Rx Note

Introduction Plantar fasciitis is one of the most common causes of heel pain . It involves inflammation of a thick band of connective tissue that runs across the bottom of your foot and connects your heel bone to your toes (plantar fascia). Clinical Presentation Plantar fasciitis commonly causes stabbing pain that usually occurs with your first steps in the morning or after a period of inactivity . The pain typically lessens with gradually increased activity, but worsens toward the end of the day with prolonged weight bearing. The sensation of the bottom of the heel is quite painful, and the patient may complain of a burning sensation. Risk factors Peak incidence at age 40-60 years old Certain types of exercise, such as long-distance running, ballet dancing and aerobic dance Flat feet (pes planus) Obesity Prolonged walking or standing on hard surfaces Treatment Provision of education about the condition including its possible causes. Patients may have unrealistic expectations that med...

Introduction Low back pain affects 60-80% of people at some stage in their lives ( most common between the ages of 35 and 55 years) and is often recurrent . Acute back pain is generally regarded as lasting less than 6 weeks, subacute for 6-12 weeks and chronic longer than 12 weeks. Clinical Features Pain in the lower lumbar or sacral area is usually described as aching or stiffness. Depending on the cause, pain might be localized or more diffuse. In case of acute injury, the symptoms come on quickly, and there will be a reduction in mobility. Risk Factors Heavy physical work Frequent bending, twisting or lifting Prolonged static postures Smoking Obesity Physical inactivity NOTE: Low back pain can be caused by gastrointestinal problems (e.g. peptic ulcer or pancreatitis) or genitourinary conditions (e.g. kidney stones , pyelonephritis) but low back pain is not the major presenting symptom. Management Most patients (95%) who present in the pharmacy will have simple back pain that wi...

Introduction Obesity is a growing epidemic , particularly in developed countries, and is largely related to an unhealthy lifestyle. Obesity is generally defined as excessive body fat mass. The medical rationale for weight loss in people with obesity is that obesity is a disease associated with a significant increase in mortality and many health risks including type 2 diabetes mellitus , hypertension , dyslipidaemia, chronic kidney disease , osteoarthritis and coronary heart disease. Body Mass Index (BMI) Body size is typically defined using body mass index (BMI) . Normal weight 18.5-24.00 kg/m 2 Overweight 25-29.99 kg/m 2 Obese class I 30-34.99 kg/m 2 Obese class II 35-39.99 kg/m 2 Obese class III ≥40 kg/m 2 Use caution when applying BMI to individuals with greater muscle mass, women or the elderly. NOTE: Generally, Asians have a higher body fat percentage compared to Caucasians of the same age, sex and BMI. Even below the BMI cut-off of 25 kg/m 2 , a substantial number of Asians d...