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Take me home

> Tr u s t e d a d v i c e f r o m y o u r l o c a l d o c t o r


Summer 2012/13 DR MERVAT AKLADIOUS 18 Auburn Road Auburn NSW 2144 Telephone: 9643 2362 Facsimile: 9643 2573 Email: Dr Mervat AKLADIOUS

MB BS Sudan 1977 AMC NSW 1991 FRACGP NSW 1998 DCH NSW 1999 Full accreditation 12/10/01. Full re-accreditation until 21/10/2013. Vocationally Registered and practising in Auburn since January 1996.

Languages spoken

English and Arabic

Special interests

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Women’s and children’s health Immunisation Weight control Diabetic control and follow up


Monday to Friday 9 am – 1 pm 3 pm – 6 pm Closed on Saturday, Sunday & Public Holidays.


Appointments are necessary. Urgent medical problems will always be dealt with promptly. Appointments for long consultations are available.

House calls

There are home visits if you are too sick to come to the surgery. Please ring 9643 2362. Ring in the morning if possible so that house calls can be made at a convenient time.


Your feedback is welcomed and will be handled promptly with absolute confidentiality. Health Care Complaints Commission: Ring 1800 043 159 or (02)9219 7444.

Living well, living longer H

appiness can be an emotional ­response to something nice like eating an ice cream, buying a TV or celebrating a loved one’s birthday. It is obviously a ­positive ­feeling, but it can also be short term. Wellbeing, in contrast, is more stable. It is associated with satisfaction and ­contentment and rather than a feeling, it is a long term mood of fulfillment. Deakin University’s Centre for Q ­ uality of Life has developed the Australian Unity ­Wellbeing Index in partnership with ­Australian Unity, which identifies two areas of wellbeing. National wellbeing, which we have less influence over, is determined by factors such as the economy. Personal ­wellbeing, which is more in our control, relates to factors such as: ‡‡ Your relationships ‡ ‡ Your health ‡ ‡ What you are achieving in life ‡ ‡ Feeling part of the community ‡ ‡ Your standard of living

Why is wellbeing important? The emotions that are associated with positive personal wellbeing are good for the mind and body. They can help build personal resources such as friendliness, creativity, optimism and better health. These resources can be used to meet the challenges of life such as stress. Lifeline’s 2012 Stress Poll found 43% of respondents experience unhealthy levels of stress. Stress isn’t all bad. It can provide the drive and energy that you need, for example, to meet a work deadline. However, extreme or long term stress may be associated with an increased risk of health problems including the common cold, depression and heart disease.

For health information and our practice details

Regular physical exercise Yo g a a n d M e d i t a t i o n Stress Management Therapy Mindfulness (living in the ­m oment) done as ­m editation or ­c ombined with ­c ognitive ­b ehavioural therapy (CBT )

You don’t have to do it alone Ultimately while it is up to you to identify the key stress triggers in your life and to ­manage these through making positive changes, you do not need to do this alone. Online resources such as the ­ website ­developed by Pfizer Australia offers free advice on the ­seemingly small but often ­significant strategies you can put into place to identify opportunities to reduce stress and ­improve your quality of life. This website has many useful tools and resources including the option to subscribe to receive updates. Often ­taking the first step is the hardest, but ­ultimately any change in lifestyle begins with making a ­single positive decision and then taking action.

Inside this edition.. New tools to help you quit for good


R ela x and reduce stress

Recipe : Summer fruit salad w/ cottage cheese 2

A strategy that may help to improve personal wellbeing is doing activities that reduce stress. These include :

Important HPV Vaccination Update

Continued on back page...

It’s vital to find regular time to reduce stress


Mythbusters vs. Varicose veins


Circumcision back in the spotlight



Your next appointment is on: ..................................................................

Your Health Reader Giveaway





Nutrition Summer fruit salad with cottage cheese

HPV vaccination ­program now for boys too


irls currently receive a free vaccine as part of the National Human Papillomavirus (HPV) Vaccination Program at school. From early 2013, 12-13 year old boys will also be entitled to free HPV vaccine as part of this school-based program.

What is human papillomavirus (HPV)? HPV is a common virus. There are more than 100 different HPV types including a­ pproximately 40 types that can affect the genital area. Most ­sexually active males and females will be ­infected with HPV at sometime in their lives.

