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Microsoft word - news letter 3rd of march 2011.doc
Dr Khashayar Ghaharian
MBBS Bsc (Hons) DFFP GP Doctor of Work and Pension
Wollaton Vale Health Centre
News Letter 3RD OF March 2011
Flu clinic; this is under way and we have achieved good response from
Patients. There are specific clinics attached to this in order to provide individualised service to the patients who are at risks i.e.
a- Over 65 years b- Immunosuppressed patients c- Patients with cardio-vascular problems d- Diabetics e- Hypertensive patients f- Hypothyroid Patients
Foundation F2 doctor; the Practice is involved in training F2 Doctors. This
is welcomed by all the members of the Practice and we have found this to be extremely productive. The patients seem to have accepted this change with enthusiasm. This teaching opportunity has provided the Practice with the chance to improve the procedures and protocols that are necessary for patient’s care. The Patients are encouraged to see the registrar so that the practice is providing the necessary ground that young Doctors require to improve their knowledge of General Practice and improve their Patient’s skill and consultation technique. We are welcoming a new F2 Doctor in December and we sadly have to say goodbye to the wonderful F2 Trainee that we have at the moment in December. Dr Sandora lai has worked extremely hard in the Practice and has achieved the highest rapport with the Patients and the Staff. We all congratulate her for excelling so well with in General Practice and the whole team wish her all the best for her career.
Patient Directive Group; this group has regular quarterly meetings to
discuss issues that would improve patient’s care and how we can provide better services to prevent dissatisfaction amongst our Patient Group . The following issues have been raised in the meetings;
A- Patient Survey ; the forms that are sent by the government is discussed
and how the surgery and this particular group can help the patient to over come difficulties like language barrier or even understanding how to fill these forms
B- Appointment system with in Practice; the Group suggested that the
Practice should improve on pre-bookable appointments such that
patient can book two weeks in advance. This is both for the Doctor and the Nurse.
DNA appointments; the Group has identified that lack of appointment
in certain days could be because of patient’s failure to attend or cancel
in good time so that others can use these appointments. The Practice
has overcome this problem by instigating a system to alert patients
about their appointment by using Text Connection Services.
4- Diabetic Audit;
we have had specific clinics for the diabetic patients who
have been invited to be assessed by The Diabetic Specialist Nurse. We have had good response to this and the patients’ has had a holistic approach to their diabetic control assessing their lifestyle as well as compliance to their drug therapy and any drug side effects which the patients could have encountered. This has provided the Practice with vital information as how the Diabetic Patients are care for. The good new is that the Audit showed that our diabetics control is fantastic and compliance to drug therapy is very good we have achieved high standards in this aspect.
5- Teenage Pregnancy;
this is still an on going issue in the Practice. We are
in the process of completing the protocols that are required to be accredited with the certificate for this. The Practice members had in house training for C Card. This enables the Practice to offer condoms free of charge to the Young patients.
6- Sexual Health screening;
the Practice is providing this service for all the
patients particularly trying to target the young people to prevent unnecessary complications in future as a result of untreated genitourinary infections some of which could sexually transmitted. Free kit is available for collection at the front reception.
7- Travel Vaccinations;
the practice is part of travel vaccination centre
offering advice and immunisations. Some of the vaccinations are chargeable i.e. Meningitis ACWY, Hepatitis B, Malaria tablets, Yellow Fever, Rabis, Japanese encephalitis. However to prevent any confusion patients are advised to discuss the place of travel with the nurse and regarding the charge they need to speak to the Practice Manager.
In conclusion we as the practice would like to encourage patients to
participate in different audits that are undertaken in the Practice these
are devised to provide the very best for the patients and identify at risk
groups who may require extra attention so that future medical
complications can be avoided. The practice as a group would like to
thank patients for their love and support. Please do not hesitate to
contact the Practice Manager if you have any queries we are here to
provide the very best of health care that is possible for our patients.
We offer a completely confidential service to all our patients regardless of age, ethnicity, religious belief
or sexual orientation. Patient records will only be viewed by health professionals, ie doctors, nurses,
health visitors and administration staff during the course of carrying out their duties.
All staff are bound by a confidentiality agreement and we will not discuss any information about you with anyone else, unless you ask us to do so or in very exceptional circumstances where either your or another person’s safety maybe at risk. In these exceptional circumstances you will be kept fully informed. Even if you are under 16, all our staff will keep anything you tell them private, just as they would for an adult.
Some patients find having another person in the room when intimate examinations are undertaken is helpful, others find it an intrusion. Chaperones have advantages and disadvantages, and occasionally the doctor, too, would like someone to be present. During surgery hours we will always be guided by your choice, and so if you would like a chaperone, please feel free to say so, it rarely creates any difficulties, and there will be no question of the doctor being offended.
No family member or friend of a patient should be routinely expected to undertake any formal chaperoning role in normal circumstances. The presence of a chaperone during a clinical examination and treatment must be the clearly expressed choice of the patient (however the default position should be
If you know in advance that an intimate examination will be needed (such as a smear test) and you would like a chaperone, just bring a friend or relative with you. If an examination is needed but you had not anticipated it, a member of staff will be happy to act as chaperon for you, or the examination can often, though not always, be delayed.
