Peshawar

Researchers are evaluating the use of non-vitamin K oral anticoagulants (NOACs) compared to no anticoagulation in people who have experienced transient atrial fibrillation episodes triggered by stress and have additional risk factors for stroke. This multinational, investigator-initiated Phase 4 trial aims to prevent stroke and other serious cardiovascular events in this group by assessing the effects of NOACs on two main outcomes: the occurrence of non-hemorrhagic stroke or systemic embolism, and a combination of vascular death and other major cardiovascular problems, over a follow-up period lasting until the last participant reaches 24 months of observation. Participants in the study are randomly assigned to either receive one of several NOAC medications—edoxaban, apixaban, dabigatran, or rivaroxaban—with dosing adjusted as needed and chosen by their prescribing doctor, or to receive no oral anticoagulation. The treatment continues throughout the follow-up period. The trial is open-label, meaning both researchers and participants know which treatment is given. The study specifically focuses on patients who had transient atrial fibrillation related to stress, such as after certain surgeries or acute medical illness. During the study, participants undergo regular monitoring to track the incidence of stroke, embolism, vascular death, heart attacks, blood clots, and other cardiovascular events. Researchers collect information over up to two years to evaluate these outcomes. Safety and adherence to treatment are also monitored. This thorough follow-up helps determine the impact of NOAC treatment compared to no anticoagulation in this particular patient population.

Researchers are studying reflux disease and postoperative vomiting in patients undergoing one anastomosis gastric bypass surgery. The study aims to compare symptoms between patients who receive an antireflux suture during surgery and those who do not. There is currently not enough evidence to support or oppose the use of this suture. The study involves two groups: one group will have an antireflux suture placed during their laparoscopic one anastomosis gastric bypass surgery, while the other group will not receive this suture. Both procedures are part of the surgery, and patients are randomly assigned to either group to evaluate the effects of the suture on reflux symptoms. Participants will be monitored for reflux disease symptoms at 3 months and 6 months after surgery. Researchers will assess and compare these symptoms to determine if the antireflux suture impacts postoperative reflux. The study focuses on patient outcomes related to reflux and vomiting following the surgical procedure.

Researchers are evaluating blood tests called Bone Turnover Markers (BTMs) to quickly assess the effectiveness of osteoporosis treatments in postmenopausal women over 50. Osteoporosis weakens bones and increases fracture risk, and is usually monitored by measuring bone mineral density (BMD) through DEXA scans, which change slowly over time. This study focuses on whether BTMs can provide earlier indications of treatment response within 3 to 6 months. The trial involves 40 postmenopausal women with primary osteoporosis who are not currently on osteoporosis medications or supplements. Participants will be randomly assigned to receive either antiresorptive drugs (oral bisphosphonates such as Alendronate, Ibandronate, or Risedronate taken weekly or monthly) or anabolic drugs (daily subcutaneous injections of Teriparatide). Both groups will also take daily calcium and vitamin D supplements. The treatment period lasts for six months, during which changes in BTMs will be measured at baseline, 3 months, and 6 months, and changes in BMD will be measured at baseline and at 6 months. During the study, participants will undergo blood tests to track specific BTMs related to bone formation and resorption, such as BsALP, TRACP-5b, and Sclerostin. Researchers will also assess bone density and monitor fracture incidence and quality of life. The goal is to determine if BTMs can serve as early, reliable markers of treatment success, which could improve osteoporosis care, especially in settings with limited access to repeated DEXA scans. The total participation duration is six months with ongoing monitoring of treatment effects.

Benign prostatic hyperplasia (BPH) is a common condition affecting men, especially as they age, with up to 90% of men experiencing it by age 80. This research aims to create an ongoing international registry to collect and analyze demographic and clinical data from men with BPH who receive either medical therapy or surgical treatments. The registry helps track treatment patterns and outcomes worldwide to better understand the effectiveness and complications related to various BPH treatments. The registry collects detailed baseline information including patient-reported symptoms, sexual health, quality of life, urinary flow, and laboratory values such as prostate-specific antigen and testosterone. It also records any complications like bleeding, infections, incontinence, strictures, ejaculation issues, and erectile dysfunction. This data is gathered over a three-year period with no set endpoint, allowing for long-term follow-up and analysis of real-world treatment results. Participants provide medical records which are securely stored and accessed only by authorized users. The study monitors symptoms using standardized scores and quality of life measures, along with clinical tests such as post-void residual urine volume. Regular audits ensure data accuracy, and the registry’s technology supports future integration with patient portals and electronic medical records. The study duration is planned for at least three years, with possible extensions to continue follow-up and research.

Researchers are evaluating the effectiveness and safety of two oral drug combinations, Bemnifosbuvir-Ruzasvir (BEM/RZR) and Sofosbuvir-Velpatasvir (SOF/VEL), in adults with chronic Hepatitis C virus (HCV) infection. This Phase 3 trial compares these treatments to determine which is better at reducing the virus in the blood. Participants include adults aged 18 to 85 years, including those with compensated liver cirrhosis, and some with controlled HIV-1 infection under specific treatment conditions. Participants will receive either BEM/RZR tablets once daily for 8 weeks if they do not have cirrhosis, or for 12 weeks if they have compensated cirrhosis. Those in the comparison group will take SOF/VEL tablets once daily for 12 weeks. The study is randomized, controlled, and open-label, meaning both participants and researchers know which treatment is given. During the study, researchers will monitor patients to see how many achieve very low levels of HCV RNA in their blood by week 24. The study will include regular medical assessments, safety monitoring, and evaluation of treatment adherence. Participants will be followed from the start of treatment until 24 weeks later to assess outcomes and any side effects.

