Comparison Of The Effectiveness Of Elastic Resistance Versus Free Weight Training Of Gluteus Medius In Improving Pain, Strength, And Overall Gait Speed In Patients With Chronic Non-Specific Low Back Pain
The gluteus medius plays a vital role in pelvic stabilization and maintaining proper gait mechanics. Dysfunction or weakness in this muscle is frequently associated with chronic non-specific low back pain, a condition affecting a significant proportion of the population. Rehabilitation strategies that target the gluteus medius are crucial for restoring lumbar-pelvic stability, optimizing functional movement, and reducing pain. Free weight training, using equipment like dumbbells and barbells, is a traditional method to enhance muscle strength and improve neuromuscular coordination. However, it often requires proper supervision to avoid injury due to the need for controlled movements and joint stability. On the other hand, elastic resistance training, which employs tools like resistance bands or tubes, offers a safer, cost-effective, and portable alternative. It allows progressive resistance throughout the range of motion, matching the user's strength curve and facilitating home-based exercise programs. This randomized controlled trial is designed to compare these two training modalities, which are elastic resistance versus free weights in terms of their effectiveness at improving gluteus medius strength, reducing low back pain, and enhancing gait speed in patients with chronic non-specific low back pain. The trial includes baseline and post-intervention assessments using validated clinical tools for measuring pain, strength, and gait speed. The goal is to determine which intervention yields greater clinical benefit and offers a more practical approach for implementation in therapeutic settings, especially for populations with limited access to conventional gym equipment. The findings could contribute valuable evidence to inform clinical decision-making in physical therapy and rehabilitation.
Phase
N/ASpan
20 weeksSponsor
Khyber Medical University PeshawarPeshawar, Khyber Pakhtunkhwa
Recruiting
The Effect of Bristle Brush, Rubber Cup, and Air Polishing on Tooth Surface Roughness of Scaled Teeth
Tooth surface roughness influences plaque retention and periodontal health. Polishing after scaling helps smoothen enamel surfaces, reducing bacterial adhesion. While various studies have assessed polishing techniques, there are inconsistencies in findings, particularly regarding air polishing vs. rubber cup polishing. Additionally, most studies focus on bovine teeth or indirect restorative materials rather than extracted human teeth. Using a randomized controlled trial (RCT) design, 56 extracted teeth will be divided into four groups: a control group (no polishing) and three experimental groups subjected to different polishing techniques. Surface roughness will be analyzed using a Scanning Electron Microscope (SEM). This study aims to fill these research gaps and provide region-specific data by determining which polishing method is most effective in minimizing roughness and preventing plaque accumulation, thus contributing to improved oral health practices.
Phase
N/ASpan
11 weeksSponsor
Khyber Medical University PeshawarPeshawar, Khyber Pakhtunkhwa
Recruiting
Healthy Volunteers
EUthyroid2: the Next Step Towards the Elimination of Iodine Deficiency and Preventable Iodine-related Disorders in Europe
BACKGROUND: Iodine deficiency (ID) is a leading risk factor for the development of thyroid disorders, of which in particular women are affected. During pregnancy, ID can increase the risk of developmental disorders in the offspring, however, it is considered as one of the most preventable causes of mental impairment in children. Therefore, the EUthyroid2 project aims to contribute to the prevention of ID and associated symptom and disease burden in adolescence and young women in Europe and beyond. AIM: An educational intervention is to be developed, implemented in ambulatory care settings and evaluated to effectively raise awareness for the risks of ID among young women (18-24 years) in three European countries (Norway, Poland, UK) as well as Bangladesh and Pakistan. METHODS: A cluster-randomised controlled trial is to be conducted in each of the five countries. 10 clusters per country (5 intervention group clusters and 5 control group clusters) are planned to achieve a final sample size of 200 study participants per implementing country with one baseline (before the intervention) and two follow-up measurements (2-4 weeks and 6-8 months after the intervention). In all, 1000 participants are to be recruited and data for all measurement points collected. Due to differences in the healthcare systems, the ambulatory care units, where the intervention will be implemented, may vary across the countries. Before recruiting the women, the healthcare professionals who carry out the intervention will receive a specially designed training program. To assure the intervention's functionality and effectiveness, recommendations for the development of complex interventions, appropriate theories and frameworks will be considered and a context analysis will be conducted. The primary outcome of the study is iodine awareness and knowledge measured by a newly developed questionnaire. Other outcomes includes measurement of iodine status (urinary iodine concentration), intake of dietary iodine sources (measured by a food frequency questionnaire), and iodine related behaviours. Sociodemographic characteristics and general dietary habits will also be measured. Descriptive analyses for all variables will be performed. Intervention groups will be compared to control groups over time to test effectiveness. Subgroup and country-specific analyses will also be computed. A process evaluation will be conducted to evaluate the implementation process with a convergent parallel mixed methods design. For this, healthcare professionals in the ambulatory care settings and the women who received the intervention will be invited to participate in an online survey. Further, ca. 20-30 semi-structured interviews will be conducted with women and healthcare professionals. CONCLUSION / OUTLOOK: The project results may support health authorities across countries to implement effective measures to reduce ID and associated risks. This may sustainably reduce the disease burden induced by ID for young women, pregnant women and their offspring.
