Saturday 24 September 2016

BOX 1: Asthma Control Questionnaire 5-item version
Circle the number of the response that best describes how you have been during the past week
1. On average, during the past week, how often were you woken by your asthma during the night?
0. Never
1. Hardly ever
2. A few times
3. Several times
4. Many times
5. A great many times
6. Unable to sleep because of asthma
2. On average, during the past week, how bad were your asthma symptoms when you woke up in the morning?
0. No symptoms
1. Very mild symptoms
2. Mild symptoms
3. Moderate symptoms
4. Quite severe symptoms
5. Severe symptoms
6. Very severe symptoms
3. In general, during the past week, how limited were you in your activities because of your asthma?
0. Not limited at all
1. Very slightly limited
2. Slightly limited
3. Moderately limited
4. Very limited
5. Extremely limited
6. Totally limited
4. In general, during the past week, how much shortness of breath did you experience because of your asthma?
0. None
1. Very little
2. A little
3. A moderate amount
4. Quite a lot
5. A great deal
6. A very great deal
5. In general, during the past week, how much of the time did you wheeze?
0. Not at all
1. Hardly any of the time
2. A little of the time
3. A moderate amount of the time
4. A lot of the time
5. Most of the time
6. All of the time.
able 1. Primary features of each rosacea subtype and their specific therapies 4
Rosacea subtypeClinical featuresTherapies available
Erythematotelangiectatic
Transient erythema and persistent centrofacial erythema with or without telangiectasia.
  • Topical brimonidine
  • Oral isotretinoin
  • Laser/light therapy
Papulopustular
Persistent centrofacial erythema with transient centrofacial papules and/or pustules
  • Topical metronidazole/
  • azelaic acid/ivermectin
  • Oral doxycycline/erythromycin/minocycline
  • Oral isotretinoin
Phymatous
Thickened skin and irregular surface nodularities, most commonly involving the nose (rhinophyma) though it can involve other facial convexities and the ears as well
  • Oral isotretinoin
  • Surgical intervention
Ocular
Foreign body sensation in the eye; burning or stinging sensation; dryness; itching; ocular photosensitivity; blurred vision; scleral telangiectasia; and/or periorbital oedema
  • Eyelid hygiene and lubricant eye drops
  • Topical cyclosporin/metronidazole
  • Oral doxycycline/azithromycin

BOX 1. CONCUSSION CLINICAL DOMAINS
Somatic
  • Headache
  • Nausea/Vomiting
  • Sensitivity to light/noise
  • Visual problems
  • Fatigue
  • Dazed, Stunned
  • Dizzy, Balance problems
Cognitive
  • Feeling mentally 'foggy'
  • Feeling slowed down
  • Answer questions slowly
  • Forgetful of event
  • Repeats questions
  • Drop in academic performance
Emotional
  • Irritability
  • Sadness/Depression
  • Personality change
  • Anxiety/Panic
  • More emotional
  • Less emotional (apathy)
Sleep
  • Drowsy
  • Sleeping more
  • Sleeping less
  • Difficulty falling/staying asleep

Post partum contraception

Here are six key contraception tips for optimal postpartum care:
  1. Initiate discussion of ongoing contraceptive needs while the patient is still pregnant and encourage her to communicate these to her clinical attendants
  2. Provide an evidence-based discussion of the pros and cons of various contraceptive methods — taking care to counter prevailing misconceptions
  3. If the choice is oral contraception, provide her with a prescription so that she can commence this immediately postpartum. It is a detail often overlooked at hospital discharge
  4. If the choice is for an IUD or implant, then ensure that she takes the device along to the hospital with her. Few hospitals or outpatient departments have these devices on hand or provide them cost-free. If she does not bring one along, she is likely to be rescheduled even if there are no contraindications to insertion at the time
  5. Be aware of the virtues of bridging contraception. If access to her preferred contraceptive method is likely to be delayed, then provide her with something until she can get it — such as the POP, DPMA or COCP, if she is not breastfeeding
  6. Encourage her to come back to discuss her options before simply stopping a method which is not suiting her.

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