Aust Prescr
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Accurate diagnostic tests that provide results in a timely manner are essential for the clinical and public health management of COVID-19 disease The choice as to which test to use will depend on the clinical presentation and the stage of the illness Nucleic acid tests, using real-time reverse transcriptase-polymerase chain reaction, are the most appropriate for diagnosing acute infection. Combined deep nasal (or nasopharyngeal) and throat swabs are the preferred sample Serology can be used to diagnose previous infection, more than 14 days after the onset of symptoms Antigen tests are in development and their role is not yet defined Interpretation of results must take into account the pre-test probability of the patient having the disease. This is based on their clinical presentation and epidemiological risk
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The prevalence of autism spectrum disorder is increasing. It usually presents in childhood with abnormal behaviour and development The diagnosis can be difficult. There are often comorbidities which can cause confusion Non-drug treatments are first line. ⋯ Cognitive behaviour therapy can be effective, but in some cases selective serotonin reuptake inhibitors may have a role Most patients have problems sleeping, but drugs are not usually used to treat sleep disorders in children Antipsychotics, such as risperidone, may be considered for irritability and aggression. Clonidine is first line for children with Tourette syndrome. Patients need regular monitoring because of the adverse effects of these drugs
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Following surgery there is often a need for ongoing pain management after the patient is discharged from hospital. This can be made easier if the patient has an appropriate discussion before leaving hospital about what pain they can expect, and they are given a management plan Paracetamol and non-steroidal anti-inflammatory drugs are suitable for most patients. ⋯ Like opioids, they have a risk of misuse The surgeon should be consulted if the patient develops new pain or the postoperative pain becomes more severe Most postsurgical pain will resolve within three months. If not, it is deemed persistent pain that may warrant specialist assessment
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Vulvovaginitis is a commonly encountered problem in general practice. It usually presents with irritation and vaginal discharge A thorough examination is essential in order not to miss the less common causes. ⋯ Antifungals and antibiotics are therefore used in management Not all causes are infective. Several skin disorders can affect the vulva Ongoing or recurrent symptoms require careful evaluation and further investigation