As per the previous ATAGI statement on 2 April, please note that it has been recommended that all community members under 50 receive the Pfizer vaccine rather than the Astra Zeneca, please see following information.
Any patients currently booked in for their first dose of Astra Zeneca will be cancelled and receive an SMS. If you still wish to proceed you will need to book in with your regular GP and discuss the options and risks.
What is this side effect that everyone is talking about associated with the AstraZeneca vaccine?
There is evidence of a likely link between the AstraZeneca vaccine and an extremely rare blood clotting syndrome (thrombosis with thrombocytopenia).
The recommendation from the Australian Technical Advisory Group on Immunisation (ATAGI) is that use of Comirnaty COVID-19 vaccine (Pfizer) is preferred over AstraZeneca COVID-19 vaccine in adults under 50 years old who have not already had a first dose of the AstraZeneca vaccine.
Is the AstraZeneca vaccine safe?
Yes. The individual benefit-to-risk balance of vaccination with the AstraZeneca COVID-19 vaccine varies with age. This balance is based on factors including the increased risk of complications from COVID-19 with increasing age and the potential lower risk of this very rare, but serious, adverse event with increasing age. ATAGI has recommended the AstraZeneca vaccine remains safe to be given to people aged 50 years and over.
I have had my first dose of the AstraZeneca vaccine, what do I do now?
If you have had your first vaccine dose without this side effect or other serious adverse effects, you should receive your second dose as planned.
What if I am worried about side effects?
If you have recently had your first vaccine dose and are experiencing any side effects that you are worried about, I can book an appointment for you to see your doctor.
I’m booked in for my first dose of the AstraZeneca COVID-19 vaccine, what do I do?
If you are an adult aged under 50 years, you should only receive a first dose of AstraZeneca COVID-19 vaccine where the benefit of receiving the vaccine clearly outweighs the risk in your individual circumstance. You may wish to discuss your individual benefit-to-risk balance with your doctor.
Generally, if you have not already received a first dose of the AstraZeneca COVID-19 vaccine, then the Pfizer COVID-19 vaccine is preferred in adults aged under 50 years.
Information about how to receive the Pfizer COVID-19 vaccine will be available on the Department of Health website shortly.
If you would like to talk about this with your doctor, I can make an appointment for you now.
If you are 50 years of age or older, you can still receive your AstraZeneca COVID-19 vaccine.
COVID-19 VACCINATION SESSION BOOKINGS NOW OPEN AT BOTH CENTRES
Please book online via HOTDOC or call practice – long delays may be expected on phones due to high volume of incoming calls, your patience is appreciated. To reduce delays please book online.
All documentation must be lodged with Mead Medical PRIOR to your booked appointment.
Lodge your completed forms by emailing to covidready@meadmedical.com.au or handing in to reception.
- Consent form
- Proof of eligibility of Chronic disease if not a regular patient of Mead Medical
Forms are available on our website or at reception. Immunisations can not be carried out without completed documentation.
Kalamunda
- Thursday 1st April: 6pm – 8pm
- Saturday 10th April: 3pm – 5pm
- Sunday 11th April: 3pm – 5pm
Forrestfield
- Saturday 17th April: 1pm -3pm
- Saturday 24th April: 1pm -3pm
Please refer to HOTDOC for further sessions post these dates.
Mead Medical would like to advise that we have been nominated as a community vaccination practice.
This means that any community members who fall under the Phase 1b as follows will be able to attend our practice for your immunisation program. It will be very important to ensure that you stick with the same practice for both of your immunisations as the second dose will be held in quarantine for you which will be 12 weeks post your first dose. A reminder will be sent for your 2nd jab via SMS.
You will need to check your eligibility for this first phase by clicking on the following link:
https://covid-vaccine.healthdirect.gov.au/eligibility
- Elderly adults aged 70 years and over
- Other health care workers
- Aboriginal and Torres Strait Islander people over 55 years
- Adults with an underlying medical condition, including those with a disability
- Critical and high-risk workers including defence, police, fire, emergency services and meat processing
VACCINES ARE NOT YET AVAILABLE IN PRACTICE. We will notify all current patients via SMS when the vaccine is available as well as on our website and Facebook page for community members.
As a fully accredited General Practice, Mead Medical has been delivering exceptional and quality patient care to the Hills area, a 30-minute drive from the Perth CBD. Their clinical services are provided by a team of 25 independent contracts, all of whom are experienced and some of which specialise in different fields, including but not limited to Aged Care, Palliative care, Skin Care, Women’s Health, Obstetrician & Gynaecology and Anaesthetics. Mead Medical was honoured with the prestigious national award of the RACGP General Practice of the Year 2013/14 (National).
Michelle Johnston, Finance Manager at Mead Medical Group, uses Cubiko every day to help their practice understand their crucial business performance, save time in reporting and provide insights to their doctors.
We used to guess what was going on. Our practice management system reporting was not consolidated. We had to go to so many different places to find the information, which took a lot of time.
