Peshawar

This research aims to compare the effects of oral anticoagulation versus no anticoagulation in patients aged 55 and older who have had recent episodes of transient atrial fibrillation triggered by stress and have additional factors that increase their risk of stroke. The study is a multinational, investigator-initiated, prospective, randomized, open-label trial evaluating the impact of non-vitamin K oral anticoagulants NOACs on preventing stroke and other serious cardiovascular events. Participants will be randomly assigned to either receive one of several NOACs, such as edoxaban, apixaban, dabigatran, or rivaroxaban, prescribed by their physician for the duration of the follow-up, or to a control group that will not receive anticoagulants unless medically indicated during the study. The choice of specific NOAC and dose adjustments are determined by the prescribing doctor. The study excludes patients with certain conditions like chronic atrial fibrillation, severe kidney or liver disease, recent cardiac surgery, or bleeding risks. During the study, participants will be monitored for up to 24 months to assess the occurrence of non-hemorrhagic stroke, systemic embolism, vascular mortality, myocardial infarction, peripheral arterial thrombosis, amputation, and venous thromboembolism. Regular follow-up will include evaluation of these outcomes to measure the effectiveness and safety of anticoagulation compared to no anticoagulation. Participants will provide informed consent and remain under medical supervision throughout the trial.

The trial investigates the effect of using an antireflux suture during one anastomosis gastric bypass surgery on preventing reflux symptoms. There is currently insufficient evidence to support or oppose the use of this suture, so the study aims to compare symptom outcomes in patients who receive the suture versus those who do not. This is a randomized controlled trial conducted by Khyber Teaching Hospital to evaluate this surgical approach. Participants are randomly assigned to one of two groups one group receives the antireflux suture during the surgery, while the other group does not have the suture applied. Both groups undergo the same type of laparoscopic one anastomosis gastric bypass surgery. The study is double-blinded, ensuring that neither the participants nor the researchers know which group each participant is in. Participants will be monitored for symptoms of reflux disease and postoperative vomiting at 3 and 6 months after surgery. Researchers will assess and compare these outcomes between the two groups to evaluate the impact of the antireflux suture. The total duration of participation includes pre-surgery and follow-up assessments for up to six months postoperatively.

Researchers are evaluating the use of blood tests called Bone Turnover Markers BTMs to quickly monitor how well osteoporosis treatments are working in postmenopausal women. Osteoporosis weakens bones and raises fracture risk. Current monitoring with DEXA scans measures bone density but changes slowly. This study compares BTMs and bone density changes over six months in women receiving different osteoporosis drugs to see if BTMs can provide earlier treatment feedback, which is especially helpful where repeat DEXA scans are hard to access. In this randomized controlled trial, 40 postmenopausal women over 50 with osteoporosis will be randomly assigned to two groups. One group will receive anabolic therapy with Teriparatide injections daily for six months, plus calcium and vitamin D supplements. The other group will receive oral antiresorptive drugseither Alendronate weekly, Ibandronate monthly, or Risedronate monthlyalong with calcium and vitamin D supplementation. The study will measure changes in specific BTMs and bone mineral density at set intervals. Participants will be monitored at the start, three months, and six months to assess BTMs, and bone density will be measured at baseline and six months. Researchers will also track new fractures and quality of life. The trial includes detailed evaluations of bone metabolism markers and bone strength to understand treatment responses, with the goal of improving osteoporosis management in clinical settings like Pakistan. The total study duration for participants is six months.

Benign prostatic hyperplasia BPH is a common condition affecting many men as they age, often leading to lower urinary tract symptoms LUTS. Due to a growing and aging population, the number of men diagnosed with BPH continues to rise, making treatment for this condition one of the most performed surgical procedures in urology. This research aims to establish a global, ongoing registry that collects detailed demographic and clinical data on men undergoing medical or surgical treatments for BPH to better understand treatment patterns and outcomes worldwide. The registry records information from men aged 18 and older with a primary diagnosis of BPH and LUTS who are receiving either medication or surgical intervention. Data collected includes baseline demographics, peri-operative details, and follow-up outcomes with no actual interventions performed by the registry team. The study uses validated patient-reported outcome measures like the International Prostate Symptom Score IPSS, Sexual Health Inventory for Men SHIM, and Male Sexual Health Questionnaire for Ejaculatory Dysfunction MSHQ-EjD, along with clinical data such as quality of life, urine flow rates, prostate-specific antigen levels, and complications related to treatment. Participants provide data over a period of three years with ongoing follow-up and no fixed end date, allowing for long-term observation of treatment effectiveness and safety. The registry also ensures data security and quality through encryption, user access controls, and regular audits. Researchers will analyze outcomes including symptom scores, quality of life, post-void residual urine, and complications like incontinence, bleeding, urinary tract infections, and erectile dysfunction, aiming to inform future BPH management and research.

Researchers are evaluating the effects of EXTOR, a fixed-dose combination of amlodipine and valsartan, in adults newly diagnosed with hypertension. This study focuses on patients in routine practice in Pakistan and aims to measure the medications impact on blood pressure control and quality of life over an 8-week period. EXTOR combines two commonly used blood pressure medications with different actions to better manage hypertension. Participants will receive EXTOR, which combines amlodipine a calcium channel blocker that relaxes blood vessels and valsartan an angiotensin receptor blocker that prevents vessel constriction in a single pill. The study tracks changes in systolic and diastolic blood pressure at 4 and 8 weeks, as well as patient satisfaction using a treatment questionnaire. Safety is monitored throughout the study for all subjects who take at least one dose. During the study, participants will undergo regular blood pressure measurements and complete questionnaires about their health-related quality of life and medication satisfaction. Researchers will review blood pressure changes and safety outcomes after 8 weeks. This observational study includes adults aged 18 to 70 years who have not previously been treated for hypertension. Participation will last at least 8 weeks, during which safety and effectiveness data will be collected.

