Enhancing Functional Rehabilitation Through Orthotic Interventions for Foot and Ankle Conditions: A Narrative Review

Non-surgical, conservative approaches to foot and ankle conditions are of important consideration. Orthotics play a significant role in treating these conditions, preventing progression, and alleviating pressure on affected areas, thereby promoting normal gait. This article aims to assess the utility and effectiveness of various orthotic treatments in different clinical scenarios. We reviewed 27 peer-reviewed articles using electronic databases, employing keywords such as "orthoses," "orthotic treatment," "arthritis," "neuropathy," and "foot and ankle trauma." Studies conducted in recent decades have explored the effectiveness of orthoses in various conditions, including connective tissue disorders, tendon and ligament injuries, foot arthritis, neuropathic and inflammatory wounds, and sports-related recurrent injuries. Orthotic management has proven effective across diverse foot and ankle conditions. Integrating orthotic treatment with systemic approaches benefits patients with foot and ankle disorders. We believe this review can be utilised by clinicians in the management of foot and ankle disorders.

Influence of COVID-19 Protocols on the Efficiency of Trauma Theater: Retrospective Observational Study

BACKGROUND

The COVID-19 pandemic has influenced health care delivery significantly. Numerous studies have highlighted that trauma theater efficiency has decreased during the COVID-19 pandemic; however, there is limited information as to exactly which stage of the patient theater journey is causing this decreased efficiency and whether efficiency can be improved. In the trauma theater of Warrington Hospital, United Kingdom, we have attempted to maintain trauma theater efficiency despite the requirement for increased infection control.

OBJECTIVE

The aim of this study was to evaluate the effects of additional COVID-19 infection control protocols on trauma theater efficiency in our center, considering the length of time taken for specific theater events, and to find out whether our interventions were successful in maintaining theater efficiency.

METHODS

We compared the efficiency of the trauma theater in a busy unit in December 2019 (pre-COVID-19) and December 2020 (with COVID-19 protocols in place). We collected time logs for different theater events for each patient in December of both years and compared the data.

RESULTS

There was no significant difference in the average number of cases performed per session between the COVID-19 and pre-COVID-19 time periods (P=.17). Theater start time was significantly earlier during the COVID-19 period (P<.001). There was no significant difference between the two periods in transport time, check-in time, preprocedure time, anesthetic time, and the time between cases (P>.05). A significant difference was observed in the check-out time between the two groups in the two time periods, with checking out taking longer during the COVID-19 period (P<.001).

CONCLUSIONS

Our results show that our theater start times were earlier during the COVID-19 pandemic, and the overall theater efficiency was maintained despite the additional COVID-19 infection control protocols that were in place. These findings suggest that well-planned infection control protocols do not need to impede trauma theater efficiency in certain settings.

Biosynthesis of car1ssol and carissic Acid

Carissa carandas belongs to family apocynaceae which consists of 300 genera and 1000 species. It is a large shrub with simple thorn and commonly cultivated throughout Pakistan for hedges and is called "Kakronda". The different parts of this plant have been used for various systems of medicine (Kirtikar et al., 1993). Cardiotonic activity was found in root of this plant (Rastogi et al., 1966; Rastogi et al., 1967; Vohra et al., 1963). This plant has been mentioned in the old chemical literature as purgative, stomachic, antihelmintics and antidote for snake-bite (Kirtikar., 1933). The physical characteristics of oil from the fruits of Carissa carandas were determined by using standard methods. In addition to this a study of sugars and amino acids from the fruits of this plant was also undertaken by the present authors (Naim et al., 1986). Our studies in the chemical investigation on this plant had led to the isolation of two new triterpene carissol Ia (Naim et al., 1985) and carissic acid lb (Naim et al., 1988).