~ Michelle Johnston, Finance Manager at Mead Medical
THE OPPORTUNITY
Before using Cubiko, Mead Medical had “lots of spreadsheets”, says Michelle Johnston, the Finance Manager. After navigating the practice through the Covid period it became very apparent how crucial real time data was for the Executive Team when needing to make quick and decisive business decisions, especially in an environment that was unknown and sometimes changing daily. The practice had the data but found it difficult to get insights promptly as doctors and staff would move across their practices which made it complex to monitor cost and consolidate data. It would have been a full-time job to get live data. They did have insights into their medical practice’s financial and business performance, but because it was time-consuming to gather it was only done as part of the end of month reporting.
COVID-19 impacted the practice significantly as well as multiple Doctors commencing maternity leave, doctors relocating due to the change of DPA boundaries and the passing of one of our Directors, the practice group saw six full-time equivalent contractors leave within a short period of time. Being no longer able to recruit IMGs and being located in outer Metro has resulted In Mead Medical with very few options for recruitment.
Mead Medical wanted a Practice Intelligence Platform that could:
- Help the practice group attract and retain doctors
- Save time in reporting across the group
- Provide financial and business insights into the practices
- Forecast future billings
THE SOLUTION
Michelle believed “there has to be something out there that automates the data collection and provides insights”. Cubiko provides Mead Medical with dashboards of their consolidated data across their multisite group. Significantly reducing the time required to report on their practice’s business performance and providing forecasting metrics so they can plan for the future.
To read more about our data-driven decisions with Cubiko, click here.
It is with great pleasure that we welcome Dr Hla Shwe to the Mead Medical team.
Dr Shwe grew up in Myanmar, Burma. He completed his Batchelor of Medicine and Surgery (MBBS) in 2004 in Myanmar, and achieved the (FRACGP) in Australia. He has completed additional studies with a Diploma in Child Health (DCH). Hla enjoys all areas of General Practice. He has a particular interest in Paediatrics, Geriatric medicine, Palliative care, Weight Loss, Family Medicine, Family planning, Women’s Health (Including Implanon insertion), Men’s health, Aboriginal health, Cardiology, Diabetes management, Immunology, Allergies, Asthma, Arthritis, Dermatology, Smoking Cessation, Workers compensation and Ear, Nose & throat (ENT) medicine. Hla is a member of Member of the Royal Australian college of General Practitioners (RACGP). Outside of work, he enjoys spending time with his family, running and playing tennis.
Mead Medical are sad to be saying farewell to some of our wonderful doctors.
To our outgoing registrars Drs Vitale and Dr Dubrawski, who we hope to see back some time in the future.
To Dr Danielle Vlahov and Dr Smailes who have both commenced their maternity leave.
To Dr Elaine Lee and Dr Sandy Braiuka who have move to alternate locations.
They will all be missed at Mead Medical.
Our beloved Dr Bill Babe will be laid to rest as per the following notice.
We offer our sincere condolences to Dr Babe’s family, friends and colleagues, his loss will be felt deeply by all.
Mead Medical will at close at 2pm for his service on the 18th November, all patients and staff are invited to attend and celebrate his life.
FUNERAL NOTICE
A funeral service to honour and celebrate the life of the late Most Worshipful Brother, Dr William (Bill) Gordon Babe, Past Grand Master – The Grand Lodge of Western Australia and Hacketts Gully; will be conducted in Stirk Park, Elizabeth Street, Kalamunda, commencing at 2.30pm Wednesday 18.11.2020.
Family request formal dress to be worn please.
It is with a very heavy heart, we report that we lost our beloved Director Dr William Babe overnight.
Bill was part of the heart and soul of Mead Medical and will be deeply missed by all.
Vitamins and Skin Cancers…can your diet help protect you from skin cancers? Let’s look at the A, B, C, D and E’s of skin cancer protection…
Sun protective clothing, a wide brimmed hat, sunglasses, sunscreen had all work very well for protecting the skin from the dangers of the Australian sun, however, some people who spend hours in the direct sun every day might benefit from a little more protection than physical barriers to help combat their risk of skin cancer.
VITAMIN A
Vitamin A has been linked to lowering skin cancer in a large study of more than 125,000 people in America. There are many established benefits of vitamin A including protecting your eyes from age related decline, supporting a healthy immune system and bone health. A recent study published in the JAMA Dermatology journal found that there is an inverse association between consuming vitamin A and the risk of cutaneous squamous cell carcinoma. What this means it that for people who ate the recommended amount of vitamin A there was a 15% lower chance that they would develop Cutaneous Squamous Cell Carcinoma.
Cutaneous SCC is a type of non-melanoma skin cancer and one of the most common forms of the disease after Basal Cell Carcinoma in Australia. While not as dangerous as melanoma, it has been known to spread to other parts of the body from the skin and pose significant risk.
The best source of vitamin A is from a balanced diet filled with fruits, vegetables and healthy animal products. Some foods with a high percentage of vitamin A include: liver from beef, lamb or other sources, cod liver oil, fish such as salmon, mackerel and tuna, cheeses such as goats cheese, cheddar and camembert.
It is important to note that too much vitamin A can have negative consequences on the body. The recommended amount of vitamin A per day is between 700 and 900 micrograms, exceeding this can cause liver damage, thinning of the bones and osteoporosis.
