Angaj Ghosh

Steroids in sudden sensorineural hearing loss

A shortcut review was carried out to establish whether steroids are of benefit in sudden onset sensorineural deafness. Altogether 175 papers were found using the reported search, of which five presented the best evidence to answer the clinical question. The author, date, and country of publication, patient group studied, study type, relevant outcomes, results, and study weaknesses of these best papers are tabulated (table 4). It is concluded that there is insufficient good evidence to recommend early steroid treatment in this condition.

The accuracy of abdominal ultrasound in paediatric trauma

Report by Ross Murphy, Senior Clinical Fellow Search checked by Angaj Ghosh, Senior Clinical Fellow An 8 year old boy is taken to the emergency department after falling out of a tree. He has no signs of injury apart from abrasions and tenderness across his upper abdomen; he is haemodynamically stable. He undergoes an abdominal ultrasound that …

Antibiotics in compound depressed skull fractures.

A short cut review was carried out to establish whether antibiotics reduce the incidence of meningitis in patients with compound depressed skull fracture. Altogether 198 papers were found using the reported search, of which one presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of this best paper are tabulated. A clinical bottom line is stated.

Antibiotics in orbital floor fractures.

A short cut review was carried out to establish whether prophylactic antibiotics are indicated in patients with undisplaced maxillary or orbital floor fractures. Altogether 214 papers were found using the reported search, but none presented any evidence to answer the clinical question. More research is needed in this area and, in the mean time, local advice should be followed.

Antibiotics for otitis media

Report by Angaj Ghosh, Senior Clinical Fellow Search checked by Rupert Jackson, Specialist Registrar A 2 year old child is brought into the emergency department with general malaise and irritability for the past 24 hours. Examination of the right ear reveals a diffusely red bulging ear drum.A diagnosis of acute otitis …

Journal clubs in clinical medicine

Journal clubs in clinical medicine have long been recognised as a useful tool for keeping up to date with new developments.1 More recently they have been used as a tool for the teaching of critical appraisal,2 which for emergency medicine trainees in the UK is an important part of …

Intra-articular lidocaine for acute anterior shoulder dislocation reduction

A short cut review was carried out to establish how intra-articular lidocaine compared with intravenous analgesia and sedation during reduction of anterior shoulder dislocations. Altogether 146 papers were found using the reported search, of which three presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results, and study weaknesses of these best papers are tabulated. A clinical bottom line is stated.

Prophylactic magnesium in myocardial infarction

Report by Mark Davies, Senior Clinical Fellow Search checked by Angaj Ghosh, Senior Clinical Fellow You see a 50 year old man with a two hour history of cardiac chest pain and an ECG suggestive of acute myocardial infarction. You decide to thrombolyse. The cardiology registrar suggests that you also give …

Negative urine analysis to exclude urinary tract infection

Report by Bruce Martin, Specialist Registrar in Emergency Medicine Checked by Angaj Ghosh, Senior Clinical Fellow A very anxious mother brings her 4 year old daughter to the emergency department concerned about her persistent fever. Examination reveals that she does indeed have a temperature of 37.6°C. She has no obvious signs of localised infection, so you decide that you need to test her urine to see …

Cautery or cream for epistaxis in children

Report by Angaj Ghosh, Senior Clinical Fellow Search checked by Rupert Jackson, Specialist Registrar A child presents to the emergency department with a nosebleed that came on spontaneously and that has not responded to simple first aid measures. The bleed appears to be from the front of the …