RESUMO
Background: Chronic plantar fasciitis has been historically treated with conventional physical therapy. The use of the Garston Technique® (GT) is a new intervention for the management of chronic plantar fascitis, but there is lack of evidence in the literature regarding its efficacy. Study Objective: To evaluate the effectiveness of the GT on pain, foot function and general foot health in patients with plantar fasciitis. Methods: This was a randomized clinical trial conducted from November 2020 to March 2021. The non-probability purposive sampling technique was used to select 30 patients. Setting: Madinah Teaching Hospital, Faisalabad, Pakistan. Participants: A total of 30 patients of both genders with a 6-week history of planter fasciitis and the presence of a calcaneus everted ≥2° were included in this study and randomly assigned to one of two groups. Intervention: Both groups received conventional physical therapy (CPT) for 4 weeks and the experimental group in addition received GT. Primary outcome measures: The primary outcome measures were pain, measured at baseline, after the second week and after the end of treatment (ie, the fourth week) on the visual analog scale (VAS); and general foot health and foot function, measured at baseline and after the end of treatment with the Modified Foot Health Status Questionnaire (FHSQ). Results: The mean age of the study patients was 34.1 ± 6.67 years. There was significant improvement in pain in the GT group compared with the CPT group after the second (P = .005; partial η2 = 0.263) and the 4th (P = .000; partial η2 = 0.535) week of intervention. Foot function was also significantly improved (P < .05) in the GT group compared with the CPT group with a large effect size (Cohen's d = 0.080). But in the case of general foot health, no significant difference was observed between the groups at the end of the fourth week. Conclusion: The use of the GT combined with CPT shows significant results compared with CPT alone; ie, GT speeds up the recovery from heel pain and foot function in patients with chronic plantar fasciitis.
Assuntos
Fasciíte Plantar , Humanos , Masculino , Feminino , Adulto , Fasciíte Plantar/terapia , Dor , Paquistão , Resultado do TratamentoRESUMO
OBJECTIVE: To evaluate the outcome of thrombolysis in patients of prosthetic valve thrombosis. METHODS: This retrospective analysis was conducted on data of 84 patients of prosthetic valve thrombosis who presented to emergency room of Faisalabad Institute of Cardiology between July 2017 to December 2019. The diagnosis of prosthetic valve thrombosis was based on clinical suspicion and bed side transthoracic echocardiography done by a consultant cardiologist. Fluoroscopy was done to confirm the diagnosis by observing immobile valve leaflet. The confirmed patients were then treated in emergency with streptokinase after taking an informed consent. Quantitative variables like age were summarized by mean and standard deviation. Qualitative variables like gender, successful thrombolysis, stroke, major bleeding, mortality or re-do surgery were summarized by frequency and percentage. RESULTS: Mean age was 29 ± 6.36, years and there were more female patients (n=43, 51.25%) as compared to males (n=41, 48.8%). Among the 66 surviving patients thrombolysis was successful without any complications in 56 patients (66.7%). Thrombolysis was successful with minor complications in six patients (7.1%) and it failed to produce desired results in four patients (4.8%). In this study 18 (21.4%) patients died. The common complications included minor bleeding in four patients (4.8%) and major bleeding in 10 patients (12.0 %). CONCLUSION: Thrombolysis produces reasonable success rate in cases of prosthetic valve thrombosis who are in functional class I or II. However, it has very high mortality rate in patients presenting with functional class III and IV.