Thus, natural sources of vitamin A are a much better solution than supplements for getting the amounts of vitamin A that you need. The 2019 study conducted over 25 years showed that people who took vitamin A supplements did not appear to have a lower chance of developing SCC. Thus, eating the right foods and having a balanced diet is the best way to get the vitamin A you need to fight the risk of skin cancer.
While it is great news about vitamin A and its impact on reducing the risk of skin cancer, we need to understand that the right amount of vitamin A in your diet still cannot replace more traditional forms of protecting your skin against the sun. When going outside, particularly on days with a high UV index, it is still important to wear sunscreen, slip on long sleeved, protective clothing and wear a hat that will cover the face, neck and ears.
VITAMIN B
Cancer Council NSW helped fund one of the biggest discoveries in skin cancer research – that vitamin B3 can help reduce non-melanoma skin cancers. Five years after this grant ended, we review what the lead researcher, Professor Diona Damian said about her pioneering work.
It all began in 2008, when Cancer Council NSW awarded a research grant to Professor Diona Damian and her team at the University of Sydney. Over the next three years, the researchers led the way globally in exploring a new approach to tackling skin cancer.
“We were interested in finding new ways of preventing and treating skin cancer, because that’s our national cancer. It’s the most common cancer in Australia, more than four times as common as all other cancers put together”, Professor Damian said.
BREAKTHROUGH FINDINGS
When Professor Damian’s team began their work, they knew that even low doses of UV radiation from the sun could cause skin cancer. UV radiation does this not only by damaging the DNA in skin cells, but also by suppressing our skin’s immune defences. Professor Damian had already tested a number of compounds which could potentially prevent this sunlight-induced immune suppression, and found that a form of vitamin B3, called nicotinamide, had the greatest potential.
Thanks to Cancer Council NSW funding, her team was able to prove that nicotinamide, either as a topical lotion or a daily tablet, is highly effective in providing immune protection. Nicotinamide does this by replenishing cellular energy, which also enables faster and more efficient DNA repair following sun exposure.
A LANDMARK CLINICAL TRIAL
Since her Cancer Council NSW project grant concluded, Professor Damian’s research on nicotinamide has made incredible progress. Her team won a grant from the National Health and Medical Research Council to undertake a landmark skin cancer prevention clinical trial called ONTRAC (“Oral Nicotinamide To Reduce Actinic Cancer”).
The trial was conducted across the Royal Prince Alfred and Westmead Hospitals and included 386 patients who were randomly assigned to receive either a twice daily dose of nicotinamide or a placebo for one year. All the patients had been diagnosed with at least two non-melanoma skin cancers in the previous 5 years, which meant they were at a high risk of developing more cancers. During the twelve months of study, this group of patients collectively grew 800 new skin cancers.
WHAT DID THE TRIAL DISCOVER?
- The final results of ONTRAC were published in the New England Journal of Medicine and made international headlines.
- The team found that at 12 months, the rate of non-melanoma skin cancers was 23% lower in the nicotinamide group than in the placebo group.
- The number of precancerous lesions was also 13% lower among the people taking nicotinamide compared to those not taking nicotinamide.
WHO CAN USE NICOTINOMIDE (VITAMIN B3) TO PREVENT SKIN CANCERS?
Professor Damian emphasised that using nicotinamide to prevent skin cancer is a high-dose treatment rather than a supplement. “This treatment is only for people with a defined medical condition – multiple skin cancers.”
“It’s not suitable for the general population, as we do not have any evidence that it would be beneficial in a lower risk setting.”
Before taking nicotinamide, people should consult with their GP to see whether nicotinamide is suitable for them. It is also very important that people planning to take vitamin B3 take the amide form, nicotinamide, and not the nicotinic acid form. “Nicotinic acid has a range of unpleasant side effects – including flushing, headache and low blood pressure – that we don’t see with nicotinamide”, says Professor Damian.
HOW DOES VITAMIN B3 WORK?
Ultraviolet (UV) radiation causes skin cancer by damaging the DNA in cells, reducing the amount of energy available to repair damage, and interfering with the immune system in skin cells. DNA provides “instructions” for cells to grow normally. Damaged DNA can result in uncontrolled growth — skin cancer.
Vitamin B3 helps repair UV-damaged cells and reduce the risk of skin cancer by:
- Making more energy available to cells
- Helping repair damaged DNA, and
- Reducing the immune suppression caused by UV radiation1.
In high-risk people who have already had a non-melanoma skin cancer, i.e. a basal cell carcinoma (BCC) or a squamous cell carcinoma (SCC), taking vitamin B3 tablets daily reduces the risk of future non-melanoma skin cancer.
HOW MUCH VITAMIN B3 TO TAKE?
The largest trial of vitamin B treatment2 showed that it is an effective and low-risk treatment. At a dose of 500mg twice daily, taken for a year, the rate of new non-melanoma skin cancers was reduced by approximately 23 per cent:
- Basal cell carcinomas were reduced by 20 per cent. Less serious superficial basal cell carcinomas were prevented more effectively than more aggressive forms of basal cell carcinoma1.
