GP Voice

voice of general practice

Omega 3 oils & CV disease – does it help?

July 15, 2018, Dr Chee L Khoo

I must declare my personal interest in this discussion. I have been taking omega-3 fish oil supplements for years to reduce my triglycerides. I am also on a statin for my hypercholesterolaemia and the fish oil is to treat the residual hypertriglyceridaemia. A recent study confirm the efficacy of this approach1. However, does the addition of fish oil and reduction of triglycerides translate to improvement in cardiovascular (CV) outcomes?…

Diagnosing Diabetes – is one reading enough?

July 15, 2018, Dr Chee L Khoo

Diabetes can be diagnosed if fasting glucose is >7.0 mmol/L, 2 hour post prandial > 11.0 mmol/L and/or HbA1c >6.5. However, clinical guidelines recommend that we repeat testing within a “short period of time” to reduce the possibility of a false positive result. Sometimes, repeat testing may not be possible or not uncommonly, patients may be lost to follow up.…

Gastrointestinal Malignancies in Cystic Fibrosis

July 15, 2018, Dr Chee L Khoo

It’s always sad to lose a patient due to complications of a disease. It’s even harder if the patient is another doctor especially if the disease has well recognised complications. Many of you may have read about the sad story of Dr Rana, known to have cystic fibrosis, who died of complications resulting from an unrecognised bowel obstruction.…

Tamsulosin for renal calculi – does it help?

July 15th 2018, Dr Chee L Khoo

Have you noticed that an increasing number of patients with renal stones discharged from emergency department are prescribed tamsulosin. It makes perfect sense, doesn’t it? Tamsulosin is an alpha blocker and by inhibiting the smooth muscles in the ureter, it facilitates the passage of stone into the bladder. Does it really? It’s logical but is there evidence that it works?…

Interventional Radiology – so many places you can stick a needle at!

July 1st, 2018, Spectrum Radiology

It’s absolutely amazing where and what they can inject or biopsy these days. The list is just mind boggling. Ok, not everyone is equipped and experienced to do those procedures. And the outcome does depend on the expertise of the operator. Have a look at the list of interventional procedures possible here.

Dr. Glen Schlaphoff and Associates, in collaboration with Spectrum Medical Imaging have established an integrated clinical service for interventional radiology. …

Prazosin in PTSD – does it help?

July 1st, 2018, Dr Chee L Khoo

We all know Prazosin (Minipress) as an alpha 1 blocker used to treat hypertension. Prazosin is also useful in treating urinary hesitancy associated with prostatic hyperplasia by blocking the alpha-1 receptors which control constriction of both the prostate and urethra. Obviously, we now have better and newer agents for hypertension and bladder problems. As such, Prazosin is a long-forgotten agent.…

Diabetes & Cancer – it’s a two way sword.

July 1st, 2018, Dr Chee L Khoo

With early diagnosis and improved treatment, many of our cancer patients have increased survival. You may already have noticed that many of our patients being managed in the multi-disciplinary oncology units are routinely promoting healthy lifestyles. Chronic co-morbidities including diabetes and cardiovascular diseases not only affect quality of life in these survivors but are the major cause of non-cancerous mortality in cancer patients.…

Tonsillectomy – do they affect future immunity?

July 1st, 2018, Dr Chee L Khoo

I am sure you have been asked by parents of young patients about to undergo tonsillectomy +/- adenoidectomy whether the removal of the tonsils will affect future immunity since the tonsils and adenoids are integral to the body’s immune response. I have had those questions asked of me and the answer used to be “Of course not.…

Acute knee injuries – importance of history taking and simple examination

June 15, 2018 Dr Chee L Khoo

Someone once said “If at the end of taking the history, you do not have the diagnosis, take the history again”. This is particularly relevant when we come to knee injuries. In 90% of the time, when I see someone with a knee injury, I have a fair idea what I am looking for in the examination before I even touch the patient.…

Prescribing antibiotics for influenza – are you one of them?

June 15, 2018, Dr Chee L Khoo

The most recent stats tell us that antibiotics prescription for viral URTIs have come down. It certainly gives us that warm and fuzzy feel good feeling that finally, the message is getting through in primary care. Well, are antibiotic prescription rates for influenza infections really coming down? How come I still come across many of patients being prescribed antibiotics for the “flu” after they were seen on the weekend.…

More GLP1 injectables coming onto the market – are you ready for them?

June 15, 2018, Dr Chee L Khoo 

Insulin secretion is augmented by incretins following oral glucose intake. In healthy individuals, incretins are responsible for 70% of insulin secretion. However, in patients with type 2 diabetes (T2D), the incretin effect is significantly blunted thereby affecting glucose control. Glucagon like peptide 1 (GLP1) and gastric inhibitory peptide (GIP)s are the most studied of the incretins.…

Weight gain with anti-depressants – is it real?

June 15, 2018, Dr Chee L Khoo

In primary care, we have to battle with the increasing incidence of obesity amongst our patients. We also have to battle with the patients with depression where anti-depressants are increasingly being prescribed. Obesity is associated with depression, which is particularly common in patients with severe obesity. Antidepressant treatment may also add on to our patients’ weight.…

Spectrum Radiology

Articles by Categories

Copyright © 2018 GP Voice