22nd March 2022, Dr Chee L Khoo
If you don’t already know that SGLT2 inhibitors (SGLT2i) have significant cardiovascular (and renal) benefits over and above its glucose lowering action, you better catch up with our many, many past issues at GPVoice. You should also be as familiar with the similar benefits of the GLP1 receptor agonists (GLP-1RA), especially the newer weekly injectables.…
12th March 2022, Dr Chee L Khoo
When you look at the management of patients with type 2 diabetes (T2D), almost all the patients are on a statin for both primary and secondary prevention of cardiovascular complications. I suspect that those that are not already on a statin should be on as some doctors are not aware of the tightened lipid targets in the management of patients with T2D.…
7th March 2022, Dr Chee L Khoo
We are all familiar with various fixed dose combination of glucose lowering agents. We have DDP4 inhibitors + metformin, SGLT2 inhibitors + Metformin and SGLT2 inhibitors + DPP4 inhibitors. We also have combination insulins for some time – rapid acting insulin + long acting insulin (so-called pre-mix or co-formulations). Pharmacologically, they make sense as these combined agents either work via different mechanisms or have different pharmacokinetics.…
6th March 2022, Dr Chee L Khoo
This is about the potential cardiovascular complications after contracting covid-19 infection. It is coined “the Covid Heart”. A recent analysis of data from 154,000 US veterans one year out from their covid-19 infection have highlighted some scarry statistics. Naturally, you would expect that those who had more severe disease had higher risks of cardiovascular complications but these complications affect patients who are not hospitalised.…
27th February 2022, Dr Chee L Khoo
Homozygous familial hypercholesterolaemia (HoFH) is one of those conditions that allow us to prescribe the new PCSK9 inhibitors under PBS Authority. It is a pretty rare inherited disorder resulting in extremely elevated low-density lipoprotein cholesterol (LDL) levels and significantly elevated risk of premature atherosclerotic cardiovascular disease (ASCVD). Despite the extreme high risks, HoFH is usually go unrecognised and if recognised are diagnosed late and undertreated.…
26th February 2022, Dr Chee L Khoo
We all know that, in theory, exercises are always good for our patients with type 2 diabetes (T2D) in more ways than one. There are a few problems though, when putting theory into practice. Most of our patients with T2D not only don’t exercise regularly, they actually don’t know what exercise to do, how they should do it for and how often they are supposed to be doing them.…
24th February 2022, Spectrum Medical Imaging
Case 1
7-year-old girl has 3-week history of headache, lethargy and vomiting.Woke up in the morning with headache and vomiting, presented to hospital casualty. Urgent CT brain showed acute hydrocephalus with raised intracranial pressure requiring urgent operative insertion of ventricular drain to reduce ventricular pressure. What is the cause of the obstruction?
Case 2
6 ½ year old girl.…
14th February 2022, Dr Chee L Khoo
TOBOGM is its final stages of recruitment. TOBOGM is the very first study to see if immediate treatment of early GDM increases or reduces pregnancy complications among women with mildly higher blood glucose diagnosed before 20 weeks’ gestation. The world is waiting on the results of this landmark study.…
13th February, 2021, Dr Chee L Khoo
One of the signs of getting old is that you are increasingly drawn to articles about efforts to reduce the effects of aging on health and age-related conditions. The positive effects of direct urolithin A (UA) administration in health, aging, and age-related conditions have been identified in several recent studies. UA is a gut microbiome derived natural compound that only 40% of people can naturally convert from dietary precursors at meaningful levels.…
12the February 2022, Dr Chee L Khoo
There is quite a bit of things to know about these medications for patients who are infected with covid-19 who are at high risk of severe disease. Whether we like it or not, we have to know them. The number of patients who qualify may not be large but we need to know who needs them and how to prescribe them as they need to be started early in the disease and not when they become sick (severe).…
28th January, 2022, Spectrum Medical Imaging
Quite a few months ago, we explored the safety of Pfizer’s Comirnaty vaccine especially in young people. In particular, we looked at the increase in the incidence of myocarditis following Pfizer’s Comirnaty vaccines. We publish the list of symptoms that may suggest myocarditis but diagnosis is not always straight forward.
Medicare has now introduced an item number which allows Cardiac MRIs to be bulk billed if you suspect myocarditis.…
27th January 2022, Dr Chee L Khoo
At GPVoice, we have covered the management of heart failure fairly comprehensively over the last couple of years. In particular, we explored the cardiovascular benefits of SGLT2 inhibitors in patients with type 2 diabetes (T2D) especially in patients with heart failure. Initial studies looked at patients with heart failure with reduced ejection fraction (HFrEF) although subsequent studies found the benefits was also seen in patients with preserve ejection fraction (HFpEF) although only empagliflozin has reported.…