#Best Skin Clinic In Karachi
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Decoding Secrets: Choosing The Perfect Skin Clinic In Karachi For Acne Scars & Botox Treatment
Are you on a quest to find hidden gems among skin clinics in Karachi? Look no further! In this one-of-a-kind blog post, we will unravel the secrets to help you discover the ultimate Best Skin Clinic In Karachi that caters to your specific needs, focusing on complete skin care.
Cracking The Code: Finding The Best Skin Clinic In Karachi
When it comes to selecting the best Skin Care Clinic In Karachi, you need a tailored approach that considers various elements. Let’s unlock the secrets together:
1. Unveiling Excellence: Begin your search by exploring the reputation and expertise of different skin clinics. Look for Skin Care Clinic In Karachi that has built a name for itself, known for its commitment to delivering exceptional results, with highly qualified dermatologists and medical staff onboard.
2. Empowering Solutions: Acne scars can be a formidable adversary, but fear not! Seek out a skin clinic that specializes in Acne Scars Treatment In Pakistan and offers innovative solutions. Look for clinics that employ advanced techniques such as laser therapy, chemical peels, micro-needling, or dermal fillers.
3. The Art of Rejuvenation: Botox Treatment In Karachi requires a skilled hand and an artistic eye. When considering a skin clinic for Botox procedures, look for professionals who are true experts in their craft. They should possess an intimate understanding of facial anatomy and possess the finesse needed to achieve natural-looking results.
4. Secrets of Innovation: The Best Skin Clinic In Karachi stays ahead of the curve by embracing advanced technology and techniques. Seek out clinics that invest in state-of-the-art equipment and offer the latest in skincare advancements. These clinics will be at the forefront of the industry, providing you with access to cutting-edge treatments that can revolutionize your skincare routine.
5. Personalized Care: Each person’s skin tells a unique story, and a personalized approach is essential for success. Opt for a Skin Care Clinic In Karachi that takes the time to assess your individual needs and creates a customized treatment plan. The secret lies in addressing your specific concerns, and ensuring that the treatments are tailored to you and you alone.
6. Whispers of Satisfaction: Listen closely to the whispers of satisfied clients through testimonials and reviews. These echoes from the past can reveal the true essence of acne scar and Botox Treatment In Karachi. Positive feedback from those who have experienced these treatments at the clinic will paint a vivid picture of the quality of care and the results you can expect.
7. Comprehensive Care: Seek a skin clinic that offers a comprehensive range of skincare services including both Botox and Acne Scars Treatment In Karachi. The key is to find a sanctuary where you can fulfil all your skincare desires, ensuring that you have a trusted partner on your journey to flawless skin.
Concluding, unveil the secrets to radiant and flawless skin at the Best Skin Clinic In Karachi. Leave behind the shadows of acne scars and embrace a brighter future with rejuvenating Botox treatments. You are the author of your own unique story, and now it's time to reveal your
For more details visit our website www.drnakhodas.com.
#Best Skin Clinic In Karachi#Botox Treatment In Karachi#Acne Scars Treatment In Pakistan#Skin Care Clinic In Karachi
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HASH CLINICS is One of the leading destination for HAIR TRANSPLANT IN KARACHI is offered by Hash Clinics with team of highly qualified surgeons. It's a surgical procedure done to cover bald area of head & it costs around Rs. 70,000 to Rs. 120,000 & takes 7-8 hours while proper results can be seen in 6-8 months. HASH CLINICS offers wide range of services for SKIN CARE, HAIR TRANSPLANT, AESTHETICS, ORTHOPEDICS & ED(Erectile Dysfunction). Our goal is to be the number one choice for skincare, health and well-being to help people feel more confident about their lifestyle & appearance. Conveniently located, 130-C, DHA Phase 1, Near Tooba Masjid, B-Commercial Area, Karachi. Contact us at 0326-3412233 or visit our website www.hashclinics.pk. Book with us! ✨
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Derma Shine Almond Massage Cream
Derma Shine Almond Massage Cream in Pakistan
Derma Shine Almond Massage Cream in the bustling realm of skincare products, one name stands out for its exceptional nourishing qualities – Derma Shine Almond Massage Cream. Hailing from the vibrant market of Pakistan, this cream has garnered attention and acclaim for its enriching properties and revitalizing effects on the skin. Let’s delve into the intricacies of this skincare elixir, exploring its ingredients, benefits, and why it has become a staple in the beauty routines of many.
