Clinical trials

Accurate working length determination is essential for successful root canal treatment and is influenced by proper glide path preparation. This in vitro study aims to compare the accuracy of working length achievement following manual and mechanical glide path preparation techniques. Sixty extracted single-rooted permanent teeth will be randomly allocated into two groups. Group 1 will undergo manual glide path preparation using stainless steel K-files, while Group 2 will receive mechanical glide path preparation using rotary PathFile instruments. Initial and final working lengths will be measured using an electronic apex locator and confirmed with digital radiographs. The difference between the initial and final working lengths will be analyzed statistically. The results of this study will help identify the more effective glide path preparation technique for maintaining working length accuracy and improving endodontic treatment outcomes.

Randomized, double-blind, parallel-group study comparing efficacy and safety of Risperidone versus Cariprazine in adults with acute manic episodes. Participants will receive oral study drug for 6 weeks. Primary outcome is change in YMRS total score from baseline to week 6.

The goal of this clinical trial is to determine whether common carotid artery blood flow measured by bedside Doppler ultrasound can accurately identify fluid responsiveness in mechanically ventilated adults with sepsis. The study will compare this method with transthoracic echocardiography-derived cardiac output, which is a commonly used non-invasive technique for assessing hemodynamic status in critically ill patients. The study also aims to evaluate whether carotid artery ultrasound can provide a faster and more practical bedside assessment during fluid resuscitation in the intensive care unit. In patients with sepsis, giving too little intravenous fluid may worsen organ perfusion and shock, while excessive fluid administration may lead to complications such as pulmonary edema, worsening oxygenation, prolonged mechanical ventilation, and longer intensive care unit stay. Because of this, clinicians need reliable methods to identify which patients are likely to benefit from fluid administration. This concept is known as fluid responsiveness. The main questions this study aims to answer are: * Can common carotid artery blood flow measured by ultrasound predict fluid responsiveness as accurately as transthoracic echocardiography-derived cardiac output? * How closely do changes in carotid artery blood flow correspond to changes in cardiac output during passive leg raising? * Can carotid ultrasound provide a quicker and simpler bedside method for assessing fluid responsiveness in critically ill patients receiving mechanical ventilation? Researchers will compare two ultrasound-based methods during a passive leg raising test. Passive leg raising is a temporary bedside maneuver used to simulate a fluid challenge without immediately giving intravenous fluids. During this maneuver, the patient's legs are elevated while the upper body is lowered, allowing blood from the lower limbs to temporarily return to the central circulation. This increases blood flow to the heart and may increase cardiac output in patients who are likely to respond to fluid administration. The study team will first record baseline measurements of common carotid artery blood flow and transthoracic echocardiographic cardiac output while the patient is in a semi-recumbent position. The passive leg raising maneuver will then be performed, and both measurements will be repeated to evaluate changes in blood flow and cardiac output. If the predefined criteria for fluid responsiveness are met, the participant will receive intravenous crystalloid fluid according to the study protocol. Participants will: * Undergo bedside Doppler ultrasound measurement of common carotid artery blood flow * Undergo transthoracic echocardiography to measure cardiac output * Have ultrasound measurements recorded before and after passive leg raising * Receive intravenous fluid administration if fluid responsiveness criteria are met * Continue routine monitoring of blood pressure, heart rate, oxygenation, urine output, and other intensive care parameters during the study period The findings from this study may help determine whether carotid artery ultrasound can be used as a practical bedside tool for fluid assessment in mechanically ventilated patients with sepsis, particularly in settings where rapid and non-invasive monitoring is needed.

Background and Purpose: Acne vulgaris is a common skin condition that can cause significant physical and emotional distress. Oral isotretinoin is a highly effective treatment for severe or persistent acne. While the standard (conventional) dose is effective, it is often associated with side effects like dry skin, chapped lips, and altered labs. The purpose of this study is to compare a lower daily dose of oral isotretinoin against the conventional daily dose in individuals with acne vulgaris. What the Study Aims to Find Out: Researchers want to determine if a low-dose regimen can match the effectiveness (efficacy) of the conventional dose while reducing the frequency and severity of side effects (safety). Study Design: Participants will be randomly assigned to receive either the low-dose oral isotretinoin or the conventional-dose oral isotretinoin. Researchers will monitor and compare acne clearance rates, patient satisfaction, and any side effects experienced by the participants throughout the treatment period.

In conventional maxillary complete dentures, the palatal surface is typically smooth and polished, lacking the natural anatomy of the palatal rugae. While this design facilitates ease of cleaning, it may compromise the functional feedback required for speech and other oral functions. Since the palatal rugae contain mechanoreceptors essential for guiding the tongue during phonation and mastication, replicating these structures may enhance oral function and patient adaptation. Given the variation in clinical outcomes reported in prior studies, a randomized crossover clinical trial is warranted to assess the impact of adding anatomically replicated palatal rugae to complete dentures.