Access to Patient Information
Only healthcare professionals within the practice are able to access patient information. Any information requested by a third party will only be processed with a signed statement from the patient involved. A computer system is used to retain records and to facilitate some aspects of patient care including recall for screening procedures and printing prescriptions. If you receive a letter from the practice please do not ignore it, we are committed to improving patient care.
The Practice is registered under the Data Protection Act and you may be sure that all records whether written or computerised are strictly confidential.
Accessing Information Held About Yourself
If you want to view your health records, you may not need to make a formal application. Nothing in the law prevents healthcare professionals from informally showing you your own records. You can make an informal request during a consultation, or by phoning the surgery or hospital to arrange a time to see your records.
If you want to make a formal request to see your health records under the Data Protection Act (1998), apply in writing to the holder(s) of the records. If you want to see your GP records, write to your GP or
the Practice Manager. Please note an administration fee maybe applicable
The Practice offers a range of services for Young People. All of our services are free
for all young people including those under 16. Even if you are aged 13 –16 you
can go in to see the doctor or nurse on your own (without a parent or carer). You can access
free condoms and other contraception, pregnancy testing, emergency contraception and
testing for sexually transmitted infections here at the surgery. We are also happy to talk to you
about contraception and sexual health, including helping you to talk through deciding whether
or not to have sex Confidentiality
This means that we will not tell anyone outside the surgery about the things you tell us, even
if you are under 16. However there are times when we HAVE to tell someone else what is
happening to ensure our best care for you. For example:
if you tell us about someone who has abused you or somebody else sexually, physically or emotionally,
if your or another person’s life is at risk.
Range of Services
• Free confidential pregnancy testing. • Free Chlamydia screening. • Free condoms. • First and ongoing prescription for contraceptive pill, combined pill and progesterone
• Prescription for contraceptive injection - given by the Nurse. • Free fitting of both the copper and Mirena Coil and Implanon (contraceptive implant) • All contraceptives are provided free of charge • Morning after pill -this ideally needs to be taken within 24 hours of having
unprotected sex but can be taken up to 72 hours after sex, however it becomes less effective the longer you leave it!
• Access to a Doctor who can refer you to abortion/pregnancy advice services. • Advice on all health issues. • Advice regarding stopping smoking. • Healthy eating advice and weight management • Advice on Diabetes management • Advice and referral for testing for all sexually transmitted diseases. • Testing and treatment for Genital herpes.
Please phone the surgery as detailed on the main home page and say that you need an urgent appointment with the doctor or nurse for emergency contraception. The receptionist will allocate you an appointment within a few hours on the day you phone or organise for you to speak to a doctor or nurse when they are free to take telephone calls.
The emergency contraceptive pills that are available are called Levonelle-2. These pills contain a progestogen hormone which is similar to the natural progesterone women produce in their ovaries.
They need to be taken within three days (72 hours) of having unprotected sex. The sooner they are taken, the more effective they are likely to be. They come in a packet of two tablets and the two pills should be taken straight away and at the same time.
The doctor or nurse will be able to give you any advice regarding this contraception. However the following information from the Family Planning Association website is important:
Emergency contraceptive pills are very effective.
If taken within 24 hours of unprotected sexual intercourse, they will prevent more than 9 out of 10 (95%) pregnancies expected to occur if no emergency contraception had been used.
If taken 72 hours after unprotected sex they will prevent more than 5 out of 10 (58%) pregnancies expected to occur if no emergency contraception had been used.
Emergency pills will not protect you from pregnancy if you have further
The doctor, nurse or pharmacist can give you information
about different contraceptive choices.
The doctor, nurse or pharmacist can also advise about this medication if you have an illness or are taking any other medication.
The tablets can make a menstrual come earlier than expected or up to a week late. Also, some irregular bleeding between taking the emergency pills and getting the next period may be experienced from spotting to quite heavy bleeding. The doctor or nurse will advise you when you should see them again, eg, if you were to miss a period or you were worried that you might be pregnant.
If the surgery is closed, the answer phone provide details of how to talk to a nurse or doctor.
Also emergency contraception can be obtained free from:
any GP who provides contraceptive services, eg, Dr Ghaharian’s Practice on prescription
any young person's clinic or Brook clinic
most genitourinary medicine (GUM) clinics
most NHS walk-in centres (in England only)
some hospital accident and emergency departments (phone first)
Also if you are aged 16 years or over, they tablets can also be purchased at some pharmacies.
stop a fertilised egg settling in your womb (implanting).
It is also possible to use the second method of emergency contraception copper intrauterine device (IUD)
in your womb up to five days after you had
unprotected sex, or up to five days after the earliest time you could have
released an egg (ovulation). If you need to come back to have the IUD fitted,
you may be advised to take emergency pills in the meantime. This can be
discussed with the doctor or nurse who will provide more information.
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CASO CLINICO Rev. Otorrinolaringol. Cir. Cabeza Cuello 2003; 63: 127-131ACTINOMICOSIS DEL HUESO MAXILAR SUPERIOR - T Schmidt, G Caselli, R Díaz Actinomicosis del Hueso Maxilar Superior Actinomycosis of the superior maxillary bone Thomas Schmidt P1, Gino Caselli M2, Reinaldo Díaz B2. La actinomicosis es una enfermedad crónica de origen bacteriano, del géneroActinomyces. Se caracteri