Southern Independent Medical Pratice
Southern Independent Medical Practice
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Patient Area

There are many benefits of becoming a registered patient with S.I.M.P.

Benefits of registration:
Your own personal 'Online Account' where you can:

Change your contact details
View your vaccination records
View your allergies list
View your last "Healthcheck"
Discounted fees
Click to see more benefits

Click here to apply for new patient membership with the doctors at Southern Independent Medical Practice in Salisbury, Wiltshire.

Southern Independent Medical Practice - We care about our patients, call us on 01722 415444

 

HPV Vaccination


Whilst the national immunisation programme offers important protection against cervical cancer for girls in the UK, it is also recommended that this vaccine is given to boys as they too can get cancers and other serious conditions caused by the human papilloma virus (HPV).

Rates of mouth cancers have risen by 68% in the last 20 years according to a recent report from Cancer UK and many of these cases are related to previous exposure to HPV. Mouth cancer is now the 8th most common cancer in the UK.

There are over 100 different types of HPV, 13 of which are linked to cervical cancer, 2 are known to cause genital warts and 2 are linked to cancers of the anus, penis, mouth, throat, vagina and vulva. HPV related cancers are on the rise and other than cervical cancer there are no screening tests to identify them early. This often leads to them being caught at a later stage and difficult to treat.

Gardasil vaccine offers protection against 4 of the HPV strains commonly linked to cancers. A new version of the vaccine is now available in the UK which offers increased protection against the 9 types of HPV responsible for most of HPV related cancers and diseases.

Patients that have already started a Gardasil vaccination schedule should complete the course on the same vaccine. Boys, girls or adults due to start a course of Gardasil are advised to have Gardasil 9, although both remain currently available.

For more information on this subject call 01722 415444 or email us for more details.

December 2016


 

Doctor Update


SIMP are pleased to welcome Dr Jeremy Meadows to the Practice.
Dr Meadows joined us in April and is proving to be a popular member of our expanding team.

We will also be pleased to welcome Dr Claudia Morley back to the Practice in the New Year.

December 2016


 

Flu Clinics


Flu vaccinations are available to all at SIMP.

Suitable for all ages, vaccination offers some inexpensive protection from the misery of flu this winter.
Call us now on 01722 415444 to book your appointment. .

December 2016


 

Travel Service


Travel vaccination enquiries have been very popular this year as many patients plan international trips. Please contact us well in advance of travel dates to ensure there is sufficient time to commence any vaccination schedules required. Our services are available to all and we hold many vaccines in stock, including Hepatitis A and BCG which are currently in short supply in the UK.

Pertussis vaccination is now a standard travel requirement if you are visiting friends or relatives with infants in Australia or the USA.

Malaria and altitude medication can also be prescribed and/or dispensed from the Practice and we can screen patients who frequently fly, especially to long haul destinations for thrombophilia (a condition that predisposes to the development of deep vein thrombosis).

Call 01722 415444 with vaccination enquiries or to arrange a Travel Health Assessment.

December 2016


 

Meningitis B Vaccine - Appointments Now Available


We are pleased to announce the Meningitis B vaccine supply situation is improving and we are able to start taking new bookings again.

The manufacturer will continue to manage allocations to private practices until the end of the year due to the unexpectedly high demand; however, we are now able to begin new vaccination courses with the assurance of being able to complete them.

We are holding special clinics over the next few weeks to provide an opportunity for those interested in the vaccine to start their schedules. These appointments will be allocated on a first come first served basis.

Details of the Meningitis B vaccination schedule are on our Vaccinations page for your information.

We feel this is an important vaccination and do not wish to exploit the opportunity of charging excessively. Each dose of the vaccination is currently charged at £118 and the total cost for the full course will vary depending on the age of the child and the number of doses required.

Please contact us on 01722 415444 for more details or to book an appointment.

June 2016


 

Health Checks


An integral part of our ethos since inception is that our patients should undergo annual health checks. A Well Man / Well Woman health check is therefore included as a benefit of our annual subscription patient membership.)

