The combined oral contraceptive pill

The combined oral contraceptive pill (COCP) has been a popular choice of contraception since it was first introduced in 1961. There are numerous varieties of COCP and tailored regimes allow patients more choice and opportunities to adapt contraception to suit individual needs. The pandemic has made it more difficult for patients to access long-acting reversible contraception support and many have been using interim methods of contraception, including the COCP. In this article we explore which pill to prescribe, developments in tailored regimes, guidance about changing pills when side effects arise, health risks and benefits, as well as best practice for remote assessments and prescribing.

Diagnosing leukaemia in a primary health care setting

This article synthesises current knowledge about the presentation and diagnosis of leukaemia. It will also suggest strategies for early diagnosis of the disease in primary care. This article is to be used as a guide by GPs in their learning for when to initiate blood tests for possible cases of leukaemia and how to recognise the common and non-specific symptoms of leukaemia.

Interpreting the full blood count

The full blood count (FBC) is one of the most commonly requested blood tests in medical practice and can provide a wealth of useful information about a patient’s general state of health, as well as highlighting abnormalities which indicate systemic or sinister pathologies. This article seeks to explore the different parameters of the FBC, and how these relate to some more common clinical presentations, as well as their relation to morphological findings seen on the blood film. As with most investigations, differential diagnoses suggested by any individual laboratory tests are wide and are most valuable when combined with history and examination.

Hearing loss: Conductive versus sensorineural

Hearing loss has a significant impact on quality of life, and may even compromise an individual’s ability to work and their safety – we use our hearing to constantly detect and react to environmental hazards around us. Hearing loss can have a profound impact on a person’s life. This is especially true for certain patient groups. For instance, the elderly, and those with co-existing problems that affect their ability to communicate (such as dementia, cerebrovascular disease or psychiatric disorders). Even those without co-morbidities suffer the burden of disease where communication is impaired: the young who are developing their speech and language skills and adults with language barriers or other impediments to their speech. The hearing apparatus is made up of conductive and sensorineural pathways, which may be affected by pathology, leading to deafness. This article describes the aetiology of conductive and sensorineural deafness, details the relevant clinical assessment and outlines management strategies in community practice.

Lymphoma for GPs across the cancer continuum

Lymphomas are a diverse and relatively common cancer type in the UK. Early diagnosis of lymphoma is vital for improving patient outcomes. The majority of patients diagnosed with lymphoma have a life expectancy of more than 5 years. Lymphoma treatments can have long-term health consequences, and patients with a history of lymphoma have a higher risk of subsequently developing other cancers. More robust evidence for the early diagnosis of lymphoma in primary care has been published in recent years, and the classification of lymphoma has recently been updated by the World Health Organisation. This article focuses on the diagnosis of lymphoma in adolescents and adults and the on-going care needs of patients who are being treated for lymphoma or have survived a diagnosis of lymphoma. Further information about lymphoma and other cancers in children can be found in the InnovAiT article by Dr Jennifer Kelly published in 2017.