Patients with diabetes commonly have significant dysfunction of the immune system leading to chronic inflammation in many organ systems. It is not uncommon to see patients with T2D suffering from oral and periodontal disease which has been shown to worsen the diabetes disease. What is less known but shown in many studies is that periodontal disease is associated with development of diabetes. …
Author: adminwp
T2D – does it have to be progressive?
February 2018, Dr Chee L Khoo
It’s frustrating isn’t it when managing patients T2D. Patients adhere to diet and lifestyle the best they can, the HbA1c is “on target” but yet we have to keep layering more tablets or injections over time to maintain the constantly deteriorating glycaemic control. Can we do better than accepting without question the “progressive nature of T2D”?…
Chronic Hep B Mx- Fairfield GPs do it better
January 2018, Dr Chee L Khoo
GPs from the Fairfield area did us all proud in south west Sydney. They were part of the B Positive Program which demonstrated that with training, increased community awareness and coordination, primary care patients with chronic hepatitis B received anti-viral treatment which was 3X higher than the average uptake in Australia. The pilot program also increased GP and community awareness of Chronic B Hepatitis (CHB). …
Treatment resistance depression – a solution finally?
Jan 2018, Dr Chee L Khoo
The mainstay for the treatment of major depression disorder (MDD) has been SSRIs since the 1980s. But up to a third of patients with MDD don’t respond to the usual treatment for depression. This is commonly referred to as treatment resistant depression (TRD). The NDMA glutamate receptor antagonist, ketamine is known to have an efficacious and rapid-onset anti-depressant effect in patients with TRD.…
Subacromial Decompression – does it achieve anything?
Jan 2018 – Dr Chee L Khoo:
Subacromial decompression was first introduced in 1972 as a last resort for subacromial pathology but there is no high level evidence on its efficacy. Nonetheless, it is now one of the most common surgical procedures done in orthopaedics. Does it actually work?…
Watchful wait in Aortic Stenosis – waiting for what?
November 2017 – Dr Chee L Khoo:
Aortic stenosis (AS) is the most common valvular heart disorder in Australia. About 3% of people >75 yo have AS and most are diagnosed on incidental auscultation of the precordium or when echocardiogram is done for other reasons. The valve progressively narrows over years leading to cardiac failure. Sadly, once symptomatic, AS is rapidly fatal and often valve replacement is necessary.…
Saturated Fats – Good or Evil?
Unhealthy eating
October 2017 – Dr Chee L Khoo
We have all been brought up to advise reducing total fat and saturated fatty acid intake, based on the presumption that replacing saturated fatty acids with carbohydrate and unsaturated fats will lower LDL cholesterol and should therefore reduce cardiovascular disease (CVD) events. Several meta-analyses of randomised trials and prospective cohort studies8–10 and ecological studies,2 largely done in European and North American countries showed either no association or a lower risk between saturated fatty acid consumption with total mortality and CVD events.…