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International Primary Care Association

Clinical Focus Volume 2 N3

Volume 2 Issue 3 - 2007


Background: The treatment of a discharging ear with a perforated tympanic membrane remains controversial. There is a consensus amongst otolaryngologists that topical antibiotic preparations are the most effective way of treating ear infections, and are generally safe to use in the face of an active infection. Little meaningful data is available and many of the studies are based on animals, which are not ideal due to anatomical differences across species. In light of the disparity of opinion surrounding this issue, we conducted a survey to determine the current practice of GPs in our local area (Berkshire).


80% of patients with type 2 diabetes die from cardiovascular disease. This reflects an excess in cardiovascular risk up to five fold compared to non diabetic individuals.

In the last fifteen years several trials have confirmed that tight blood pressure control significantly reduces vascular risk. In the UKPDS, a mean blood pressure reduction of 10/5mmHg reduced all diabetes endpoints by 24%, diabetes related deaths by 32% and the risk of developing microvascular disease by 37%.1 Unfortunately under-diagnosis and under-treatment of hypertension in the UK remain widespread.


Depression is one the commonest psychiatric presentations in older people in the community and general hospitals. Depression is a pervasive feeling of low or miserable mood for a period of 2 or more weeks along with poor energy and motivation. The NICE guidelines put emphasis on GPs to recognize and treat most cases of depression. It is important to have awareness of presentations and treatment in the elderly.


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