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Clinical

Living with long COVID

The new guideline for NICE (2021) recommends that patients presenting with new or ongoing symptoms 4 weeks or later after an initial COVID-19 infection should have the following investigations done: a...

Understanding the use of pulse oximetry in COVID-19 disease

The fundamental principle in pulse oximetry is that when light is shone through a substance, some of that light is absorbed as it passes through the substance and the light that is not absorbed can be...

Improving outcomes for older people with diabetes

There are increasing numbers of people with diabetes over the age of 65 years. This is principally driven by the rise in prevalence of type 2 diabetes (T2DM) that correlates with greater rates of...

Understanding primary prevention of cardiovascular disease

The NHS Health Check programme was designed to identify people with risk factors for CVD and ensure that they had access to the support and medication they might need to reduce that risk (Waterall,...

Managing the side effects of contraception

Headache is a reported side effect of all hormonal methods of contraception, but is also very common in women of reproductive age, particularly those age >35 years old (Grossman Barr, 2010). Because...

Anaphylaxis: how to recognise and manage in primary care

‘a serious systemic hypersensitivity reaction that is usually rapid in onset and may cause death. Anaphylaxis is characterized by potentially life-threatening compromise in airway, breathing and/or...

You know where you can stick that … or do you? Where to inject the deltoid and why

Finding the important landmarks of the deltoid in the living is not difficult and can soon be learned with a little practice on yourself, your partner and patients; having a clear mental picture...

Hormone replacement therapy: update and practical prescribing

Symptoms are experienced by around 70-80% of women during the perimenopause and menopause (O'Neill and Eden, 2012). The symptoms are varied and include vasomotor symptoms, such as flushing and night...

Managing otalgia in general practice

A thorough history is needed to guide clinicians towards making an accurate diagnosis. A detailed history of the degree and severity of pain, any discharge from the ear (otorrhea), hearing loss,...

Supporting people with dementia during the COVID-19 pandemic

‘Dementia is a syndrome – usually of a chronic or progressive nature – in which there is deterioration in cognitive function (ie the ability to process thought) beyond what might be expected from...

Management pathways for erectile dysfunction in primary care

Epidemiological evidence suggests that 8% of men in their 40s report moderate or complete ED and this increases to 40% of men in their 60s (McKinlay, 2000). Risk factors for developing ED are shown in...

Dermatology prescribing update: eczema

Emollients are first line therapy in eczema, this is evidence-based UK guidance (NICE, 2007; 2018; PCDS, 2019). Complete emollient therapy should always be advised, this is: ‘everything that goes on...

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