12th June 2020, Dr Chee L Khoo
Like me, you probably have come across homocysteine, methionine and MTHFR gene polymorphism from time to time and are aware of some connection between those things and cardiovascular disease but not quite sure how to connect them together. Which patient should we be checking homocysteine levels in? What about the MTHFR gene polymorphism?…
24th May 2020, Dr Chee L Khoo
In primary care, we are frequently preventing disease or at least we try to. Apart from lifestyle measures, we prescribe statins, anti-hypertensive, aspirin and beta-blockers to reduce cardiovascular events. What about arthritis? In patients who do not have arthritis (yet) but are at high risk of degenerative osteoarthritis, is there something we can do to reduce the patients’ risk of progressing to full blown arthritis?…
22nd May 2020, Dr Chee L Khoo
Let’s imagine we have a pregnant woman who tested positive for β-thalassaemia trait (minor) on antenatal screening blood tests. If both partners carry the same thalassaemia trait, there is a 25% chance of having a baby with thalassaemia major. Thus, we are advised to screen her partner for thalassaemia as well. Say, the partner’s blood picture is normal with no microcytosis and high performance cation-exchange chromatography (HPLC) shows normal levels of HbA2 and HbF.…
21st May 2020, Spectrum Medical Imaging
As many of you are consulting from home using Telehealth due to the Covid-19 pandemic, there will be occasions when there is a need for referral for medical imaging. It can be a hassle trying to print xray forms, scan them to email or to fax them to your favourite medical imaging provider. Spectrum Medical Imaging have streamlined the whole process to make life easy for all of us.…
13th May 2020, Dr Chee L Khoo
Covid-19 have exposed the numerous risks patients with type 2 diabetes (t2D) face when the two pandemics meet head on. We have seen that patients with diabetes are over-represented in patients hospitalised with Covid-19 in Wuhan. Patients with diabetes are also affected more severely if they contracted Covid-19 especially if glycaemic control is suboptimal.…
11th May 2020, Dr Chee L Khoo
Most of you would have run out of flu vaccines by now. The bad news is that we don’t know when new stocks will arrive. So much for the assurance from the government in mid-March that “there is enough vaccines for all who needs them” but “go to your GP now anyway”.…
11th May 2020, Dr Chee L Khoo
Although the Covid-19 pandemic seems to be under some control, we are still in danger of a second wave if we relaxed the social distancing rules too much too quickly. One of the big unknowns is what is the proportion of people with SARS-COV-2 who are asymptomatic? These are the people we are not testing.…
28th April, Spectrum Radiology
This month’s radiology series is brought to you by Dr Chee Chung Hiew, a Paediatric Radiologist at Spectrum Medical Imaging.
In Case 1, we have a 7 year-old girl with a 3 week history of headache, lethargy and vomiting. She woke up one morning with severe vomiting and presented to ED.
In Case 2, a 6.5 year-old girl had headaches for 2 months.…
28th April 2020, Dr Chee L Khoo
The incidence and mortality from coronary artery disease in Australia continue to decline. Coronary revascularisation consisting of percutaneous coronary intervention and coronary artery bypass graft (CABG) is rapidly increasing as the standard of care for coronary artery disease. There have been numerous trials comparing CABG with percutaneous coronary intervention (PCI) and so far, no studies have convincingly shown any overall difference between the two revascularisation strategies.…
26th April 2020, Dr Chee L Khoo
Although the Covid-19 pandemic seems to be under some control, we are still in danger of a second wave if we relaxed the social distancing rules too much too quickly. One of the big unknowns is what is the proportion of people with SARS-COV-2 who are asymptomatic? These are the people we are not testing.…
11th April 2020, Dr Chee L Khoo
You are probably overwhelmed by the whole Covid-19 saga. Just because we are dealing with Covid-19 “everywhere”, doesn’t mean existing chronic diseases can take a breather. Patients with chronic illness especially diabetes and hypertension are affected by the current Covid-19 chaos in more ways then one. GPs play a vital role in managing these patients during this difficult and challenging time especially when there is much emphasis on telehealth.…
10th April 2020, Dr Chee L Khoo
It’s amazing how quickly news travel during a pandemic. A bit of information came out a few weeks ago that suggests SARS-CoV-2 enters the body via the angiotensin converting enzyme receptor 2 (ACE2) present in abundance in pulmonary tissues. Initial reports out of Wuhan found that patients with chronic obstructive pulmonary disease (COPD), diabetes and hypertension were at higher risks of getting the infection as well as developing the severe form of Covid-19 if they do get the infection.…