28th July 2023, Spectrum Medical Imaging
I couldn’t never work out the work flow of electronic referrals (e-referrals) for patients whom I refer for imaging. We are so used to having a piece of paper in our hand to make an appointment. You will be surprised how many patients look at you wondering what to do with that piece of paper.…
26th July 2023, Dr Chee L Khoo
It is coming up to 10 years now when we, as GPs, were suddenly not allowed to prescribe TRT for our patients with low serum testosterone levels. The rationale cited at the time was that testosterone replacement therapy (TRT) was potentially harmful because we were told that TRT is associated with increased cardiovascular risk in men with hypogonadism.…
26th July 2023, Dr Chee L Khoo
First it was aducanumab then lecanemab. Now it’s donanemab. All of them purportedly showed statistically significant improvement in clinical outcomes although the “significance” is hotly debated. Although aducanumab was the first to be approved by FDA (June 2021), the limited clinical improvement together with the increased risk of severe adverse effects meant that aducanumab is no longer used these days.…
13th July 2023, NIA Diagnostic Imaging
Aortic aneurysms are known as silent killers as the majority of patients with the condition are asymptomatic and are usually found incidentally during physical examinations or diagnostic imaging studies performed for other reasons (Faiza & Sharman, 2023). Ruptured aortic aneurysms are associated with high mortality rates of approximately 80-90% for patients with ruptured AAAs (Wise et al., 2016) in which “more than 50% of patients die before they reach the emergency room” (Shaw et al., 2023).…
12th July 2023, Dr Chee L Khoo
The WHO define biological markers or biomarkers as “any substance, structure or process that can be measured in the body or its products and influence or predict the incidence of outcome or disease”. In heart failure, many biomarkers have been studied but B-type natriuretic peptide (BNP) and N-terminal pro–B-type natriuretic peptide (NT-proBNP) come close to the characteristics of “ideal” heart failure (HF) biomarkers.…
12th July 2023, Dr Chee L Khoo
It’s almost a year since we foreshadowed the arrival of finerenone and it’s finally on the PBS, albeit with the usual and expected very restricted criteria. We discussed finerenone’s impressive cardiovascular and renal outcomes in patients with heart failure and chronic kidney disease. We further discussed why finerenone is a better mineralo-corticosteroid receptor antagonist (MRA) than what we have at the moment, spironolactone and eplenerone.…
29th June 2023, Spectrum Medical Imaging
At Spectrum Medical Imaging, we are pleased to offer your patients a wide range of obstetric imaging options throughout all stages of their pregnancy. We are committed to providing you with high quality services at affordable prices. All of our sonographers who perform Nuchal Translucency scans are certified by the Fetal Medicine Foundation and all of our reporting Radiologists have a special interest in obstetric ultrasound.…
25th June 2023, Dr Chee L Khoo
Consensus cardiology recommendations previously supported the ’blanket’ disqualification of athletes with hypertrophic cardiomyopathy (HCM) from competitive sport. Clinically, it is almost impossible to exclude HCM from physical examination. Thus, sudden cardiac death (SCD) is always on our minds when we are asked to sign off on a clearance to participate in sporting activities.…
25th June 2023, Dr Chee L Khoo
A few weeks ago we explored familial hypercholesterolaemia (FH) primarily in adults. The issues we touched on were how not so rare FH really is and further, how aggressive we should target the LDL-Cholesterol (LDL-C). As we know, commencing lipid lowering agents is only the first step. The next step is to agree on what the LDL-C target should be in this patient based on the cardiovascular risk of the patient.…
11th June 2023, NIA Diagnostic Imaging
The incidence of pelvic organ prolapse is highly associated with increased age and vaginal childbirth (Weintraub et al., 2020). Majority of patients who present with POP may not report any symptoms. Patients who do present with symptoms, however, often describe a sense of feeling of a bulge protruding through the vaginal opening. In younger women, vaginal laxity is more commonly noticed and related to sexual dysfunction (Peter Dietz, 2015).…
11th June 2023, Dr Chee L Khoo
First, we have short acting GLP1-RA (exenatide) which requires twice a day injections. Then, we have once daily GLP1-RA injections (e.g. Exenatide ER, liraglutide, lixisenatide) which makes it more convenient for most patients. Of course, once daily injection is still too many. Once a week would be better, wouldn’t it? Of course, we now have weekly dulaglutide and semaglutide and patients love them.…
10th June 2023, Dr Chee L Khoo
It’s all very confusing, isn’t it? Low fat, low carbohydrate, Mediterranean diet, Paleo diet, Nordic diet or DASH diet. There are many other diets which we haven’t even heard of. Are they any good? Do they cause harm? How can we advise our patients if we don’t know what those diets are?…