9th November 2024, A/Prof Chee L Khoo
Metformin has been the first line treatment for patients with type diabetes for many years. It has many mechanisms of action with many more that we have yet to uncover. We know that it improves glucose control by improving insulin resistance. These days we have many other glucose lowering agents that are a lot more potent than metformin.…
9th November 2024, NIA Diagnostic Imaging
What is shoulder bursitis?
Shoulder bursitis is one of the most common causes of shoulder pain and is referred as an inflammatory disorder affecting the subacromial-subdeltoid bursa (Faruqi & Rizvi, 2023). The subacromial-subdeltoid bursa is a fluid-filled sac lined with synovium which separates the supraspinatus tendon from the acromion, coracoacromial ligament and deltoid and helps ease movement between the rotator cuff and other structures of the shoulder joint (MacMahon & Yablon, 2017).…
27th October 2024, A/Prof Chee L Khoo
Patients with heart failure have high mortality and morbidity. Each time they are admitted into hospital with an exacerbation, their cardiac function deteriorate and usually do not return to pre hospital level when they are better. Many of these patients have other co-morbidities which can mask their symptoms or they are in and out of hospital with the other co-morbidities that the HF is overlooked.…
24th October 2024, A/Prof Chee L Khoo
We all know about how effective and potent the GLP1 agonists are in improving metabolic control in patients with T2D and obesity. We also know about how even more potent the new dual GIP/GLP1 agonist is in improving glycaemic control and losing body weight. There are further studies demonstrating their efficacy in reducing heart failure mortality, sleep quality in patients with obstructive sleep apnoea and liver fibrosis in patients with metabolic dysfunction associated fatty liver disease (MAFLD) (albeit in combination with other agents).…
13th October 2024, NIA Diagnostic Imaging
Menopause is characterised by complete absence of menstrual cycle due to no ovarian follicles left in reserve and it is clinically diagnosed when a woman has amenorrhea for at least 1 year (Sung, 2023).
Any post-menopausal women with vaginal bleeding should be appropriately managed through comprehensive clinical examinations and diagnostic studies; these include diagnostic imaging and, in some cases, endometrial biopsies (Sung, 2023).…
13th October 2024, A/Prof Chee L Khoo
We dissected the latest consensus statement from GESA in the last issue of GPVoice when we looked at metabolic dysfunction related fatty liver disease (MAFLD). We highlighted the risk groups that are very likely to have MAFLD. Essentially, these are patients with metabolic syndrome (type 2 diabetes, obesity, hypertriglyceridaemia and hypertension). We looked at the recommendations of using ultrasonography as the first line investigation to diagnose MAFLD and not to rely on abnormal liver function tests (LFTs) to rule in or rule out MAFLD.…
28th September 2024, A/Prof Chee L Khoo
Patients are often given tacit recommendations about lifestyle changes for MAFLD because it’s “just a little fat in the liver”. For those of us who have that few patients with those liver as well as non-liver complications, we will remember how horrible these patients fare moving forward. Yet, we can’t refer all our patients with fatty liver to the hepatologist.…
28th September 2024, A/Prof Chee L Khoo
Diabetic retinopathy (DR) is the leading cause of new cases of blindness in patients with diabetes mellitus. In 2020, more than 103 million individuals with diabetes mellitus worldwide were affected by diabetic retinopathy and it is expected that this number will increase to 160 million by 2045 (1). We are all familiar with the association between poor glycaemic control and diabetic retinopathy development and progression.…
12th September 2024, A/Prof Chee L Khoo
We explored the four pillars of treatment for patients with heart failure with reduced ejection fraction (HFrEF) a few years ago now. In patients with heart failure with preserved ejection fraction (HFpEF) however, the options are quite limited. SGLT2 inhibitors is the only class of agents that has been shown to reduce major adverse cardiovascular events (MACE).…
12th September 2024, A/Prof Chee L Khoo
Inadequate protein intake in older adults may cause impairments of muscle mass and muscle function as well as impairment in immune function. Higher protein intake has been associated with increased muscle mass and strength, slower rate of bone loss, higher bone mineral density, lower risk of frailty, and improved cardiovascular function and recovery from illness (including wound healing) (1,2).…
8th September 2024, NIA Diagnostic Imaging
Computed tomography (CT) is widely recognised as the gold standard for detecting and diagnosing a broad range of pathologies due to its ability to provide detailed cross-sectional imaging. However, concerns about radiation exposure continue to be raised by both patients and clinicians. As a result, it is crucial to understand the impact of technological advancements in ensuring that radiation exposure is kept as low as reasonably achievable (ALARA) while still maintaining diagnostic accuracy.…
30th August 2024, A/Prof Chee L Khoo
Up until GLP1RAs +/- GIPs were shown to be efficacious in assisting patients lose weight and keeping the weight off, long term sustainable weight loss was practically unachievable. Not everyone wants to or is able to afford bariatric surgery to assist in weight loss. Even then, the weight loss is usually not sustainable. International guidelines (including Australian) include medical nutritional therapy in the management of obesity.…