How do people get HPV?

Serves 2

Ingredients: ½ punnet strawberries, hulled and halved 2 kiwifruit, peeled and cut into wedges 1 nectarine, cut into bite-sized pieces ½ cup low-fat cottage cheese or quark a few spearmint leaves 2 tablespoons coarsely chopped pecan nuts

Anyone who has any kind of sexual activity ­involving genital contact can get genital HPV. That means it’s possible to get the virus without having intercourse. Many people with HPV may not show any signs or symptoms and can pass on the virus without even knowing it. A person can be infected with more than one type of HPV. The virus is usually harmless and has no ­symptoms. For the majority of people, the body’s defences are enough to clear the virus. However sometimes HPV infection can cause diseases including: ‡‡ genital warts ‡‡ cervical cancer ‡‡ some cancers of the vulva, vagina, penis and anus

The types of HPV that can cause genital warts aren’t the same as the types that cause cancer.

12 and 13yo boys will now be covered by the school vaccination program from 2013

HPV vaccination Vaccination can help protect against some of the most common types of HPV that can lead to disease and cancer. Vaccination does not protect against all HPV types and is most effective when given before a person becomes sexually ­active. Importantly, women should continue with regular Pap smears (screening test for cervical cancer). Condoms provide only partial protection, though they help prevent other sexually transmitted infections (STIs).

School consent forms Parents should receive vaccination consent forms at the start of the 2013 school year. Parental consent is required for your child to receive the free vaccine, so it’s important that you look out for these forms. For more information speak with your doctor or visit or

For Winter... Replace strawberries, kiwifruit and nectarine with: 1 orange, cut into bite-sized pieces 1 banana, cut into bite-sized pieces 1 apple, peeled, cored and cut into bite-sized pieces

Instructions: 1. Combine the strawberries, ­k iwifruit and nectarine in a bowl 2. Dollop with cottage cheese or quark and scatter with mint leaves and pecans Nutrient

Per Serve

Energy (kJ/cal)


Total Fat (g)


Saturated Fat (g)


Carbohydrate (g)


Dietary Fibre (g)


Sodium (mg)


This recipe is from the website ­ ­Reproduced with permission.

Making the most of quitting N

icotine replacement therapy (NRT) can assist smokers with quitting. However many smokers hold ­mistaken beliefs that cause them to not to start or prematurely stop this helpful treatment.

What is NRT? Nicotine is the drug in tobacco that causes addiction. When you stop smoking nicotine levels decrease in your body, which can cause withdrawal symptoms (such as mood changes, increased appetite, urge to smoke). NRT aims to reduce these symptoms by replacing some of the nicotine. It’s available as: skin (transdermal) patch, inhaler and oral products - gum, tablet and recently, mouth spray.

Correct information for common ­mistaken beliefs and concerns ‡‡ Safety: Nicotine doesn’t cause cancer, lung disease or heart attacks. It is the other ­chemicals in tobacco that do ‡‡ Addiction: NRT is not addictive like ­cigarettes because it has much less nicotine

‡‡ Effectiveness: Don’t stop NRT when ­symptoms stop. You should continue for at least 8 weeks to give you time to break the smoking habit

It’s also a mistake to take smaller NRT dosages (drug amounts). Higher dosages are more effective and relatively harmless. ‡‡ NRT costs much less compared to cigarettes in the long term. ‡‡ Side effects are mostly mild and settle with time. ‡‡ Smoking while using NRT is safe. So if you lapse back into smoking while on a patch, keep it on to help prevent a full relapse. In ­addition, it’s more effective if you start ­wearing a patch 2 weeks before quitting, not on quit day. ‡‡ Combining NRT products is also safe and more effective.

For example, you can use a patch ­combined with, a faster-acting NRT like gum (for ­cravings), lozenges or mouth spray. Of these three, the mouth spray provides ­smokers with a new opportunity to quit ­successfully. For more information visit

Women’s Health

Dr LOL! Sun ‘Dumb’

Breast Screening Update ith over one million women screened and more than 4,000 cancers found each year, Australia’s breast screening ­program has generally been ­considered to be a success. However it’s also important when deciding about screening to know that it has potential harms as well as benefits.

