Does induction of labour prevent shoulder dystocia?

 Early IOL for women with suspected fetal macrosomia,who do not have gestational diabetes,does not improve either maternal or fetal outcome.(Evid level 4) In women with gestational diabetes, the incidence of SD is reduced with early IOL.(Evid level 2+) The NICE diabetes guideline recommends that pregnant women with diabetes who...

What dose Ketorolac?

Comparison of Intravenous Ketorolac at Three Single-Dose Regimens for Treating Acute Pain in the Emergency Department: A Randomized Controlled Trial Motov, Sergey et al. Annals of Emergency Medicine 2016 Dec. Study Design: N = 240, 18-65 years Randomised to receive 10mg, 15mg, 30mg IV ketorolac as single dose (double blinded)...

Even Short-term Oral Steroids Carry Serious Risk

Short term use of oral corticosteroids and related harms among adults in the United States: population based cohort study BMJ 2017; 357 doi: https://doi.org/10.1136/bmj.j1415 (Published 12 April 2017)Cite this as: BMJ 2017;357:j1415 Cohort study of more than 1.5 million adults 30 days of initiating these drugs, even at relatively low...

Should we be giving our women steroids prior to elective caesarean section?

Delivery by elective caesarean section at less than 39+0 weeks of gestation can lead to respiratory morbidity in neonates, requiring admission to the neonatal intensive care unit A recent retrospective cohort study showed that, compared with elective caesarean section births at 39+0 weeks of gestation, births at 37+0 weeks...

CKD goals, what am I doing with this raised PTH?

Phosphate-Binding Agents in Adults With CKD: A Network Meta-analysis of Randomised Trials.  Suetonia C. Palmer, PhD, Sharon Gardner, MA, Marcello Tonelli, MD, Dimitris Mavridis, PhD, David W. Johnson, PhD, Jonathan C. Craig, PhD, Richard French, MBChB, Marinella Ruospo, MScMed, Giovanni F.M. Strippoli, PhD’Correspondence information about the author PhD Giovanni...

Smoking cessation: Is abrupt quitting more effective than a gradual approach?

Lindson-Hawley N, Banting M, West R, Michie S, Shinkins B, Aveyard P. Gradual versus abrupt smoking cessation. A randomized, controlled noninferiority trial. Ann Intern Med 2016;164(9):585-592. Patients in the “abrupt cessation group” were asked to stop smoking on their quit day. Participants in the “gradual cessation group” were also...

Lung ultrasound for paediatric pneumonia

Q. Can Lung ultrasound reduce need for CXR in children with suspected pneumonia? Jones BP, Tay ET, Elikashvili I, et al. Feasibility and safety of substituting lung ultrasonography for chest radiography when diagnosing pneumonia in children: a randomized controlled trial. Chest 2016;150(1):131-138. randomized 191 children and adolescents with clinically suspected...

What is the best duration for nicotine replacement therapy?

  —525 smokers enrolled. —Randomized groups for nicotine replacement via patch at 8, 24, 52 weeks —6 month cessation rates were significantly higher if patches used for 24 wks. vs 8 wks. —No adverse effects noted —Cost effective benefit long term. —No additional therapeutic advantage with long term treatment...

POEM 16.03.17

Q. How do I treat resistant Mycoplasma Genitalium? ›Management of Mycoplasma genitalium infections – can we hit a moving target? BMC Infect Dis. 2015 Review and meta-analysis of 19 studies Azithromycin standard single dose failure (40%) No randomised controlled trial has compared azithromycin 1 g single dose with extended azithromycin...

POEM 15.03.17

  Q How well can we predict the risk of developing asthma in preschool children? A simple asthma prediction tool for preschool children with wheeze or cough.  J Allergy Clin Immunol. 2014 10 predictors with total score between 0 -15: sex, age, wheeze without colds, wheeze frequency, activity disturbance,...