e-learning – Tinnitus

This is a new guideline from NICE published in Mar 2020 on the management of tinnitus. I will summarise the advice below. There isn't much new in this for us, but I would highlight that they encourage us to explore a patient's mental health from their initial presentation. What advice and information can we give…
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Hearing loss and ear wax

This is a new guideline from NICE on managing hearing loss and ear wax, published in June 2018. Exciting? Well, there are a couple of good bits in here, especially given how common a problem this is. Some top tips that were new for me: Consider an urgent referral to ENT for someone of Chinese…
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Otitis Media – when to use antibiotics

This is a new guideline from NICE on when to use antibiotics for otitis media (March 2018). It doesn't change common practice, but I found some of the statistics really helpful for explaining why we prescribe in some groups and not others. There is an excellent patient leaflet explaining things too. Some background info: Most have…
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Sore throat – when to use antibiotics

This is a new guideline from NICE which advises on when to use antibiotics in patients with tonsillitis or sore throat. If you already use a scoring system to help you decide when to prescribe it doesn't change a lot. Take home points: use a scoring system (FeverPAIN or Centor) and prescribe penicillin 500mg QDS…
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Sinusitis treatment down to five days

This is a NICE guideline from a couple of months ago in the use of antibiotics in sinusitis. I must say that this has changed my practice significantly, so well worth a read, especially the background information. Main learning points: 1st line antibiotic is now penicillin. Length of treatment is five days. Only consider antibiotics…
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Nice | New treatments for migraines and sinusitis

These are 2 new guidelines from NICE. I thought it was interesting to know that they are out there, but we don't need to know much about them at this stage. Transcutaneous stimulation of the cervical branch of the vagus nerve for cluster headache and migraine. This is safe, but there is limited evidence of…
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Vertigo

An elderly patient enters your room appearing unsteady, ‘No, I haven’t had too much to drink, Doc!’. You probably already have a differential diagnosis in your head, labyrinthitis being one of them. But, as this BMJ editorial reminds us, not all vertigo is labyrinthitis (BMJ 2012; 345:e5809). The authors stress that the terms vertigo and…
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