Latest Questions

Is there any evidence comparing almotriptan with other triptans especially sumatriptan?

Associated Tags: neurology, migraine, treatment, almotriptan, sumatriptan, triptans

Question answered: 07/09/10

I have a male patient with rheumatoid arthritis on methotrexate and long term steroids and alendronate as osteoporosis prevention. He can’t tolerate alendronate because of symptomatic Barretts oesophagus. What evidence is there for other osteoporosis treatments in men re efficacy and safety?

Associated Tags: men's health, muskuloskeletal, osteoporosis, harm, corticosteroid

Question answered: 07/09/10

I recently saw a 65year old woman, who is requesting treatment[for osteoporosis with bisphosphonates] but her Dexa scan shows only osteopenia [left hip and femoral neck]. She has Coeliac disease and IBS symptoms. She had sustained a fall on the outstretched hand and had a distal radius # in 2005. The DEXA scan organised by the gastroenterologist shows only osteopenia but she wants treatment for osteoporosis. Is there any evidence to treat her with bisphosphonates for osteopenia? Thanks.

Associated Tags: musculoskeletal, osteopenia, treatment, bisphosphonates

Question answered: 06/09/10

is there any evidence that a male taking epilim is a potential teratogenic risk for his offspring ?

Associated Tags: neurology, men's health, epilepsy, teratology, epilim

Question answered: 01/09/10

The SIGN guidelines on management of stroke and TIA state: All patients with a previous stroke or TIA should be considered for treatment with an ACE inhibitor (for example, perindopril) and thiazide (for example, indapamide) regardless of blood pressure, unless contraindicated. Does the evidence support applying this to all patients with non-recent previous history of stroke/TIA, however long ago? For the purposes of audit and management can a duration of delay since the event be established beyond which the evidence does not adequately support initiation of such treatment?

Associated Tags: cardiovascular, secondary prevention, stroke, TIA, treatment, ACE inhibitors, thiazides

Question answered: 01/09/10

How common is non response to midazolam? could this be predicted?

Associated Tags: palliative, sedation, harm, prevelance, midazolam

Question answered: 01/09/10

What is the evidence for low iron levels causing tiredness in people who are not anaemic.

Associated Tags: haematology, low iron, aetiology, tiredness

Question answered: 26/08/10

What is the risk of GI bleeding in patients 50-60 years old who are taking SSRIs? Should they be prescribed PPIs?

Associated Tags: gastroenterology, harm, antidepressants, bleeding, PPIs, SSRIs

Question answered: 23/08/10

Is there any evidence on calcichew and MI risk?

Associated Tags: cardiovascular, musculoskeletal, MI, harm, calcichew

Question answered: 16/08/10

I would like to know guidelines on measuring uric acid levels whilst being on allopurinol?

Associated Tags: endocrinology, hyperuricaemia, monitoring, allopurinol

Question answered: 11/08/10

I have been asked by a local rheumatolgist to titrate up doses of alloprinol based on a set plan of serial uric acid levels . I am not aware of any evidence to support this as in practice the dose of allopurinol is often guided on clinical response . I would if anything monitor LFTs with higher doses of allopurinol because of its associated liver toxicity at high doses but I am reluctant to start a protocol of routinely checking uric acid levels in response to allopurinol dose schedules.To me it seems inappropraite and costly and clinically unecessary

Associated Tags: musculoskeletal, gout, dose, allopurinol

Question answered: 06/08/10

Can vancomycin be prescribed in liquid form?

Associated Tags: infection, drug administration, antibiotics, vancomycin

Question answered: 05/08/10

I have a lady with asymptomatic raised uric acid of 500.She is not on antihypertensives or drugs that cause this.She is not in renal failure.what investigations should I carry out to make sure there is no secondary cause for this ?

Associated Tags: musculoskeletal, nephrology, hyperuricemia, aetiology, assessment

Question answered: 05/08/10

what is the evidence for neem oil in scalp psoriasis?

Associated Tags: CAM, dermatology, psoriasis, treatment, neem oil

Question answered: 05/08/10

A young male (18 ys old) suffering from Type 1 DM(diagnosed 8 yrs ago) presented with symptoms of Erectile Dysfunction. Is it more psychological in nature or is it due vascular causes? What is the management in such cases?

Associated Tags: endocrinology, men's health, diabetes, erectile dysfunction, treatment

Question answered: 26/07/10

Does doxazosin MR give better BP control over plain doxazosin? Can the MR version be switched to plain?

Associated Tags: cardiovascular, hypertension, drug administration, doxazosin

Question answered: 26/07/10

What is the evidence for the use of oral steroids in refractory coeliac disease?

Associated Tags: gastroenterology, coeliac disease, refractory, corticosteroids

Question answered: 22/07/10

Are there any benefits from using topical anaesthetic rather than intradermal in minor operations?

Associated Tags: minor surgery, efficiency, anaesthetic

Question answered: 21/07/10

Are there any current guidelines about the use of vaginal ring pessaries for prolapse in the elderly ?

Associated Tags: women's health, genital prolapse, treatment, pessary

Question answered: 21/07/10

Is there any benefit from minoxidil lotion for male pattern baldness in women? Are there any contraindications to its use?

Associated Tags: dermatology, male pattern baldness, treatment, minoxidil

Question answered: 20/07/10

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