Clinical trials

Total knee arthroplasty(TKA) is the most commonly performed procedure for advanced knee osteoarthritis. Enhanced recovery after surgery (ERAS) protocols are primarily implemented to reduce perioperative stress and improve surgical and functional outcomes. Evidence of the implementation of ERAS protocols in low to middle-income countries like Pakistan is limited. This study aims to evaluate the effectiveness of ERAS protocols in TKA patients. A prospective randomized controlled trial study was conducted within our institute from July 2025 to January 2026, in which a total of 239 patients who underwent primary bilateral TKA, of which 121 patients received conventional treatment and protocols, and a study group with 120 participants were managed according to the ERAS protocol. Patients were in the 50-70 years age bracket, and had an American Society of Anesthesiologists grade I-III. The protocol included preoperative physiotherapy, reduced fasting time, multimodal anesthesia, perioperative tranexamic acid, early ambulation and early oral intake. Postoperative outcomes included time to oral intake, postoperative nausea and vomiting, time to mobilization, length of hospital stay, range of motion and Hospital for Special Surgery score.

To assess hemodynamic changes with hyperbaric bupivacaine with spinal anesthesia

Allergic rhinitis is a very common condition that can cause symptoms such as sneezing, a runny nose, nasal blockage, and itching in the nose. These symptoms can interfere with sleep, daily activities, and overall quality of life. Although several medicines are available to treat allergic rhinitis, it is not always clear which combination of treatments works best for patients in everyday clinical practice. The purpose of this study is to compare two commonly used treatment combinations for allergic rhinitis in adults. One group of participants will receive an intranasal corticosteroid along with an oral antihistamine. The other group will receive an intranasal corticosteroid along with an oral antileukotriene. Both treatment approaches aim to reduce inflammation and improve symptoms, but they act through different pathways in the body. This study is designed as a randomized controlled trial. Participants who meet the eligibility criteria will be assigned by chance to one of the two treatment groups. This method helps ensure that the comparison between treatments is fair and unbiased. The main goal of the study is to find out whether one treatment combination provides better relief of nasal symptoms than the other, or if both treatments are equally effective. To assess this, participants' symptoms will be recorded using a structured symptom scoring system at the start of the study and during follow-up visits. Participants will be evaluated at baseline and at scheduled follow-up visits. Changes in their symptoms over time will be carefully monitored and compared between the two groups. The results of this study may help doctors choose the most effective treatment approach for adults with allergic rhinitis and support better evidence-based care. This study has been reviewed and approved by the institutional ethical review committee. Participation in the study is voluntary, and informed consent will be obtained from all participants before enrollment.

The goal of this study is to know how effectively TAP block can reduce postoperative pain in total abdominal hystrectomy patients when given ketamine in addition to bupivacaine in TAP block and to compare it with the conventional TAP block with bupivacaine only. The main question it aims to answer is: Does intervention with ketamine in TAP block lowers the postoperative pain measured via visual analog scale and decreases the need for rescue analgesia? Patients will be assessed for pain in PACU( post anesthesia care unit), 6 hours, 12 hours and 24 hours postoperatively. Time of rescue analgesia will also be noted if given.

In this study, atropine 0.01% eye drops will be given to myopic children once at night daily for 6 months as compared to a control group to see the effect on axial length and refraction

To assess the hemodynamic difference after spinal anesthesia with hyperbaric bupivacaine and isobaric bupivacaine in elective cesarean section

Assessing the reduction in pain and anxiety by the use of showing an animated video of the procedure, among pediatric patients undergoing pin removal after fixation of supracondylar fractures.

This study aims to compare intranasal dexmedetomidine versus intranasal ketamine as a premedication in children undergoing surgery in our population. Hypothesis is Intranal dexmedetomidine is better than intranasal ketamine in producing preoperative sedation in pediatric patients undergoing surgery under general anesthesia.