The Origins of Derma Shine Almond Massage Cream
Derma Shine Almond Massage Cream epitomizes the fusion of traditional wisdom with modern skincare science. Crafted with meticulous care, this cream embodies the essence of almonds, harnessing their natural goodness to deliver unparalleled skincare benefits. Almonds, renowned for their richness in vitamins, minerals, and antioxidants, have been a cornerstone of skincare practices for centuries, revered for their ability to nourish, moisturize, and rejuvenate the skin.
The Enriching Ingredients
Central to the efficacy of Derma Shine Almond Massage Cream in Karachi are its meticulously selected ingredients. Almond extract, the star component, infuses the cream with its nourishing properties, deeply hydrating the skin and replenishing lost moisture. Enriched with vitamins E and B, almond extract aids in improving skin elasticity, combating signs of aging, and promoting a radiant complexion.
Complementing the almond extract are other skin-loving ingredients such as glycerin, known for its moisturizing prowess, and various botanical extracts that soothe and revitalize the skin. Together, these ingredients form a potent blend that addresses multiple skincare concerns, from dryness and dullness to fine lines and uneven texture.
How to Use Derma Shine Almond Massage Cream
Apply: Take a small amount of Derma Shine Almond Massage Cream and massage it gently onto your face or body using circular motions. Focus on areas that are dry or in need of hydration.
Massage: Enjoy a relaxing massage as you gently massage the cream into your skin, paying special attention to areas of tension or stiffness.
Absorb: Allow the cream to absorb fully into the skin before applying any additional skincare products or makeup.
Repeat: For best results, use Derma Shine Almond Massage Cream regularly as part of your skincare routine, both in the morning and at night.
Benefits Galore
The benefits of Derma Shine Almond Massage Cream extend far beyond mere hydration. Regular use of this cream can yield a plethora of positive outcomes for your skin:
Intense Hydration: The rich, creamy texture of the formula deeply moisturizes the skin, providing long-lasting hydration and preventing moisture loss.
Nourishment: Almond extract and other nutrient-rich ingredients nourish the skin, leaving it feeling soft, supple, and replenished.
Improved Skin Texture: With regular massage, the cream helps improve blood circulation, leading to improved skin texture and a healthy, radiant glow.
Anti-Aging Properties: Vitamin E present in almond extract helps combat free radicals, reducing oxidative stress and minimizing the appearance of fine lines and wrinkles.
Soothing and Calming: Botanical extracts soothe and calm irritated skin, making the cream suitable for those with sensitive skin types.
Versatility: Beyond its use as a massage cream, it can also double up as a nourishing mask or an intensive overnight treatment for extra hydration and rejuvenation.
Availability and Customer Reviews
Derma Shine Almond Massage Cream in Lahore is widely available in Pakistan through various online and offline retailers, as well as beauty salons and skincare clinics. Customers who have tried the product have generally been impressed with its moisturizing and nourishing properties, as well as its soothing and relaxing effects. Many users have reported improvements in skin texture, hydration, and overall appearance after using the cream regularly.
Why Derma Shine Almond Massage Cream Stands Out
In a market inundated with skincare products, Derma Shine Almond Massage Cream distinguishes itself through its efficacy, quality, and affordability. Here’s why it has earned a special place in the hearts of skincare enthusiasts in Pakistan:
Effective Formulation: The cream’s formulation is carefully crafted to deliver tangible results, ensuring that users experience noticeable improvements in their skin’s health and appearance.
Trusted Brand: Derma Shine is a trusted name in the Pakistani skincare industry, known for its commitment to quality and customer satisfaction.
Accessibility: Widely available across Pakistan, Derma Shine Almond Massage Cream offers accessibility without compromising on quality, making it a preferred choice for many.
Value for Money: Despite its exceptional quality, the cream is affordably priced, offering excellent value for money compared to higher-end skincare products.
Positive Reviews: Glowing reviews from satisfied users attest to the cream’s efficacy, further cementing its reputation as a skincare staple.
Conclusion
Derma Shine Almond Massage Cream in Pakistan emerges as a shining example of skincare innovation rooted in natural wisdom. With its nourishing formula, enriching ingredients, and manifold benefits, it has captured the hearts of skincare aficionados across Pakistan. Whether you’re seeking intense hydration, radiant skin, or age-defying results, this cream offers a holistic solution that revitalizes and rejuvenates from within. Embrace the nourishing embrace of almonds and experience the transformative power of Derma Shine Almond Massage Cream for yourself.