Phase
N/ASpan
59 weeksSponsor
EUthyroidPeshawar, Khyber Pakhtunkhwa
Recruiting
Healthy Volunteers
The Comparative Efficacy of Standard Treatment Plus Ribavirin vs Standard Treatment Alone in Preventing Clinically Significant Hemorrhage in Patients With Dengue Fever
Dengue fever, a significant public health concern, presents varying severity from asymptomatic to life-threatening complications such as hemorrhage or shock. This study evaluates the effectiveness of Ribavirin when combined with standard treatment in mitigating severe bleeding complications in dengue patients. Conducted at multiple public sector hospitals in Khyber Pakhtunkhwa, the trial employs a rigorous methodology, including block randomization, double-blinding, and predefined eligibility criteria. Outcomes include changes in bleeding grades, platelet counts, acute-phase reactants, and hospital stay length. The findings aim to inform policy decisions and enhance dengue fever management protocols.
Phase
3Span
24 weeksSponsor
Khyber Medical University PeshawarPeshawar, Khyber Pakhtunkhwa
Recruiting
Effect of Psilocybin Only and Psilocybin Assisted Cognitive Behavioral Therapy in the Management of Major Depressive Disorder and Associated Metabolic, Immune, Inflammatory, Neuroplasticity and Electrical Activity Markers
This single-masked randomized controlled trial investigates novel therapeutic interventions for Major Depressive Disorder (MDD). MDD is a leading cause of disability worldwide, with a significant proportion of patients being treatment-resistant or showing only partial response to conventional antidepressants. Emerging evidence suggests that psilocybin, a serotonergic psychedelic, has potential as a rapid-acting antidepressant. The study will recruit 60 participants meeting DSM-V criteria for MDD, randomized into four groups: Control group (Conventional therapy only), Psilocybin therapy group, Cognitive Behavioral Therapy (CBT) group, and Psilocybin-assisted CBT group. Participants will receive interventions over 10 weeks, with psilocybin administered in two heroic doses six weeks apart, and CBT delivered in 8-10 structured sessions. Biochemical and neurochemical markers such as CD4/CD8 ratio, TNF-α, IL-6, BDNF, and oxytocin will be measured, along with inflammatory markers (resistin and visfatin). Depression scores will be assessed using scales like HAM-D, MADRS, and BDI. EEG recordings will evaluate changes in brain activity pre- and post-intervention. The primary objective is to assess improvements in depression symptoms, while secondary objectives include evaluating changes in immune, inflammatory, and neurochemical markers and EEG activity. Data will be analyzed using ANOVA with Tukey's post-hoc tests to determine statistical significance.
Phase
2Span
35 weeksSponsor
Khyber Medical University PeshawarPeshawar, Khyber Pakhtunkhwa
Recruiting
Short Leg Walking Plaster Cast Versus Walking Foot Cast for Jones Fracture
Jones fractures represent 26.3% of fractures at the base of the fifth metatarsal and are commonly treated conservatively through various weight-bearing casts. The lack of consensus on the optimal casting method for Jones fractures necessitates further study, particularly given the absence of published guidelines. This trial, unique in its randomized and prospective approach within Pakistan, aims to compare Short Leg Walking Plaster Casts and Walking Foot Plaster Casts specifically for Jones fractures. Patients meeting the inclusion criteria will be randomly assigned to one of the two treatment groups, with the primary endpoints being fracture healing (union) and functional outcomes at six weeks, assessed via radiographs and the American Orthopaedic Foot and Ankle Score (AOFAS). This study seeks to produce robust evidence to inform treatment guidelines, allowing patients, especially in low- and middle-income settings, to continue daily activities with minimal disruption during recovery.
Phase
N/ASpan
24 weeksSponsor
Khyber Medical University PeshawarPeshawar, Khyber Pakhtunkhwa
Recruiting
Light vs Heavy Weighted Mesh Repair in Primary Abdominal Hernia in Terms of Surgical Site Infection
Hernias, a protrusion of abdominal contents through the abdominal wall, are often treated surgically using synthetic polypropylene mesh. Two varieties of polypropylene mesh exist: light and heavy weighted. The lighter mesh is softer, less allergenic, and potentially leads to fewer post-surgical complications, including SSIs. In contrast, heavier mesh, which has been traditionally used, consists of thicker threads with narrower gaps and has a higher chance of eliciting an immune response. This trial aims to assess the effectiveness of light mesh over heavy mesh in reducing SSIs in abdominal hernia repairs, thereby providing data to support best practices in surgical care.
