A common recessively inherited blood disorder resulting in excess iron in the body due to increased absorbtion from the intestine. An incidence of about 1 in 200.
May be manifested by the following symptoms –
- Fatigue and lethargy
- Cirrhosis of liver
- Liver cancer
- Skin pigmentation
- Testicular failure
- Diabetes mellitus
Diagnosis is usually by a combination of blood film , iron studies and gene testing.
Treatment is usually by venesection – draining off excess blood
All patients over 40 should be screened for glaucoma every 2 years by an optometrist or ophthalmologist. Glaucoma is the insidious painless rise in internal eye pressure that may lead to permanent loss of vision if untreated.
All diabetics should have regular 1-2 yearly eye testing, to avoid having diabetic retinopathy a treatable condition which may lead to loss of vision .
All circumstances with all or part loss of vision suddenly in one or both eyes should be reviewed to exclude diseases that may lead to permanent loss or impairment of vision Also sudden onset of flashing lights like lightning or a camera flash,or single black or red spots as these may be associated with a retinal tear, vitreous haemorrhage or retinal vascular occlusion.
1 in 6 couples have difficulty in achieving pregnancy within 12 months.
Factors involved alcohol intake , smoking , weight extremes underweight or obese , diet , exercise extremes under or over , drug usage – recreational or body building or increased female age.
Medical fertility investigations subsequently investigate ovulatory dysfunction , abnormal semen, genito urinary anatomical abnormality or dysfunction
Cervical Cancer Screening
In 2013-2014 3 .8 million women in the eligible 20-69 yo age group had a pap smear within the recommended regular 2 year period for standard Pap smears which was only 57% of the eligible age group. Despite HPV vaccination pap smears are still required to ensure early diagnosis of this highly treatable disease.
Pap smears will be replaced by Human Papilloma Virus (HPV) testing of the cervix which is still done in the usual way from Dec 2017. Routine Screening will then occur every 5 years if the test has been negative and commence at age 25 for those who have had Gardasil immunization, all others will still have standard pap , Thin Prep smears from 18 yo when appropriate at 2 year intervals until HPV testing has commenced
Skin tears in the elderly
Inappropriate treatment or untreated tears in the elderly lead to skin ulcers
Prevention is better than cure.
- Maintain adequate nutrition and hydration
- Use moisturizer twice a day
- Wear long sleeves and slacks
- Use gloves to protect skin from the job or the tools
- Remember hats and glasses to protect eyes and scalp
- Review the work site for falls risk or tight spaces
Remember common skin tears occur from pets, self closing doors , sharp cupboards, tow bars, corners of car doors in tight car parks, wheel chairs and walker frames.
First Aid for flap tears
Wash with cold water only
Apply a non adherent dressing kept in place with a compressive bandage and elevate the injured part – AVOID adhesive dressings and cotton wool.