During foetal life, blood flows through the ductus arteriosus (DA) from the pulmonary artery into the aorta, thereby bypassing the lungs. After birth, the DA undergoes active vasoconstriction and eventual closure. A patent ductus arteriosus (PDA) occurs when the DA does not close completely after delivery.
This is the third article in the oral lesion series, focusing on oral blistering associated with systemic diseases such as gastrointestinal diseases, nutritional diseases, haematological disorders, pulmonary conditions, endocrine disorders and connective tissue disorders.
This is the second CPD article on oral lesions which MIMS Doctor engages with Dr Thomas Abraham. This article focuses on oral blistering due to autoimmune diseases, ie, pemphigus vulgaris, mucous membrane pemphigoid and lupus erythematosus.
Oral lesions are common oral problems seen by general practitioners (GPs) in their day-to-day practice. Accurate diagnosis by GPs is vital in helping patients to recover from their painful lesions, as well as in alleviating their fears arising from their condition. To help GPs better understand oral lesions, MIMS Doctor exclusively invited Dr Thomas Abraham to shed light on the importance of early diagnosis of this oral problem, which would then allow the initiation of appropriate investigations and help make the decision if a referral to a specialist is necessary.
The main causes of increased perinatal mortality and morbidity in multiple pregnancies as compared to singletons are preterm delivery and low or extremely low birth weight. Even in those infants that survived, the risk of cerebral palsy and other forms of neurological developmental defects was estimated to be around four times that of singleton pregnancies. The incidence of milder forms of neurological or developmental deficits such as educational difficulties or behavioural problems are even more common in these pregnancies.
Menstrual problems are the commonest gynaecological complaint in adolescent females.The most common menstrual problems seen in paediatric and adolescent gynaecology clinic include dysmenorrhoea, heavy menstrual bleeding, oligomenorrhoea and amenorrhoea.
Cholestatic jaundice is a potentially serious condition that may be associated with significant pathology involving the hepato-pancreatico-biliary system that merits early recognition, evaluation and management. Awareness and early detection of cholestatic jaundice at primary care level, followed by appropriate referral to a paediatric gastroenterology centre is crucial in avoiding delay and achieving optimal patient outcomes.
Acute gastroenteritis (AGE) remains a significant contributor to paediatric disease burden across the world in the 21st century. Rehydration remains the mainstay of therapy, while pharmacotherapy may have adjunctive benefits. We seek to review the evolution in management strategies of paediatric AGE, in particular the child with viral AGE.
We can no longer afford to ignore the problem of frailty. Older adults must be screened objectively for frailty in primary care. Multiple interventions are likely to be necessary, including attention to good nutrition and physical activity.
A subgroup of patients with HBeAg-negative chronic hepatitis B virus (HBV) infection who ceased their long-term nucleotide analogue treatment maintained virological suppression, pointing to a group of patients who may be suitable for treatment cessation, according to a recent study.
Use of mirabegron in the treatment of men with overactive bladder (OAB) appears to effectively alleviate urgency and storage symptoms, but not reduce the frequency of micturition episodes, according to data from the MIRACLE study.