#Derma Shine Almond Massage Cream in Islamabad#Derma Shine Almond Massage Cream in Karachi#Derma Shine Almond Massage Cream in Lahore#Derma Shine Almond Massage Cream in Pakistan#Derma Shine Almond Massage Cream in Peshawar#Derma Shine Almond Massage Cream price in Islamabad#Derma Shine Almond Massage Cream price in Karachi#Derma Shine Almond Massage Cream price in Lahore#Derma Shine Almond Massage Cream price in Pakistan
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#advanced_beauty_treatments_karachi#beauty_treatment_karachi#cosmetic_medical_treatments#cosmetic_treatment#cosmetic_treatment_in_karachi#sister_aesthetic_clinic#hair_treatment_karachi#hair_loss_treatment_karachi#best_hair_treatment_in_karachi#skin_care-treatment_karachi#Best_HydraFacials_In_Karachi#hydrafacial_in_karachi#slimming_drip_treatment_in_karachi#lip_fillers_karachi#lip_fillers_treatment_karachi
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What is Persian Cat Price in Pakistan?
Persian Cat Price In Pakistan
Do you live in Pakistan and are you a cat lover? And do you say buy a Persian cat in Pakistan at your home? We are going to tell you through this blog that how much is the Persian cat price in Pakistan.
A Persian cat can easily impress people with its beautiful skin and gentle nature. A Persian cat’s long hair and beautiful color attract people to it.
Before you bring a Persian cat into your home, you need to know a few things about it.
How much does a Persian cat Price in Pakistan?
Where can you buy a Persian cat?
What and how should you feed a Persian cat?
What environment should you keep a Persian cat in?
How should you groom a Persian cat?
How can you keep a Persian cat healthy?
How Much Does A Persian Cat Cost?
If you want to buy a Persian cat or a white Persian cat for your home in Pakistan, then you need to know what is the price of a Persian cat in the area or location where you live and what is the current price of the cat. And for how much can I buy it?
Where Can You Buy A Persian Cat In Pakistan?
You have to keep this thing in your mind that from where you should buy or buy Persian cat in Pakistan.
You can buy a Persian cat from your relative or any pet house near your house. Apart from that you can also buy Persian cat online in Pakistan like OLX is a big platform.
What And How Should You Feed A Persian Cat?
It is important to keep in mind what food you should feed your Persian cat in Pakistan and how many times a day it should be fed.
Keeping in mind the height of your cat and his physical fitness, you should feed him a good brand food so that his health and Persian cat is healthy.
Amazon and Flipkart are online platforms where you can order food for your White Persian cat online at the best prices.
Also Visit: Healthy and Fit Persian Cat Food in India 2023
What Environment Should You Keep A Persian Cat In?
You should also consider how to keep your Persian cat and what kind of environment is best for him. For example, the white Persian cat should be kept in a cool and less sunny environment for its long and white coat.
How Should You Groom A Persian Cat?
You should ever take care of your Persian cat in Pakistan from bathing to grooming him. You should know how many times a day you can bathe your cat. And when and how should you play with him so that the bonding of your Persian cat with you is good.
• How can you keep a Persian cat healthy? To keep the Persian cat healthy for a long time, you should also think about its health. You should take your Persian cat for regular check-ups. So that he can stay healthy and fit.
Also Visit: Persian Cat Food Price in India 2023
Persian Cat Price In Pakistan With Different Location
Persian Cat Price In Pakistan, Lahore
Location Price Range (PKR) Unique Features
Gulberg25,000–40,000 Proximity to pet stores and veterinary clinics
Defence 40,000–60,000 High-end breeders, premium lineage
Johar Town 20,000–35,000 Accessible options for budget-conscious buyers
Model Town 30,000–45,000 Mix of breeders offering various coat colors
Wapda Town 15,000–25,000 Affordable choices for first-time cat owners
Bahria Town 35,000–50,000 Well-maintained pet-friendly environment
Persian Cat Price In Pakistan, Karachi
Location Price Range (PKR) Unique Features
Clifton 25,000–40,000 Pet-friendly parks and grooming services
DHA 35,000–50,000 Reputable breeders and premium lineage
Saddar 15,000–25,000 Budget-friendly options for first-time owners
Gulshan-e-Iqbal 20,000–35,000 Mix of breeders offering various coat colors
Tariq Road 30,000–45,000 Access to veterinary clinics and pet supplies
North Nazimabad 18,000–30,000Family-oriented environment and affordability
