Low back pain may be defined as pain perceived as arising from the posterior region of the trunk within an area bounded more or less capital planes tangential to the lateral borders of the erector spine, transverse plane through the lower dorsal spinous process and a transverse plane through the posterior superior iliac spines. Chronic Low Back Pain is when low back pain has been existing for more than three consecutive months’ chronic low back pain may start with a history of an injury, spinal ailment or stresses on diverse structures of our body. Low back pain is coined when there is pain, protective spasm and muscular tension, or stiff movement localized to low back, and is well-defined as chronic low back pain when it continues for 12 weeks or longer duration. Low back pain is considered as one of the most frequently mentioned reason for participation restriction secondary to activity limitation under the age group of 45years, and almost roughly 2% of the work force are receiving reimbursement for low back pain annually. A rough estimate of 1.3 billion days a year are lost from work because of Low back pain

The Covid-19 is a worldwide pandemic that was first reported in Wuhan, China and began to spreading rapidly through several countries. Persons infected with Covid-19 impacts the physical and psychological health of not only the person who is infected, but also is near and dear ones, who share many of the characteristic of the infected person. This may mean they are also labelled, stereotyped, discriminated against treated separately, and experience loss of status because of perceived link with the disease. It is evident that persons infected with Covid-19 will have mental health issues which need to be addressed. The fear of transmission of the illness has created lot of fear, anxiety, insecurity, and depressive disorders, among family members of person infected with Covid-19

IBS is a functional gut disorder with abdominal pain and discomfort, bloating, urgency, irregular bowel habits, and increased sensation to bowel contents, the latter called visceral hypersensitivity. IBS treatments are historically unrewarding and unsuccessful for both the patients and providers. Quantitative research has provided a better understanding of the pathological etiology of visceral hypersensitivity and its role in abdominal pain. Qualitative research highlights the emotional struggles of patients coping with IBS and the impact on their life and daily routines. This article spotlights using a combination of quantitative and qualitative research methods to better understand visceral hypersensitivity and treatments addressing it for improved clinical outcomes.

Wernicke’ encephalopathy is a rare but potentially reversible neurological disorder characterized by ophthalmoplegia, ataxia and confusion. Wernicke’s encephalopathy occurs as result of severe vitamin B1 (i.e., thiamine) deficiency. The most common etiology of Wernicke’s encephalopathy is malnutrition among alcoholics. Here, we report an unusual case of hyperemesis gravidarum induced Wernicke’s encephalopathy. A 25-year-old female, G2P1, with recent miscarriage at 20 weeks gestation and hyperemesis gravidarum presented with 1-month history of confusion, blurred vision, and progressive bilateral lower extremity weakness. The magnetic resonance imaging of brain revealed bilateral symmetrical hyperintensities in the thalami, mammillary bodies, and surrounding aqueduct of the midbrain suggesting Wernicke’s encephalopathy. Patient was subsequently managed with aggressive thiamine replacement therapy. Her symptoms gradually improved, and she was eventually discharged to an inpatient rehabilitation facility for long term physical therapy. Wernicke’s encephalopathy is a rare complication of hyperemesis gravidarum. This case highlights the importance of recognizing neurological changes due to thiamine deficiency during pregnancy. We would like to emphasize the importance of thiamine supplementation and monitoring in pregnant women with severe and prolonged vomiting history.

This case illustrates a classic presentation of methanol poisoning with its associated radiologic and clinical manifestations. It also provides a comparison with another toxic alcohol, ethylene glycol, highlighting the similarities and the importance of rapid diagnosis to prevent devastating long-term consequences. The patient presented to Kaiser-Permanente South Sacramento with signs and symptoms of methanol poisoning. Clinical and imaging findings included severe metabolic acidosis and altered mental status that progressed to coma and bilateral lesions of the putamen on MRI, characteristic of methanol poisoning [1]. Upon awakening from the coma the patient was noted to have abulia, psychomotor slowing, and decreased executive functioning. Neurologic consultation was obtained on hospital day 11. Patient was followed and demonstrated gradual improvement in neurologic function that continued until the time of discharge. This clinical picture is very similar to that associated with ethylene glycol poisoning that can also present with altered mental status, severe metabolic acidosis and bilateral lesions of the putamen. This report provides a direct comparison of methanol and ethylene glycol toxicity including clinical and imaging findings. The case shows that methanol poisoning can cause short-term and long-term morbidity, but prompt recognition and treatment can lead to meaningful recovery.

After spending four days in the Capital city of Beijing China, I noticed as an American doctor, something very evident in the population. All the local Chinese were just plain skinny. I looked long and hard for an obese person while traveling there but was unable to find any. It was so obvious. Was it the gross domestic product,economy, poverty, or a lack of resources?

Emerging studies have called attention to the rising environ- mental impact of healthcare delivery. In the United States, the healthcare sector has a carbon footprint exceeding 7-10% of to- tal national carbon dioxide emissions annually [1,2]. Hospitals are the largest contributor, responsible for approximately 40% of total healthcare-related greenhouse gas (GHG) emissions.1 US health- care has been estimated to cause an annual loss of 614,000 disability-adjusted life-years due to the harmful effects of GHG emission[3]. The relative contributions of various surgical specialties to the environmental footprint of healthcare remain unknown.

Introduction: Numerous studies have proliferated to clarify the personality types that show an implication in the development of cardiovascular diseases, especially type A and Type D personality, although in clinical practice we also find people with type C personality pattern, who although more predisposed to suffer cancer among other factors, we believe that it is also related to cardiovascular problems. Objectives: To analyze the personality traits and the characteristic clinical syndromes in population that will be subjected to cardiac transplantation.

Background: Brain tumor surgery requires special equipment but also remains expensive around the world. The aim of this study is to share our experience in brain tumor surgery and the difficulties we encountered (socioeconomic restraints and lack of equipment) to perform brain tumor surgery in low-income country. Methodology: we did retrospective study in one year, we included all patient who undergone craniotomy for tumor resection at Matlaboulfawzaini hospital. We compared costs of care from our hospital to costs of referral hospital in our capital City

With increasing quality of life and access to health services in most communities, population growth has increased. Life expectancy is higher in most societies than ever before. And these factors have caused most people to reach old age [2]. The phenomenon of aging is already happening in most societies and if it is not managed properly, this opportunity becomes a threat.

We report a case of accidental ingestion of organophosphate (OP) resulting acute OP poisoning shows delayed neuropathy and myelopathy in follow up.

Preterm cerebral white matter injury (WMI) frequently encompasses hypoxic–ischemic lesions such as periventricular leukomalacia (PVL) and hypoxic–ischemic encephalopathy (HIE). These infants are extremely vulnerable to brain injury and are at high risk of developing motor and cognitive abnormalities at later stages in life.

In patients with severe traumatic brain injury (TBI) initial neurological evaluation and follow-up are difficult, especially in the context of multiple trauma. Multimodal neuromonitoring is essential in the management of traumatic brain injury as it allows early individualized therapeu- tic behavior that prevents secondary brain injury.