To assess the effectiveness of topical tapinarof to topical betamethasone in patients with mild to moderate plaque psoriasis presenting to tertiary care hospital in Islamabad

This randomized clinical trial aims to compare the recurrence rates of two surgical techniques-Winograd procedure and sleeve (gutter) method-in the treatment of ingrown toenails (onychocryptosis). A total of 312 nails will be randomized into two groups, with patients receiving either the Winograd procedure or sleeve method. Participants will be followed for 30 days post-intervention to assess recurrence and other clinical outcomes. The study seeks to determine the more effective treatment modality for reducing recurrence in a tertiary care setting.

Lower abdominal surgeries cause significant pain and can be managed by injecting local anesthetic agents between muscles of abdominal wall that can provide post operative pain relief and its duration can be prolonged by adding drugs to local anesthetic regimen

dult patients with multiple traumatic injuries admitted to the ICU from the operating room, emergency department, or hospital wards who meet the study criteria will be included after obtaining informed consent from the patient or their legal guardian. Participants will be randomly divided into two groups: one group will receive treatment guided by the difference between carbon dioxide levels in venous and arterial blood, while the other group will receive treatment based on standard resuscitation parameters commonly used in critical care. As part of routine monitoring, all patients will have a central venous catheter and an arterial line inserted to measure blood parameters. Blood samples from both lines will be taken shortly after ICU admission and at regular intervals during the first three days. These samples will be analyzed using a bedside blood gas machine, and the results will be compared between the two groups to determine whether monitoring the difference in carbon dioxide levels between venous and arterial blood improves patient outcomes compared with standard care.

To compare rate of infection and wound healing between chlorhexidine impregnated paraffin gauze and dry povidone-iodine dressings in post-traumatic wounds.

This prospective, comparative clinical study evaluates two techniques of chest tube wound closure-purse-string suture and the simple suture/plug method-to determine differences in cosmetic outcomes, wound complications, and overall patient satisfaction following chest tube removal. The study aims to identify the closure technique that provides optimal wound healing with fewer postoperative complications.

Statement of the Problem WHO stated that the average life expectancy has been recorded as 40 years among these in South Asian countries and 98 million people relate to Pakistan. Wang pointed out that the significant difference has been seen regarding provision of the health care facilities being provided in the rural and urban settings, called as health poverty in rural area as compared to urban areas. Therefore, accessibility of essential healthcare facilities such as experienced staff, vaccination and necessarily supply of medicines in rural population would be supporting reducing health poverty and will maintain equal and equitable opportunities. Andersen and Newman argued that there are main factors such as distance, time and travel costs that affect health accessibility for the poor people living in rural settings which are deprived of emergency care and common in developing economies. Cardiac Rehabilitation is a efficient, safe and affordable intervention that lowers overall health service financial burden. Additionally, CR are planned to optimize and restore physical, psychological, and social functioning by combining medical consultation, individualized exercise sessions, education, cardiac risk factor modification, and health counseling. CR is highly and mostly suggested as the key multicomponent and multi-dimensional intervention for the prevention of death by cardiac attacks, the lowering chances of hospital readmissions, and the enhancement of quality of life (QoL) of the people. Therefore, CR is one of the effective techniques to decrease the increasing number of cases and provide an efficient cardiac health intervention program with appropriate planning and organization. Despite the evidence of cost-effective rehabilitation program to optimize cardiac functioning at the hospital-based settings but the participation in cardiac rehabilitation, traditionally delivered in hospital outpatient departments or community, Despite the evidence of cost-effective rehabilitation program to optimize cardiac functioning at the hospital-based settings but the participation in cardiac rehabilitation, traditionally delivered in hospital outpatient departments or community centers, has remained low, with average participation rates \< 20% recorded in the United States and similarly in the Europe. Low participation has predominantly recorded mostly in few groups like women, elder population, ethnic minorities, and those living in rural settings or who are socioeconomically and financially resource constrained. Subsequently, these patients were contacted through calls for alternative options to center-based cardiac rehabilitation. Recommended interventions included cardiac rehabilitation at home transited by healthcare professionals with the support of telehealth technologies to maximize participation. Thus, the home-based cardiac rehabilitation program was recommended by the American Heart Association and the American College of Cardiology in 2019 through a scientific statement. Guidelines from NICE on chronic heart failure in the UK in 2018 said that "delivery of home-based rehabilitation may enhance the accessibility and participation. For changing behavior and improving quality of life, HBCR is an essential component of secondary prevention and an important alternative technique, for those patients who suffered a cardiac incident or experienced any other cardiac event. Hence, HBCR is one of the effective t strategies to reduce the higher number of cases. HBCR contains techniques for secondary prevention that facilitate cardiac patients to rebuild their functional cardiac capacity and decrease the magnitude of hospital visits and workload in emergency management in coronary critical areas. Most of the studies were done on cardiovascular disease and on the conventional approach of hospital-based cardiac rehabilitation, but rare literature in the context of Pakistan, especially Islamabad, was found on home-based cardiac rehabilitation to improve the quality of life and behavior of the patients. Thus, the study aims to evaluate the effectiveness of home-based cardiac rehabilitation to improve the quality of life and health behavior of patients with cardiovascular disease in low resource settings in Islamabad.

