"I'm Dorothy Gale from Kansas"
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blake kathryn
occasionally subtle
Cosmic Funnies
Andulka
Show & Tell
we're not kids anymore.
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Sade Olutola
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trying on a metaphor
Game of Thrones Daily
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Origami Around
roma★
Today's Document
🪼
Noah Kahan
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@drsamheard
Warning
Australian doctors cause more brain tumours than they detect with CT Scans. It may reassure us at the time, but what a cost. Careful clinical assessment is going to pick up most brain tumours, vomiting is a very common symptom, and new headache over 50 is much more likely to be of concern (and the CT is far safer then). We need more clinicians taking a careful history and examination and exposing people to less potentially harmful radiation.
Street Cred
Nerve pain - either through irritation of a nerve or damage to the nerves particularly in the legs - requires a different approach. Amitriptyline is an old antidepressant that is cheap. The interesting thing is that very low doses seem to work the best. We used to use 75-150mg for depression and even 25mg for kids wetting their bed (I never did!). Interestingly 10mg at night works best for nerve pain. It is particularly good for diabetic feet.
Warning
Tests are only as good as the clinician who orders them. If a test detects the disease that is present 95% of the time but gives a false positive result 5% of the time (and that is better than a lot of tests) then it is pretty close to useless until you have at least a 1:10 chance of having the disease. Even then you will have about 10 positives and 5 false positives for every 100 tests: only two thirds of those with a positive result will actually have the disease.
The major feature of a good tests is that it is carried out when the condition being tested for is quite likely to be present. Hence the need for quality clinicians and not more tests.
Gem
Time is worth a thousand tests.
Street Cred
Picture from http://www.nhs.uk/Conditions/pityriasis-versicolor/PublishingImages/Pityriasis_versicolor_342x198_M2400769.jpg
Tinea Versicolor: Common minor yeast infection of the skin but usually treated ineffectively. It always scales slightly when you scratch it - may look paler on brown or tanned skin or darker on lighter skin. Here's a cheap, low tech and very effective solution:
Get hold of some Selsun lotion and start in the morning.
Rub it into your skin from elbows to chin to waist (all of your torso) and leave it for 8 hours or so. (If it is very irritant you can wash it off and use it diluted).
Get in pool or bath and wait until the skin on your fingers is quite wrinkled.
Get out and rub your torso with a towel, Get someone to do your back if you can. Watch the little rolls of skin which contain all of the fungus.
Have a shower.
It will take a couple of months for the colour to get back to normal.....(as it will no matter what you do.)
Warning
A healthy child in a developed country almost never needs antibiotics for a fever, sore throat, earache or respiratory tract infection. Further, if you prescribe antibiotics complications of such infections are no less likely to occur. See for example: http://summaries.cochrane.org/CD007880/antibiotics-for-common-respiratory-infections-with-unclear-causes-and-undifferentiated-symptoms-in-children-up-to-five-years-of-age
Gem
When things are tense people answer questions with either the full truth or the opposite.