- Squamous cell carcinomas were reduced by 30 per cent. This reduction was the same for superficial and more aggressive squamous cell carcinomas.
Some people get better results than this. In an earlier study3, nicotinamide was found to reduce non-melanoma skin cancer rates by up to 75 per cent, but these figures have not been reproduced across larger numbers of patients.
Vitamin B seems to work best in people with the highest levels of risk, i.e. those who have had many BCCs or SCCs previously2.
Oral nicotinamide is now recognised as an important part of the routine treatment of people at high risk of BCC and SCC and is about to become part of the Cancer Council’s national treatment guidelines for BCC and SCC4.
Protection from vitamin B3 only lasts while it is being taken5. In other words, for long term reduction of non-melanoma skin cancer, it needs to be taken indefinitely.
WHAT FOODS IS VITAMIN B3 PRESENT IN?
Vitamin B3 is present in small amounts in yeast, meat, fish, eggs, milk, nuts, legumes and cereals12. The average daily requirement for vitamin B3 is 15-20mg1. This is easily met by a balanced diet containing the foods mentioned above. But the amount shown to reduce skin cancer risk is about 50 times this amount and can’t be achieved by dietary intake alone.
VITAMIN C
Vitamin C is a potent antioxidant drug that can be used topically in dermatology to treat and prevent changes associated with photoageing. It can also be used for the treatment of hyperpigmentation. Because it is unstable and difficult to deliver into the dermis in the optimum dosage, research is being directed to find stable compounds of Vitamin C and newer methods of delivery of Vitamin C into the dermis.
The toxic effects of vitamin C on tumor cells may be related to the induction of oxidative stress in cells. However, when the antioxidation system of tumor cells is incomplete, the balance is destroyed, and the oxygen-promoting effect of vitamin C leads to the death of tumor cells (Kim K. et al., 2015; Uetaki et al., 2015). Vitamin C is often used as an adjunct to chemotherapy for tumors. Vitamin C can also increase 5-hydroxymethylcytosine (5hmC) content in melanoma cells and cause a decrease in tumor-cell invasiveness and growth (Gustafson et al., 2015). Thus, vitamin C can be regarded as a potential antitumor drug for the prevention of invasion and metastasis of melanoma, which weakens the tumor capsule integrity and invasiveness and reduces the degree of malignancy.
However, there is still a lack of understanding about the route of administration for vitamin C, the dosage of medication and the complications. We should increase awareness of the fact that high concentrations of vitamin C induce apoptosis of malignant melanoma cells, while low concentrations promote the growth of tumor cells (Yang et al., 2017). H
VITAMIN D
Vitamin D forms in the skin when it is exposed to UV from sunlight. It can also be obtained from some foods. We need vitamin D to maintain good health and to keep bones and muscles strong and healthy.
The best source of vitamin D is UVB radiation from the sun. UV radiation levels vary depending on location, time of year, time of day, cloud coverage and the environment.
For most people, adequate vitamin D levels are reached through regular incidental exposure to the sun. When the UV Index is 3 or above (such as during summer), most people maintain adequate vitamin D levels just by spending a few minutes outdoors on most days of the week.
In late autumn and winter in some southern parts of Australia, when the UV Index falls below 3, spend time outdoors in the middle of the day with some skin uncovered. Being physically active (e.g. gardening or going for a brisk walk) also helps boost vitamin D levels.
Adequate levels of Vitamin D promote good immunity. Vitamin D can modulate the innate and adaptive immune responses. Deficiency in vitamin D is associated with increased autoimmunity as well as an increased susceptibility to infection. At this point in time however we have insufficient evidence to recomment Vitamin D supplementation as a method to decrease Malignant Melanoma.
VITAMIN E
Vitamin E is an important fat-soluble antioxidant and has been in use for more than 50 years in dermatology. It is an important ingredient in many cosmetic products. It protects the skin from various deleterious effects due to solar radiation by acting as a free-radical scavenger. Experimental studies suggest that vitamin E has antitumorigenic and photoprotective properties
By Dr Leena Uppal
It’s winter time..but don’t let less skin fool you-it is still our largest human organ. The average adult carries 3.5kg and 2sq meters of it!
Did you know that Australia has one of the highest rates of Melanoma in the world?
This year it is expected there will be close to 1 diagnosis of Melanoma every 30 min
Melanoma is the 3rd most common cancer in both Australian men and women and THE most common cancer in Australians aged 15-39 years
SCAN your skin
Is it Sore?
Is it Changing?
Is it Abnormal compared to the rest of your spots?
Is it New-especially over the age of 40?
If you haven’t had a skin check in the last year, it is an easy and painless procedure, book yours in today.
Farewell to 2023, Welcome 2024
As we near the end of another teaching year for our Registrar GPs, we
How Dense are your bones? You may be eligible to attend our visiting Bone Density service
Farewell to Dr Elizabeth Dernie
This Friday the 26th May will be Dr Elizabeth Dernie's last day as she
IMPORTANT COVID VACCINATION UPDATE
As per the previous ATAGI statement on 2 April, please note that it has been recommended that all community members under 50 receive the Pfizer vaccine rather than the Astra Zeneca, please see following information.
