Managing Chronic Diseases in Family Medicine: Best practices and Evidence-Based Approaches

The management of chronic diseases within the realm of family medicine presents a multifaceted challenge with profound implications for healthcare systems and patients alike. Chronic diseases, such as diabetes, hypertension, and cardiovascular conditions, are prevalent and impose a significant burden on individuals, families, and society as a whole. This article explores best practices and evidence-based approaches for managing chronic diseases in family medicine. It delves into the epidemiological landscape of chronic illnesses, emphasizing the need for effective prevention and management strategies. Evidence-based Models, such as The Chronic Care Model (CCM), Patient-Centered Medical Home (PCMH), and Self-assessment models are discussed in the context of family medicine. The importance of comprehensive, coordinated, and patient-centric approaches is underscored, highlighting the pivotal role of primary care physicians in the ongoing battle against chronic diseases. It is clear, that development in the field of family medicine underscores the importance of patient involvement in diseases management process through shared-decision making model. Although such model require physicans to spend more time educating patients so they can make informed decisions and implement self-management strategies, it has overall better health outcomes and eventually needs to requiring less intervention by physicians

DIAGNOSIS AND SURGICAL INTERVENTION ACUTE CHOLECYSTITIS

Cholecystitis is inflammation of the gallbladder that take place usually because of an obstruction of the cystic duct by gallstones arising from the gallbladder. For early treatment and preventing the complications, diagnostic methods, surgical approach and its contraindications are reviewed. MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were electronically searched for studies reporting surgical intervention acute cholecystitis published in English through 2018. Acute cholecystitis results from blockage of the cystic duct, generally by a gallstone, followed by distension and succeeding chemical or bacterial swelling of the gallbladder. Individuals with acute cholecystitis usually have constant right upper quadrant pain, anorexia nervosa, nausea, vomiting, and fever. Concerning 95% of people with acute cholecystitis have gallstones (calculous cholecystitis) and 5% lack gallstones (acalculous cholecystitis). Severe acute cholecystitis might result in necrosis of the gallbladder wall surface, referred to as gangrenous cholecystitis

Vesicoureteral Reflux and Renal Scarring in Infants after the First Febrile Urinary Tract Infection

Urinary tract infection (UTI) is common in children. It is caused by bacteria and can lead to complications such as renal scarring in cases of late diagnosis and a lack of early treatment. Vesicoureteral reflux (VUR) occurs when urine flows from the bladder to the ureter and kidney, and is more common in children with UTI. VUR predisposes patients to pyelonephritis and can cause renal scarring. This retrospective study aimed to determine whether VUR was associated with the evolution to renal scarring in 132 infants aged 9 days to 24 months admitted to a tertiary care hospital in Jeddah, Saudi Arabia, with the first episode of febrile UTI (mean age = 4.48 months [standard deviation = 5.48]; 82 [62.1%] males; 50 [37.9%] females). Data from their medical records were investigated[INLINE:1]for VUR and renal scarring. The VUR was related to renal scarring (P = 0.001). C-reactive protein (CRP) levels were significantly higher in patients with VUR (P = 0.027) and renal scars (P = 0.05). There was a statistically significant difference between VUR and renal scarring with the first UTI (P = 0.001). In conclusion, our study revealed a significant association of CRP with renal scarring (P = 0.05) and VUR and (P = 0.027)