RESUMO
Objective: In Bangladesh, the factors that contribute to the reduced quality of life were not systematically investigated in long-term stroke survivors, and only a few studies have used preference-based measures to assess the quality of life. We sought to assess the quality of life in stroke survivors who comprise physical health status, psychological state, social relationship, and surrounding environment of the stroke patients. Methods: The quality of life among stroke patients was assessed with a semi-structured questionnaire using the validated Bangla Version of the World Health Organization, Quality-of-Life scale among the patients who survived beyond 28 days of first-ever stroke occurrence presenting in the Department of Physical Medicine and Rehabilitation, Bangabandhu Sheikh Mujib Medical University in the period between November 2020 and October 2021. Results: Of the 77 patients who were identified as post-stroke patients, the mean score of overall quality of life (as assessed by Q1 and scored in a range of 1-5) was 3.14 ± 1.08. The mean scores of quality of life were highest for the psychological domain (51.18 ± 19.73) followed by environmental (52.08 ± 13.13), social (45.62 ± 22.73), and physical domains (37.18 ± 18.56). According to the classification of the Bangla Version of the World Health Organization, Quality-of-Life, 75.3% had a low physical quality of life, 37.7% had a low psychological quality of life, 53.2% had a low social quality of life, and 53.2% had a moderate environmental quality of life. The average scores for the physical, psychological, social, and environmental domains were notably lower in stroke survivors with comorbid chronic conditions such as hypertension, diabetes, heart disease, asthma or chronic obstructive pulmonary disease, obesity, and ischemic heart disease in comparison to those without such conditions. Conclusion: In our study, post-stroke patients with lower quality of life were associated with factors such as female gender, lower level of education, urban dwellers, and chronic diseases.
RESUMO
Background Plantar fasciitis is the most common cause of foot pain. Patients with plantar fasciitis typically present with 'first step pain,' which tends to decrease with activity and worse with heavy use. This study determines the effect of ultrasound-guided, single-dose, platelet-rich plasma (PRP) injection in patients with chronic plantar fasciitis. Materials and methods It was a quasi-experimental trial carried out in the Department of Physical Medicine and Rehabilitation, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, from March 2019 to March 2022. A total of 148 patients diagnosed with chronic plantar fasciitis were selected as samples. A total of 75 patients were allocated to group A (intra-lesional injection of autologous PRP with conservative management) and 73 patients to Group B (only conservative management). Both groups of patients were allocated to conservative management with exercises, shoe modification, activities of daily living (ADLs) instruction, and oral paracetamol. Results This study shows that in group A, the mean visual analog scale (VAS) score significantly reduced to 1.47±0.51 after six months of single-dose PRP injection (p<0.001). In group B, the VAS score also decreased substantially after conservative treatment. Though in groups A and B, pain reduction was significant, in group A, the pain was decreased more compared to group B and statistically significant differences were found between the two groups at the 12th week and 24th week. The foot function index (FFI) scores decreased significantly in group A after a single dose PRP injection, compared with group B treated with conventional therapy. In group A, FFI scores decreased from 49.09±5.72 to 7.67±3.41. The study revealed a significant difference between study groups in the 12th week and 24th week regarding FFI scores. Conclusion Ultrasound-guided intra-lesional autologous PRP Injection is safe and effective and recommended in patients with chronic plantar fasciitis, especially in recalcitrant cases after the failure of conservative treatment and corticosteroid injection.