Any patients currently booked in for their first dose of Astra Zeneca will be cancelled and receive an SMS. If you still wish to proceed you will need to book in with your regular GP and discuss the options and risks.
What is this side effect that everyone is talking about associated with the AstraZeneca vaccine?
There is evidence of a likely link between the AstraZeneca vaccine and an extremely rare blood clotting syndrome (thrombosis with thrombocytopenia).
The recommendation from the Australian Technical Advisory Group on Immunisation (ATAGI) is that use of Comirnaty COVID-19 vaccine (Pfizer) is preferred over AstraZeneca COVID-19 vaccine in adults under 50 years old who have not already had a first dose of the AstraZeneca vaccine.
Is the AstraZeneca vaccine safe?
Yes. The individual benefit-to-risk balance of vaccination with the AstraZeneca COVID-19 vaccine varies with age. This balance is based on factors including the increased risk of complications from COVID-19 with increasing age and the potential lower risk of this very rare, but serious, adverse event with increasing age. ATAGI has recommended the AstraZeneca vaccine remains safe to be given to people aged 50 years and over.
I have had my first dose of the AstraZeneca vaccine, what do I do now?
If you have had your first vaccine dose without this side effect or other serious adverse effects, you should receive your second dose as planned.
What if I am worried about side effects?
If you have recently had your first vaccine dose and are experiencing any side effects that you are worried about, I can book an appointment for you to see your doctor.
I’m booked in for my first dose of the AstraZeneca COVID-19 vaccine, what do I do?
If you are an adult aged under 50 years, you should only receive a first dose of AstraZeneca COVID-19 vaccine where the benefit of receiving the vaccine clearly outweighs the risk in your individual circumstance. You may wish to discuss your individual benefit-to-risk balance with your doctor.
Generally, if you have not already received a first dose of the AstraZeneca COVID-19 vaccine, then the Pfizer COVID-19 vaccine is preferred in adults aged under 50 years.
Information about how to receive the Pfizer COVID-19 vaccine will be available on the Department of Health website shortly.
If you would like to talk about this with your doctor, I can make an appointment for you now.
If you are 50 years of age or older, you can still receive your AstraZeneca COVID-19 vaccine.
COVID-19 VACCINATION SESSION BOOKINGS
COVID-19 VACCINATION SESSION BOOKINGS NOW OPEN AT BOTH CENTRES
Please book online via HOTDOC or call practice – long delays may be expected on phones due to high volume of incoming calls, your patience is appreciated. To reduce delays please book online.
All documentation must be lodged with Mead Medical PRIOR to your booked appointment.
Lodge your completed forms by emailing to covidready@meadmedical.com.au or handing in to reception.
- Consent form
- Proof of eligibility of Chronic disease if not a regular patient of Mead Medical
Forms are available on our website or at reception. Immunisations can not be carried out without completed documentation.
Kalamunda
- Thursday 1st April: 6pm – 8pm
- Saturday 10th April: 3pm – 5pm
- Sunday 11th April: 3pm – 5pm
Forrestfield
- Saturday 17th April: 1pm -3pm
- Saturday 24th April: 1pm -3pm
Please refer to HOTDOC for further sessions post these dates.
VACCINATION CLINIC – COVID-19
Mead Medical would like to advise that we have been nominated as a community vaccination practice.
This means that any community members who fall under the Phase 1b as follows will be able to attend our practice for your immunisation program. It will be very important to ensure that you stick with the same practice for both of your immunisations as the second dose will be held in quarantine for you which will be 12 weeks post your first dose. A reminder will be sent for your 2nd jab via SMS.
You will need to check your eligibility for this first phase by clicking on the following link:
https://covid-vaccine.healthdirect.gov.au/eligibility
- Elderly adults aged 70 years and over
- Other health care workers
- Aboriginal and Torres Strait Islander people over 55 years
- Adults with an underlying medical condition, including those with a disability
- Critical and high-risk workers including defence, police, fire, emergency services and meat processing
VACCINES ARE NOT YET AVAILABLE IN PRACTICE. We will notify all current patients via SMS when the vaccine is available as well as on our website and Facebook page for community members.
Mead Medical makes data-driven decisions with Cubiko
As a fully accredited General Practice, Mead Medical has been delivering exceptional and quality patient care to the Hills area, a 30-minute drive from the Perth CBD. Their clinical services are provided by a team of 25 independent contracts, all of whom are experienced and some of which specialise in different fields, including but not limited to Aged Care, Palliative care, Skin Care, Women’s Health, Obstetrician & Gynaecology and Anaesthetics. Mead Medical was honoured with the prestigious national award of the RACGP General Practice of the Year 2013/14 (National).
Michelle Johnston, Finance Manager at Mead Medical Group, uses Cubiko every day to help their practice understand their crucial business performance, save time in reporting and provide insights to their doctors.
We used to guess what was going on. Our practice management system reporting was not consolidated. We had to go to so many different places to find the information, which took a lot of time.