Persian Cat Price In Rawalpindi
Location Price Range (PKR) Unique Features
Bahria Town 30,000–45,000 Well-maintained environment, pet amenities
Saddar 20,000–35,000 Mix of budget and premium options
Satellite Town15,000–25,000 Affordable choices, pet-friendly vibe
PWD Colony 25,000–40,000 Proximity to veterinary services, convenience
Adiala Road 18,000–30,000 Variety of breeders, diverse coat colors
Chaklala Scheme 35,000–50,000 Prestigious lineage, upscale options
Persian Cat Price In Faisalabad
Location Price Range (PKR) Unique Features
D Ground 25,000–40,000 Proximity to veterinary services
Madina Town 20,000–35,000 Blend of affordability and choices
Susan Road 15,000–25,000 Budget-friendly options for all
Sargodha Road 30,000–45,000 Mix of breeders, diverse coat options
Millat Town 18,000–30,000 Family-friendly, affordable options
Samanabad 35,000–50,000 Premium lineage, upscale choices
Persian Cat Price In Islamabad
Location Price Range (PKR) Unique Features
F-6 30,000–45,000 Premium breeders, luxurious choices
G-11 20,000–35,000 Mix of budget and upscale options
I-8 15,000–25,000 Affordability without compromising
E-11 25,000–40,000 Access to pet services, convenience
F-10 18,000–30,000 Family-friendly options for all
Bahria Town 35,000–50,000 Prestigious lineage, well-maintained area
Persian Cat Price In Peshawar
Location Price Range (PKR) Characteristics
Hayatabad 25,000–40,000 Proximity to pet services, convenience
University Town 20,000–35,000 Blend of budget and premium options
Saddar 15,000–25,000 Accessible choices for all
Warsak Road 30,000–45,000 Diverse breeders, coat color variety
Gulberg 18,000–30,000 Family-friendly options, affordability
Cantt 35,000–50,000 Prestigious lineage, upscale choices
Persian Cat Price In Pakistan, Gujranwala
Location Price Range (PKR) Characteristics
Model Town 25,000–40,000 Mix of breeders, diverse coat options
Satellite Town 20,000–35,000 Access to pet services, convenience
Civil Lines 15,000–25,000 Blend of affordability and charm
Peoples Colony 30,000–45,000 Premium lineage, upscale choices
Sialkot Bypass 18,000–30,000 Budget-friendly options, family comfort
G.T. Road 35,000–50,000 Prestigious options, well-connected area
Black Persian Cat Price In Pakistan
Location Price Range (PKR) Characteristics
Lahore 20,000–45,000 Diverse options, from budget to premium
Karachi 25,000–50,000 Wide range of choices for all preferences
Islamabad 22,000–48,000 Prestigious lineage and luxurious allure
Rawalpindi 18,000–40,000 Affordable to upscale options
Faisalabad 20,000–42,000 Accessible options with distinct coat color
Multan 19,000–44,000 Affordable to upscale, catering to all buyers
Peshawar 21,000–46,000 Premium appeal with a touch of mystery
Cats for sale in Pakistan
Cats for sale in Pakistan Price
Persian Cats & Kittens Available15000/-
Persian brown kitten triple coted12000/-
Cat nal for Sale original 100%30000/-
Persian Sami punch face kitten12000/-
Persian kitten for sale8000/-
Persian cat (Pecky Face)110000/-
Persian n American Short Hair6000/-
Percian female cat6000/-
pure Persian white cat16000/-
Pure Persian Grey colour kitten8500/-
Persian triple coated Pair65000/-
Russian nebelung cat15000/-
Trained Persian kitten with sky blue eyes8000/-
Conclusion:
We have tried to tell you this information in our blog that what is the of Persian cat price in Pakistan. What should you keep in mind for your cat? How and where can you buy a Persian cat? You can order Persian cat food online. What is the cost of a Persian cat in different cities of Pakistan? All those things have been told.
FAQs
What is the price of a Persian cat in Pakistan?
The price of a Persian cat in Pakistan can vary based on factors such as the cat’s age, pedigree, coat color, and the breeder’s reputation. On average, Persian cat prices in Pakistan can range from around 15,000 PKR to 70,000 PKR or more, depending on the specific characteristics and location.
What is the price of a Persian cat?
The price of a Persian cat can vary depending on factors like its pedigree, coat color, age, and location. On average, Persian cats can cost anywhere from around 15,000 PKR to 70,000 PKR or more, with premium and unique traits potentially commanding higher prices.
How much does a Persian cat cost in Pakistan?
The cost of a Persian cat in Pakistan varies due to factors such as its breed quality, lineage, and coat color. Generally, you can find Persian cats priced between 15,000 PKR to 70,000 PKR or even higher, depending on the specific characteristics and the breeder.
What is the price of a white Persian cat in Pakistan?