The value of health checks is often debated in the medical press and elsewhere and many will say they are an unnecessary waste of resources and have no value. This is certainly not the view we take here. We see them as a very important part of providing effective and preventative healthcare.

Health checks provide an opportunity not only to have a full and thorough check up (in particular to look for any signs of cardiovascular disease or noted skin problems) but also to review any health concerns that might not merit a separate consultation. This also allows us to review family history of illness which can be very important in assessing an individual’s risk of disease and review lifestyle, which is increasingly recognised to play a significant part in our risk of illness, including cancer and cardiovascular disease.

Well Man and Well Woman Health Checks, and Executive Health Screening services are accessible to all at Southern Independent Medical Practice. These include a physical examination, a variety of tests and a detailed report. More information can be found on our Medical Services page. Call 01722 415444 or contact us for details or to book an appointment.

December 2015


 

The Importance of Vitamin D


It has long been appreciated that Vitamin D is important in the prevention of osteoporosis (thinning of the bones), rickets in children and also osteomalacia in adults. It has only recently been recognised that Vitamin D deficiency may be linked to many diseases, including heart disease and strokes, autoimmune diseases (such as rheumatoid arthritis and multiple sclerosis), high blood pressure, inflammatory bowel disease, Alzheimer’s disease, Parkinson’s disease and depression.

Research has suggested that Vitamin D supplementation in childhood can significantly reduce the risk of developing Type I diabetes. Vitamin D also regulates production of antimicrobial peptides and deficiency can result in an increased tendency to infections.p>

There is some evidence that high levels of Vitamin D both help the body recover from cancer and also play a major part in cancer prevention. It is considered that optimising your Vitamin D levels could help to prevent as many as 16 different types of cancer including pancreatic, lung, breast, ovarian, prostate, and colon cancers. Furthermore, there are now oncologists in the UK using Vitamin D as part of cancer treatment.

It is recognised that many adults and possibly a third of all children may be Vitamin D deficient. This deficiency is related to our lack of sunlight exposure and the use of sun blocking creams. It is also known that some people need more Vitamin D than others, in particular the elderly, pregnant and breastfeeding women, children under five, those with darker skin and the housebound. In February 2012 the Chief Medical Officer for England and Wales recommended vitamin D supplementation for this group in particular.

Since studies have shown that possibly 70-80% of the UK population may have low levels of Vitamin D, it is now being recommended that we should all consider taking a daily supplement. The best food sources of Vitamin D3 are oily fish (such as mackerel, sardines, herrings, salmon and trout). However even a daily helping of one of these could only provide about 300 IU of vitamin D. There continues to be uncertainty regarding the most effective dose but it is undoubtedly the case that previously recommended doses of 400 IU a day is not sufficient to provide effective blood levels.

Southern Independent Medical Practice recommend that patients should consider taking 1000 IU daily throughout the year. Vitamin D supplements are best taken as Vitamin D3. These can be purchased over-the-counter at many outlets and patients are welcome to order supplies directly through the practice.

December 2015


 

Reticence and Remedies in Erectile Dysfunction


Erectile dysfunction (ED) is common yet can be a difficult topic for men to broach. This is partly because men have a reputation for not seeking necessary medical help and for concealing intimate problems in particular. It is, however, important that men (particularly those aged under 50) do discuss this with their doctor as it is well established that it can be linked to pre existing but silent (and therefore undiagnosed)cardiovascular disease, which can lead on to a heart attack or stroke.

Causes of Erectile Dysfunction

ED can be either physical or psychological. Usually men with physical erectile dysfunction have a gradual onset so it is difficult for them to date exactly when it happened. Men who suddenly experience ED usually have an underlying psychological cause.

The most common physical problem in ED is reduced circulation to the penile artery due to the build-up of atheroma. The risk factors here include, lack of exercise, obesity, smoking, high cholesterol, high blood pressure, hypertension and diabetes mellitus. Other physical causes of ED include medication side effects, testosterone deficiency, renal failure, brain, spinal or peripheral nerve problems, alcoholism and pelvic surgery. Testosterone deficiency is more likely if there is a loss of facial or body hair or loss of morning erections. A decrease in libido may also suggest a decrease in testosterone levels as the cause of ED.

