Iron infusion therapy is now available at our clinic which only takes 15 to 20 minutes. The iron infusion therapy is Ferinject (Ferric carboxymaltose) which was listed on PBS June 2014. If you have low iron studies and anaemia on blood tests and unable to tolerate oral iron tablets, iron infusion therapy is another alternative treatment available. It has very good safety profile with very rare occasion of anaphylaxis or anaphylactoid reaction. Other side effects are headache, nausea, abdominal pain and injection site reaction (includes possible skin staining from leakage of iron infusion). In the past, a doctor had to refer a patient to a hospital for iron infusion and been put on long waiting list. However, this will no longer necessary. Iron infusion procedure will cost $130 with Medicare rebate $41.20 (this does not include the cost of Ferinject)

NB: Patient will need to see a doctor first. The doctor will assess the patient and check on latest blood test results. The doctor will then write prescription for Ferinject. The patient will book a time for iron infusion to be done on designated day. As per our medical centre policy, we are only doing iron infusion for a patient who is 15 year old and above.

Psoriasis is a chronic inflammatory skin condition characterised by red and scaly plaque rash. It is thought to be immune-mediated inflammatory (autoimmune) disease. It is not contagious. Psoriasis also can affect nails and joints (causing psoriatic arthritis). Psoriasis affects 2-4% of males and females. It affects at any age from childhood to adult. It has peaks onset of 30-39 years and 50-69 years.

Risk factor for triggering or worsening psoriasis:

• Family history especially in those with first degree relatives. Genetics suspectibility with major histocompatibility complex on chromosome 6p21, IL-12 and IL-23 genes had been implicated in psoriasis
• Smoking
• Obesity
• Drugs such as Lithium, Beta- blockers, antimalarials, nonsteroidal anti-inflammatory drugs
• Infections due to viral or bacterial infections. Poststreptococcal infection causes flare of guttate psoriasis. HIV is known to worsen the condition of psoriasis.
• Excess alcohol consumption
  

Clinical features:

Psoriasis usually presents with symmetrically distributed, red, scaly plaques with well defined borders. The scale can be silvery white and may have peeling surface. Scaling and redness of skin occurs due to increased growth than normal and cells turnover in psoriasis with inflammation. In normal skin, the skin cells turnover is 27 days but in psoriasis, the skin cells turnover become shortened to 4 days. The most common sites affected are scalp, elbows and knees. In severe form of psoriasis, it can affect the whole body. Some patient can complain itchy of the skin leading to scratching and lichenification (thickened leathery skin).

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Osteoporosis is the bone condition characterised by low bone mass, which is associated with with reduced bone strength and an increased risk of fractures. Osteoporosis occurs most commonly in postmenopausal women. Low bone mass may be related to either inadequate peak bone mass acquisition and/or ongoing bone loss. 

Risk factors for osteoporosis (causing bone loss):

• Overactive thyroid (hyperthyroidism)
• Advanced age
• Previous fracture
• Long term glucocorticoid therapy
• Low body weight (less than 58kg)
• Family history of hip fracture
• Cigarette smoking
• Excessive alcohol intake
• Drop in estrogen (late onset of menstrual periods, absent or infrequent periods and premature early menopause before age of 45)
• Pituitary gland failure (hypopituitarism)
• Chronic illness such as chronic liver disease, chronic kidney disease, coeliac disease, rheumatoid arthritis, systemic lupus erythematosus
• Lack of physical activity
• Low Vit D
• Low Calcium intake
• Eating disorders such as anorexia nervosa and bulimia

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Tinea is a fungal infection of skin, nail and hairs. Tinea is usually caused by filamentous fungi such as Trichophyton, Microsporum and Epidermophyton. Among those fungi, Trichophyton is the most common cause of Tinea in human skin.

Tinea can be spread by skin to skin contact or indirectly through sharing of towels, clothes or walking with barefoot on floors. Tinea tends to grow on warm, sweat prone areas of the body.

There are few types of Tinea which depends on the locations of the body affected:

• Tinea corporis- Infection of body surfaces other than feet, groin, face, scalp hair or beard hair
• Tinea pedis- Infection of the foot (Athelete's foot)
• Tinea cruris- Infection of the groin (Jock itch)
• Tinea capitis- Infection of scalp hair
• Tinea unguium (dermatophyte onchomycosis)- Infection of the nail

Symptoms:

• Itching and stinging
• Circular red scaly rash with central clearing (usually happens on body, groin, arms and legs)
• Blister scaly rash due to intense inflammatory reaction 
• Yellow or white discolouration of the nails. Loosening or separation of fingernail or toenail from its bed
• Bald spots on the scalp known as Kerion

Treatment:

• Antifungal cream such as Lamisil cream can be used to treat Tinea but it takes time to work and can be expensive. Canestan cream does not work well in treatment of Tinea
• Terbinafine tablet. More effective but also take time to work. The medication is generic and therefore, even without approval from PBS authority, the price is still reasonable to purchase privately
• Azole tablets such as Itraconazole and Fluconazole  
• Griseofulvin