Over-diagnosis Screening involves performing x-rays of your breasts (mammograms) to check for an ­ abnormality. It is done for women who don’t have symptoms, mostly aged 50 to 69. Many breast cancers that are found become worse and need to be treated. But some women have a type of breast cancer that wouldn’t have caused symptoms during their lifetime if it had been left alone. We know this type exists because there are women who die at an old age from other causes and it’s then ­discovered they had a symptomless breast cancer. Finding this type of cancer through screening is called ­over-diagnosis.

Reduce illness and death The aim of screening is to enable the

t­ reatment as early as possible to reduce illness and death. But current ­medical ­technology can’t identify which type of breast cancer needs to be treated and which can be left alone. As a result, when screening finds an a­ bnormality, most woman start medical care just in case. This usually involves tests and perhaps treatment for cancer such as surgery and c­ hemotherapy. So while screening aims to reduce harm, it may end up leading to ­unnecessary treatment.

What to do Breast screening is clearly still important because it can reduce illness and save lives. But you may also want to receive information about the potential impact of over-diagnosis, particularly when weighing up benefits and harms. Talking to your doctor or ­screening ­program provider can help. For more ­information visit or

Mythbusting : Varicose Veins V aricose veins are twisted, bulging, blue veins raised above the skin surface, ­usually in the legs. Normally blood in veins flows back to the heart when leg muscles squeeze the veins. This happens with every step you walk. Valves in the veins are one-way flaps that Myth They are caused by sitting with crossed legs

Unfortunately there are some ­commonly held myths about varicose veins (see ­table below). While having a normal weight, ­regular ­exercise, avoiding constipation and c­ ompression ­stockings are worth trying, there’s no ­guaranteed prevention. For many people treatment ­provides the only m ­ provement, ­including surgery and ­injections. ­­­Each ­treatment involves Research Incorrect - the most common causes include: * Working in jobs that require standing for long periods * Genetics and ageing * Increased pressure on blood in veins due to obesity and constipation * Increased blood volume and hormone changes during pregnancy (most disappear 3 months after delivery)

Only women get them

Men also get them. While they affect an estimated 30 to 39% of women, the rate for men isn’t far behind at 10 to 23%.

They are just a cosmetic issue

In some people they can develop into a more severe form of a medical problem called chronic venous insufficiency (CVI) with symptoms including: pain, swelling, skin blemishes and open sores (ulcers).

That they can be prevented

allow blood to go up and stop blood flowing back down. Varicose veins occur when valves fail.

Tell us why you read Your Health for a chance to win a ....

While having a normal weight, regular exercise, avoiding constipation and compression stockings are worth trying, there’s no guaranteed prevention.

benefits and risks. You should discuss ­prevention and treatment with your doctor. For more ­information visit

Strapless Heart Rate monitor by and available in REBEL SPORT STORES (RRP.$99.99 - 2 available to win)

Enter at our website

(see front page of this newsletter) or post this entry slip to: Aussie Fit Sport Science Competition Po Pox 780 Artarmon NSW 1570 Name ________________________ Address_______________________ _____________________________ Med. Practice__________________ _____________________________ In 25 words or less, why do you enjoy reading Your Health? _____________________________ _____________________________ _____________________________ _____________________________ _____________________________ Drawn 1 March 2013 winning ­entries may be published online at


Children’s Health

Surgery Info After-hours When the surgery is closed, please ring the Sydney Medical Service, on 8724 6300.

Spotlight back on circumcision


eligious, cultural and family ­tradition are often the main reasons raised by parents for circumcising their sons. Putting these aside, another ­important ­reason parents ­consider is whether there are health benefits.

You can call 0410 349 040 between: Mon-Frid: 7am-8am & 6pm-7pm. Sat: 7am-12 noon. In an emergency ring 000 for an ambulance.