~ Michelle Johnston, Finance Manager at Mead Medical
THE OPPORTUNITY
Before using Cubiko, Mead Medical had “lots of spreadsheets”, says Michelle Johnston, the Finance Manager. After navigating the practice through the Covid period it became very apparent how crucial real time data was for the Executive Team when needing to make quick and decisive business decisions, especially in an environment that was unknown and sometimes changing daily. The practice had the data but found it difficult to get insights promptly as doctors and staff would move across their practices which made it complex to monitor cost and consolidate data. It would have been a full-time job to get live data. They did have insights into their medical practice’s financial and business performance, but because it was time-consuming to gather it was only done as part of the end of month reporting.
COVID-19 impacted the practice significantly as well as multiple Doctors commencing maternity leave, doctors relocating due to the change of DPA boundaries and the passing of one of our Directors, the practice group saw six full-time equivalent contractors leave within a short period of time. Being no longer able to recruit IMGs and being located in outer Metro has resulted In Mead Medical with very few options for recruitment.
Mead Medical wanted a Practice Intelligence Platform that could:
- Help the practice group attract and retain doctors
- Save time in reporting across the group
- Provide financial and business insights into the practices
- Forecast future billings
THE SOLUTION
Michelle believed “there has to be something out there that automates the data collection and provides insights”. Cubiko provides Mead Medical with dashboards of their consolidated data across their multisite group. Significantly reducing the time required to report on their practice’s business performance and providing forecasting metrics so they can plan for the future.
To read more about our data-driven decisions with Cubiko, click here.
Welcome Dr Hla Shwe
It is with great pleasure that we welcome Dr Hla Shwe to the Mead Medical team.
Dr Shwe grew up in Myanmar, Burma. He completed his Batchelor of Medicine and Surgery (MBBS) in 2004 in Myanmar, and achieved the (FRACGP) in Australia. He has completed additional studies with a Diploma in Child Health (DCH). Hla enjoys all areas of General Practice. He has a particular interest in Paediatrics, Geriatric medicine, Palliative care, Weight Loss, Family Medicine, Family planning, Women’s Health (Including Implanon insertion), Men’s health, Aboriginal health, Cardiology, Diabetes management, Immunology, Allergies, Asthma, Arthritis, Dermatology, Smoking Cessation, Workers compensation and Ear, Nose & throat (ENT) medicine. Hla is a member of Member of the Royal Australian college of General Practitioners (RACGP). Outside of work, he enjoys spending time with his family, running and playing tennis.
Farewell
Mead Medical are sad to be saying farewell to some of our wonderful doctors.
To our outgoing registrars Drs Vitale and Dr Dubrawski, who we hope to see back some time in the future.
To Dr Danielle Vlahov and Dr Smailes who have both commenced their maternity leave.
To Dr Elaine Lee and Dr Sandy Braiuka who have move to alternate locations.
They will all be missed at Mead Medical.
Funeral Notice – Dr Bill Babe
Our beloved Dr Bill Babe will be laid to rest as per the following notice.
We offer our sincere condolences to Dr Babe’s family, friends and colleagues, his loss will be felt deeply by all.
Mead Medical will at close at 2pm for his service on the 18th November, all patients and staff are invited to attend and celebrate his life.
FUNERAL NOTICE
A funeral service to honour and celebrate the life of the late Most Worshipful Brother, Dr William (Bill) Gordon Babe, Past Grand Master – The Grand Lodge of Western Australia and Hacketts Gully; will be conducted in Stirk Park, Elizabeth Street, Kalamunda, commencing at 2.30pm Wednesday 18.11.2020.
Family request formal dress to be worn please.
Sad News
It is with a very heavy heart, we report that we lost our beloved Director Dr William Babe overnight.
Bill was part of the heart and soul of Mead Medical and will be deeply missed by all.
Vitamins and Skin Cancers
Vitamins and Skin Cancers…can your diet help protect you from skin cancers? Let’s look at the A, B, C, D and E’s of skin cancer protection…
Sun protective clothing, a wide brimmed hat, sunglasses, sunscreen had all work very well for protecting the skin from the dangers of the Australian sun, however, some people who spend hours in the direct sun every day might benefit from a little more protection than physical barriers to help combat their risk of skin cancer.
VITAMIN A
Vitamin A has been linked to lowering skin cancer in a large study of more than 125,000 people in America. There are many established benefits of vitamin A including protecting your eyes from age related decline, supporting a healthy immune system and bone health. A recent study published in the JAMA Dermatology journal found that there is an inverse association between consuming vitamin A and the risk of cutaneous squamous cell carcinoma. What this means it that for people who ate the recommended amount of vitamin A there was a 15% lower chance that they would develop Cutaneous Squamous Cell Carcinoma.
Cutaneous SCC is a type of non-melanoma skin cancer and one of the most common forms of the disease after Basal Cell Carcinoma in Australia. While not as dangerous as melanoma, it has been known to spread to other parts of the body from the skin and pose significant risk.
