RESUMO
Background: Clubfoot is a congenital deformity that can affect one or both of a newborn's lower extremities. The main objective of the study is to evaluate and compare the outcomes of the Ponseti method for the management of different types of clubfoot. Methods: A retrospective analysis of 151 children with 253 clubfeet (idiopathic untreated, idiopathic recurrent, and syndromic) with at least one year of follow-up was conducted in four months after ethical approval. Data were collected with a structured proforma after the consent of the parents. An independent sample t-test was applied to show the comparison between the groups, and a p-value of 0.05 was considered significant. Results: Out of 151 patients, 76% were male and 24% were female. Out of a total of 235 feet, 96 (63%) were idiopathic untreated, 40 (26.5%) were idiopathic recurrent, and 15 (9.5%) were syndromic clubfoot. The average number of casts was higher in syndromic clubfoot (9 casts per foot). There was no significant difference in the baseline Pirani score of the three groups (p-value > 0.05); but after one year of follow-up, there was a significant difference in the Pirani score of idiopathic and syndromic clubfoot (p-value ≤ 0.05) and between recurrent clubfoot and syndromic clubfoot (p-value = 0.01). Conclusions: The aetiology of syndromic clubfoot affects the outcomes of the Ponseti method and leads to relapse. In idiopathic (untreated and recurrent) clubfoot, the Ponseti method does not produce a significant difference in outcome. Poor brace compliance and a lack of tenotomy lead to orthotic (ankle foot orthosis AFO and foot orthosis FO) use in the day time and the recurrence of clubfoot deformity in these three types of clubfoot.
RESUMO
OBJECTIVE: To determine the effect of aerobic exercises and progressive muscle relaxation in migraine patients. METHODS: The quasi-experimental study was conducted at the Sheikh Khalifa Bin Zayed Al Nayhan Hospital / Combined Military Hospital, Muzaffarabad, Azad Jammu and Kashmir, from February to July 2017, and comprised migraine patients of either gender aged 20-50 years. They were divided into experimental and control group. Experimental group A received supervised exercises protocol, including aerobic exercise (stationary bicycle) 30min with 10min warm-up and 5min cool-down followed by progressive muscle relaxation for 15min 3 times a week for 6 weeks along with prophylactic medicine. The control group received prophylactic medicines flunarazine 5mg twice daily, inderal 10mg thrice daily and nortriptyline 25mg at night. Patients were assessed using Numeric Pain Rating Scale, Migraine Disability Assessment Scale, Headache Disability Index, Headache Impact test-6 and the Central Sensitisation Inventory at baseline, midline and at the completion of intervention. Data was analysed using SPSS 21. RESULTS: Of the 28 patients, there were 14(50%) in each of the two groups. Overall, there were 24(85.7%) females and 4(14.3%) males with a mean age of 29.7±10 years. There were significant improvements in all parameters in both the groups, but group A had significantly better outcome post-intervention (p<0.05). CONCLUSIONS: Prophylactic medicine, aerobic exercises and progressive muscle relaxation, when used together, were found to be effective means of intervention for migraine.