Study Overview Summary This randomized controlled trial will evaluate the effectiveness of structured counseling in improving the continuation rates of long-acting reversible contraception (LARC) among women in Islamabad, Pakistan, who present to family planning clinics for early removal of their contraception devices (copper-T IUD or Jadelle implant). The study, starting December 15, 2025, will recruit women from three federal government-approved clinics. The trial will randomly assign participants to either an intervention group, where they will receive culturally sensitive counseling to encourage continued use of LARC, or a control group, where contraception will be removed upon client request without counseling. The goal is to determine if structured counseling can increase the likelihood of women continuing their LARC method.

In vitro study to compare the sealing ability of bioceramic-coated gutta-percha with bioceramic sealer against conventional gutta-percha with bioceramic sealer in root canal obturation. A total of 60 extracted human single-canal teeth will be prepared and obturated according to standardized protocols, then evaluated for microleakage. Data will be analyzed using SPSS (version 25) with appropriate non-parametric tests at a significance level of p\<0.05. The outcomes are expected to identify the more effective obturation material combination in achieving a fluid-tight seal, thereby contributing to improved success rates in endodontic therapy.

In this study the investigators aimed to explore the antibiofilm effect of fluoride varnish loaded with titania nanoparticles synthesized from moringa oleifera leaves extract vs conventional fluoride varnish in multibracket fixed orthodontic patients.

This study will assess the impact of voice instructions delivered by advance voice feature of Chat gpt followed by remote support with chatbot in form of customized chat gpt named Brace AI which is customized by principal investigator.AI generate post operative instructions will be compared with post bracketing instructions given verbally in traditional chair side manner and home support with pamphlet in terms of oral hygiene outcome ,satisfaction with both modalities of instruction , recall ability and knowledge of the orthodontic patients

* Prior approval from SOD ethical committee has been received. * All patients presenting to the General OPD of School of Dentistry, Islamabad will be screened. Those patients who fulfill the criteria will be referred to the Prosthodontics department. * The patients will undergo detailed history and oral examination after informed consent (Annexure-A). Patients will undergo radiographic investigation and based on this information they will be selected for the study according to the exclusion and inclusion criteria. * Eligible participants will be randomly assigned to one of the following groups using a computer-generated sequence with allocation concealment via sealed opaque envelopes: * Group A: Control group * Group B: Full-coverage PFM crowns * Group C: Full-coverage Zirconia crowns * Baseline gingival samples will be collected with the help of sterile swab from the target tooth region prior to prosthesis placement and at the follow-up visits i.e. 1, and 3 months; both for experimental groups and control group. * Microbial analysis will be conducted through culture techniques to quantify CFUs and identify species. * A summary of the micro-organisms, their incubation media, temperature and time is presented in the following table: Table 1: Summary of the micro-organisms, their incubation media, temperature and time Micro-organism Growth Media Temperature Incubation time Candida albicans Saboraud Agar 370C 24-48 hours Streptococcus mutans BHI broth 370C 24-48 hours Staphylococcus aureus BHI broth 370C 24-48 hours Porphyromonas gingivalis BHI broth 370C 18-24 hours * Alongside, the same sample from sterile swabs will be smeared by fixating it on a microscopic slide and then Candida albicans will be stained by Periodic Acid Schiff technique, and the bacterial species using Gram staining. * All participants will receive standardized verbal and written instructions oral hygiene instructions to control for hygiene-related variation

The study will be conductued at the Pediatric Oncology Department of the Children's Hospital, PIMS Islamabad, over the peroid of six months. This single-blinded, two-arm RCT study will involve 80 children aged 8 to 16 years with maligancies recieving chemotherapy. Participants will be randomly allocated to either interventional or CBT group which will recieve weekly five sessions of Cognitive Behaviour Therapy (CBT) or the control group, which will recieve the usual care. CBT session will be contducted by Clinical Psychologist will last 30-35 minutes. Outcomes will be measured at Baseine and one month post intervention using Revised Child Anxiety and Depression Scale (RCADS) and Pediatric Quality of Life Generic Core Score 4.0.