PRP injections for knee OA – do they work?

29th November 2021, Dr Chee L Khoo

Knee osteoarthritis

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.…

Micro-AF – harbinger of AF?

29th November 2021, Dr Chee L Khoo

One of our biggest fears is missing an atrial fibrillation (AF) and patient is discharged from hospital following their first embolic stroke. Almost all the automatic sphygmomanometers do not check for cardiac rhythm and I make it a point to put a finger on the pulse each time to make sure patients are in sinus rhythm.…

Dyslipidaemia in the young – who should we suspect?

24th October 2021, Dr Chee L Khoo

Last fortnight we explored the disease burden in patients who have high lipids from a very young age and the effect on their future cardiovascular risk. This consideration allows us to think about who should be aggressively treated and whom we can just safely watch, at least for a few years. It would be nice to be able identify who we should screen for high lipids from a young age so that we can start lifestyle measures early.…

Covid-19 vaccine booster for the immunocompromised – who is eligible?

Booster jab, anyone?

10th October 2021, Dr Chee L Khoo

Updated 17th October 2021

You would have caught a bit of the announcement that some people may be due a Covid-19 vaccine booster. As usual, the announcement is not precise or detailed enough and now everyone is confused whether they are the intended target group for the booster. It is not a call to boosters for most vaccinated people.…

Dyslipidaemia in young adults – should we be treating?

2nd October 2021, Dr Chee L Khoo

cumulative high lipids

We generally see two categories of patients with high lipids, one who had normal lipids earlier on in life but developed high lipids later in life because of modern living and one whose lipids were already high when they were young (and slim and fit). Most of the scientific studies linking high lipids with cardiovascular (CV) events look at lipid levels at a snap point in time, at enrolment and the follow up period just aren’t long enough.…

Comirnaty vaccine – how safe is it? What about myocarditis?

13th September 2021, Dr Chee L Khoo

mRNA covid-19 vaccines

Phase 3 trials have inherent limitations in assessing vaccine safety because of the small number of participants and the sample population is generally reasonably young and healthy. They are often underpowered to identify less common adverse events. For example, the AZ interventional arm had about 11,000 participants and the interventional arm of the Pfizer Comirnaty vaccine had about 23,000 participants.…

Rotator cuff tears – do steroid injections work?

14th August 2021, Dr Chee L Khoo

Shoulder pain has to be one of the most common musculoskeletal complaints in general practice. Rotator cuff pathology makes up at least 70% of those cases (1). It is commonly very debilitating, causing pain the whole night, causing significant reduction in function and often last for years. Apart from rest, analgesia, non-steroidal anti-inflammatory drugs, treatment options include physiotherapy, corticosteroid injections and surgical repair.…

General check up – does it do anything?

27th June 2021, Dr Chee L Khoo

We all do it. Either we arrange for patients to come in once a year to have a “general check-up” or patients come in requesting one. There are no set rules what we check for and what blood tests to order. Somehow, patients feel better that they have been given a clean bill of health and at times, we feel that we have check them out properly and all is good.…

AZ Covid-19 vaccine – who shouldn’t have it?

9th June 2021, Dr Chee L Khoo

Covid-19 vaccines

We all know that detailed information relating to Covid-19 is both fluid and rapidly changing. It’s only a mere 3 months since the first reports of thrombosis with thrombocytopaenia (TTS) relating to the administration of the AstraZeneca (AZ) vaccine emerged from Austria. The recommendations as to who should not have the AZ vaccine is constantly being revised as more information comes in from the case reports.…

AZ vaccine and clots – number crunching time

13th April 2021, Dr Chee L Khoo

Every time the government overpromise and underdeliver, we are the ones that have to deal with the public whose expectations have been led unnecessarily high for political reasons. With the issue of clots relating to the AZ vaccine on the front page over the last week or so, patients are now utterly confused and look to their GP for advice as to where and when to proceed.…

New T2D treatment option – are you using it?

13th March 2021, Dr Chee L Khoo

diabetes treatment option

Medical treatment options for type 2 diabetes (T2D) have increased over the last decade and enhance the possibility of individualised treatment strategies where insulin is still one of them. In spite of the advancements in treatment options, less than one-third of the population with diabetes achieve their glycaemic target. What if I tell you that there is a new treatment option available that has been shown to significantly reduce HbA1c, hypoglycaemia, hospitalisation, complications and diabetic medications?…