The price of a white Persian cat in Pakistan can range from approximately 20,000 PKR to 60,000 PKR or more, depending on factors like pedigree, coat quality, and breeder reputation. White Persian cats are often sought after for their striking appearance and unique charm.
How much does a cat cost in Pakistan?
The cost of a cat in Pakistan varies based on the breed, age, and other factors. On average, you can expect to find cats available for adoption or purchase starting from around 5,000 PKR to 30,000 PKR or more. However, specific breeds like Persian cats may have higher price ranges due to their unique characteristics.
How much is a Persian cat in rupees?
The price of a Persian cat in rupees (PKR) can vary widely depending on factors such as the cat’s pedigree, coat color, and breeder reputation. On average, Persian cats can range from around 15,000 PKR to 70,000 PKR or more, with certain exceptional cats commanding higher prices.
Which cat is best for a pet in Pakistan?
In Pakistan, various cat breeds can make great pets. Popular choices include Persian cats, Siamese cats, and local breeds like the Pakistani stray cat. The best cat for you depends on your lifestyle, preferences, and the level of care you can provide. Consulting with breeders or visiting shelters can help you find the ideal feline companion.
How much does a Persian cat cost in Kerala?
The price of a Persian cat in Kerala, India, can vary depending on factors such as pedigree, coat color, and breeder reputation. On average, Persian cats can range from around 10,000 INR to 50,000 INR or more. It’s advisable to research local breeders and inquire about the specific prices in your area.
What is the price of an Arabic cat in India?
The term “Arabic cat” isn’t a recognized breed name in the cat world. If you’re referring to a specific breed from the Arabic region, it’s important to know its proper breed name (e.g., Arabian Mau). The price of any cat breed in India can vary based on factors such as pedigree, rarity, and breeder reputation. Researching the specific breed and contacting reputable breeders can give you a better idea of the cost.
#Persian Price Pakistan#Price In Pakistan#Persian Cat Price#Cat Price Pakistan#Persian Cat Price in Pakistan 2023
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Looking for Best Dermatologists and Skin Care Clinics in karachi?
We are one of the Best Dermatologists and Skin care clinics in karachi. We connect you with the Best skin specialist in karachi to deal with the diseases of the skin, hair, and nails.
Book an appointment with the Best Dermatologist in karachi by contacting one of the best dermatologists and skin care clinics in karachi. We offer reliable customer service and best skincare solutions
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Centrum Silver in Lahore, Karachi, Pakistan, Islamabad Call & WhatsApp 24/7: 0321_9966664
Centrum Silver in Lahore is a present for all of those individuals who need to resuscitate their lives in a predominant way. It contains every single one of those trimmings that support muscles and comparably key for the strength of the body. It engages the body and makes valuable results on the bones of the body. It is without gluten and has worthwhile outcomes on the body. Centrum Silver has all that helps with reshaping the body like it has Vitamins including Selenium and Zinc it has Lutein that helps and guarantees eyes on all conditions. Centrum Silver has all credits that help to swallow with no issue. Another benefit of this tablet is, it is for all individuals paying little regard to sex. It is amazing for all bits of the body.
How it capacities Centrum Silver?
Centrum Silver is astoundingly introduced for those individuals who are frail and need to improve their prosperity. Regularly, people don't take their eating routine suitably and protest about deficiency. Centrum Silver is available to keep up prosperity and making sound. Centrum Silver Price in Pakistan is the best thing that commonly proposed for those individuals who are disappointed with their prosperity. It is the panacea for all ailments and deficiencies and oftentimes proposed for real prosperity Centrum Specialist energy it has everything and the best way to deal with recuperate prosperity right away. The thing has everything that can reshape the body and complete it in a wonderful way.
Benefits of Centrum Silver:-
Heart Health: B-supplements that help to accelerate heart prosperity. It has Zinc and B supplements that sort out some way to make authentic sufficiency of the brain. It has Vitamin and is ordinarily used for the strength of the eyes. Centrum Silver tablet has everything that could possibly be used as a fix of sickness, not exactly heavenly eating schedule, or all insufficiencies. It has similarly helped with making prosperity incredible. Centrum Silver in Islamabad is used for making strong, incredible, and genuinely obliging for prosperity.
How to take Centrum Silver?
Centrum Silver in Pakistan can take each time in a day. There is no constraint about it. One can swallow it whenever somebody needs it.
