Multan

Researchers are evaluating how a combination of foot-ankle therapeutic exercises and mindful walking affects pain, foot and ankle disability, and quality of life in people with diabetic polyneuropathy. This condition causes nerve damage that leads to pain and mobility issues, and while exercise therapies and mindful walking have been studied separately, their combined effects have not been fully explored. The study aims to fill this knowledge gap and develop better strategies for managing diabetic polyneuropathy symptoms. Participants will take part in a 12-week program that includes strengthening exercises such as toe spreads, toe curls, heel raises, calf raises, single leg stance, and ankle dorsiflexion, along with flexibility stretches targeting the ankle, plantar fascia, calf, toes, and Achilles tendon. These exercises are paired with mindful walking practices that use sensory cues like kinesthetic, visual, auditory, and tactile signals to enhance awareness. The program is carefully structured to progress over the 12 weeks, providing a unique combination of physical and mindfulness techniques. During the study, participants will be assessed at the start and after 12 weeks using measures like the Numeric Pain Rating Scale to track changes in pain levels. Researchers will also monitor foot and ankle disability and overall quality of life. The study focuses on adults aged 40 to 75 with diabetic polyneuropathy who can walk independently and have moderate foot or ankle pain. The overall participation spans 12 weeks, with evaluations to determine how these combined interventions impact clinical outcomes and well-being.

Recent observational studies suggest that starting caffeine treatment early may lower the risk of acute kidney injury (AKI) in preterm newborns, but high-quality randomized trials comparing early caffeine use to standard supportive care are needed. This research evaluates whether early caffeine therapy reduces the incidence and severity of AKI compared to supportive care alone in preterm neonates born before 32 weeks gestation. The goal is to provide evidence to guide clinicians in choosing the best option to prevent AKI, potentially reducing mechanical ventilation duration, hospital stays, and newborn mortality. In this study, preterm neonates admitted within 6 hours of birth are randomly assigned to receive either early caffeine therapy or supportive care without caffeine. Those receiving caffeine get a loading dose of 20 mg/kg caffeine citrate intravenously or enterally within the first 24 hours of life, followed by a daily maintenance dose of 5 mg/kg. The supportive care group receives standard treatment without caffeine. The study compares the effects of these two approaches on AKI occurrence. Participants are closely monitored for acute kidney injury over the first 14 days after treatment begins. Data collected includes clinical assessments and treatment details to evaluate kidney health and overall outcomes. The study aims to provide clear evidence on the safety and potential benefits of early caffeine therapy in preterm neonates, helping to improve care practices for this vulnerable population.

Researchers are evaluating the effectiveness of two corticosteroids, dexamethasone and methylprednisolone, in reducing postoperative complications such as pain and swelling in patients with isolated mandibular parasymphysis fractures. This Phase 2, double-blind randomized clinical trial aims to fill the gap in knowledge about which steroid is better for managing symptoms after surgery. Previous studies have shown benefits of both drugs individually, but no direct comparison in this specific fracture type has been made, and this study also incorporates objective measures like serum C-reactive protein to assess inflammation. Participants will receive a single dose of either 8 mg dexamethasone or 40 mg methylprednisolone injected submucosally at the surgical site 30 minutes before the incision. The study focuses on patients undergoing open reduction and internal fixation for their fractures. Both drugs are administered once before surgery, and the effects will be compared to determine which provides better control of postoperative pain and swelling. During the study, participants will be monitored for facial swelling and pain intensity before surgery, then at 24 hours and 72 hours after surgery. Blood samples will be taken to measure serum C-reactive protein as an indicator of inflammation. Researchers will also record analgesic use and any adverse effects. This detailed follow-up will provide comprehensive data on the benefits and safety of each steroid over the early postoperative period.

Researchers are evaluating whether Faradic Nerve Stimulation (FNS) combined with standard physiotherapy can help children recover from Post-Injection Sciatic Nerve Injury (PISNI) more effectively than physiotherapy alone. PISNI happens when the sciatic nerve is injured by an injection given incorrectly, causing pain, muscle weakness, and difficulty moving the legs. This condition is especially common in children in low-resource areas where healthcare providers may lack proper training. The study focuses on pediatric patients aged 3 to 19 years to find better treatments for nerve injury recovery and improved quality of life. The study randomly assigns 80 children with PISNI to two groups. Group A receives Faradic Nerve Stimulation with standard physiotherapy, where low-frequency electrical pulses stimulate the injured nerve and muscles to promote healing. Group B receives standard physiotherapy plus Transcutaneous Electrical Nerve Stimulation (TENS), which helps reduce pain but does not promote nerve regeneration as FNS does. Both groups undergo therapy sessions three times a week for 8 to 16 weeks. After treatment, participants are monitored for an additional 4 weeks to assess ongoing recovery. Children will attend regular therapy sessions where their nerve function, pain levels, and mobility will be assessed. Evaluations include nerve conduction studies at baseline, 8 weeks, and 16 weeks to measure nerve recovery. Pain is measured using pediatric pain scales, and functional mobility is assessed with disability inventories. The study also looks at the impact on quality of life for children and their families. Follow-up visits during the 4-week post-treatment phase will monitor sustained improvements and safety throughout the study period.

Researchers are studying whether adding the medicine letrozole to misoprostol can help women have a complete abortion more often compared to using misoprostol alone. The trial focuses on women up to 13 weeks pregnant who have a missed miscarriage, meaning the pregnancy has stopped developing but has not yet passed naturally. This is a Phase 4 clinical trial aiming to answer if taking letrozole for 3 days before misoprostol increases the chance of complete abortion and if letrozole affects the time it takes for abortion to occur. Participants will be randomly assigned to one of two groups: Group A will receive 10 mg of oral letrozole daily for 3 days followed by a single 800 microgram dose of vaginal misoprostol. Group B will receive oral placebo tablets for up to 3 days followed by the same single dose of vaginal misoprostol. The study compares these treatments to see if the addition of letrozole improves outcomes for managing missed miscarriages. During the study, doctors will monitor whether the abortion is complete within 24 hours after taking the study medication. If the abortion is not complete, other medical procedures will be offered as needed. Products of conception will be examined to confirm abortion. A total of 92 women will participate, and the main outcome measured is the completion of abortion within 24 hours after randomization and treatment.

Researchers are evaluating whether vitamin D supplements can help prevent pre-eclampsia from returning in pregnant women who had this condition in a previous pregnancy. The study focuses on pregnant women attending the antenatal clinic at the Department of Obstetrics and Gynaecology, Nishtar Hospital Multan. It aims to find out if taking vitamin D reduces the chance of pre-eclampsia coming back, which is important for improving pregnancy outcomes and maternal health. Participants will be randomly divided into two groups. One group will take 4,000 IU of oral vitamin D daily until they reach 36 weeks of pregnancy. The other group will receive a placebo pill that looks, tastes, and feels the same but contains no vitamin D. Both groups will follow this treatment schedule up to 36 weeks of gestation. During the study, each woman will visit the clinic every two weeks for blood pressure checks. If a participant’s blood pressure reaches 140/90 mmHg or higher, a urine test will be done to check for protein, which helps diagnose pre-eclampsia. Any diagnosed cases will receive standard care and be recorded. The main outcome measured is the occurrence of pre-eclampsia from enrollment until 36 completed weeks of pregnancy.