Rx Note

Introduction Benign Prostatic Hyperplasia (BPH) is a histologic condition of proliferation of smooth muscle and epithelial cells in prostatic transition zone. The prevalence increases with age , affecting approximately 42% of men between the ages of 51 and 60 years and 82% of men between the ages of 71 and 80 years. BPH may progresses to benign prostatic enlargement (BPE) and subsequent bladder outlet obstruction (BOO), leading to lower urinary tract symptoms (LUTS). Lower tract urinary symptoms (LUTS) may include Storage symptoms : daytime frequency, urgency, nocturia and incontinence Voiding symptoms: weak stream, dribbling, dysuria, straining Symptoms can significantly impact quality of life. Complications include acute urinary retention, urinary tract infection, bladder calculi and renal insufficiency. Treatment Principles The severity of reported BPH symptoms guides selection of treatment. Validated severity and bother scores exist, such as the American Urological Association Sym...

Introduction Faecal incontinence is defined as the involuntary loss of solid or liquid faeces. Based on the mechanism, it is divided into the following: Urge incontinence is characterized by the desire to defecate, but incontinence occurs despite efforts to retain stool. Passive incontinence is characterized by the lack of awareness of the need to defecate before the incontinent episode. The prevalence is higher in adults that are ≥65 years old and care-seeking (adults in home care and long-term care settings). General Approach All staff working with people with faecal incontinence should be aware of the physical and emotional impact this condition can have on their patients and their carers. Consider patients' needs and preferences when planning treatment and ensure they have the opportunity to make informed decisions in this partnership. Initial management of faecal incontinence consists of supportive care, medical therapy and pelvic floor physical therapy. Supportive care...

Introduction A cataract is a clouding in the lens of the eye, which changes the way light passes through the lens. It usually develops slowly and may occur in one or both eyes. Risk Factors Risk factors for cataracts include Increasing age - the most common cause Family history of cataracts Smoking Alcohol consumption Long-term sunlight exposure Certain medical conditions, e.g. diabetes Certain medicines, e.g. prednisolone Symptoms At first, you may not notice that you have a cataract. But over time, cataracts can cause symptoms such as Cloudy, blurred or double vision Fading or yellowing of colours Poor night vision Increased sensitivity to glare. A halo may appear around lights Management Initially, cataracts may be managed with New spectacles, Brighter lighting, Anti-glare sunglasses and Magnifying lenses for reading and other activities. When cataract symptoms interferes with daily living activities, cataract surgery and placement of an intraocular lens should be considered. On...

Introduction Ingrown toenail, or onychocryptosis, is a common condition in which the corner or side of a toenail grows into the soft flesh , causing pain, inflamed skin, swelling and sometimes, an infection. It usually affecting the skin on the side of the first toenail. These occur when a section of the nail presses into the soft tissue of the nail groove. The nail curves into the flesh of the toe corners and becomes embedded in the soft tissue of the toe, causing pain. Causes Anatomical predispositions to ingrown toenails are Congenital malalignment of the nail Hereditary overcurvature of the nail Imbalance between the width of the nail matrix and the nail bed Environmental factors include Trauma to foot (e.g. sports) Narrow or tight-fitting shoes. Certain medical conditions, such as diabetes mellitus , obesity or onychomycosis . Oral retinoids Incorrect trimming of nails (excessive or convex cutting of the nail) Management Initial management of an ingrown toenail should be conserva...

Introduction Kidney stone disease (nephrolithiasis) is a common problem in primary care practice. The stones are formed on the inner surfaces of the kidneys when the urine becomes too concentrated, causing the minerals and other substances in the urine to crystalise. These crystals then tend to combine in time, forming a mass, known as kidney stones or renal calculi. Symptoms Patients may present with the classic symptoms of renal colic and haematuria . Others may be asymptomatic or have atypical symptoms such as Vague abdominal pain Acute abdominal or flank pain Nausea Urinary urgency or frequency Difficulty urinating Penile pain Testicular pain NOTE: Patients are often asymptomatic until a stone causes partial, intermittent, or complete obstruction, resulting in acute and potentially debilitating renal colic. Acute Management In general, if patients can take oral medications and fluids, they can be managed at home. Supportive measures include Hydration until the stone passes Pain c...