Volume 5 Issue 2 - 2011
The planned NHS reforms have kept our medical leaders and politicians very busy over the last few months. The focus has been on the process of commissioning and who should have control of the financial levers, the problem of the private sector cherry picking the lucrative elements and conflict of interest of GPs. The previous structure of PCTs was mired in stagnation, planning blight with an emphasis on managing the finances and not the delivery of care. Any reform that allows us to put clinicians at the front end of the decision making process will be better than what we have had in the past, even if there are warts on the new framework. The public still trust doctors more than most other professional groups, including politicians!
Temporal arteritis (TA) also known as giant cell arteritis (GCA) is the most commonly occurring chronic vasculitis, typically affecting individuals older than 50 years. GCA typically manifests as new onset headache with features of systemic illness although presentation is highly variable. Because many conditions can mimic GCA, accurate diagnosis is essential to avoid over-treatment.
Polycystic Ovarian Syndrome (PCOS) is a common disorder with clinical manifestations of anovulatory infertility and hyperandrogenism with oligomenorrhea/amenorrhoea, hirsuitism and acne. There is a higher prevalence of obesity, impaired glucose tolerance, type2 diabetes, hyperinsulinaemia and adverse cardiovascular profile in these patients. The complicated interplay between genetic factors, abdominal obesity and insulin resistance play a key role in pathophysiology. Management should be tailored to individual needs. The understanding of the principles of management of long term implications aids to offer holistic approach to this disorder. Many different therapies may be offered to regulate menstrual cycle, induce ovulation and improve signs of hyperandrogenism. Lifestyle improvement and weight reduction are the most important predictors of long term health.