Researchers are evaluating the effects of EXTOR, a fixed-dose combination of amlodipine and valsartan, in newly diagnosed patients with hypertension. This study focuses on adults aged 18 to 70 years who have not previously received antihypertensive treatment. The goal is to understand how well EXTOR lowers blood pressure and improves patients' quality of life over an 8-week period, following guidelines that recommend dual therapy for stage 2 hypertension. Participants receive EXTOR, which combines amlodipine, a calcium channel blocker that relaxes blood vessels, and valsartan, an angiotensin receptor blocker that prevents blood vessel constriction. This combination is expected to be more effective than either drug alone. The treatment lasts 8 weeks, during which blood pressure and patient satisfaction with medication are assessed at 4 and 8 weeks. Throughout the study, participants undergo standard blood pressure measurements and complete questionnaires about their quality of life and treatment satisfaction. Safety is monitored for all patients who take at least one dose of EXTOR. The study aims to measure changes from baseline in systolic and diastolic blood pressure and quality of life, ensuring thorough evaluation of both effectiveness and safety during the 8-week treatment period.

Researchers are evaluating the effects of Maitland mobilization combined with Kendall exercises compared to Kendall exercises alone on pain and posture in adults with Upper Cross Syndrome (UCS). UCS is a condition involving muscle imbalances that cause forward head posture, rounded shoulders, and increased thoracic kyphosis. The study focuses on reducing pain and improving postural alignment by measuring pain intensity, craniovertebral angle, thoracic kyphosis, and shoulder posture. Participants are divided into two groups. The experimental group receives Kendall exercises along with Maitland mobilization, which involves strengthening specific muscles such as deep cervical flexors and lower trapezius, stretching tight muscles, and applying manual mobilization to the cervical and upper thoracic spine. The control group performs only the structured Kendall exercise program focusing on muscle strengthening and stretching related to UCS. Both groups include warm-up and cool-down routines. During the 8-week study, participants will be assessed at the start and end for changes in thoracic kyphosis using a flexicurve ruler, forward head posture with a protractor app, rounded shoulder posture with a vernier caliper, and pain levels using a visual analogue scale. The study aims to monitor improvements in posture and pain, with all evaluations conducted at baseline and at the final week of the intervention.

Laparoscopic cholecystectomy is a common surgical procedure for treating gallstones, but the process of laryngoscopy and intubation during anesthesia can cause sudden increases in heart rate and blood pressure. These changes may pose risks, especially for patients with limited heart and blood vessel health. This randomized controlled trial aims to compare two medications, intravenous labetalol and lignocaine, to see which better controls these cardiovascular responses during surgery in adult patients. Participants in this study will be adults aged 18 to 60 undergoing elective laparoscopic cholecystectomy. They will be randomly assigned to receive either labetalol at a dose of 0.25 mg/kg or lignocaine at a dose of 1.5 mg/kg, both given as intravenous bolus injections over 60 seconds, three minutes before laryngoscopy. The study will monitor how these drugs affect heart rate and blood pressure around the time of intubation. During the study, researchers will track blood pressure and heart rate from five minutes before anesthesia induction to ten minutes after intubation. They will also record details of the intubation process, any need for additional rescue medications, and possible side effects such as slow heart rate or low blood pressure. This information will help determine which medication provides better cardiovascular stability during surgery, supporting safer anesthesia care.

Researchers are comparing two types of tendon grafts used in surgery to repair anterior cruciate ligament (ACL) injuries. The study focuses on adults aged 18 and older who have an isolated ACL injury confirmed by clinical and MRI assessments. The goal is to evaluate and compare early recovery of knee function using a specific knee scoring system at 6 weeks and 3 months after surgery. This trial is conducted as a prospective, single-blinded, randomized controlled study to provide high-quality evidence about the potential benefits of the newer peroneus longus tendon graft compared to the commonly used hamstring tendon graft. Participants will undergo arthroscopic ACL reconstruction surgery using either a peroneus longus tendon (PLT) autograft or a hamstring tendon (HST) autograft. Both procedures are performed under spinal anesthesia with grafts harvested from the patient's own tendons on the same leg. The PLT graft is taken through a small incision near the ankle, with additional care to preserve surrounding tendons. Both grafts are fixed in place using specialized surgical devices following a standard single-bundle technique. All surgeries occur at a single hospital, and patients follow a standardized rehabilitation program afterward. During the study, participants will have their knee stability and function measured at 6 weeks and 3 months post-surgery using the Lysholm Knee Score. Researchers will monitor recovery progress and any complications, ensuring careful follow-up. The study aims to provide information on early functional outcomes to help guide surgical choices for patients with ACL injuries, with results shared through scientific publications and conferences.

This research aims to compare the effects of a topical cream and laser treatment for excessive facial hair in women, a condition known as hirsutism. Hirsutism involves the growth of coarse hair in areas typical for males, often due to increased hair follicle response to androgens or higher androgen levels. The study focuses on women aged 18 to 45 years and evaluates these treatments in a Phase 4 clinical trial setting. The study includes two groups: one receiving both eflornithine cream and intense pulsed light laser treatment, and the other receiving only the eflornithine cream. The cream is applied to the face in both groups, while the laser is used on areas with increased hair in the combination group. Participants in the combination group will return monthly for follow-up laser sessions, allowing comparison of combined versus cream-only treatment effects. Participants will be monitored for treatment efficacy over a three-month period. Assessments include evaluating hair reduction and treatment response. Safety is also observed, with exclusion of pregnant women, those with severe acne, or immunodeficiency. The study measures how well the treatments reduce excessive facial hair and tracks participant progress throughout the study duration.