Journal of General Practice

The cardiovascular system is the first system to develop and to function. It supplies tissues and organs with oxygen, nutrients, hormones, immune competent cells and others and deliberates them from waste products and metabolic heat. Many attempts were made to gain insights into its three-dimensional structure by injecting air, liquids, waxes or hardening substances.

Background: Sialadenitis (inflammation of the salivary glands) is commonly caused by salivary calculi or infection, although less common causes such as neoplasia or systemic inflammatory conditions are important to consider and rule out.

Objectives: This article provides an overview of the clinical presentation, workup and management of sialadenitis in the primary care setting, including common differential diagnoses and recommendations on when to refer for specialist care.

Discussion: The three major salivary glands are the parotid, submandibular and sublingual glands. Management of acute sialadenitis involves antibiotics, massage, hydration, sialogogues and removing medications causing salivary stasis. Salivary calculi may require removal via transoral or endoscopic techniques, or gland excision. It is important to consider other causes including viral infections, juvenile recurrent parotitis, or neoplasia. Patients with chronic sialadenitis or where the diagnosis is unclear should be referred to an Ear, Nose and Throat (ENT) specialist.

Purpose: Obesity, stress, poor adherence to dietary rules and lack of exercise during the necessary distancing measures to limit the spread
adversely affect the course of COVID-19 disease, according to available medical literature. The purpose of our study is to detect how the above
factors increase the severity of the disease and to suggest options for addressing this critical problem.
Methods: We conducted a bibliography review of 50 articles, from studies related to obesity, stress, nutrition and COVID-19 Disease in
the Databases (PubMed, Embassy, MEDLINE and Cochrane) and we selected, finally, 17 articles that matched and harmonized with our
research question.
Results: During lockdowns, Obesity and less disposition to perform physical exercise, increases vulnerability of COVID-19 patients, as
produces and exacerbates anxiety, depression, panic attacks, post-traumatic stress, psychotic symptoms and suicidal ideations. The above
findings are due in part to social determinants of human health status. The Mediterranean diet seems to outperform the Western diet but
there is a need for more research. The recommendations that result from studies and benefit the patient with COVID-19 disease consist in the
application of a hypo caloric diet that improves metabolic health and respiratory function with adequate intake of micronutrients and fiber,
vitamins. Also necessary is the intake of trace elements such as Copper, Zinc which limits the reproduction of the virus and Omega-3 lipids.
Moderate aerobic exercise is recommended, which decreases inflammatory cytokines and enhances the immunity response. Treating
stress with relaxation techniques, behavioral psychotherapy and medication when needed is crucial.
Conclusions: Drastic measures are needed to regulate the weight of citizens, with hygienic and dietary measures, by
strengthening the idea of exercise and systematic aerobic activity, which will be extremely beneficial for the prevention of COVID-19
and will benefit even more the most vulnerable groups-citizens with increased vulnerability due to multi-disease. Finally, it is necessary to
preserve the mental health of citizens and to develop psychosocial interventions that will strengthen the mental and social health of the most
vulnerable groups during the COVID-19 pandemic.

Aims: Clinical letters are vital for Clear and effective communication. Our aim was to evaluate the quality of clinical letters against audit
standards in a community psychiatry clinic.
Methods: In the first cycle of the audit we assessed quality of letters All letters (n=30) written by the author for patients who attended
community mental health clinic between last two weeks of September 2015. The 2nd cycle of the audit we assessed letters (n=29) written
in last two weeks of November 2015. The audit standards were developed as per recommendations of 21st European Congress of Psychiatry
and relevant literature research.
Results: The standard of clinical letters in the first cycle of audit varied significantly. The information related to bio data details (name, D.O.B.
address, diagnosis and pharmacological treatment) was accurately stated 100% (30/30) in the letters. The All Day Living activities (ADLs) and
standard length of letter were found in 66.7% (20/30) and 73.3% (22/30) of letters respectively. The quality of letters improved in the 2nd cycle
of the audit as per audit standards.

Over Active Bladder (OAB) is a common problem affecting millions of men and women worldwide. It has far-reaching consequences
on individual quality of life. No single treatment has been proven to be most effective, although many management options exist. Often a
combination of options is required to successfully tackle OAB symptoms. In this review, we provide an overview of OAB, including risk
factors for OAB; keys to diagnosis and therapeutic options including conservative and medical treatment, as well as management of refractory
OAB; when to consider referral to a specialist; and resources for clinicians and patients. The aim of this review is to inform clinicians
regarding OAB management in order to improve patient counseling and care in primary care setting.