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
• Arthritis
• Skin pigmentation
• Cardiomyopathy
• 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

Eye testing

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.