Benefits and harms Circumcision involves surgery to remove the foreskin which covers the end of the penis. It is usually performed on babies. It may be r­ ecommended to treat rare medical conditions such as phimosis ­(foreskin can’t be moved back) but most babies who are circumcised are healthy. Some doctors in Australia agree with the American Academy of Paediatricians (AAP) that circumcising male babies is better for their long term health. The claimed benefits include reductions in: ‡‡ Urinary tract infections (including bladder and kidney) in infants ‡‡ Cancer of the penis, usually in men ‡‡ Sexually transmitted infections (STIs)

The Royal Australasian College of Physicians

(RACP), ­representing ­paediatricians, makes a different conclusion. The RACP says some of the research the AAP relies on is based on people living ­overseas, doesn’t ­apply to the same The experts are divided on extent in Australia. whether circumcision is The RACP also says any recommended ­benefits of reduced illness and disease are outweighed by ­potential complications such as excessive bleeding and infection. Most complications are minor but some can be severe.

What to do? Differing opinions on circumcision can be confusing. But most doctors agree it’s ultimately up to parents to decide on the pros and cons. Reading reliable sources and talking to your GP is ­recommended. For more information visit the RACP website www.racp. or the AAP website

Don’t be sun ‘dumb’ this summer

Monday to Friday: 6pm – 8am Saturday to Monday : 12noon (Sat.) - 8am (Mon.)

Our practice You can contact your doctor by ringing during surgery hours. Emergency calls will always be put straight through. A message will be taken if your doctor is with a patient. Our friendly reception staff Almas and Rene are available to help in any way. Michelle is our new nurse. Our practice policy ensures confidentiality of personal health information. Arrangement to transfer copies of your medical notes is done at your request and expense. The surgery is located near Auburn Railway Station.

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hilst we know that it’s important to be sun ‘smart’ with children to prevent excessive sun ­exposure and reduce the risk of skin cancer, you also don’t want to be sun ‘dumb’ and cause them to get too little sun. Children need enough sun to avoid ­developing vitamin D deficiency, and whilst foods provide 10% of the vitamin D children need, the remaining 90% i­s produced in the skin when exposed to U ­ V rays in sunlight. Vitamin D also helps the gut absorb ­calcium and phosphorus - minerals essential for healthy and strong bones, m ­ uscles and other body parts. Vitamin D deficiency is ­regarded as a ­significant health issue for children in ­Australia. Symptoms may include: ‡‡ Rickets: Bone weakness leading to deformities such as bow legs ‡‡ Muscle weakness, aches and pains ‡‡ Delayed motor development

Children most vulnerable include those who stay indoors alot, cover up when outside or have naturally dark skin, which reduces

Vitamin D deficiency is considered a serious issue for children in Australia

s­ unlight getting through. Another risk is having a mother with low vitamin D. The good news is that a simple blood test can identify vitamin D deficiency.

Treatment and Prevention Treatment includes supplements and of course, getting enough sun. The ­recommendation for children for ­prevention in summer is to still be SunSmart when ­playing outside (avoid middle of the day, wear protective clothing/hat/­sunglasses, use sunscreen) but also get a few minutes a day of sun exposure to an area of skin equivalent to the face, arms and hands. For more information visit

SponsorS OF THIS ISSUE: Pfizer Australia Pty Ltd 38-42 Wharf Rd, North Ryde NSW.; CSL Biotherapies ABN 66 120 398 067, 45 Poplar Road, Parkville, 3052; Johnson &Johnson Pacific Pty Ltd . Opinions expressed in this newsletter are not n­ ecessarily those of the sponsors.

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Home visits Check-ups Family planning, Pap smears IUCD and Implanon insertion We offer enrolment in a reminder system for pap smears child i­ mmunisation, flu and pneumococcus vaccines for elderly ­patients, diabetes, asthma management plans and mental health Ante-natal care ECG; 24 hour BP monitor Vaccination: children, travel Blood tests, INR by fingerprick Minor surgery: stitching cuts Liquid nitrogen ‘freezing’ therapy for sunspots and warts Nutrition advice and lifestyle ­program enrolment Translation services are available

Fees All patients are bulk-billed. Please bring your Medicare card with you to the surgery. A gap of $6.00 is payable by those who are over 16 years old and do not hold a health care card. Visa and MasterCard are accepted. Your HealthTM is provided as an educational service to patients of our practice. It contains general information only. Please seek our ­f­ormal advice before acting on any matter ­arising from it. The content herein is covered by copyright.


Your Health Newsletter for Akladious Summer 12/13

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