Phase
N/ASpan
37 weeksSponsor
Khyber Medical University PeshawarPeshawar, Khyber Pakhtunkhwa
Recruiting
Clinical Study of the Efficacy and Safety of BCD-263 and Opdivo® As Monotherapy in Subjects with Advanced Melanoma of the Skin
Following screening, subjects will be randomized to receive either BCD-263 or Opdivo in a 1:1 ratio and enter the main study period. During the main study period, subjects will receive therapy with BCD-263 or Opdivo, which will be administered intravenously until disease progression or signs of unacceptable toxicity develop (whichever occurs earlier). At Week 25, after completion of all scheduled procedures subjects in both groups will continue to receive open-label BCD-263 for up to a total of 2 years of therapy, or disease progression, or signs of unacceptable toxicity (whichever occurs first). Following discontinuation of the study therapy, the subjects will enter a follow-up period, during which data on overall survival will be collected through telephone contacts.
Phase
3Span
158 weeksSponsor
BiocadPeshawar
Recruiting
Comparison of High and Moderate Intensity Statins in Achieving the Target LDL-C Level After Acute Coronary Syndrome
Statins are the cornerstone of therapy for reducing cardiovascular events in patients with atherosclerotic cardiovascular disease. Current guidelines recommend high-intensity statins for patients with ACS to lower LDL-C levels by 50% or more. However, emerging evidence suggests that the benefits of lowering LDL-C may be independent of the statin dose and type. This randomized controlled trial investigates the effectiveness of moderate-intensity statins compared to high-intensity statins in reducing LDL-C levels among local populations. The study also explores whether moderate-intensity statins can mitigate adverse effects, such as myopathy or liver dysfunction, commonly associated with high-intensity statin therapy, particularly in populations with lower baseline LDL-C levels and high statin responsiveness. Participants will be randomly assigned to receive either high-intensity or moderate-intensity statin therapy. The primary outcome measure is the percentage of participants achieving an LDL-C reduction of ≥50% after three months of treatment. Secondary outcomes include the frequency of adverse effects, adherence to therapy, and changes in liver function tests (LFTs) and creatine phosphokinase (CPK) levels. The study will contribute to understanding the role of moderate-intensity statins in managing LDL-C levels and guide future clinical practices for patient subgroups at risk of adverse effects from high-intensity therapy.
Phase
N/ASpan
19 weeksSponsor
Khyber Medical University PeshawarPeshawar, Khyber Pakhtunkhwa
Recruiting
The Next Step Towards the Elimination of Iodine Deficiency and Preventable Iodine-related Disorders in Europe
Detailed Description: BACKGROUND: Iodine deficiency (ID) is a leading risk factor for thyroid disorders and developmental impairments in offspring. It is recognized as one of the most preventable causes of mental impairment in children. The EUthyroid2 project aims to contribute to the prevention of ID and its associated symptoms and disease burden in adolescents across Europe and beyond. AIM: This project seeks to develop and implement an educational intervention in various educational settings, effectively raising awareness of the risks associated with iodine deficiency. METHODS: The intervention will be conducted in each participating country, with three clusters (secondary schools, high schools, and vocational schools) per country. The goal is to achieve a final sample of 4500 study participants in all countries combined, involving one baseline measurement and two follow-up assessments (2-4 weeks and 6-8 months post-intervention). Data will be collected at all measurement points, with variations in implementation accounted for due to differences between countries. To ensure the intervention's functionality and effectiveness, the project will consider recommendations for developing complex interventions, appropriate theoretical frameworks, and conduct a context analysis. Outcome measures will include a newly developed iodine awareness questionnaire (primary outcome) and an iodine-specific food frequency questionnaire. Additionally, socio-demographic characteristics will be measured. Descriptive analyses will be performed on all variables, with subgroup and country-specific analyses computed. A process evaluation will assess the implementation process using a convergent parallel mixed methods design, inviting teachers and students to participate in an online questionnaire. Semi-structured interviews will further enrich this evaluation. CONCLUSION/OUTLOOK: The results of the EUthyroid2 project may assist health authorities across participating countries in implementing effective strategies to reduce iodine deficiency and its associated risks. Ultimately, this could lead to a sustainable decrease in the disease burden induced by iodine deficiency.
Phase
N/ASpan
53 weeksSponsor
EUthyroidPeshawar, Khyber Pakhtunkhwa
Recruiting
Healthy Volunteers