Topiramate (TPM) is a sulfonamide drug with multiple modes of action. It inhibits carbonic anhydrase, blocks sodium channels, enhances potassium channels, and stimulates postsynaptic gamma-aminobutyric acid (GABA) receptors. Pharmacists Joe Gardocki and Bruce Maryanoff synthesized TPM for the first time in 1979. The FDA did not approve it for medical use in the US until 1996. Around 2004, it was authorized for the prevention of migraine headaches. TPM, like any medication, has several side effects. Common aftermaths include weight loss, diarrhea, dizziness, sleepiness, fatigue, and coordination issues. Some people may experience mental health issues like memory problems, confusion, and speech or language difficulties. The most well-known ocular side effects of TPM are choroidal effusion syndrome, angle-closure glaucoma, and myopic shift. Aside from these, other ophthalmic adverse effects may arise in some people, including retinal problems, uveitis, visual field defects, myokymia, and neuro-ophthalmology complications. If such complications are not identified and treated promptly, they can be severe and vision-threatening, potentially leading to permanent blindness. TPM's application as a standalone and adjunctive therapy has increased over time. In 2019, more than 10 million prescriptions of TPM were issued. Due to its extensive use, medical professionals and patients must be aware of its potential repercussions, especially ophthalmic issues. The current review paper likewise makes a step in this direction. This article's primary purpose is to educate readers by providing a comprehensive assessment of the research on TPM's ocular side effects. All the information has been collected via a thorough search of the Google Search Engine and PubMed.

Prostatitis is generally characterised as painful inflammation of the prostate, with or without bacterial infection. It is the most frequent urological diagnosis in men under 50 years in age, and the third most common urological diagnosis in men over that age. It tends to occur in young and middle-aged men. Prostatitis-like symptoms have a lifetime prevalence of up to 10%, although the proportion of these confirmed to be true prostatitis is unknown. The presentation of prostatitis can sometimes be vague and multifaceted. Initial therapy with antimicrobials remains the mainstay of treatment, although less than 10% of cases have a proven bacterial infection. The aims of this article are to initially outline the forms of prostatitis and then subsequently to review the clinical presentation and management for the commonest forms of prostatitis seen in UK general practice.

Eye problems are a common presentation in primary care and they are the presenting problem in about 2–3% of all consultations. GPs are responsible for diagnosing eye conditions and making appropriate specialist referrals. The tools usually available in general practice, such as Snellen charts, penlights, and direct ophthalmoscopy, are sufficient to diagnose most eye disease. This article aims to help GPs approach eye examination in an organised, logical fashion. This article will outline how to perform each step of the examination and the diagnosis of common eye conditions including those that need immediate referral to a specialist. A fictional case scenario is used to illustrate the importance of a good history and accurate eye examination in the diagnosis and management of eye disease.

Case historyA 56-year-old gentleman presented via telephone triage with a 3-week history of morning headache. He had no significant comorbidities. He described a unilateral aching pain extending from his right eye to the occiput. The GP also elicited poor sleep, apnoeic episodes and snoring. Obstructive sleep apnoea was the provisional diagnosis and the patient was booked for review with a GP registrar.At review the pain was noted to be worse in the mornings and associated with increased fatigue. The patient commented: 'I can fall asleep at a moment's notice'. His partner reported a decline in mood and more aggressive behaviour. There were no signs of focal neurology, no nausea or vomiting and examination was unremarkable. A sleep apnoea-focused history was taken and the patient reassured that the headache was benign. Safety netting was documented as, 'worsening advice given'. The patient sought further advice over the phone 10 days later and reported worsening pain and mild photophobia. The diagnosis of sleep apnoea was reaffirmed and the patient was advised to seek help if symptoms deteriorated, but specific safety netting advice was not documented.After a further two weeks the patient presented with vomiting, confusion and drowsiness. Nystagmus was noted and he was sent to the emergency department for a suspected space-occupying lesion. A computerised tomography scan showed a right frontal tumour, in keeping with a glioblastoma and the patient was commenced on dexamethasone, providing significant symptomatic relief. The diagnosis was confirmed by a subsequent magnetic resonance imaging and biopsy, following which chemotherapy and radiotherapy were organised.

While telemedicine has been extensively researched throughout the globe, the Middle East has seen relatively little research on the topic. The purpose of this study was to investigate the primary care physicians' perceptions of the use of telemedicine, as well as its hurdles and benefits, during the COVID-19 pandemic in the state of Qatar.In this multicenter cross-sectional study, an internally validated questionnaire was distributed among primary care physicians utilizing telemedicine during the pandemic at Primary Health Care Corporation (PHCC), the main primary care provider in Qatar. A convenience sample was taken due to the pandemic restrictions.Out of 254 analyzed questionnaires, about half of the physicians (48%) had used telemedicine in the past primarily in the form of telephone consultations. Nearly three-quarters (74%) of physicians agreed that telemedicine is an easy way to communicate during the pandemic, but only half (52%) felt it improved job performance and effectiveness. Most physicians (90%) agreed that telemedicine is safe during the pandemic, but opinion was split on whether an optimum assessment of COVID-19 disease could be conducted. The majority also considered telemedicine an effective tool for chronic disease reviews (63%) and other consultations such as blood test results and medicine prescriptions (71%). The most significant barrier to telemedicine use was a language barrier followed by a lack of proper training. About 79% of responders felt that telemedicine improves access to healthcare and assists in contacting difficult-to-reach individuals, and 74% also thought it minimizes no-shows in the clinics.Our study has shown that most physicians felt comfortable and safer using telemedicine as an alternative means to conduct consultations during the pandemic. Keeping in view its advantages, the majority suggested that it could be incorporated into daily practice even beyond the pandemic. However, concerns were raised about its use to assess COVID-19 disease, lack of training, and potential barriers such as language differences. Further studies are needed to assess the efficiency and cost-effectiveness of telemedicine as well as the evaluation of alternative media such as video consultation, which could increase the utility of telemedicine and potentially mitigate some of its disadvantages.