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Introduction:A presence or consequences of the plantar spur as a cause of plantar fasciitis are currently uncertain. But literature is deficient with conflicting findings regarding the relationship between the PS and PF. The study was undertaken to assess the incidence of types and sizes of the plantar spurs and to find the relationship between the plantar spur and plantar fasciitis. Material & Methods:We studied 30 patients with the complaints of plantar fasciitis having plantar spur were included. Length and size of the plantar spur were assessed radiologically using lateral view ankle X-rays. Pain and functional assessment were evaluated using VAS and AOFAS score before and after treatment. Results: Length of the plantar spur was classified as type 0/absent in 4 patients, 1/small in 4 patients, 2/medium in 12 patients and 3/large in 10 patients Plantar spur size was measure spurs as <5mm, 5-10mm, and >10mm. The highest incidence spurs size was 5-10mm and >10mm accounts for 36.67% each (n=11). Statistically, significant improvement was found in the mean VAS and AOFAS score in all the patients after treatment especially patient with a medium sized spur (grade 2).Cohen's Kappa statistic showed excellent intra and inter-observer agreement. Conclusions: These suggest that the presence or consequences of the plantar spur are not necessarily as a cause of plantar fasciitis. These results may enlighten the knowledge to understand the role of the plantar spur in a patient with plantar fasciitis.

Background This is an observational study conducted to determine the prevalence of osteoporosis and osteopenia in patients undergoing elective arthroplasty and spinal procedures in India. Methods This observational, multicentre study included both male and female patients. Their bone mineral density and fracture risk were measured using dual-energy x-ray absorptiometry (DEXA) and Fracture Risk Assessment Tool (FRAX ® : Centre for Metabolic Bone Diseases, University of Sheffield, UK), respectively, in compliance with the guidelines for Good Epidemiological Practice (ISRCTN: 14543098). Results The study revealed that majority (76.4%; 97/127) of the patients had low BMD; over one-third had osteoporosis (39.4%; 50/127) or osteopenia (37%; 47/127). Among those undergoing total knee replacement (TKR)/total hip replacement (THR), majority (75.6%; 59/78) had low BMD (osteoporosis: 38.5% {30/78}; osteopenia: 37.2% {29/78}). Among the patients undergoing spinal procedures, all except two (93.10%; 27/29) had low BMD, two-thirds had osteoporosis (65.5%; 19/29), and around one-fourth had osteopenia (27.6%; 8/29). Radial BMD measurements showed higher prevalence of osteoporosis and osteopenia. Based on FRAX score, nearly 30% of patients were at a high risk of hip fracture in the next 10 years. As per National Osteoporosis Foundation (NOF) guidelines, most (59.79%; 58/97) patients with osteoporosis/osteopenia met criteria for pharmacological treatment. Conclusions Regular preoperative bone health evaluation should be adopted and osteoporosis/osteopenia patients should be adequately managed pharmacologically in India.

OBJECTIVETo Compare the Efficacy of combination therapy of Methotrexate (MTX) and Hydroxychloroquine (HCQ) with MTX and Sulfasalazine (SSZ) in Rheumatoid Arthritis (RA) patients of Kumaon region. METHODSRA patients of age group in between 18-60 years, a definite rheumatoid arthritis patients based on 2010 ACR/EULAR CRITERIA, presenting to the medicine OPD with Disease Activity Score 28 (DAS 28) Score >3.2 were included in the study, and patients receiving treatment combinations were divided into study groups. In the OPD, HCQ was given at a dosage of 200 mg twice a day, whereas dosage of MTX was 10 to 20 mg/week. The dosage of SSZ was 500 mg to 1000 mg twice a day. The primary end point of the study was based on EULAR DAS 28 response criteria at the end of study period. RESULTSThe mean values of DAS 28 score show statistical significant decline within the group in every follow-up and during 2 nd and 3 rd follow-ups DAS 28 score between 2 groups shows statistical significant difference. At the end of study period (6 months), the difference between 2 study groups was not statistically significant. According to EULAR RESPONSE CRITERIA, good response was seen in 26 patients from group 1 st and 27 patients from group 2 nd . CONCLUSIONThe efficacy of drug combinations, i.e. MTX plus SSZ and MTX plus HCQ, in treating Rheumatoid Arthritis patients are comparable. Combination of MTX plus SSZ, however, shows rapid decrease in disease activity as compared to combination of MTX plus HCQ.

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