Precautions for Centrum Silver:-
It is critical to contact the expert first and discussion about clinical issue and consulting to using it. If you are delicate to Centrum silver any piece of Centrum Silver in Karachi or some different drugs, food assortments, or substances. Illuminate your PCP concerning the excessive touchiness and what signs you had. If somebody has heart issues, skin issues, and some different issues like low or hypertension need to stay away. Preceding taking Centrum Silver, the recently referenced unsafe issues need a standard to expert first.
Side Effects of Centrum Silver:-
Here, it is admonished that this prescription could similarly make a few outcomes also. There are certain that are cared for here: Nausea, stomach furious, free entrails, flushing, and horrible taste may occur. Advise your PCP concerning the affectability and what signs you had. If somebody has heart issues, skin issues, and some different issues like low or hypertension need to stay away. Preceding taking Centrum Silver, the recently referenced unsafe issues need a standard to expert first.
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Implants provide a strong foundation for teeth and fill the missing teeth’ place.
Visit Zia Dental Care and book an appointment to get yours.
Your teeth need the same care as you care for your skin, your smile is your most prized possession and they should not be ignored at any cost. Various Dental Care Clinics around you claim to be the best but the one that we have picked for you is BEST DENTIST FOR DENTAL IMPLANTS IN KARACHI a place you can trust blindly when it comes to Dental Services.
For further details contact us at +92 300 2278864 to book an appointment with our expert team of dentists.
Address:FT-12, G6, Mehran Excellency Apartments, besides Old Clifton Bridge, Khayaban-e-Iqbal Service Road, in the lane of Dattari Villas, Bath Island, Karachi.
Timings 10 am till 10 pm
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BEST DENTAL CLINIC IN KARACHI
Your teeth need the same care as you care for your skin, your smile is your most prized possession and they should not be ignored at any cost. Various Dental Care Clinics around you claim to be the best but the one that we have picked for you is Best Dental Clinic in Karachi a place you can trust blindly when it comes to Dental Services.
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Juniper Publishers- Journal of Physical Fitness, Medicine & Treatment in Sports Efficacy of Positional Release Therapy versus Integrated Neuromuscular Ischemic Technique in the Treatment of Upper Trapezius Trigger Point-Juniper Publishers Abstract Background and Purpose: To evaluate the efficacy of positional release therapy versus integrated neuromuscular ischemic technique in the treatment of upper trapezius trigger points. Subject: 40students were selected for the study. Method: The 40 selected subjects with trapezius trigger points were randomly divided into 2 groups of 20 patients each. All participants who fulfilled inclusion criteria were selected from Isra Institute of Rehabilitation Sciences. Informed consent was taken from students. In both groups, trigger points were identified by the STAR palpation method, assessment Performa was filled up by the therapist and neck range of motion assessed by INCLINOMETER and neck pain was assessed by NUMERIC PAIN SCALE as base line measurement on the first day (pre-test scores) before starting the treatment. Results: PRT and INIT patients, results showed, among PRT patients NPR before treatment was 4.05±0.76 and after treatment it went down significantly to 2.25±0.79, similarly among INIT patients mean NPR was 4.4±1.1 and after treatment it was 1.4±0.76 and differences were statistically significant with p-value less than 0.05. Conclusion: The present study was done to find out the effectiveness of INIT versus PRT in the treatment of upper trapezius trigger points. This study endorses that trigger points in trapezius can cause neck pain with restriction in cervical range of motion. Both groups were found to be effective in reducing pain and improving cervical range of motion. However, when both groups were compared, there was a significant improvement in INIT group with greater mean than the PRT group. Keywords: Trigger Point; Trapezius; Integrated Neuromuscular Inhibition Technique; Positional Release Abbreviations: PRT: Positional Release technique; SCS: Strain Counter strain; PIR: post-isometric relaxation; INIT: integrated neuromuscular ischemic technique; MET: Muscle Energy Technique Introduction Trapezius fibers like occipital and nuchal passed down but insertion into the clavicle transverse mainly. Fibers from C7 to T1 vertebrae distributed diagonally and insert into the acromion process and spine of the scapula and thoracic fibers inserted into the deltoid tubercle of the scapula. Fibers from C7 to T1 vertebrae and the lower half of ligamentum nuchae were the largest. Drawing the scapula and clavicle backwards are action of these fibers rather or to rotate the clavicle and elevates the scapula around the sternoclavicular joint [1]. Myofascial pain syndrome correlated to activate sockets is a no inflammatory ailment of musculoskeletal origin, allied with native discomfort and muscle rigorousness, described by the existence of hyperirritable palpable nodules in the skeletal muscle fibers, which are termed activate points. Myofascial pain syndrome is