Multan

Researchers are evaluating how combining foot-ankle therapeutic exercises with mindful walking affects pain, disability, and quality of life in people with diabetic polyneuropathy. This study aims to improve clinical outcomes and enhance overall well-being by assessing the combined effects of these therapies, addressing gaps in previous research that focused on these treatments separately. Participants will be randomly assigned to one of two groups for 12 weeks. One group will perform foot-ankle exercises including strengthening and flexibility movements alongside mindful walking sessions three times a week, each lasting 30 minutes. The other group will receive standard care combined with mindful walking sessions at the same frequency and duration. Mindful walking involves sensory cues such as kinesthetic, visual, auditory, and tactile inputs. Assessments take place at the start and end of the intervention period. During the study, participants will be evaluated for pain using the Numeric Pain Rating Scale, as well as foot and ankle disability and quality of life. Baseline and 12-week assessments will monitor changes. The study involves regular sessions to track adherence and progress. The total participation duration is 12 weeks, with safety and outcome measures carefully observed throughout the trial.

Researchers are evaluating the effects of two corticosteroids, dexamethasone and methylprednisolone, on reducing postoperative pain, swelling, and limited mouth opening trismus in patients with isolated mandibular parasymphysis fractures. This clinical trial addresses the current uncertainty about which steroid is more effective for managing these postoperative complications. The study aims to provide clear evidence to guide clinicians in choosing the best steroid treatment to improve patient recovery after surgery. The trial compares two groups one receiving a single submucosal dose of dexamethasone 8 mg and the other receiving a single submucosal dose of methylprednisolone 40 mg. Both drugs are administered at the surgical site 30 minutes before the incision during open reduction and internal fixation surgery. The study uses a double-blind, randomized design to fairly assess the outcomes of both treatments. Participants will be monitored for facial swelling and pain intensity at baseline, 24 hours, and 72 hours after surgery. Blood samples will be taken to measure serum C-reactive protein, an objective marker of inflammation, at the same time points. Researchers will also track the use of additional pain medication and any side effects. This thorough assessment combining clinical signs and lab tests will help determine which steroid provides better postoperative control of symptoms. The study will continue until late 2026, ensuring comprehensive follow-up.

Researchers are investigating whether Faradic Nerve Stimulation FNS can improve recovery in children with Post-Injection Sciatic Nerve Injury PISNI, a condition caused by nerve damage from improper injections. This injury can lead to pain, muscle weakness, and difficulties moving the legs. The study compares the effects of FNS combined with standard physiotherapy against standard physiotherapy with Transcutaneous Electrical Nerve Stimulation TENS, aiming to find better treatments for nerve recovery in children. Children aged 3 to 19 with PISNI will be randomly divided into two groups one receiving FNS plus standard physiotherapy, and the other receiving TENS plus standard physiotherapy. Both therapies involve electrical stimulation applied through surface electrodes, with sessions lasting 20 to 30 minutes, three times a week, over 8 to 16 weeks. After treatment, participants will be followed for 4 weeks to monitor continued recovery. During the study, children will attend regular therapy sessions and undergo assessments of nerve function using nerve conduction studies, pain levels via pediatric pain scales, functional mobility through disability inventories, and quality of life questionnaires. Follow-up visits will check the lasting effects of treatment. Data will be analyzed to compare improvements in nerve recovery, pain, mobility, and overall well-being between the two groups over the treatment and follow-up periods.

Emergency nurses frequently face indirect traumatic experiences through their care for critically ill and injured patients, which can lead to psychological distress and vicarious trauma. Researchers are evaluating the effectiveness of a Vicarious Post-Traumatic Growth VPTG Intervention designed to foster positive psychological changes, resilience, and coping skills among these nurses. This study uses a randomized controlled design to compare the intervention with routine professional support. The intervention includes structured sessions incorporating psychoeducation about trauma, cognitive behavioral therapy techniques, mindfulness exercises, resilience-building activities, stress management training, emotional regulation skills, and peer support. Participants are randomly assigned to either the intervention group receiving this program or a control group continuing standard institutional support. Assessments are conducted at baseline, immediately post-intervention, and at follow-up periods up to six months. Participants will complete questionnaires measuring vicarious post-traumatic growth, vicarious trauma, resilience, coping strategies, psychological well-being, and occupational functioning. These assessments occur at weeks 0, 8, 20, and 32. The study aims to gather evidence to improve psychological support programs for nurses working in high-stress emergency settings, with full participation expected throughout the intervention and follow-up phases over approximately eight months.

