Globally, dementia affects 47.5 million people, making it a significant health concern. The growing number of people with dementia is posing a challenge to the health care systems. Dementia is a complicated progressive syndrome which is characterized by impairment of cognition, changes in personality leading to impeded daily life activities. Dementia poses burden to patients, their families society and healthcare systems in context of cost and care. People with dementia need intense medical, nursing, psychological, and social support to slow the disease's progression and retain autonomy and social inclusion. Primary care has been shown to be the first point of contact for patients with dementia (PWD), making it an appropriate setting for diagnosis, in-depth needs assessments, and the beginning of dementia-specific therapy and care. The majority of dementia patients are treated in primary care settings and deal with complex medical and psychological conditions. They also suffer from various comorbid diseases along with dementia and take numerous psychotropic medications, including anticholinergics. However, the primary care system frequently fails to recognize their dementia-related symptoms due to certain constraints including time and lack of resources. Hence, the primary care system has to be supported with a variety of resources, such as dementia care managers, access to and coordination with interdisciplinary dementia specialists, and a practical dementia screening and diagnostic procedure, in order to provide better care for these vulnerable patients. The purpose of this research is to review the available information about safety and effectiveness of dementia care management in primary care.

Evidence shows that the management of chronic disorders is associated with massive expenditure and increased utilization of healthcare resources. Therefore, innovative management approaches to these conditions are encouraged to overcome these burdens and enhance the quality of care for the affected patients. Home visits and health promotion programs have been described in this context with favorable outcomes over individuals and communities. We have discussed the efficacy of home visits and health promotion programs on the outcomes of patients suffering from chronic disorders. Our findings indicated the validity of these approaches in enhancing the quality of care for patients with chronic conditions. Adequately applying these outcomes can be associated with enhanced quality of life for patients. Besides, estimates also showed that they can reduce the number of visits to the emergency department and the frequency of hospital admissions. Health promotion programs can also reduce the utilization of the different healthcare resources including medication use and the availability of healthcare providers. However, the current evidence lacks validation by proper investigations. Accordingly, we encourage further studies to be conducted to enhance the current findings adequately.

Abnormalities in serum electrolyte levels and impaired electrolyte homeostasis may aberrate cardiac conduction by altering cardiac ion current kinetics. Oftentimes, the bedside electrocardiogram (ECG) can render expeditious insight and prompt emergency therapy while laboratory investigations of fluid, acid-base and electrolyte imbalances are underway for establishing a definitive diagnosis. The most frequent electrolyte aberrations affecting the ECG include disturbances of potassium, calcium, and magnesium concentrations. Electrolyte dyshomeostasis impacts the depolarization and repolarization phases of action potential in cardiomyocytes by modifying potentials across their cell membranes. Further, individual electrolyte disturbances often have wide-ranging consequences due to their effect on one another. Serum potassium concentration changes can cause considerable repercussions on myocyte conduction and potentially resulting in ECG changes. The ECG changes in hypokalemia mimic those of myocardial ischemia. With severe hypokalemia, the telltale ECG change is the development of U waves. In hyperkalemia, the primary ECG manifestation is T wave tenting, that is seen as a symmetrical narrowing or peaking but with oftentimes a wide deflection and high amplitude. With very severe hyperkalemia, a slurring “sine-wave” appearance may be observed on the ECG due to significant prolongation and widening of QRS complex and subsequent fusion with the T wave. Hyper-and hypo-calcemia mainly change the action potential span (phase 2), which causes either shrinking (in hypercalcemia) or extension (in hypocalcemia) of the QT interval. The effect on the QT interval is mainly the result of an alteration of the ST-segment time span. Both situations can impact T wave structure. No classic ECG presentation is observed in hypo-or hyper-states of magnesium. Bedside electrocardiography serves as an important aid in forming diagnoses and managing patients presenting with electrolytic dyshomeostasis.

Estimates show that otitis externa is a common presentation in different settings and can be acute, chronic, or necrotizing. Eczema of the ear canal is usually associated with the condition. It has also been demonstrated that humid environments, swimming, and mechanical trauma, using hearing aid supplements, and absence or reduce air wax are all significant risk factors that can increase the risk of having otitis externa. The pathology of otitis externa is simply an inflammation of the external auditory canal, which can either be attributed to an infection or other non-infectious etiologies. In the present literature review, we have discussed the epidemiology, risk factors, and monitoring of patients with acute otitis externa. Our findings indicate the high prevalence of the condition, especially among developing countries and areas with high temperature and humidity levels. Swimmers are more commonly affected together with adults. However, children might also be affected in some cases. Male individuals also have a higher risk. Nevertheless, data is limited and further studies are needed. The condition can be easily treated and symptoms usually resolve within 1 day from initiating the treatment. However, some cases might persist, and in these events, consultation with an otolaryngologist is required together with culture for adequate identification of the etiology and management of the case.

Contraception is a critical tool in achieving favorable family planning, which has been reported with remarkable outcomes on the individual and country-based levels. Using contraceptive approaches has been reported to be cost efficacious with minimal side effects. It gives couples more freedom, privacy and control over their lives, which might also enhance the quality of life of these individuals. In the present study, we have reviewed evidence from current studies in the literature about the different approaches to contraception in primary care. We have discussed the different barrier and non-barrier approaches that have been validated in the literature as efficacious approaches that can achieve contraception. We also reviewed the safety profiles for the different modalities and whether they can be used or not. Overall, couples should consult with the primary care physician before approaching any modality to give them a better judgment about the potential benefits and risks of each suitable contraception tool. We suggest that educational campaigns should also be conducted to increase awareness and attitude about family planning and using contraceptive modalities to expand the application and favorable outcomes of using these tools.