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How reliable are PTH levels for the prediction of hypocalcaemia after thyroid surgery?

Hypoparathyroidism is one of the most common complications of thyroid surgery. There is significant controversy in calcium management practices post thyroid surgery. The drop in PTH levels has been used to predict the likelihood of hypocalcaemia after thyroid surgery. But...

Algorithm for malignant otitis externa

Timely detection and effective management of this potentially fatal condition cannot be overemphasised. This study presents 16 cases over 12 months in a tertiary referral centre. Most patients had diabetes and others were immunocompromised due to radiotherapy, immunosuppressive medication or...

Argh! Facial pain! What to do??

We often come across patients with presentation of facial pain, but unless this is sinugenic in origin, our understanding and management of it can often be found wanting. Craniofacial pain is in fact highly complex and encompasses a wide range...

Nasal decongestants don’t improve Eustachian tube function

Prescribing nasal steroids and decongestants. It’s something most of us do routinely, in an effort to reduce chronic middle ear effusion in an adult by trying to improve eustachian tube (ET) patency. This study used clever devices (tube manometry and...

Burnout: is this just a pandemic phenomenon?

The phrase ‘burnout’ is often heard, but what is it, and what are the early warning signs? Importantly, how can it be prevented or managed? Over the last few years, health professional wellbeing, mental health, and burnout have come to...

Can prediction models help identify dysphagia in ventilated patients?

Dysphagia commonly affects patients in intensive care units (ICU), particularly those on mechanical ventilation, and is associated with high risk of mortality. This systematic review and meta-analysis aimed to identify predictors for dysphagia in ventilated ICU patients by summarising existing...

Depth of invasion of oral cancer should be incorporated in new AJCC staging system

Since 1977, when the first edition of the Manual for Staging of Cancer was published by the American Joint Committee on Cancer (AJCC), the primary tumour staging for oral squamous cell carcinoma (SCC) has remained unchanged. In the last four...

Timing of surgery in chronic rhinosinusitis: does it matter?

While many patients with chronic rhinosinusitis respond to medical treatment, some do not. The next step for these patients is surgery, but how soon should this be offered? Sooner rather than later seems to be the answer, as Claire Hopkins...

Role of potassium channel opener in salicylate induced tinnitus

The exact mechanism in the origin of tinnitus is not known. Many pharmacological agents have been tried to to treat tinnitus without great success. Aspirin is a commonly used medicine in the elderly population to reduce the risk of stroke...

Treatment algorithm for olfactory disorders

The purpose of this paper is to review the current evidence in diagnosing olfactory disorders and suggest an algorithmic approach to patients with relevant complaints. Age-associated olfactory loss is often multifactorial and requires a careful history and physical exam. A...

Chronic cough hypersensitivity syndrome

We all have patients who give us a ‘heartsink’ feeling; for many of us, the coughing patient is exactly such a situation. In this overview, Bhaskar Ram and Sangeeta Maini outline their approach to diagnosis. Declan Costello, Editor. Introduction Chronic...

Andrew Foster and deaf education

This article examines the career of deaf African American, Andrew Foster, and his contribution to deaf education in Sub-Saharan Africa. The history of medicine has often been guilty of attributing great revolutions to a single person (usually a white man)...