Preventative Medicine: Healthy Kai Kai & Deadly Exercise

As primary healthcare doctors we have the privilege of educating and promoting good health amongst our patients. We know that preventive medicine is essential in reducing the morbidity and mortality of chronic disease including the most commonly seen here in Torres Strait Islanders: cardiovascular disease, diabetes and chronic kidney disease.

How do you promote healthy eating and physical activity with your patients? We would love to hear from you! Sent us a tweet @Island_Docs

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The Pressure Is On: Will Australia Adopt New Hypertension Guidelines?

The Evidence:

A randomised trial of intensive versus standard blood-pressure control

The Summary:

The SPRINT trial was a randomised, controlled trial comparing the safety and efficacy of intensive lowering of systolic blood pressure (SBP) to less than 120mmHg, compared with standard management to less than 140mmHg. The study included a total of 9361 patients,  who were eligible to participate if their age was greater than, or equal to, fifty years and had hypertension with a SBP greater than 130mmHg. Exclusion criteria included those patients with diabetes mellitus, previous stroke and/ or end stage renal disease. Continue reading “The Pressure Is On: Will Australia Adopt New Hypertension Guidelines?”

A 7-year-old boy with Omnipresent Oedema

This case has been inspired by events in the Torres Straits and details have been changed to ensure patient anonymity.

History

A 7-year-old boy presented to the Primary Healthcare Centre one afternoon after school with his grandmother. She was concerned that his eyes had become quite puffy over the past few days. He had been swimming at the local pool over the weekend and she thought it might be because he had been wearing swimming goggles. He denied any pain around his eyes, diplopia or blurred vision. He also noticed that his school shoes hurt when he put them on. Continue reading “A 7-year-old boy with Omnipresent Oedema”

Two 20-year-old Males with Impending Sense of Doom

 

This case has been inspired by events in the Torres Straits and details have been changed to ensure patient anonymity.

History

It was a quiet afternoon in the Emergency Department when a call came from the Ambulance Office informing us of 000 call from a boat out on the reef. “We’ve been told told that there are two young men out there who are both unwell and feel like they are going to die.” We didn’t receive much more information than that, and waited until a helicopter went to retrieve them, where they were both winched from the ocean. Continue reading “Two 20-year-old Males with Impending Sense of Doom”

A 62-year-old Male with Dreadful Dysuria

This case has been inspired by events in the Torres Straits and details have been changed to ensure patient anonymity.

History

A 62-year-old Male trudged into the Emergency Department on a Friday night. There was a downpour of rain outside as the wind was whistling through the windows and doors. This weather came as no surprise to anyone – it was after all the wet season. He complained of dysuria, urinary frequency and hesitancy for over two months. There was no blood or pus in his urine, no bowel symptoms, no abdominal or flank pain and no fevers. He had visited his GP a few weeks ago who diagnosed a urinary tract infection and given him a course of Trimethoprim.  Urine cultures at that time grew sensitive E. Coli. But his symptoms never seemed to have resolved and in fact now were worse. “Just fix the problem doc!!” were his words.

His had diabetes (on metformin and gliclazide); hypertension (on ramipril) and hypercholesterolaemia (on a statin). He was a ex-smoker, non-drinker, not currently working and enjoyed gardening.

Continue reading “A 62-year-old Male with Dreadful Dysuria”

A 25-year-old Female with a Mysterious Myalgia

This case has been inspired by events in the Torres Straits and details have been changed to ensure patient anonymity.

History

A 25-year old previously well female presented to the remote area nurse on an outer island somewhere in the Torres after being carried into the clinic by her family. She had woken that morning with severe muscle pains in her neck, back, abdomen and hips. She described the pain as ‘just like a cramp’ and denied joint pains, nausea, vomiting, fevers and bowel or bladder symptoms.

The patient had been Crayfish diving the day prior but can’t remember being stung by anything in the water. She ate cooked boxfish the night before – a regular meal in her family. She didn’t drink alcohol and denied drug use. Continue reading “A 25-year-old Female with a Mysterious Myalgia”

A 40-year-old Male with a Serpiginous Foot Rash

This case has been inspired by events in the Torres Straits and details have been changed to ensure patient anonymity.

History

A 40-year-old male presented to his primary health care practice during the wet season somewhere in the Torres during the wet season. He had an intensely itchy rash to his right ankle for the past five days. It started out as a small but painful raised erythematous lesion then began to migrate around his ankle. The rash was found nowhere else on his body. He didn’t have a fever, abdominal pain, diarrhoea or cough. He had recently been doing some gardening barefoot around a flooded creek and described the water to be quite muddy and contaminated. He is an otherwise well male with no past medial history, regular medications or allergies. Continue reading “A 40-year-old Male with a Serpiginous Foot Rash”