The best source of vitamin A is from a balanced diet filled with fruits, vegetables and healthy animal products. Some foods with a high percentage of vitamin A include: liver from beef, lamb or other sources, cod liver oil, fish such as salmon, mackerel and tuna, cheeses such as goats cheese, cheddar and camembert.
It is important to note that too much vitamin A can have negative consequences on the body. The recommended amount of vitamin A per day is between 700 and 900 micrograms, exceeding this can cause liver damage, thinning of the bones and osteoporosis.
Thus, natural sources of vitamin A are a much better solution than supplements for getting the amounts of vitamin A that you need. The 2019 study conducted over 25 years showed that people who took vitamin A supplements did not appear to have a lower chance of developing SCC. Thus, eating the right foods and having a balanced diet is the best way to get the vitamin A you need to fight the risk of skin cancer.
While it is great news about vitamin A and its impact on reducing the risk of skin cancer, we need to understand that the right amount of vitamin A in your diet still cannot replace more traditional forms of protecting your skin against the sun. When going outside, particularly on days with a high UV index, it is still important to wear sunscreen, slip on long sleeved, protective clothing and wear a hat that will cover the face, neck and ears.
VITAMIN B
Cancer Council NSW helped fund one of the biggest discoveries in skin cancer research – that vitamin B3 can help reduce non-melanoma skin cancers. Five years after this grant ended, we review what the lead researcher, Professor Diona Damian said about her pioneering work.
It all began in 2008, when Cancer Council NSW awarded a research grant to Professor Diona Damian and her team at the University of Sydney. Over the next three years, the researchers led the way globally in exploring a new approach to tackling skin cancer.
“We were interested in finding new ways of preventing and treating skin cancer, because that’s our national cancer. It’s the most common cancer in Australia, more than four times as common as all other cancers put together”, Professor Damian said.
BREAKTHROUGH FINDINGS
When Professor Damian’s team began their work, they knew that even low doses of UV radiation from the sun could cause skin cancer. UV radiation does this not only by damaging the DNA in skin cells, but also by suppressing our skin’s immune defences. Professor Damian had already tested a number of compounds which could potentially prevent this sunlight-induced immune suppression, and found that a form of vitamin B3, called nicotinamide, had the greatest potential.
Thanks to Cancer Council NSW funding, her team was able to prove that nicotinamide, either as a topical lotion or a daily tablet, is highly effective in providing immune protection. Nicotinamide does this by replenishing cellular energy, which also enables faster and more efficient DNA repair following sun exposure.
A LANDMARK CLINICAL TRIAL
Since her Cancer Council NSW project grant concluded, Professor Damian’s research on nicotinamide has made incredible progress. Her team won a grant from the National Health and Medical Research Council to undertake a landmark skin cancer prevention clinical trial called ONTRAC (“Oral Nicotinamide To Reduce Actinic Cancer”).
The trial was conducted across the Royal Prince Alfred and Westmead Hospitals and included 386 patients who were randomly assigned to receive either a twice daily dose of nicotinamide or a placebo for one year. All the patients had been diagnosed with at least two non-melanoma skin cancers in the previous 5 years, which meant they were at a high risk of developing more cancers. During the twelve months of study, this group of patients collectively grew 800 new skin cancers.
WHAT DID THE TRIAL DISCOVER?
- The final results of ONTRAC were published in the New England Journal of Medicine and made international headlines.
- The team found that at 12 months, the rate of non-melanoma skin cancers was 23% lower in the nicotinamide group than in the placebo group.
- The number of precancerous lesions was also 13% lower among the people taking nicotinamide compared to those not taking nicotinamide.
WHO CAN USE NICOTINOMIDE (VITAMIN B3) TO PREVENT SKIN CANCERS?
Professor Damian emphasised that using nicotinamide to prevent skin cancer is a high-dose treatment rather than a supplement. “This treatment is only for people with a defined medical condition – multiple skin cancers.”
“It’s not suitable for the general population, as we do not have any evidence that it would be beneficial in a lower risk setting.”
Before taking nicotinamide, people should consult with their GP to see whether nicotinamide is suitable for them. It is also very important that people planning to take vitamin B3 take the amide form, nicotinamide, and not the nicotinic acid form. “Nicotinic acid has a range of unpleasant side effects – including flushing, headache and low blood pressure – that we don’t see with nicotinamide”, says Professor Damian.
HOW DOES VITAMIN B3 WORK?
Ultraviolet (UV) radiation causes skin cancer by damaging the DNA in cells, reducing the amount of energy available to repair damage, and interfering with the immune system in skin cells. DNA provides “instructions” for cells to grow normally. Damaged DNA can result in uncontrolled growth — skin cancer.
Vitamin B3 helps repair UV-damaged cells and reduce the risk of skin cancer by:
- Making more energy available to cells
- Helping repair damaged DNA, and
- Reducing the immune suppression caused by UV radiation1.
In high-risk people who have already had a non-melanoma skin cancer, i.e. a basal cell carcinoma (BCC) or a squamous cell carcinoma (SCC), taking vitamin B3 tablets daily reduces the risk of future non-melanoma skin cancer.
HOW MUCH VITAMIN B3 TO TAKE?