Treatments for Erectile Dysfunction 
  • In physical ED, tablets such as the PDE-5 inhibitors Viagra, Levitra or Cialis can be useful though caution is needed in ischaemic heart disease and men cannot take them if they are on regular nitrates for angina. The underlying physical cause also needs to be treated appropriately. There are also injections, devices, topical remedies and surgical solutions for selected men with ED.
  • For ED with testosterone deficiency, testosterone replacement is beneficial. There are testosterone gels, patches, and injections available. We can advise you about these also.
  • Marriage guidance, counselling and psychosexual counselling can be useful where there are psychological issues leading to ED. Occasionally, the PDE-5 inhibitor medications can assist short term performance anxiety or as an adjunct to psychological therapies.

This is only a brief summary of key points in ED, to encourage men that this is an important subject for which there is good remedies.

Don’t suffer in silence

It is very important to seek medical advice. Please don’t die of embarrassment – contact your GP.

Southern Independent Medical Practice offer confidential medical consultations, advice and treatments. For men with possible physical ED we check the history and smoking status, blood pressure, testicles, body hair, pulses and heart sounds. More physical tests are appropriate in diabetes and men aged over 50 years. We also check if any medication could be causing ED as a side-effect. Blood tests include fasting cholesterol, fasting blood glucose or HbA1c, thyroid hormone, kidney function, 9am testosterone and sometimes PSA. Sometimes other hormones such as prolactin, LH and FSH are checked in order to see whether there is a testicular or a pituitary problem.

We have male doctors available where is too challenging to talk such problems over with a female doctor. Call 01722 415444 or contact us to book an appointment.

December 2015


 

Meningitis ACWY Vaccination Programme


There has been a rapid and accelerating increase in cases of a highly aggressive form of meningococcal group W disease (Meningitis W).Meningitis causes inflammation of the brain and septicaemia (blood poisoning) that can kill in hours, and those who recover may be left severely disabled.

Meningitis W has been increasing year-on-year since 2009, with 23 cases confirmed in 2009,119 confirmed cases in 2014 and the incidences are accelerating further this year.
Provisional figures show that since July 2014, there have been more than 150 cases in England to the end of April 2015, compared to 80 cases in the same period the previous year.
The government has introduced a programme of vaccination for children aged 13 and also first time university entrants, however this leaves many teenagers and young adults without protection.
We would recommend that all adolescents from the age of 13 are vaccinated and any young adults up to the age of 25 who have not been vaccinated should consider having this protection.A single vaccination is all that is required and it will help to prevent this very serious and sometimes deadly disease.
SIMP are pleased to offer this vaccination to member and non-member patients. Please contact us for details or view more information on our vaccination page.

October 2015


 

Driving and Diabetes


A statutory requirement was introduced last year for insulin dependent diabetic drivers.

Do please remember if you are an insulin dependent diabetic that you are now required to test your blood sugar no more than 2 hours before the start of a car journey and then every 2 hours while driving.
More frequent testing may be required if for any reason there is a greater risk of low blood sugar (hypoglycaemia), for example after physical exercise or an altered meal routine.
 
If you have noticed a change in the symptoms or management of your diabetes, please do contact your doctor to arrange a review.

October2015


 

Hot Flushes and HRT (Hormone Replacement Therapy)


Most doctors and many women were very happy with the benefits of HRT until about 10 years ago when the Women's Health Initiative study emphasized the risks of HRT. Then the UK use of HRT fell to under half of what it was before. There has been reassurance in studies in recent years, so the pendulum is moving in a more positive way towards HRT though there now needs to be a little more caution in decision making. This article summarises current thinking on Hot Flushes and HRT (Hormone Replacement Therapy)

Although there are many symptoms of menopause,the main 2 are hot flushes and vaginal dryness/soreness. For vaginal symptoms,lubricants (such as Replens) and topical HRT creams (such as Ovestin) or pessaries can be used. With hot flushes, sometimes benefit is found from antidepressants, weight loss, exercise and herbal remedies such as Black Cohosh and Red Clover. But the controversy is whether women with hot flushes should take HRT the only powerful remedy.
 
