Monthly Archives: January 2019

Nasal irrigation

A useful if unlovely tidbit from this month’s BJGP: Nasal douching, with isotonic or hypertonic saline solutions, has strong evidence of effectiveness as a treatment for chronic rhinosinusitis, including rhinosinusitis with associated nasal polyps (it supplements the effectiveness of steroid … Continue reading

Posted in Credits 2019, ENT | Leave a comment


Note that this may present indirectly; repeated failure to attend cervical screening, persistent dissatisfaction with contraception, describing disgust with her genitals, dissociating during examination. History Open questions, kept to a minimum; encourage description. ‘When do you get the pain?’ ‘Show … Continue reading

Posted in Credits 2019, Gynaecology, Sexual health | Leave a comment

Mirtazapine + SSRIs

I’ve occasionally seen Mirtazapine used as an add-on to SSRIs in resistant depression. An RCT recently showed that adding Mirtazapine to an SSRI or SNRI in resistant depression works no better than adding placebo. That said, the definition of ‘resistant’ … Continue reading

Posted in Credits 2019, Medication, Psychiatry | Leave a comment