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International Primary Care Association

Clinical Focus Volume 6 N3

Editor Admin

Editor Admin


Somatic symptom disorders (SSD’s) are a complex set of psychological disorders in which patients experience physical symptoms that cannot be traced to a physical cause. Examples of SSD’s include illness anxiety disorder, conversion disorder, psychological factors affecting other medical conditions, factitious disorder, other specified somatic and related disorder and unspecified somatic symptom and related disorder. The diagnosis of SSD’s follows a thorough medical workup and/or psychiatric evaluation. Treatments should centre on a biopsychosocial approach and employ the appropriate medical, psychological and psychosocial interventions. 


Atrial fibrillation (AF) is the commonest arrhythmia associated with a significant cardiovascular disease burden, with increased risk of a number of comorbidities; of particular concern is the five-fold increased risk of stroke. The management of the condition consists of effective symptom control and adequate protection from associated adverse events. A combination of different therapeutic agents can be used to achieve these goals, tailored to the needs of the individual. The cardiologist’s input may only be relatively small, concerned with managing acute presentations and performing certain procedural interventions. The role of the primary care physician is arguably more significant, delivering a holistic package of care that considers the broad needs of a person with AF.


The diagnosis of acute coronary syndrome (ACS) in a primary care setting is challenging; it is seldom seen, compared to other more benign conditions presenting with chest pain, and missing the diagnosis can be catastrophic for the patient. Prompt diagnosis facilitates access to early revascularisation which improves outcomes. This article will update general practitioners on the diagnosis and management of acute coronary syndromes and provides case-based examples with ECGs to improve diagnostic confidence.

Since my last editorial the medico-political remain the same but the calamities seem to have risen, confusion reigns and decision making is blighted.  


With the increasing burden of musculoskeletal disease, and an ageing population in the community, an up-to-date summary of how to manage the commonest of these conditions is required to aid primary care physicians. With focus on the inflamed hot joint and giant cell arteritis. This review highlights the necessary features that can help to unpick these potentially complex conditions.


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