OBJECTIVE : To compare the outcome of treatment with silymarin or N-acetyl cysteine in patients taking anti-tuberculous drugs for tuberculosis at Tertiary Care Hospital, Karachi. SAMPLE SELECTION : Patients presenting with tuberculosis previously not on anti-tuberculous drugs, between 40-80 years of age, both genders will be included .Patients with history of alcohol use,Discontinuation of drug due to other adverse effects except hepatotoxicity ,Inadequate date of laboratory testing at baseline or 2 to 4 weeks after treatment initiation, Cases with human immunodeficiency virus (HIV) co-infection, viral hepatitis, or suspected mal absorption (e.g., gastrointestinal disease or diarrhea) ,Chronic liver disease, COPD, asthma, myocardial infarction, chronic kidney disease and stroke will be excluded

Dexmedetomidine, an alpha-2 adrenergic agonist, has been shown to provide several benefits during endotracheal intubation: 1. \_Reduced anxiety and stress\_: Dexmedetomidine's anxiolytic and sedative effects help reduce anxiety and stress associated with endotracheal intubation. 2. \_Improved intubating conditions\_: Dexmedetomidine can improve intubating conditions by reducing the incidence of coughing, bucking, and laryngospasm. 3. \_Decreased hemodynamic responses\_: Dexmedetomidine can attenuate the hemodynamic responses to intubation, including tachycardia, hypertension, and increased cardiac output. 4. \_Increased ease of intubation\_: Dexmedetomidine can facilitate smoother and easier intubation by reducing the need for additional anesthetics or muscle relaxants. The physiological responses to dexmedetomidine during intubation include: 1. \_Decreased heart rate\_: Dexmedetomidine can cause a decrease in heart rate due to its effects on the sympathetic nervous system. 2. \_Decreased blood pressure\_: Dexmedetomidine can also cause a decrease in blood pressure due to its vasodilatory effects. 3. \_Increased sedation\_: Dexmedetomidine's sedative effects can help reduce anxiety and stress during intubation. 4. \_Reduced respiratory rate\_: Dexmedetomidine can cause a decrease in respiratory rate due to its effects on the respiratory centers in the brain. The clinical benefits of dexmedetomidine during intubation include: 1. \_Improved patient comfort\_: Dexmedetomidine's sedative and anxiolytic effects can improve patient comfort during intubation. 2. \_Reduced need for additional anesthetics\_: Dexmedetomidine can reduce the need for additional anesthetics or muscle relaxants during intubation. 3. \_Decreased risk of complications\_: Dexmedetomidine's effects on hemodynamic responses and respiratory rate can decrease the risk of complications during intubation.

\*Ketamine:\* Ketamine is a medication that can help reduce shivering by blocking certain nerve signals in the brain. It's like a "nerve blocker" that helps calm down the body's shivering response. \- \*Tramadol:\* Tramadol is a pain medication that can also help reduce shivering. It works by affecting the brain's temperature regulation centers, which helps to reduce the shivering response.

This study evaluates the effectiveness of oral gabapentin in reducing the pressor response (increased MAP, HR, and BP) during laryngoscopic intubation. It is a prospective, double-blind randomized controlled trial involving 144 patients undergoing elective surgery. Gabapentin 300 mg or placebo will be administered preoperatively, with hemodynamic parameters monitored before and after intubation. The study aims to determine if gabapentin attenuates the sympathetic stress response compared to placebo.

Acute watery diarrhea is defined as the passage of 3 or more loose or liquid stools per day for 3 or more days but less than 14 days, including patients with mild to moderate dehydration per WHO classification. The study's outcome variables are stool frequency, measured by the total number of stools passed during 24 and 48 hours from the initiation of treatment, and hospital duration, measured by the total duration of hospital stay in hours. The null hypothesis states that racecadotril combined with standard treatment has no effect on reducing the mean number of stools passed during 48 hours compared to standard treatment alone in pediatric patients with acute watery diarrhea, while the alternate hypothesis suggests that racecadotril combined with standard treatment will significantly reduce the mean number of stools passed during 48 hours compared to standard treatment alone in these patients.