Benefits of HRT. The main benefit of HRT is the reduction of hot flushes and this is clear for most women within a few days. There is also a reduced risk of bone fractures with HRT if used for 4 years or more.
 
Risks of HRT.As the benefits are so clear, the risks of HRT are the key to decision making for hot flushes and these risks are increasingly well understood. Long term use of combined HRT (oestrogen with progestagen) slightly increases the risk of stroke, heart attacks and leg clots. After 5 years of use there is also an increased risk in breast cancer. In women over 65 there is also a small increase in dementia risk.
 
Reduced Risks in Oestrogen-only HRT. For women who have had a hysterectomy and therefore only need oestrogen in their HRT, leg clots and strokes are still increased,but not heart attack risk or breast cancer risk.
 
Reduced Risks for Younger Women on HRT.However, for younger women on combined HRT in their 50s, when hot flushes are most common anyway, only leg clot risk was increased even by combined HRT. Better still for younger women, a study on women up to age 58 who started combined HRT around the menopause and had taken HRT for 10 years were shown to have a REDUCED risk ofdeath from all causes and reduced risk of strokes and heart attacks in particular. There was also no significant increase in breast cancer in this group.
 
In Conclusion. As most women who have troublesome hot flushes are younger in their 50s the outlook is better than we had thought. The concerns about HRT are much more with regard to long term use in older women.
 
You need an individual solution for your menopausal symptoms, as every woman is different and these differences can make HRT a good or a bad choice for you. There are also a great variety of HRT products with their own benefits and disadvantages.
 
At SIMP, we can help you to make sense of the menopause and the options in HRT. Contact us on 01722 415444 to arrange an appointment if you would like to discuss this with a member of our medical team.

October2015


 

BCG Vaccine back in stock


We are pleased to announce the BCG (tuberculosis) vaccine is now back in stock.

Tuberculosis or TB is a common and potentially fatal infectious disease which most commonly attacks the lungs as pulmonary TB, but can also affect the central nervous system, the lymphatic,circulatory and genitourinarysystems, bones, joints and even the skin.

BCG vaccination is available from infants to adults. Itis routinely given to adolescentsfrom age 12 to 16 years, consisting of an initial skin test to check for immunity, followed by a vaccination as required 48 - 72 hours later, however, the method given will depend on age.This vaccination ceased under the regular NHS vaccination schedule and isnow only given to those considered to be at risk of the disease.

For more information or to book an appointment, call us on 01722 415444.

June 2015


 

Acupuncture returns to SIMP


We are pleased to announce Caiti Buck is now offering acupuncture at Southern Independent Medical Practice.

Caiti says "Traditional acupuncture can be effective for a wide range of health complaints. It's focus on treating the whole person rather than symptoms in isolation can also help improve general wellbeing."

Caiti trained at the College of Integrated Chinese Medicine in Reading and is a member of the British Acupuncture Council, the largest body of traditional acupuncturists in the UK, with a guarantee of excellence in training, practice and conduct.

To welcome clients new to acupuncture, Caiti has a half price offer on an Introductory Treatment Package. This includes a consultation and the first 5 treatments and is valid for initial consultations booked by 31 July 2015.

To find out how acupuncture can help you, contact Caiti or call 07955 236015 for more information.

May 2015


 

Confidential Counselling


Ian Burton BSc(Hons) FRGS MBPsS MBACP is an experienced and qualified counsellor, providing open ended and short term counselling for adults of all ages and young people aged 16+.

Ian holds one-to-one counselling sessions in a quiet, safe and confidential environment at Southern Independent Medical Practice

His counselling sessions aim to help clients come to a better understanding of their personal situations and support them in the changes they may wish to take.

For more information or to arrange a free, no obligation initial meeting, call Ian on 07951 509606.

May 2015


 

Facial Aesthetics Practitioner


Many of our patients will already know Dr Claudia Morley as one of our highly qualified GPs at the Practice.

Claudia has also been trained by some of London's leading aesthetics practitioners and provides a facial aesthetics service at Southern Independent.

