducted at Bahawalpur Victoria Hospital involving adults aged 40 to 50 years. The trial compares two groups one practicing Bensons Relaxation Technique and the other practicing Tai Chi. Both groups will perform their assigned exercises five days a week for 45 minutes over eight weeks, in addition to their standard COPD care and medications. Bensons Relaxation involves steps to trigger the bodys relaxation response and breathing exercises, while Tai Chi focuses on gentle movements combined with controlled breathing. Participants will be assessed at the start and after eight weeks using tools like the Modified Borg Dyspnea Scale, Six Minute Walk Test, and spirometry to measure lung function and breathlessness. They will also complete the St. Georges Respiratory Questionnaire to evaluate quality of life. Data will be analyzed using statistical software to compare the effects of the two techniques. The study will monitor participants throughout the eight-week period to observe changes related to their COPD symptoms and physical endurance.

Physical inactivity among school children increases risks of heart and lung diseases, obesity, and poor health. This research evaluates the effects of rope skipping on cardiopulmonary fitness in children aged 6 to 12. The study compares improvements in heart rate, endurance, and lung function between children doing rope skipping and those in regular physical education. Participants are randomly assigned to two groups one practices rope skipping for 50 minutes, three times a week, over 8 weeks including warm-up and cool-down. The other group participates in self-directed, unsupervised free play for the same duration and frequency. The trial is conducted in a school setting to assess the impact of these activities on cardiopulmonary fitness. Children will be evaluated before and after the 8-week period using the Borg rating scale, talk test of perceived exertion, and the 20 Meter Shuttle Run Test. Researchers will analyze changes in endurance, heart rate recovery, and lung function. The study aims to monitor safety and effectiveness through these measures and will last the entire 8-week intervention period.

Researchers are evaluating treatments for moderate to severe scalp seborrheic dermatitis SD, a chronic inflammatory skin condition linked to Malassezia yeast that causes scaling, itching, and redness. This randomized controlled trial compares oral itraconazole pulse therapy to topical 2% ketoconazole shampoo to determine which better controls symptoms and prevents relapses. The study will enroll 80 participants aged 14 to 70 years with moderate to severe scalp SD. Participants are divided into two groups one group receives oral itraconazole in a pulse regimen over six months, starting with 100 mg twice daily for one week in the first month, then 100 mg twice daily for two days each month for five months. The other group uses 2% ketoconazole shampoo daily for 14 days followed by twice-weekly application for five months. Both treatments are given according to the study protocol to assess their effectiveness. Throughout the six-month study, participants will have their disease severity measured with the Scalp Seborrheic Dermatitis SSD score at baseline, 3 months, and 6 months. Clinical Global Impression CGI and Patient Global Impression PGI scales will assess treatment response and patient satisfaction. Side effects like nausea and dermatitis will be monitored. Data analysis will compare treatment effectiveness, relapse frequency, and patient satisfaction to guide better management of scalp SD.