Antihistamines, for allergic rhinitis may produce mild sedation and reduce other associated symptoms, like a runny nose and watery eyes. Examples are diphenhydramine, chlorpheniramine, brompheniramine, loratadine, and cetirizine. Decongestants may improve nasal congestion in a sinus infections. Examples are ephedrine, phenylephrine, pseudoephedrine, and oxymetazoline. Fever or pain medication. Examples are paracetamol (acetaminophen) and NSAIDs such as ibuprofen or naproxen. Also employed are various substances supposed to soften the coughing, like honey or supplement syrup. Effectiveness
The efficacy of cough medication is questionable, particularly in children. A 2014 Cochrane review concluded that "There is no good evidence for or against the effectiveness of OTC medicines in acute cough". Some cough medicines may be no more effective than placebos for acute coughs in adults, including coughs related to upper respiratory tract infections. The American College of Chest Physicians emphasizes that cough medicines are not designed to treat whooping cough, a cough that is caused by bacteria and can last for months. No over-the-counter cough medicines have been found to be effective in cases of pneumonia. They are not recommended in those who have COPD, chronic bronchitis, or the common cold. There is not enough evidence to make recommendations for those who have a cough in cancer. Medications
Dextromethorphan (DXM) may be modestly effective in decreasing cough in adults with viral upper respiratory infections. However, in children it has not been found to be effective. Codeine was once viewed as the "gold standard" in cough suppressants, but this position is now questioned.
This is a less common finding in ovarian torsion
Absent or reversed diastolic flowNormal vascularity does not exclude intermittent torsion. There may occasionally be normal Doppler flow because of the ovarys dual blood supply from both the ovarian arteries and uterine arteries.Other ultrasonographic features include:
Enlarged hypoechogenic or hyperechogenic ovary
Peripherally displaced ovarian follicles
Free pelvic fluid. This may be seen in more than 80% of cases
Whirlpool sign of twisted vascular pedicle
Underlying ovarian lesion can often be found
Uterus may be slightly deviated towards the torted ovary. Treatment
Surgical treatment of ovarian torsion includes laparoscopy to uncoil the torsed ovary and possibly oophoropexy to fixate the ovary which is likely to twist again. In severe cases, where blood flow is cut off to the ovary for an extended period of time, necrosis of the ovary can occur. In these cases the ovary must be surgically removed. Epidemiology
Ovarian torsion accounts for about 3% of gynecologic emergencies. The incidence of ovarian torsion among women of all ages is 5.9 per 100,000 women, and the incidence among women of reproductive age (15–45 years) is 9.9 per 100,000 women. In 70% of cases, it is diagnosed in women between 20 and 39 years of age. The risk is greater during pregnancy and in menopause. Risk factors include increased length of the ovarian ligaments, pathologically enlarged ovaries (more than 6 cm), ovarian masses or cysts, and enlarged corpus luteum in pregnancy. See also
Testicular torsion – equivalent condition in males

References


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