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**Daily(17.9.18) chamber statistics:**

Total patients consulted: **23**
Pediatric patients(age < 10 years): **1**
Male patients: **23**
Female patients: **0**
http://www.tinglado.net/tic/manuel/se/doctor.gif
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**Daily(17.9.2018) health activities:**
**Steps:**![walking.gif](https://files.steempeak.com/file/steempeak/hafiz34/79PEtqAn-walking.gif)
Total:**11273**
Total distance: **9km**
Total calories burned: **520kcal**
N.B: _Steps being counted during walking and cycling_
**Cycling:**
Duration: **00:34:50** 
Distance: **10.3km**
Calories burned: **271kcal**
Max speed: **34.6km/h**
Avg speed: **17.7km/h**

**Walking:**
Duration: **00:26:33**
Distance: **2.31km**
Calories burned: **177kcal**
Max speed: **8.2km/h**
Avg speed: **5.2km/h**
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<center>**Mention-able diseases/conditions(top 5) I have treated today**</center>

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* **Severe Low Back pain:** Got a few patients with similar symptoms. Some of them were having pain localized only lower lumber area mostly due to work related musculoskeletal pain. One patient had low back pain which was radiating to the left lower limb (below the knee). It is called radicular pain. 
* **Allergic dermatitis:** This condition is quite common in Oman especially who work as construction workers and who are working in the farm. Cement is the main causative factor for such dermatitis. Every day, a few patients will come with this condition.
* **Right flank and lower abdominal pain:** It was a case of renal stone. Urine report showed hematuria and the presence of calcium crystals. Interestingly, he came bringing a tiny stone which passed with his urine few days ago. 
* **Gluteal abscess:** Two guys came with gluteal abscess. Another diabetic man came with a big abscess in his anterior abdominal wall. 
* **Aphthous ulcer in the oral cavity:** A patient came with two ulcers in each side of his oral cavity.


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<center>**Today's health discussion**</center>

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## <center>Back pain and low back pain (LBP)</center> 
<div class="text-justify">Back pain is one of the most common symptoms with which patients  present to a doctor. There is not a single person who hasn’t suffered from it in any point of his/her lifetime. In western countries, it is the most common cause of sickness-related work absence. In the UK, around 7% of adult population consults their doctor each year with back pain. Globally, 9% of the population is affected by LBP.</div><br> 
<div class="text-justify">There are a wide variety of causes for LBP. Some cases of LBP are self-limiting which happen due to acute mechanical pain, mostly work related. It is acute on onset, associated with lifting heavy weight or bending, exacerbate by activities and relieved by rest. It is usually confined to the lower lumber or sacral (buttock) area, sometimes in the thigh. This pain is usually asymmetrical i.e. affect one side only and does not radiate beyond the knee joint. If the pain goes below knee, it indicates that there is some problem in the nerve root which prompts further investigations. There shouldn’t be any other system features like weight loss, fever, sweating etc. In most of the cases (90%) a patient recovers from such pain in 6 weeks.</div><br> 

<center>![Lower_back_pain.jpg](https://files.steempeak.com/file/steempeak/hafiz34/G6Grsvsn-Lower_back_pain.jpg)
[image source](https://commons.wikimedia.org/wiki/File:Lower_back_pain.jpg)</center>
On the other hand, some cases of back pain are the external manifestation of serious spinal pathologies. The pathology may be:
* Destructive due to malignancy (cancer) or infections (tuberculosis, HIV)
* Inflammatory due to axial spondyloarthritis, psoriatic spondyloarthritis
* Spinal stenosis 
* Prolapsed intervertebral disk
* Paget’s disease
* Fracture<br>

<div class="text-justify">In case of possible spinal pathology, the pain is constant, progressive and unrelieved by rest. Pain in the thoracic region is a red flag sign of back pain. Previous history of cancer, tuberculosis, HIV, prolonged use of systemic steroids (glucocorticoids), osteoporosis etc. should be enquired. Any major trauma/accident, long standing fever or evening rise of temperature, sweating, weight loss should be searched in a patient with LBP.</div>  


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