The most popular treatments are anti-wrinkle injections (botox) and dermal fillers.

Claudia offers aesthetic treatments with the reassurance of being provided by a medically trained, experienced doctor, and an approach aimed at enhancing the natural you.

Subscription paying members of Southern Independent Medical Practice receive a 10% discount on all treatments. Contact Morley Aesthetics to book a free consultation.

May 2015


 

Miscarriage: Help and Hope


Miscarriage occurs in 20% of recognized pregnancies and can be very distressing for many reasons.

Following 3 consecutive miscarriages, (known as recurrent miscarriage,) the risk of yet a further miscarriage is about 40%.

It can be particularly difficult to cope with simply not having a reason for the occurrence and if you dont know why it has happened, you may begin to wonder if it could have been avoided.

A better understanding of both causes and prevention of miscarriage provides reassurance of misplaced guilt as well as reducing recurrence.

The list of potential causes of miscarriage is long. Many early miscarriages are caused by one-off genetic faults and occasionally due to a parental genetic fault. However, there are various potentially remediable causes of miscarriage, including:

     
  • Progesterone hormone deficiency. A Cochrance review found evidence of the benefit for progestogen therapy in women with a history of recurrent miscarriage. Luteal phase defectwhich underlies progesterone deficiency is present in up to 35% of cases of recent miscarriage.
  • Antiphospholipid syndrome (APS) is an important treatable cause of recurrent miscarriage. Antiphospholipid antibodies are present in 15% of women with recurrent miscarriage. In primary APS, aspirin, sometimes combined with heparin improves live birth rate to 70%.
  • Inherited thrombophilia, (clotting disorder) such as protein C and S deficiency and MTHFR variants may have a role in recurrent miscarriage, because of an increased risk of thrombosis (clots) in the placental circulation. Women with a second-trimester miscarriage (beyond 14 weeks) should be screened for inherited thrombophilia. (Inherited thrombophilia also increases the risk of the mother having blood clots and pulmonary embolism in her pregnancy.) If one of these inherited clotting disorders is found, then heparin and aspirin therapy should be discussed with a specialist.
  • Uterine anomalies are seen in between 10-25% of cases of recurrent miscarriage and may be remedied surgically.
  • Bacterial vaginosis in the first trimester is a risk factor both for second-trimester miscarriage and for preterm delivery. A vaginal swab will reveal such infections.
  • Cervical incompetence may cause mid-trimester recurrent miscarriage and is treated by cervical support known as cerclage.
  • Women with polycystic ovarian syndrome are at higher risk of miscarriage and there is ongoing research regarding the use of metformin (a diabetic medication), during pregnancy to reduce this risk.
  • Natural Killer cells are increased in the uterine lining of women with high rates of miscarriage and there are encouraging ongoing UK studies using steroids to reduce recurrent miscarriage in these women. Hopefully these treatments will become mainstream. (Natural killer cells in the bloodstream do not appear to be a marker for treatable recurrent miscarriage).

Traditionally, testing has not been offered until after 3 early miscarriages (up to 14 weeks). With better investigation and treatments as well as the increasing age of expectant mothers, there are good reasons to consider whether it is necessary to wait for 3 early miscarriages Southern Independent Medical Practice will sympathetically discuss your case and arrange appropriate investigations, treatments and specialist referrals according to the best evidence.

If you would like to discuss this sensitive matter with a doctor at our practice, contact us or call 01722 415444 to book an appointment.

May 2015


 

Flu Advice


Although influenza is around all year, it is particularly common at this time of year. It is an infectious viral illness spread by coughs and sneezes, and the germs can easily be spread now that we are spending more time indoors either at work or at home with guests, friends and family.

Flu is not the same as the common cold. Although many symptoms are the same, flu can result in a high fever and make you feel so exhausted and unwell that you have to stay in bed and rest until you feel better. It can also lead to serious chest problems and hospitalisation.

Generally flu symptoms are at their worst for 2-3 days and it can take 2-3 weeks to fully recover. Following a good hygiene routine can help to prevent spreading the germs. eg: cough and sneeze into a tissue, regularly wash hands, avoid touching your nose and eyes, promptly dispose of tissue waste and disinfect surfaces in common use.

