Abstract
InnovAiT is produced on a 3-year cycle. However, many articles do not significantly go out of date in that time. This section of InnovAiT summarises articles from the previous cycle of InnovAiT that GPs and GPs in training might still find useful today. In August 2019 the issue also included Crammer’s Corner on time management in consultations and a short article explaining relative and absolute risk.
The progesterone-only pill
Dr Zarah Yusuf, Dr Chloe Evans and Dr Annabel Forsythe
InnovAiT 2019 12(8): 425–433
The progesterone-only pill is popular with patients and effective. It is useful when an oral method of contraception is preferred or there are problems with use of a combined pill. It is taken without a pill-free interval and works mainly by the effect on cervical mucus, although desogestrel also inhibits ovulation. This detailed article reviews guidance and addresses common clinical queries.
Hyperemesis gravidarum
Dr Yusra Khan
InnovAiT 2019 12(8): 434–441
Nausea and vomiting in pregnancy are experienced by 80% of pregnant women. Early treatment can prevent progression to hyperemesis gravidarum, the most extreme form of this affliction affecting just 1% of pregnancies. This article offers a framework for assessment and management. Research suggests a genetic cause. Suggested cures, such as ginger, are not recommended. Use of antiemetics is unlicensed but safe and effective.
Heavy menstrual bleeding
Dr Grace Castronovo
InnovAiT 2019 12(8): 442–446
Menorrhagia or heavy menstrual bleeding is common and accounts for around 5% of primary care consultations with female patients. Most patients can be managed in primary care. This article explores diagnosis and management according to updated guidance. Dysfunctional uterine bleeding is the most common cause. All patients should have a full blood count. Failure of treatment or large fibroids require referral of patients for possible surgical interventions.
The management of hirsutism
Dr Michael Hardway and Ms Kinza Younas
InnovAiT 2019 12(8): 448–453
This article covers the normal physiology of hair growth in women and describes the excessive hair growth that requires urgent referral of affected patients for advice and management. Rapid onset alerts to androgen-secreting tumours and Cushing’s syndrome. The assessment and available treatments are detailed. Topical eflornithine is recommended for facial hair.
Bacterial skin infections
Dr David Gleeson
InnovAiT 2019 12(8): 454–458
Skin problems prompt 24% of patients to consult their GPs every year. Bacterial skin infections are common in the young and elderly populations. Most patients can be managed in primary care but signs of more serious infection, such as necrotising fasciitis, with pain and systemic upset require urgent hospitalisation.
Community management of burn injuries
Mr Nader Henry, Mr Ishan Radotra and Dr Sheirin Khalil
InnovAiT 2019 12(8): 459–465
Burns are common in adults and children but knowledge about management is lacking in society and not routinely taught to clinicians. This article provides a useful overview for classification, assessment, management and referral. It considers important safeguarding issues and red flags for non-accidental injury.
Opportunities to develop a research interest in general practice
Dr David Shukla
InnovAiT 2019 12(8): 466–471
This article gives a good account of different opportunities for research delivery in primary care, the resources available and practical considerations to help find research opportunities. There are potential benefits to practice finances, staff development, quality improvement, learning and research development.