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CaseA man, 84 years of age, presented to the dermatology clinic with a progressively growing and occasionally bleeding lesion on the sole of his left foot. Of note, there was no history of trauma and he was otherwise healthy. The patient did not remember when the lesion first appeared and was...

CaseDr Jana is a general practitioner (GP) in a practice where pharmaceutical company representatives are generally welcomed. However, Dr Jana has decided to have no contact with the representatives, receive no drug samples, and nor does she attend lunches offered by the companies. One of the...

MethodWe analysed GP encounters with children aged <15 years that were collected in the Bettering the Evaluation and Care of Health (BEACH) program from April 2000 to March 2003 and April 2012 to March 2015, referred to as 2000–03 and 2012–15, respectively. The methods of the BEACH program are...

What is St Johns wort?Extracts of St John’s wort (SJW) or Hypericum perforatum, a perennial herb with small yellow flowers, are widely available in pharmacies and health food stores. Historically, SJW has been used for a variety of conditions including abdominal pains, alcoholism, earaches and...

What is ginkgo biloba?Ginkgo biloba is extracted from the leaves of the maidenhair tree, which is native to China. The nuts from the tree are considered a delicacy in some countries but are known to be toxic when consumed in large quantities.1,2 The leaf extract has featured prominently in...

A Caucasian woman, 55 years of age, was referred to a general practitioner (GP) after an optometry assessment revealed possible signs of diabetes. Her blood glucose, measured at a community pharmacy, was found to be 28.5 mmol/L. The patient was generally healthy and not on any regular medications...

CaseA woman, aged 21 years, presented to her general practitioner with a 1-month history of severe headaches. On further questioning she reported intermittent episodes of blurred vision. She was overweight and had a body mass index (BMI) of 32 kg/m2.Snellan visual acuity was reduced to 6/18 in...

CaseA patient, aged 48 years, presented with diabetic ketoacidosis (DKA) in a semi-comatose condition. She had a 3-day history of vomiting and loss of appetite. In the previous weeks she had undergone radiotherapy for metastatic squamous cell carcinoma (skin primary). The patient had two similar...

CaseA man, aged 69 years, presented with a 2-year history of diarrhoea, including nocturnal symptoms, faecal incontinence, abdominal pain and weight loss of 22 kg. He had no per-rectal bleeding. His past medical history included chronic obstructive pulmonary disease (COPD), gout, paroxysmal...

It is not possible to talk about feeding or starving of fevers and colds without firstly defining what they are and what they do.What is a fever?The normal body temperature is not as clearly defined as we might think. The mean oral temperature of adults is 36.8ºC plus or minus 0.4ºC, but it also...