Researchers are evaluating whether adding the medicine letrozole to misoprostol can help women have a complete abortion more often compared to using misoprostol alone for treating missed miscarriage, a condition where a pregnancy has stopped developing but has not passed naturally. The study focuses on women up to 13 weeks pregnant with a single pregnancy and excludes those with previous cesarean sections or uterine scars. This phase 4 trial aims to answer if taking letrozole for 3 days before misoprostol increases the chance of complete abortion and if it affects the time for abortion to occur. Participants will be randomly assigned to one of two groups. One group will take letrozole tablets orally once daily for 3 days, followed by a single dose of vaginal misoprostol. The other group will receive placebo tablets for up to 3 days before the vaginal misoprostol dose. The misoprostol dose is 800 micrograms given vaginally. Doctors will monitor the abortion progress closely within 24 hours after the medication to determine if the abortion is complete. During the study, 92 women will be monitored to see if the abortion completes within 24 hours after starting the study medication. If not complete, other medical procedures will be offered as needed. Researchers will examine products of conception to confirm the abortion. This careful monitoring helps understand the effects of adding letrozole to misoprostol for managing missed miscarriage and supports participant safety throughout the trial.

Non-specific low back pain is a common condition characterized by pain in the lower back area without a clear cause such as infection, tumor, or structural spinal problems. This trial aims to evaluate which physical therapy technique, either Spray and Stretch or Strain Counterstrain, is more effective in reducing pain, improving movement, and decreasing disability caused by tight hamstring muscles in adults aged 35 to 50 with this type of back pain. Participants are randomly assigned to one of two groups Group A receives the Spray and Stretch technique, which uses a cooling spray to numb the skin and then stretches the hamstring muscles to reduce muscle spasms and improve range of motion. Group B receives the Strain Counterstrain technique, a gentle method that places the body in pain-free positions to relax tight muscles and improve mobility. Both treatments are applied in 2 sets of 5 repetitions, three times a week for 4 weeks. During the study, participants undergo assessments before and after the 4-week treatment period, including pain measurement using the Numeric Pain Rating Scale, movement tests like Active Knee Extension and Straight Leg Raise, and disability evaluation with the Oswestry Disability Index. Data are analyzed to compare results between the two groups. The total study participation lasts approximately 4 weeks with monitoring of pain, mobility, and function throughout.

Non-specific neck pain is a common condition characterized by neck pain without a specific injury or disease cause. It often involves reduced neck movement, poor posture such as forward head position, and some disability affecting daily activities. This study evaluates whether adding the SNAGs Sustained Natural Apophyseal Glides technique to the usual Strain Counterstrain SCS therapy improves pain, neck movement, posture, and disability compared to SCS alone in adults with non-specific neck pain. Participants are randomly assigned to one of two groups. Group A receives both Strain Counterstrain and SNAGs treatments, while Group B receives only Strain Counterstrain. Both groups have 12 sessions over four weeks, with treatments three times weekly. The SCS technique involves holding the neck in pain-free positions to relax muscles, and SNAGs involve joint glides while the patient moves their neck. Treatments target specific neck muscles and spinal segments. Participants undergo assessments before and after treatment, including pain levels measured by the Numeric Pain Rating Scale, neck movement measured with a goniometer, craniovertebral angle assessed by digital photos, and disability measured by the Neck Disability Index. The study tracks changes over the four-week treatment period. Data will be analyzed to compare the effects of the two treatments on these outcomes.

This clinical trial investigates whether giving vitamin D supplements to pregnant women who had pre-eclampsia in a previous pregnancy can help prevent the condition from returning. The study aims to find out if vitamin D reduces the chance of recurrent pre-eclampsia in this group of women. Pregnant women attending the antenatal clinic at Nishtar Hospital Multan are invited to participate in this research. Participants will be randomly assigned to one of two groups. One group will take 4,000 IU of oral vitamin D daily until 36 weeks of pregnancy. The other group will receive a placebo pill that looks, tastes, and feels the same but contains no vitamin D. Each woman will visit the clinic every two weeks during the study period. During each visit, blood pressure will be checked, and if it reaches 14090 mmHg or higher, a urine test will be done to check for protein, which helps identify pre-eclampsia. If pre-eclampsia is diagnosed, standard care will be provided and recorded. The main outcome is to compare how many women in each group develop recurrent pre-eclampsia by 36 completed weeks of pregnancy.