وہ جو روٹھیں گے تو ہر بار منانا ہو گا
پیار کرنا ہے تو یہ بوجھ اُٹھانا ہو گا
ہے یقیں مجھ کو نہ آئیں گے شبِ وعدہ وہ
پھر نیا اُن کا کوئی اور بہانہ ہو گا
کیوں بناتے ہو محلات ذرا سوچو تو
ایک دن تم کو انھیں چھوڑ کے جانا ہو گا
ہم چلیں گے تو کوئی ساتھ نہ دے گا اپنا
وہ چلیں گے تو رفاقت کو زمانہ ہو گا
گو کہ مشکل ہے زمانے سے بچانا تائبؔ
پھر بھی دامن تو بہر طور بچانا ہو گا
Great lineage, good manners, trustworthiness, sincerity, courage and bravery, obedience, generosity, modesty, humility, thankfulness, absolute trust in Allah, education and upbringing, affection and compassion towards the elderly, the youth, slaves and animals, the regard for truth, the endurance and patience etc. Are such features that at them neither was the match for the Holy Master (saw) born, nor will any such person be ever born. In addition, let alone friends, his enemies were helpless to hold him as-Sadiq (the Truthful) and al-Ameen (the Trustworthy) due to these and many other great attributes; and they would say: Muhammad is not a liar at all, but we can’t believe in him as a prophet sent by Allah. Moreover, even a non-Muslim or polytheist has never criticized his character to this day, nor will anybody do till the judgment day. Whenever the greatest personalities of the world were listed or somebody committed to writing on the said topic, the Holy Prophet (saw) remained at the top of the list. Drawing of the swords of father and son against each other, the change of the standard of friendship and enmity, fighting of master and his slave against each other, chanting the slogan of Ahad-Ahad (the only One, the only One) on the blazing sand, giving priority to martyrdom over the utterance of a word of unbelief, taking a husband away from his wife and separating a mother from her infant, deforming the condition after a blasphemous blow on the blessed face, forced migration to Habsha (Abyssinia) at times, and laying siege to Shb-e-Abi Talib (the valley of Abi Talib) at times.
Background: Heel pain is a common clinical entity that requires appropriate diagnostic evaluation. Multiple clinical conditions are known to cause heel pain but plantar fasciitis is the most common. Calcaneal spurs are thought to be associated with heel pain and plantar fasciitis but conclusive studies to prove this are sparse. Plain radiography is usually the first line imaging modality for imaging patients with heel pain. Magnetic Resonance Imaging is the gold standard for diagnosing plantar fasciitis but studies have shown ultrasound to be comparable in sensitivity and specificity. The aim is to establish whether a relationship exists between calcaneal spurs and heel pain caused by plantar fasciitis.
Objective: To estimate the strength of association between plantar fasciitis and calcaneal spurs.
Methods: The study was conducted at the Aga Khan Radiology department between October 2016 and March 2017. The study design was a case-control study nested within a cross-sectional study. Patients with heel pain were recruited and had a plain radiograph and ultrasound of one or both feet. Case and control status was determined sonographically by the presence or absence of plantar fasciitis respectively.
Results: A total of 96 heels (55 participants) were evaluated and calcaneal spurs were present in 35 (36% [27%,46%]) which increased to 62 (65% [55%,74%]) on ultrasound. The crude odds ratio for the association between calcaneal spurs and plantar fasciitis was 3.8 [1.4,10.2] p=0.004. After controlling for age, sex and physical activity and accounting for within individual clustering, the adjusted odds ratio was 2.7 [0.9,8.0] p=0.072. There was a statistically significant difference in the mean calcaneal spur length measured on radiographs and ultrasound, 4.7 mm [3.7,5.7 mm] and 3.5 mm [3.0,4.0 mm], p= 0.020.
Conclusion: Calcaneal spurs and plantar fasciitis are common findings among patients with heel pain but there is no statistically significant association between them.