If you are otherwise fit and well, the best advice is to rest at home, keep warm and drink plenty of fluids. Paracetamol or ibuprofen should help to reduce a high temperature and relieve aches and pains.

If you are pregnant, over 65 or have an existing medical condition, please contact your GP for further advice.

Southern Independent Medical Practice offer an accessible flu vaccination service available to anyone interested in immunisation, including an alternative vaccine suitable for those with an egg allergy. Flu vaccination is 6.50 for our subscription paying members and 11.50 for all others.

Call us on 01722 415444 to book your appointment today.

December 2014


 

Radiation doses in X-Ray and CT Scan Examinations


As we all know, doctors request x-ray and other imaging investigations as part of the diagnostic process or for screening purposes. X-ray examinations and computed tomography (CT) scanning both involve some radiation exposure; however, MRI scanning and ultrasound do not.

Different types of examination require different imaging to provide the information required and X-rays and CT scanning are often the most effective way of imaging specific organs or tissues, both for diagnostic purposes or screening.

We are all exposed to background, naturally occurring, radiation all the time and the dose of radiation used in medical procedures is measured against this background exposure.

Radiation is expressed in milliSieverts (mSv). We are all exposed to between about 2.5 3.0 mSv a year from this background radiation.

It is important to recognise that radiation from these procedures is cumulative over our lifetime and doctors are very conscious that we should not expose patients to unnecessary radiation. However, it is reassuring to note that with modern imaging equipment, radiation is kept to a minimum.

We thought it would be helpful to provide some information about the amount of radiation that common procedures involve and whether these procedures carry any additional lifetime risk.

Other than for mammography and bone density assessments, we prefer not to use X-rays or CT scanning for screening because of the radiation doses that patients would be exposed to.

For this procedure:
* Your approximate effective radiation dose is:
Comparable to natural background radiation for:
** Additional lifetime risk of fatal cancer from examination:
ABDOMINAL REGION:
Computed Tomography (CT) - Abdomen and Pelvis
10 mSv
3 years
Low
Computed Tomography (CT) - Colonography
10 mSv
3 years
Low
BONE:
X-ray - Spine
1.5 mSv
6 months
Very Low
X-ray - Extremity
0.001 mSv
3 hours
Negligible
Bone Density Scanning (DEXA)
0.001 mSv
3 hours
Negligible
CENTRAL NERVOUS SYSTEM:
Computed Tomography (CT) - Head
2 mSv
8 months
Very Low
Computed Tomography (CT) - Spine
6 mSv
2 years
Low
CHEST:
X-ray - Chest
0.1 mSv
10 days
Minimal
HEART:
Coronary Computed Tomography Angiography (CTA)
12 mSv
4 years
Low
Cardiac CT for Calcium Scoring
3 mSv
1 year
Low
WOMEN'S IMAGING:
Mammography
0.4 mSv
7 weeks
Very Low

December 2014


 

Meningitis B Vaccine Latest


The most common cause of meningitis is meningitis B, with around 2000 cases in the UK each year. Of these 10% die of the infection and many others are left with disabilities.

Typically this affects young children under the age of 5 and teenagers aged between 15 and 20.

Southern Independent Medical Practice has been pleased to offer this important vaccination since 2013. Our full Meningitis B article can still be found on our website for more information.

We routinely recommend all patients take paracetamol or ibuprofen, as appropriate, prior to all vaccine appointments to help manage typical vaccination symptoms.

At present, the Joint Committee for Vaccinations and Immunisations (JCVI), hold their position of not recommending the introduction of this vaccine into the UK routine immunisation schedule, primarily on the grounds of cost.

As the manufacturer's introductory price for the initial Meningitis B vaccine supply has run its course, the standard rate has now been applied to new stock.

Southern Independent Medical Practice now offers this vaccination for 115 each. For more information, refer to the full Meningitis B article on our website, call us on 01722 415444 or contact us for vaccination information relevant to your child.

December 2014


 

SIMP Flu Campaign 2014/15


We are pleased to announce we now have supplies of the 2014/15 flu vaccine in stock and would like to invite patients to book their vaccination appointments.

