Background: Completed treatment of congenital clubfoot deformity using the non-surgical Ponseti method yields very good results. However, many children do not complete the treatment course, potentiating relapse of the deformity, forever compromising independent gait and quality of life. If the factors precipitating 'drop out' from treatment can be averted, more children will complete the Ponseti method of treatment which has low rate of complication and is both economical and highly effective. Children depend on parents to bring them to the clinics, hence we aimed to identify factors obstructing parents and ultimately the children's outcomes. Once identified, barriers to completing treatment may be removed. Aim:To identify the factors obstructing completion of clubfoot treatment.Method: Two of the 32 Walk for Life (WFL) clubfoot clinics in Bangladesh were utilised for participants, who were parents and children (n=72) who had dropped out from completing the clubfoot treatment course four to six years earlier. Bootstrapping was used to improve statistical power (based on 1000 random sample). Validated outcome measures included a specific context drop out questionnaire, the Oxford Ankle Foot questionnaire, the Bangla clubfoot assessment, and the Foot Posture Index. Parent's insights, experiences and recommendations were canvassed both qualitatively and quantitatively.Result: Relapse occurred in 15/72 drop out cases, predicted by problems with the initial casting process. The main reasons for drop out were difficulty with the foot abduction brace (42%), family issues (31%), and other problems with the child's clubfoot treatment (15%). Despite problems and incompletion, the parents were generally satisfied (93%), although many felt sad or ashamed for not completing the treatment course and realizing clubfoot deformity recurrence (96%). Parents who had dropped out, were noted by WFL staff to be regretful, and especially so if their now older child's clubfoot had relapsed to obviously compromise independent gait and mobility. A lack of discernment of postural clubfeet from 'true' clubfeet was identified in some clinicians, indicating variable practice methods despite uniform training, and probably lowering the overall relapse rate with inclusion of 'postural' cases. Conclusion:Relapse was predicted by problems with casting and predicted worse foot posture and reduced physical functioning. Walk for Life adopted appointment reminders, parent support groups, cost sharing, and staff updates.
Introduction: Infection is the most prominent cause of delayed or non-union in tibial fractures because of the bone's sensitive subcutaneous location. Ilizarov external fixator application is regarded as the best approach for treating them because of several benefits. Analysis of the role of Ilizarov fixation in infected tibial non-union was the goal of this investigation and evaluating clinical & functional outcomes of infected tibial non-union. Materials and Methods: A Multicenter based non-randomized quasi-experimental prospective study was performed in Rajshahi Medical College Hospital, Rajshahi, Bangladesh. From 1st January 2015 to 31st December 2020. The study comprised a total of 61 (n=61) Tibial non-union patients treated with the Ilizarov fixator who also had an infection. ASAMI score criteria were used to evaluate the outcome. Results: The most common organism for infection was identified to be at Staphylococcus Aureus. The final follow-up showed that all but one patient had achieved union; one patient had to amputate due to infection and non-union. ASAMI score rating methodology for bone and function results rated the majority of patients as outstanding. Pin tract infections were the most prevalent problem discovered in this research. Conclusion: The Ilizarov external fixator is safe and successful for treating infected non-union of the tibia since it can offer a stable mechanical environment, bone transfer, rectify deformities, eradicate the infection, and allow patients to bear weight. Therefore, we still suggest it despite its disadvantages.
Background: Stroke is a disorder where brain is damaged either by blockage in the blood vessels or rupture of the blood vessels. It is the approximately number five leading cause of death. It is also the leading cause of longer period disability as well as preventable cause of disability. Objectives: To determine and compare balance, functional status and mobility before and after application of task oriented physiotherapy along with conventional physiotherapy among patients with Stroke. Methodology: Classic experimental study design was used in this study. 30 patients with stroke were randomly assigned into two groups among them 15 patients were assigned into experimental group received task oriented physiotherapy with conventional physiotherapy and another 15 into control group received only conventional physiotherapy. Total treatment sessions were twenty-four comprising of 3 sessions per week for 8 weeks. Single blinding procedure was used during data collection. Outcome measurement tools: Berg balance scale (BBS) was used to measure balance, functional independence measurement (FIM) was used to measure functional status and timed up and go test (TUG) to measure mobility. Analysis of data: Inferential statistics such as for between group analysis of BBS and FIM used Mann-Whitney U test, and within group analysis of BBS and FIM used Wilcoxon test. Besides Independent t test used for between group analysis and Paired t test was done for within group analysis of TUG by using SPSS version 22. Results: It was found that balance, functional status and mobility improved both between and within group results except standing unsupported one foot in front. Conclusion: This research showed that task oriented physiotherapy along with conventional physiotherapy was more effective than only conventional physiotherapy for patients with stroke.
Background: Parent quality of life refers to the degree to which parent of individuals of children with disabilities are able to meet their basic needs, enjoy time together, and pursue leisure interests and activities. Children with ASD causes stress in the family, most especially among parents, consequently affecting parental quality of life (QOL). Objective: Our objective was to identify the quality of life among the parents of children with autism spectrum disorder and behavioural aspects of children with autism spectrum disorder. Methods: This paper describes the QOL of parents and behavioural aspects of children with Autism Spectrum Disorders (ASD) by using a quantitative method design. The participants are parents of children with ASD (n=153) and were asked to answer the World Health Organization Quality of Life-Brief (WHOQOL-BREF) Questionnaire Bengali Version and The Nisonger Child Behavior Rating Form (NCBRF). The WHOQOL-BREF was used to assess parental QOL while the Nisonger Child Behavior Rating Form (NCBRF) was used to assess the child's social behavior/ competence and problem behavior, demographic data were also obtained. Results: The result identified the significant association between parent's quality of life (physical domain, psychological domain, social domain and environment domain) with all the characteristics of children with ASDs problem behavior as conduct problem, anxious, hyperactive, stereotypic and self-isolated. The result showed that positive weak correlation between parent's quality of life (physical health, psychological, social relationships and environment) with children with ASD's social behavior (0
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