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Open Access March 31, 2025

Flat Foot and Its Association with Mechanical Low Back Pain: A Case-Control Study Utilizing Clarke’s Angle Measurement

Abstract Background: Mechanical low back pain (MLBP) is a leading cause of disability worldwide, with well-established risk factors such as obesity, occupational ergonomics, and core muscle strength. However, the role of pes planus (flat foot) as a contributing factor remains underrecognized. This study aims to investigate the association between flat foot and MLBP using Clarke’s angle as an [...] Read more.
Background: Mechanical low back pain (MLBP) is a leading cause of disability worldwide, with well-established risk factors such as obesity, occupational ergonomics, and core muscle strength. However, the role of pes planus (flat foot) as a contributing factor remains underrecognized. This study aims to investigate the association between flat foot and MLBP using Clarke’s angle as an objective measure of foot posture. Methods: A case-control study was conducted in South Timor Tengah Regency, East Nusa Tenggara, Indonesia, from December 2024 to February 2025. Fifty patients diagnosed with MLBP and 50 healthy controls were enrolled. Foot type assessment was performed using Clarke’s angle, with a cutoff of ≤30° indicating flat foot. Pain severity in the LBP group was recorded using the Numerical Rating Scale (NRS). Statistical analysis was conducted using chi-square and independent t-tests, with significance set at p < 0.05. Results: Flat foot was significantly more prevalent in the LBP group (58%) than in the control group (18%) (p = 0.000; OR: 6.29, 95% CI: 2.52-15.69), indicating that individuals with flat feet are over six times more likely to experience MLBP. No significant differences were observed between the groups regarding BMI, age, or gender. Conclusion: These findings suggest that flat foot is an independent risk factor for MLBP, likely due to altered spinal biomechanics and compensatory postural changes. Clinicians should consider foot posture assessments in MLBP patients and explore targeted interventions, such as orthotic support, to mitigate symptoms.
Article
Open Access October 13, 2023

A Report of Three Cases with Moderate Psoriasis Treated with New Topical Treatment

Abstract Practice guidelines recommend fixed combinations of calcipotriol, a topical vitamin D analogue, and betamethasone dipropionate, a high potency corticosteroid, as first line topical treatment for mild to moderate plaque psoriasis of the body and scalp. A new foaming lotion for treatment of Psoriasis was developed and patented by the Spanish Ministry of Industry, Trade and Tourism (Invention patent [...] Read more.
Practice guidelines recommend fixed combinations of calcipotriol, a topical vitamin D analogue, and betamethasone dipropionate, a high potency corticosteroid, as first line topical treatment for mild to moderate plaque psoriasis of the body and scalp. A new foaming lotion for treatment of Psoriasis was developed and patented by the Spanish Ministry of Industry, Trade and Tourism (Invention patent reference number 202030824). The foaming lotion is composed of clobetasol, papaverine hydrochloride, spironolactone, milk-peptide-complex and propylene glycol. Three cases with moderate Psoriasis aged 34, 36 and 66 years old were treated with our new foaming lotion for 7-8 days. The three patients reported important improvement in the itching sensations and remission of the scaled lesions. Before and after application of the new foaming lotion, Psoriasis Area Severity Index (PASI) scores improved in the first patient from 24.3 to 1.8, in the second patient from 26.1 to 1.8, and in the third patient from 27 to 1.8. Our results show the short-term effectiveness of the new foaming lotion in treating moderate and extensive Psoriasis. Long follow-up is needed to evaluate the remission period of Psoriasis and possible side effects of the new topical treatment.
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Open Access April 28, 2023

Evaluation of the Incidences of Risk Occurrence and Severity in PPP-Procured Mass Housing Projects (PPP-MHPs) in Abuja, Nigeria