Researchers are evaluating the effects of combining Maitland mobilization with Kendall exercises compared to Kendall exercises alone on pain and posture in adults with Upper Cross Syndrome UCS. UCS is a condition marked by muscle imbalance causing forward head posture, rounded shoulders, and increased thoracic kyphosis. This trial aims to measure changes in pain intensity, head and shoulder alignment, and thoracic spine curvature. Participants are divided into two groups. One group receives Maitland mobilization techniques applied to the cervical and thoracic spine by a trained physiotherapist, alongside Kendall exercises that strengthen weak muscles and stretch tight ones. The other group performs only the Kendall exercise program targeting postural correction. Both interventions focus on muscles involved in UCS and are designed to improve posture and reduce pain. During the 8-week study, participants will have their thoracic kyphosis measured with a flexicurve ruler, forward head posture assessed using a mobile protractor app, rounded shoulder posture checked with a caliper, and pain recorded on a visual analogue scale. These assessments occur from the start to the end of the trial to track progress. The trial uses a randomized design with single masking and is sponsored by Ibadat International University, Islamabad.

This research aims to compare the effects of two medications, intravenous labetalol and lignocaine, on heart rate and blood pressure changes during laryngoscopy and intubation in patients undergoing elective laparoscopic cholecystectomy. The study focuses on adults with good physical status ASA Grade I and II aged 18 to 60, investigating which drug better maintains cardiovascular stability during this procedure by limiting heart rate and mean arterial pressure changes to within 20% of baseline values. Participants will be randomly assigned to receive either labetalol at a dose of 0.25 mgkg or lignocaine at 1.5 mgkg. Both drugs are administered intravenously over 60 seconds, three minutes before laryngoscopy and intubation. The study will track blood pressure and heart rate from five minutes before induction until ten minutes after intubation, recording any adverse events such as bradycardia, hypotension, or allergic reactions. During the study, researchers will monitor systolic and diastolic blood pressures, mean arterial pressure, and heart rate closely around the time of airway instrumentation. They will also observe the use of any rescue medications and note adverse events from induction through recovery, approximately one hour. The findings aim to guide anesthesiologists in selecting the safer and more effective medication to control hemodynamic responses during laparoscopic surgery.

This research aims to compare treatments for hirsutism, a condition causing excessive facial hair in women. It evaluates the combined use of eflornithine cream and intense pulsed light laser versus eflornithine cream alone. The goal is to find out which approach better reduces unwanted facial hair in women aged 18 to 45 years. Participants are divided into two groups one receives both eflornithine cream applied twice daily and monthly sessions of intense pulsed light laser over three months the other group uses only the eflornithine cream twice daily for the same period. The treatments focus on targeting hair growth through medication and light therapy. Throughout the study, women will attend monthly follow-ups for laser treatment if assigned, and researchers will assess treatment effectiveness after three months. The main measurement is the reduction of excessive facial hair. Safety and response to treatment will be monitored during the study, which is sponsored by Khyber Teaching Hospital.

Chronic mechanical neck pain affects many adults, especially middle-aged individuals, and can limit neck movement and daily activities. This research compares two treatmentsCervical Retraction Exercise and Facet Oscillatory Mobilizationto see how they help ease pain, improve neck movement, and reduce disability in people aged 35 to 50. The study is a randomized controlled trial involving 32 participants divided into two groups. One group will perform Cervical Retraction Exercises, which involve sitting or standing while pushing the chin backward and raising the head within a pain-free range, combined with conventional treatments like TENS, heating pads, and muscle stretching. The other group will receive Facet Oscillatory Mobilization on the cervical spine along with the same conventional treatments. Both groups will have 20-30 minute sessions, three times every other day for two weeks, totaling six sessions, followed by a follow-up visit after four weeks. Participants will be assessed before and after treatment using measures like the Neck Disability Index, a pain rating scale, and range of motion using an inclinometer. The study will monitor pain, disability, and neck movement over six weeks. Participants will be evaluated for safety and effectiveness of the treatments throughout the trial, which ends in December 2024.

This research aims to compare the effectiveness of two commonly used iron preparations, Ferrous sulphate and Iron Polymaltose complex, for treating children with iron deficiency anemia. The study focuses on identifying which drug has better efficacy, considering differences in bioavailability, side effects, and cost. Iron deficiency anemia is a widespread condition linked to nutritional and socioeconomic factors and causes low iron levels in the blood. Participants will be randomly assigned to one of two groups. Group A will receive Ferrous sulphate syrup at a dose of 6 mgkgday of elemental iron once daily for 8 weeks. Group B will receive Iron Polymaltose complex at the same dose and frequency for 8 weeks. Both treatments are given orally, and the study is designed to compare these two active treatments in a single-masked way. During the 8-week treatment period, researchers will monitor the increase in hemoglobin levels as the primary outcome measure. Participants will be evaluated for treatment response and any side effects. The study includes children with iron deficiency anemia, and participants progress will be observed through medical history and clinical assessments. The total participation duration aligns with the 8-week treatment period.