Aust Fam Physician
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Primary nocturnal enuresis is common, and if left untreated has considerable psychological ramifications on children as they get older. ⋯ By far the most successful treatment is the bed wetting alarm. In recent years desmopressin nasal spray has also found a clinical niche as a short term solution for children attending school camps or sleeping over at friends' houses. It may also be used as an adjunct to the use of the alarm. Treatment with imipramine is increasingly in disfavour because the relapse rate is unacceptably high and fatal overdose is a possibility.
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Paediatric lacerations and burns are common problems. ⋯ A significant number of lacerations are minor and can be managed without hospitalisation, provided due care is paid to adequate assessment and pain relief. Minor burns can also be managed without hospitalisation. Frequent change of dressings should be avoided but any burn that is not healed within 7-10 days should be considered for possible skin grafting.
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Evidence is mounting that antibiotics have little impact on the duration of sore throat symptoms, regardless of aetiology. Complications of sore throat are now so rare that an adverse drug reaction from antibiotic therapy is more likely.
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Mortality secondary to insect sting anaphylaxis, though uncommon in this country, is a genuine risk to patients with venom hypersensitivity. A number of non specific and specific preventive measures are available to minimise this risk. They include proper patient counselling regarding sting avoidance and the use of self injectable adrenaline, as well as venom specific immunotherapy. ⋯ The most common causes of insect stings in Australia are bees and wasps. Insect sting reactions cover a spectrum of responses, from normal to anaphylactic. Immunotherapy is indicated in those patients who experience anaphylactic responses. The presence of venom specific IgE must be demonstrated before commencing immunotherapy. Venom sensitive patients should be educated in anaphylaxis first aid with adrenaline self injectable syringes.
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Many venomous marine creatures inhabit Australian waters, causing significant morbidity and occasional fatalities. No antivenom is available for most of these creatures. Little is known about the venom or syndromes produced by many of these creatures. ⋯ The information contained within this article is intended to provide the reader with an overview of some of the more common marine envenomations, and hopefully with the knowledge to effectively manage such problems.