26th January 2022, Dr Chee L Khoo
How many reps have you seen recently promoting their bronchodilators? It’s all very confusing to me with the LAMA/LABA combo and now they have inhaled corticosteroids in the triple combo puffers. Who are these puffers for? Initially, they suggest triple therapy for COPD but they are now recommending the same for patients with severe asthma if the traditional LABA/ICS combo is not controlling the asthma.…
January 7th, 2022, Dr Chee L Khoo
There is a trend across the medical specialties to make their guidelines a live document as emerging data comes thick and fast these days. 12 months is a long time for once a year updates. But when you have guidelines or protocols that are updated on a daily basis, it could mean that either there are really, really lots of data coming through or those guidelines are not based on scientific data.…
3rd January 2022, Dr Chee L Khoo
Diabetes is associated with a whole myriad of complications. Traditionally, complications were categorised into macrovascular and microvascular complications. We have added heart failure and arrhythmias to that list. We have made much headway and have seen declines in non-fatal incidence of these traditional diabetes complications, in parallel with declines in all-cause mortality in people diagnosed with diabetes.…
1st January 2022, Dr Chee L Khoo
This definitely wasn’t in the curriculum when I left med school (alright, it was more than 30 years ago now) but I don’t remember being updated about its relevance. I am talking about the epidermal growth factor receptor (EGFR). It is not really in the realm of general practice as such but we do have patients coming back from the oncologist with a tumour bearing an EGFR gene mutation.…
25th December, 2021, Spectrum Medical Imaging
As CT procedure volume grows – reaching an all-time high ahead of the COVID-19 pandemic – so too does the need to optimise CT protocols and expand patient positioning options to help expedite exams and accommodate more patients. The actual scan itself only takes a few minutes and the remainder of the time is dedicated to patient prep – including positioning the patient and identifying the correct protocols and settings, plus image reconstruction and report time.…
25th December 2021, Dr Chee L Khoo
There is increasing evidence that supports an inverse association between statin use and cancer risk. The findings for prostate cancer, particularly advanced disease, are the most promising of all cancers studied. There are studies suggesting the usefulness of statins in secondary and tertiary prevention. For example, patients undergoing radiotherapy for prostate cancer improved their prostate specific survival if they are on statins.…
24th December 2021, Dr Chee L Khoo
Obesity is often the core underlying pathology leading to many degenerative and inflammatory diseases. Unfortunately, there is no easy fix to treat obesity. Over the last 12 months we have explored a number of novel molecules which have proven efficacious in reducing fat mass in patients with obesity with or without diabetes. We last looked at the up and coming tirzepatide.…
12th December 2021, Dr Chee L Khoo
We touched on the subject of osteosarcopenia on a number of occasions over the years. These are people who have weak bones and have lost muscles. These are often older patients that have become weak for various reasons. Aging reduces the quality and strength of bones and muscles and increases body fat, which lead to the simultaneous occurrence of sarcopenia, osteopenia, and adiposity.…
11th Dec 2021, Dr Chee L Khoo
By now, most of you would be familiar with the significant cardiovascular benefits with all the SGLT2 inhibitors (SGLT2i). This is particularly stark in the reduction in hospitalisation for heart failure (Hhf). Of course, patients with heart failure is not a homogeneous group. There is heart failure with preserved ejection fraction (HFpEF) and heart failure with reduced ejection (HFrEF).…
11th December 2021, Dr Chee L Khoo
Cataract is a leading cause of blindness worldwide, affecting more than 35 million people globally and causing blindness in approximately 20 million. Visual impairment is an important dementia risk. Addressing sensory loss from visual impairment that affects older adults may be a potentially modifiable risk factor for dementia in late life (1,2) Because sensory impairments and dementia are both strongly associated with aging the link between sensory impairment and dementia may have important implications for individual and global public health, particularly if interventions to improve sensory function reduce dementia risk (3).…
29th November 2021, Spectrum Medical Imaging
If you are like me, you will be confused as which joints or joint can be injected for which clinical condition. Then you need to know whether they are ultrasound guided procedures or CT scan guided procedures. There just a myriad of musculoskeletal conditions that can improve with corticosteroid injections. Spectrum Medical Imaging has assembled a team of subspecialist interventional and musculoskeletal expert radiologists to assist us in managing our patients with these conditions.…
29th November 2021, Dr Chee L Khoo
If you are over 50 years old, there is no Medicare rebate for an MRI of the knee. They won’t do a “clean out” arthroscopy for symptom relief even if you have significant pain requiring opioids because the symptom relief is only temporary and you will end up needing a total knee replacement anyway.…