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Human foot is a biological masterpiece, which is strong enough to support the body weight and flexible enough to adjust to various surfaces. Foot postural deviation can alter the alignment of the entire body. The collapse of the medial longitudinal arch of the foot causes one of the most prevalent deformities i.e. flat foot. Diabetic patients are more prone to have flat foot due to degeneration of posterior tibial tendon over the course of their disease. The aim of this study was to determine the occurrence of adult acquired flat foot and assess the disability of flat foot among diabetic population in Rawalpindi and Islamabad, Pakistan. In this cross-sectional descriptive study, 384 diabetic patients aged 35-60 year were enrolled after obtaining informed consent. Non-probability convenience sampling technique was employed. The data was gathered by performing navicular drop test to determine the presence of flat foot, assessment of posterior tibial tendon dysfunction through single heel rise test and by using foot function index questionnaire to assess pain, disability and activity limitation. Based on results of the study, posterior tibial tendon dysfunction was observed to cause the appearance of low navicular height leading to flat foot in 58.33% of the population. Moreover, there is a moderate tendency of occurrence of flat foot among diabetic population in the absence of other risk factors such as hypertension, obesity, steroids use and previous foot trauma etc. With regard to the functionality measured by foot function index, it was implied that the functional status of the patient was reduced because of the pain, disability and activity restriction in the presence of flat foot. [ABSTRACT FROM AUTHOR]

Objective: To define the link of HLA-B27 with Spondyloarthritis (SPA) among the study population. Study Design: Cross-sectional study. Place and Duration of Study: Rheumatology Department Pak-Emirates Military Hospital (PEMH) Rawalpindi Pakistan, from Jun 2019 to Jan 2020. Methodology: Patients assumed to be suffering from spondyloarthritis (Spa), reporting for routine follow-up at subject OPD, were enrolled. Socio-demographic and clinical variables were measured with HLA-typing. Results: Among 550 subjects; age and BMI scores were 31.15±10.399 (18-63 years) and 23.39±4.19 (17.2-35.0 kg/m2), respectively. 391 (71.1%) patients were found positive for HLA-B27, which was significantly more amongst 20-40 years aged (p=0.003), those with non-professional education (p=0.003), associated with raised CRP(C-reactive protein, p<0.001) and ESR(erythrocyte sedimentation rate, p<0.001), with 3-6 years since the onset of symptoms (p<0.001), up to 2 years delay in diagnosis(p<0.001), peripheral arthritis(p 0.008), having co-morbidities (p=0.011), less DAL (daily activities of life, p<0.001) with no significant impact of gender, SEC (socio-economic class), pain severity, co-morbidities and formal exercise. Severe pain was stated more by females (p=0.008), low SEC (p=0.003) and overweight patients with BMI 25-29.9 (p=0.001). Conclusion: There is a strong association between HLA-B27 and spondyloarthritis (Spa), predominance in the 2nd and third decade, and no gender predilection. Auxiliary exploration would be valuable to recognize the predominant subtypes of the HLA-B27 allele in Pakistani patients with spondyloarthritis (Spa). [ABSTRACT FROM AUTHOR]