The practice encourages all adults and children over 6 months to consider a flu vaccination.

Specific groups at particular riskwho should be vaccinated, include adults over 65 and also younger adults and children with chronic heart or lung disease, chronic kidney or liver disease, chronic neurological disease, diabetes or diseases where the immune system is compromised.Pregnant women are also at risk.

 

A small charge is payable to cover the vaccination costs, however, Southern Independent Medical Practice

is pleased to be able to keep the fees at the same rate as last year. For members (subscription paying registered patients) the cost of the vaccine will be only 6.50. For our other patients and any family or friends considering the flu vaccination, the vaccination cost will be 11.50.

 

This year we also have a suitable vaccine for those with egg allergies available at the same cost.

 

We would also encourage patients to consider other important immunisation protection at this time of year, including shingles and pneumococcal vaccinations.

 

Please call us on 01722 415444 to book your flu vaccination appointment or speak to your doctor about other immunisation recommendations during your next appointment.

October2014


 

Heart Rhythm Week 2 - 6 June 2014


Of the 152,000 strokes that occur in the UK every year (1 every 5 minutes) around 15% will be associated with atrial fibrillation, a particular cause of heart rhythm disturbance (arrhythmia).

Each heartbeat is triggered by an electrical impulse, which under normal circumstances occurs regularly, usually around 60-80 times a minute. All of us have occasional innocent extra heartbeats. These may be felt as palpitations and are called ectopic beats. However, other causes of arrhythmia which can also cause palpitations include episodes of atrial fibrillation. Because of the association with the development of a stroke, it is very important to identify any of these episodes. Once identified, a number of effective treatments are available which will minimise the risk of strokes.

Atrial fibrillation episodes become more common as we age, although can occur in younger patients often due to a structural abnormality of the electrical wiring in the heart or sometimes related to an overactive thyroid gland.

It is generally not possible to be sure whether palpitations are due to atrial fibrillation or something less serious without ECG confirmation.

Southern Independent Medical Practice takes disease prevention very seriously. We have a heart monitor which can be loaned to patients who experience palpitations to make sure these are entirely benign and carry no risk. There are also a number of free guides and apps available online, including some that patients can download to their smart phones. Arrhythmia Alliance is promoting Heart Rhythm Week, from 2nd to 6th June and they recommend Know Your Pulse, a free app available for the iPhone.

Any patients who are concerned about their heartbeat regularity should contact their practice for further advice.

June 2014


 

Do Multiple Vaccines Overwhelm or Weaken an Infant's Immune System?


Many of us considering vaccination needs, particularly for our young families, naturally have concerns about the impact of having multiple vaccinations or ongoing vaccination schedules for disease prevention.

A study in Paediatrics - the official Journal of the American Academy of Paediatrics - examined this question in great detail in 2002 and there is additional reassurance that no studies since then have altered the conclusion of this report.

The immune systems of babies, infants and young children and indeed adults, is able to handle a very large number of vaccines at the same time, significantly more than are currently ever given together. There is no evidence that giving several vaccinations at the same time carries any risk of overwhelming the immune system, nor of the immune system giving a poor response after they have been administered.

There is also no evidence that infants and children vaccinated when they are fighting an infection reduces the immune response and so, in theory, vaccines can even be given in the presence of a feverish illness. In practice, this is generally avoided to reduce the risk of superimposing a possible vaccine reaction or of mistakenly attributing an underlying illness to the vaccine.

Disease prevention remains an essential form of protective healthcare, with various options available and we encourage all families to ensure their vaccinations are up to date. Please contact us for further information on childhood vaccinations.

June 2014


 

Prescription Drugs and Grapefruit Juice


Over the last few years and with the increasing availability and consumption of grapefruit juice, it has become clear that this juice may interact with as many as 85 prescribed medicines.

Grapefruit and/or grapefruit juice cause a specific activation of an enzyme pathway in the liver and small bowel that a number of drugs use for their metabolism. It is therefore important that patients check the leaflet with prescribed medications and if there is an identified association, avoid having grapefruit at the same time.

