The burden of chronic diseases such as chronic obstructive pulmonary disease (COPD) is increasing rapidly in low and middle-income countries. Despite this, their management in such countries has often not been well studied. In a paper published in JRSM Short Reports, Ailsa McKay and colleagues reviewed the nature and efficacy of current management strategies for COPD in India. They found information regarding current management – particularly on the implementation of national guidelines and primary prevention – to be very sparse. This led to difficulty in interpreting studies of management strategies, which were varied and generally of positive effect. Data regarding current management outcomes were very limited. They concluded that the current understanding of management strategies for COPD in India is limited due to a lack of published data. Determination of the extent of current use of management guidelines, availability and use of treatment, and current primary prevention strategies would be useful. This would also provide evidence that could be used to interpret existing and future studies of management outcomes and novel interventions.
Dear Dr, I am writing to refer a 28-year-old male patient of mine, Mr [Patient's Name], for assessment for the diagnosis and treatment of Attention Deficit Hyperactivity Disorder (ADHD). After a thorough clinical assessment, I believe that Mr. [Patient's Name] meets the criteria for adult ADHD as outlined in NHS guidance for primary care teams in SE London. Mr [Patient's Name] has been under my care for XX years and, during this time, he reports several symptoms (greater than five symptoms in total) consistent with ADHD in adults that have been present for more than six months. These symptoms include difficulties in focusing, following through on tasks, hyperactivity, forgetfulness, impulsiveness, restlessness, and irritability. Mr [Patient's Name] also reports being easily distracted, struggling with time management, organisation, and completing tasks efficiently. Many of Mr [Patient's Name]'s symptoms have been present since he was under 12 years old; and have
Comments