Abstract Risks in Public Private Procurement mass housing project (PPP-MHP) initiatives are emerging and this requires early risk identification and allocation to achieve the goal and sustenance of the scheme. The study, being a follow-up of a Delphi survey, elicits the opinion of respondents on the probability of occurrence and severity of identified risks in PPP-MHPs in Nigeria. The study adopts a [...] Read more.
Risks in Public Private Procurement mass housing project (PPP-MHP) initiatives are emerging and this requires early risk identification and allocation to achieve the goal and sustenance of the scheme. The study, being a follow-up of a Delphi survey, elicits the opinion of respondents on the probability of occurrence and severity of identified risks in PPP-MHPs in Nigeria. The study adopts a quantitative research design approach by administering structure questionnaire survey on identified PPP-MHPs partners in Abuja, Nigeria. Data analysis was performed using descriptive and inferential statistical tools such as Mean item score (MIS), standard deviation, and Kruskal Wallis analytical techniques with the aid of SPSS software packages. The findings show that all the listed risk factors were found to be extremely high, very high, high, or moderate in terms of occurrence while all the listed risk factors recorded a very high level of severity on the delivery of PPP-MHPs. The top ten (10) risk factors frequently associated with PPP-MHPs are non-availability of finance, high finance cost, non-involvement of the host community, poor execution of housing policies, corruption and lack of respect for law, wrong perception of housing need by low-income earners, Illegal title to land, land acquisition and site availability, level of demand for the mass housing projects and unstable value of local currency. The respondents differs significantly on 29 risk factors in terms of occurrence and 40 risk factors in term of severity. The study, therefore, recommends that risk management culture should be highly encouraged among the PPP Partners in the sector. The study intends to enumerate the rate of occurrence of some itemized risk factors and their severities on the delivery of PPP – procured mass housing projects in Nigeria and the need to bookmark these risk factors in ensuring the sustainability of the PPP mass housing scheme.
Article
Open Access April 27, 2023

Evaluation of the Critical risk factors in PPP - procured Mass Housing Projects in Abuja Nigeria - A fuzzy synthetic evaluation (FSE) approach

Abstract The study accessed the critical risk factors in public-private partnership (PPP)-procured mass housing project (MHP) delivery in Nigeria. The research design adopts a quantitative approach, using well-structured questionnaires distributed to stakeholders involved in PPP-MHPs i.e. consultants, in-house professionals, contractors, and the organized private sector (OPS) registered with PPP [...] Read more.
The study accessed the critical risk factors in public-private partnership (PPP)-procured mass housing project (MHP) delivery in Nigeria. The research design adopts a quantitative approach, using well-structured questionnaires distributed to stakeholders involved in PPP-MHPs i.e. consultants, in-house professionals, contractors, and the organized private sector (OPS) registered with PPP departments in the Federal Capital Territory Development Authority (FCDA) Abuja, Nigeria. The instrument relates to the background information of respondents and the risk peculiar to PPP-MHP. Sixty-three (63) risk factors were submitted for the respondents to rank using Mean Item score (MIS) for risk occurrence and its severity, while risk significance index (RI) was used to determine the risk impact. Fuzzy Synthetic Evaluation (FSE) method was subsequently applied to determine the risk criticality groups and the overall risk level in the sector. The fuzzy set theory deals with ambiguous, subjective and imprecise judgments peculiar to decision making in construction project risk assessment. It aims to provide a synthetic evaluation of an object relative to a fuzzy decision environment with multiple criteria that requires qualitative linguistic terms. The findings show that thirty-one (31) risk factors were critical in the sector while financial and micro-economic risk group is contributing most significantly to the overall risk level in PPP-MHPs in Nigeria. The top 10 risk factors in the sector include availability of finance, high finance cost, the unstable value of the local currency, lack of creditworthiness, influential economic events (boom/recession), high bidding cost, poor financial market, financial attraction to project investors, interest rate volatility, inflation rate volatility, corruption and lack of respect for the law, non-involvement of the host community and poor execution of housing policies. The implication for practice is that having known the risk group contributing most significantly to the overall risk level in PPP-MHPs, adequate financial and budgetary allocation should be made available before embarking on such venture so as to sustain the scheme in the country. The study is one of the recent researches conducted on housing, since the procurement option is novel in the sector. The study is of immense value to PPP actors in providing necessary information required to formulate risk response methods in minimize the identified risk impact sector.
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