incredibly usual with the local population. Chances of acquiring said ailment can be reaching up to 54% in the female locality and 45% in the male locality [2]. Active trigger points produce pain at resting tender on palpation and have referred pain pattern [3-5]. Latent Trps cause weakness and restrict the movement and pain is not spontaneous [5]. There are three portions of trapezius like upper middle and lower trapezius muscle and each portion have two trigger points plus one unusual due to autonomic phenomena. Trigger points of upper trapezius were found most frequently identified in body. Superior trapezius Trps referred ache in post lateral part of the neck, ear, and temple. Sudden trauma, downstairs, falling from height, poor posture, misfit furniture, muscular abuse and longtime immobility are factors due to which trigger points are formed in trapezius muscle [6]. Trigger points can be activated due to numerous factors which include prolonged muscle excess, by the initiation of further Trps like (primary/secondary), infection, emotional issues like (stress/anxiety), trauma, homeostatic imbalance, infections, and smoking [7]. Diagnosis of trigger points depends on examiner’s accuracy, experience, teaching and palpation abilities. There is no consent among clinicians concerning physical outcomes. Clinicians accept stiff, intense swelling identified as an active Myofascial trigger point. There is low sensitivity or specificity of digital examination which consider as Gold Standard [8]. Passive or active stretching of the concerned muscle consequents in a pain increase when trigger points are present. Limited muscle stretch. The pain increases when the affected muscle undergoes an isometric contraction and there is a reduced maximum contractile force. Deep sensitivity and dysaesthesia are commonly found in trigger point referral pain zones. Muscle palpation adjacent to active myofascial trigger points feels tense [9]. Positional Release technique (PRT) is a soft tissue application, correspondingly acknowledged as Strain Counter strain (SCS) is a moderate physical management for muscle pain and spasm which include readjusting muscle tone and increasing circulation [10]. Palpate connecting contradictory muscles to localize central and other Trps. Palpable Trps on a consistent measure (enormously sensitive, exact sensitive, temperately sensitive, no painfulness). Do not strain to disrupt the Trps with firm pressure—first dent the skin (1 kg of force). Grasp the position of comfort until fasciculation declines considerably or ends altogether [11]. In neuromuscular inhibition technique a trigger point is situated by palpation, nearly all frequently with the fingers. A trigger point is a confined area of deep hardening. The skilled practitioner will frequently observe a palpable change as a finger pass above the trigger point. Stress on a trigger point will frequently cause twitching in the muscle that within the trigger point. Finger strain is maintained on top of the trigger point, the trigger point will fabricate a pain which refers to an area exterior the muscle which within it. Area doesn’t have to be adjacent with the muscle contain the trigger point. There might very well be a number of diverse trigger points and their mention areas may well overlie [12]. A study was done to compare the effectiveness of postisometric relaxation (PIR) along with ultrasound and massage versus integrated neuromuscular ischemic technique (INIT) along with ultrasound and massage in the treatment of trigger point pain of the upper trapezius muscle. Results of this study reveal that subjects with trigger points in the upper trapezius muscle had significant reduction in pain, improvement in ROM and reduction in scores of NPNPQ. This study concluded that in the treatment of trigger point pain in the upper trapezius muscle both treatment techniques were highly effective [13]. In the year 2017 a study was done by Dr. Priyanka Devang Rana et al. to compare the effectiveness of Muscle Energy Technique (MET) versus Positional Release Technique (PRT) in terms of subjective improvement in Pain, Range of Motion and Function in computer workers suffering from trapezius muscle spasm and study concluded that. PRT was a lot of statistically and clinically superior for decreasing VAS pain score, NDI score and rising range of motion and MMT. PRT showed earlier pain relief as compared to MET. So, if patient needs prompt pain relief positional release technique is that the best treatment which may be offered by therapist [14]. Methodology The study was experimental (Pre and Post). Setting was Isra Institute of Rehabilitation Sciences Karachi Campus. Both male and female Presence of a taut band in the upper trapezius muscle with an active painful trigger point at its middle, pain is produced upon palpation. Patients complain from neck pain restriction of neck ROM 19 years to 25 years old. The data collection tool was Numeric pain scale Inclinometer was used. The 40 selected subjects with trapezius trigger points were randomly divided into 2 groups of 20 patients each. All participants who fulfilled inclusion criteria were selected from Isra Institute of Rehabilitation Sciences. Informed consent was taken from students. In both groups, trigger points were identified by the STAR palpation method, assessment Performa was filled up by the therapist and neck range of motion assessed by INCLINOMETER and neck pain was assessed