The largest trial of vitamin B treatment2 showed that it is an effective and low-risk treatment. At a dose of 500mg twice daily, taken for a year, the rate of new non-melanoma skin cancers was reduced by approximately 23 per cent:
- Basal cell carcinomas were reduced by 20 per cent. Less serious superficial basal cell carcinomas were prevented more effectively than more aggressive forms of basal cell carcinoma1.
- Squamous cell carcinomas were reduced by 30 per cent. This reduction was the same for superficial and more aggressive squamous cell carcinomas.
Some people get better results than this. In an earlier study3, nicotinamide was found to reduce non-melanoma skin cancer rates by up to 75 per cent, but these figures have not been reproduced across larger numbers of patients.
Vitamin B seems to work best in people with the highest levels of risk, i.e. those who have had many BCCs or SCCs previously2.
Oral nicotinamide is now recognised as an important part of the routine treatment of people at high risk of BCC and SCC and is about to become part of the Cancer Council’s national treatment guidelines for BCC and SCC4.
Protection from vitamin B3 only lasts while it is being taken5. In other words, for long term reduction of non-melanoma skin cancer, it needs to be taken indefinitely.
WHAT FOODS IS VITAMIN B3 PRESENT IN?
Vitamin B3 is present in small amounts in yeast, meat, fish, eggs, milk, nuts, legumes and cereals12. The average daily requirement for vitamin B3 is 15-20mg1. This is easily met by a balanced diet containing the foods mentioned above. But the amount shown to reduce skin cancer risk is about 50 times this amount and can’t be achieved by dietary intake alone.
VITAMIN C
Vitamin C is a potent antioxidant drug that can be used topically in dermatology to treat and prevent changes associated with photoageing. It can also be used for the treatment of hyperpigmentation. Because it is unstable and difficult to deliver into the dermis in the optimum dosage, research is being directed to find stable compounds of Vitamin C and newer methods of delivery of Vitamin C into the dermis.
The toxic effects of vitamin C on tumor cells may be related to the induction of oxidative stress in cells. However, when the antioxidation system of tumor cells is incomplete, the balance is destroyed, and the oxygen-promoting effect of vitamin C leads to the death of tumor cells (Kim K. et al., 2015; Uetaki et al., 2015). Vitamin C is often used as an adjunct to chemotherapy for tumors. Vitamin C can also increase 5-hydroxymethylcytosine (5hmC) content in melanoma cells and cause a decrease in tumor-cell invasiveness and growth (Gustafson et al., 2015). Thus, vitamin C can be regarded as a potential antitumor drug for the prevention of invasion and metastasis of melanoma, which weakens the tumor capsule integrity and invasiveness and reduces the degree of malignancy.
However, there is still a lack of understanding about the route of administration for vitamin C, the dosage of medication and the complications. We should increase awareness of the fact that high concentrations of vitamin C induce apoptosis of malignant melanoma cells, while low concentrations promote the growth of tumor cells (Yang et al., 2017). H
VITAMIN D
Vitamin D forms in the skin when it is exposed to UV from sunlight. It can also be obtained from some foods. We need vitamin D to maintain good health and to keep bones and muscles strong and healthy.
The best source of vitamin D is UVB radiation from the sun. UV radiation levels vary depending on location, time of year, time of day, cloud coverage and the environment.
For most people, adequate vitamin D levels are reached through regular incidental exposure to the sun. When the UV Index is 3 or above (such as during summer), most people maintain adequate vitamin D levels just by spending a few minutes outdoors on most days of the week.
In late autumn and winter in some southern parts of Australia, when the UV Index falls below 3, spend time outdoors in the middle of the day with some skin uncovered. Being physically active (e.g. gardening or going for a brisk walk) also helps boost vitamin D levels.
Adequate levels of Vitamin D promote good immunity. Vitamin D can modulate the innate and adaptive immune responses. Deficiency in vitamin D is associated with increased autoimmunity as well as an increased susceptibility to infection. At this point in time however we have insufficient evidence to recomment Vitamin D supplementation as a method to decrease Malignant Melanoma.
VITAMIN E
Vitamin E is an important fat-soluble antioxidant and has been in use for more than 50 years in dermatology. It is an important ingredient in many cosmetic products. It protects the skin from various deleterious effects due to solar radiation by acting as a free-radical scavenger. Experimental studies suggest that vitamin E has antitumorigenic and photoprotective properties
Skin Cancer
By Dr Leena Uppal
It’s winter time..but don’t let less skin fool you-it is still our largest human organ. The average adult carries 3.5kg and 2sq meters of it!
Did you know that Australia has one of the highest rates of Melanoma in the world?
This year it is expected there will be close to 1 diagnosis of Melanoma every 30 min
Melanoma is the 3rd most common cancer in both Australian men and women and THE most common cancer in Australians aged 15-39 years
SCAN your skin
Is it Sore?
Is it Changing?
Is it Abnormal compared to the rest of your spots?
Is it New-especially over the age of 40?
If you haven’t had a skin check in the last year, it is an easy and painless procedure, book yours in today.
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