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IPCA

International Primary Care Association
 
 
 

Clinical Focus Volume 8 N3

Editor Admin

Editor Admin

Chronic viral hepatitis due to hepatitis B (HBV) and hepatitis C (HCV) is a global health concern with almost 500 million people infected and an estimated 1.46 million deaths per year. Many patients are asymptomatic and general practitioners should have a good working knowledge of risk factors and the appropriate tests to make a diagnosis, particularly as hepatitis B testing can be challenging to interpret. The natural history of disease is variable but both infections can lead to cirrhosis and hepatocellular carcinoma. The epidemiology and virology of HBV and HCV differ and their management can be complicated as there has been a huge increase in the number of drugs approved to treat both infections, particularly HCV, over the last few years. This article will provide a review of HBV and HCV for general practitioners who are often the first providers to encounter patients with viral hepatitis. A working knowledge of these conditions will permit a thorough work up and informed discussion with patients.

Many diseases result from a combination of genetic, environmental and lifestyle factors. There is a huge amount of genetic variation between individuals, and genomics allows us to identify variations across whole genomes. Here we describe key concepts in genomics and discuss how it can be used to improve patient care.

Oral health problems are extensive and multi-factorial in nature. Patient outcome will be compromised if there is limited access to trained dental professionals for oral health issues. The increasing number of dental patients going to the General Practitioners (GP) costs the NHS ‡26 million per year. The reasons why patients visit their GP for oral health issues are numerous; however, GPs are not responsible for treating dental patients. GPs do play an important role in identifying patients with undiagnosed dental problems, and being aware of the ones caused by other medical problems. Therefore, inter-professional cooperation is required to reduce the global burden of dental diseases.

Early spring brought atrocious weather, The Beast from the East mingled with Storm Emma, putting pressure on public services across the board. It has illustrated again how much on the cusp such services are performing, particularly the NHS, as additional pressures could barely be accommodated.  

A 37 year old young lady attends the Emergency Department with cough, breathlessness and green phlegm of 3 days duration. She has never smoked and there was no significant past medical history. Her observations were as follows:

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