by NUMERIC PAIN SCALE as base line measurement on the first day (pre-test scores) before starting the treatment. The patients in group A and group B received the following treatment a) Group A-Positional Release Therapy (PRT). b) Group B-Integrated Neuromuscular Ischemic Technique (INIT). c) Patients with upper trapezius trigger points received 4 weeks treatment of INIT. Protocol The study was divided into 3 phases. i. Phase (A) Pre-treatment assessment: Baseline outcome measure was NRS scale, ROM. ii. Phase (B) Intervention phase: INIT was given for 3 days in a week for 4 weeks. iii. Phase(C) Post- treatment assessment outcome measures were recorded at the end of 4 -weeks [15]. As the primary focus of the INIT approach is to deactivate specific TrPs, the practitioner first identified the TrPs to be treated within the upper trapezius muscle. The subjects were placed in supine to reduce tension in the upper trapezius muscle. Their arm was positioned in slight shoulder abduction with the elbow bent and their hand resting on their stomach. Using a pincer grasp, the practitioner moved throughout the fibers of the upper trapezius and made note of any active TrPs. Once the TrPs were identified treatment began. The therapist again utilized a pincer grasp, placing the thumb and index finger over the active TrP. Slow; increasing levels of pressure were applied until the tissue resistance barrier was identified. Pressure was maintained until a release of the tissue barrier was felt. At that time, pressure was again applied until a new barrier was felt. This process was repeated until tension/tenderness was unable to be identified or 90 s had elapsed, whichever came first. Treatment duration: 3 sessions per week for 4 weeks. All identified TrPs were treated (Figure 1) [16]. [Click here to view Large Figure 1] Application of PRT-Total 20 subjects was given Positional Release technique. The subject was in supine with therapist sitting on the affected side, trigger points were located along the upper fibers of the trapezius. The subject’s head was laterally flexed toward the side of trigger point, then therapist grasps the subject’s forearm and abducts shoulder to approximately 90° and adds slight flexion or extension to fine-tune. The ideal position of comfort achieved was held for a period of 90 seconds and followed by a passive return of the body part to an anatomically neutral position continued for 5minutes (Figure 2). Treatment duration: 3 sessions per week for 4 weeks [17]. Data were stored and analyzed using SPSS, version 16.0 , count and percentages were reported for gender, and number of patients enrolled in each technique, mean and standard deviation were reported for age , duration of pain, cervical range of motions at pre- post treatment, and NRS scores, paired sample t-test was used to compare the mean levels of pre and post treatment and independent sample t-test was used to compare the post mean scores of PRT and INIT patients, p-values less than 0.05 were considered as significant. Pie and Bar chart were also used to give the graphical presentation of mean scores (Figure 3). Table 1 gives the baseline characteristics of studied sample, in the following study total forty sample were enrolled, 80% were female samples, patients equally divided into two treatment groups of PRT and INIT, the mean age of samples was 20.92±3.82 years and the mean pain duration was 1.43±1.15 months. (Table 2) reports the mean and standard deviations of cervical moments among PRT treated patients at pre and post levels, results showed that, right rotation, left rotation, right lateral flexion and left lateral flexion were significantly improved after the treatment with p-values less than 0.01. (Table 3) reports the mean and standard deviations of cervical moments among INIT treated patients at pre and post levels, results showed that, right rotation before treatment was 65.6 degree and after treatment it was 73.4 degree, significantly improved, left rotation before treatment was 65 degree and after treatment it was 73.15 degree, similarly right and left flexion rotation were significantly improved after the INIT treatment with p-values less than 0.01. Figure 4 gives the mean comparison of NRS scores among PRT and INIT patients, results showed, among PRT patients NRS before treatment was 4.05±0.76 and after treatment it went down significantly to 2.25±0.79, similarly among INIT patients mean NRS was 4.4±1.1 and after treatment it was 1.4±0.76 and differences were statistically significant with p-value less than 0.05 Figure 5 gives the post mean comparisons of cervical moments and NRS scores between PRT and INIT techniques results showed that, right rotation significantly get improved among INIT patients, right lateral flexion and left lateral flexion were also significantly improved among INIT patients , however left rotation did not give any significant differences between PRT and INIT techniques, the mean NRS scores was significantly low among INIT patients as compared to PRT patients with p-value less than 0.05. For more Open Access Journals in Juniper Publishers please click on: https://juniperpublishers.com For more articles in Journal of Physical Fitness, Medicine & Treatment in Sports please click on: https://juniperpublishers.com/jpfmts/index.php For more about juniper publishers please click on: https://www.juniperpublishersgroup.com/
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