Common drugs that are affected:

Nifedipine and other calcium channel blockers (primarily used for high blood pressure)
Losartan (also used for high blood pressure)
Simvastatin and Atorvastatin (used for cholesterol reduction) - other statins are not affected
Carbamazepine (an anti-convulsant drug)
Sildenafil (Viagra), Tadalafil (Cialis) and Vardefanil (Levitra) (used for erectile dysfunction)

For information: The license for the production of Sildenafil by Pfizer has expired and is thereforesignificantly more economic to prescribe.

Your doctor will be pleased to discuss any concerns you may have with your medication.

June 2014


 

Reduce Your Risk of Age-Related Macular Degeneration - ARMD


Macular degeneration is the most common cause of severe visual loss in patients over 60. The main symptom is a change in central vision, either with distortion or blurring or a change in colour perception. It is often picked up before any symptoms develop during a routine eye check.

Although the cause of macular degeneration is not well understood, it is considered part of the ageing process. There may be a hereditary component, it is slightly more common in women and Caucasians and Asians are more susceptible to developing it than African and Caribbean people in whom the condition is rare.

ARMD is thought to be caused by hardening and blocking of the very small blood vessels (arteriosclerosis) supplying the retina at the back of the eye.The same factors that are associated with the development of arteriosclerosis in the heart and elsewhere are likely to play a part. These include smoking and a diet rich in saturated fat. However, many patients who do not smoke and eat a sensible healthy diet will also develop the condition. A deficiency of vitamin D may play a part, as could exposure to ultraviolet light.

There are 2 different types of macular degeneration, dry and wet. At present only wet macular degeneration is amenable to any treatment.

Since 2001, the Age-Related Eye Disease Study (AREDS) has been taking place, looking at the place of nutritional supplements to try and help reduce the risk of ARMD. The second part of this study, AREDS2, reported its findings last year and showed that a significant benefit (25 to 30% reduction in risk) was obtained by taking nutritional supplements containing Vitamin C, Vitamin E, Zinc and essential fatty acids, together with lutein and zeaxanthin. This is called the AREDS2 formula.There are a number of products containing the AREDS2 formula and these are available over-the-counter or online. Two preparations that are widely recommended by eye specialists include Viteyes 2 and Ocuvite Complete.

We advise that patients consider this from the age of 50, particularly those with a family history of macular degeneration or have a known risk for arteriosclerosis. It is also sensible that patients already diagnosed with macular degeneration consider taking this to try and help reduce progression of the condition.

As always, we would be pleased to provide further advice.

June 2014


 

Meningitis B Vaccine Now Available


Southern Independent Medical Practice endeavours to provide the highest standards of prevention and care. This sometimes means we are able to offer our patients services beyond that which the NHS is able to provide. The Meningitis B vaccination is a case in point.

Although very effective vaccines against meningitis C and other germs that cause meningitis, including Hib and pneumococcus, have been available for over a decade, the most common cause of meningitis is meningitis B. Currently there are around 2000 cases of meningitis B infection each year in the UK, of whom 10% will die and many others will be left disabled. Most commonly it affects young children under the age of 5 and teenagers between the ages of 15 and 20.

Until now, it has proved extremely difficult to manufacture a vaccine that protects against meningitis B. However, after many years of research, Novartis have now developed a vaccine, Bexsero. This was licensed by the European Commission in January this year as being safe and effective. It is also licensed for use in Australia and is also being used in the United States.

At present, the Joint Committee for Vaccinations and Immunisations (JCVI) have not recommended introducing this vaccine to the UK routine immunisations schedule, primarily on the grounds of cost. Therefore, the NHS can only currently offer this vaccination to people considered to be at particular risk of infection.

While meningitis charities are pressing for a review of the JCVI recommendations regarding the NHS position, Southern Independent Medical Practice are pleased to be able to offer this important vaccine. Because of the age group that are commonly affected, we particularly recommend that infants and teenagers are vaccinated.

The recommended schedule is:

  • For infants between the ages of 2 and 5 months -3 doses of vaccine at intervals of not less than one month should be given with abooster between
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