Medicine

How to approach and manage palpitations in clinical practice

Mon, 02 Feb 2026 00:00:00 GMT

How to approach and manage palpitations in clinical practice Alsararatee, Hasan H; Ahmed, Kawser Palpitations are a common and often anxiety-provoking symptom for people who present in primary care. While many cases are benign, some indicate significant cardiac arrhythmia with potential haemodynamic compromise, highlighting the need for structured evaluation and timely intervention. This review provides health professionals with a practical, evidence-informed framework for the assessment, investigation and management of patients presenting with palpitations, integrating current guidance from the National Institute for Health and Care Excellence and the European Society of Cardiology.

Advancing patient care: the role of advanced clinical practitioners in abdominal paracentesis services

Wed, 02 Apr 2025 00:00:00 GMT

Advancing patient care: the role of advanced clinical practitioners in abdominal paracentesis services Alsararatee, Hasan H Abdominal paracentesis is a key therapeutic procedure for patients with ascites, particularly those experiencing liver cirrhosis. While effective in providing rapid symptom relief, the procedure carries potential risks such as infection and haemorrhage. This clinical review explores the role of advanced clinical practitioners (ACPs) in leading paracentesis services within the NHS. It critically examines the benefits of ACP-led services, including improved patient outcomes, reduced waiting times and optimised resource use. By operating across the four pillars of advanced clinical practice, ACPs enhance service efficiency while maintaining high standards of care. The involvement of ACPs in multidisciplinary teams ensures continuity of care and a holistic approach to patient management. In addition, ACPs contribute to ongoing research and provide educational support to trainees, fostering a sustainable model for future healthcare delivery. This review also highlights the potential of ACP-led paracentesis services to alleviate pressure on consultant-led teams, enhance patient satisfaction and meet the growing demand for this critical procedure. Recommendations for future practice include investment in ACP training and developing clear clinical protocols to further optimise service delivery.

The contribution of advanced practitioners to equitable and person-centred continence care

Thu, 04 Dec 2025 00:00:00 GMT

The contribution of advanced practitioners to equitable and person-centred continence care Alsararatee, Hasan H Continence problems remain widespread across community and secondary care, yet provision in the UK continues to be shaped by inequities, fragmented commissioning, stigma and variation in workforce capability. This article examines the contribution of advanced practitioners (APs) to continence care through the four pillars of practice and considers how their clinical expertise, leadership influence, educational role and engagement with research can strengthen assessment, co-ordination and person-centred support. Evidence from national reports and existing studies demonstrates the need for improved pathways, enhanced staff capability and dignity-focused practice, particularly for populations affected by frailty, cognitive impairment, or cultural and communication barriers. By integrating comprehensive assessment, sensitive communication, culturally responsive engagement and informed use of innovation, APs can advance equitable continence provision and improve the lived experience of individuals with bladder and bowel needs. The article concludes that AP-led practice is essential for progressing continence care within a system that requires greater consistency, stronger evaluation and sustained attention to wellbeing and quality of life.

Unmasking pulmonary vein thrombosis: a rare mimic of pulmonary embolism

Wed, 01 Jan 2025 00:00:00 GMT

Unmasking pulmonary vein thrombosis: a rare mimic of pulmonary embolism Alsararatee, Hasan H; Ahmed, Kawser; Elachola, Mohammed A female in her 50s was referred by her general practitioner (GP) with a 6-day history of left calf pain and swelling. She had a history of recurrent deep vein thrombosis (DVT) and a strong family history of thrombosis involving her mother and sibling. On examination, there was mild tenderness in the left calf with <3 cm asymmetry. Blood tests were normal apart from an elevated D-dimer. Doppler ultrasound ruled out DVT. However, an ECG performed at the GP clinic confirmed paroxysmal atrial fibrillation, and the patient also reported palpitations and shortness of breath at that time. Her Wells score for pulmonary embolism was 7.5, warranting urgent CT pulmonary angiography (CTPA) and initiation of therapeutic enoxaparin. CTPA demonstrated acute pulmonary vein thrombosis rather than pulmonary embolism. A multidisciplinary team discussion was held, and apixaban was commenced following haematology consultation. Follow-up CTPA confirmed complete resolution of the thrombus.