Sex hormones and eye abnormalities – how are they related?

11th January 2021, Dr Chee L Khoo

Sex hormones are not just responsible for the function of the reproductive system. They are also responsible for bone and cardiovascular health. Interestingly, they are produced, not only by the gonads, but also by other organs (1,2) including the central nervous system (CNS). Well, the eye is a neural structure and there is increasing evidence that oestrogens exert a neuro-protective role (3,4).…

Does wearing a facemask cause hypoxia?

14th November 2020, Dr Chee L Khoo

facemasks

It’s been at least 12 weeks since we started to wear facemasks at the practice full time with all face to face consultations. I must admit that during the first week, I did feel a bit suffocating with the mask on. I remember having to stop mid-sentence to catch my breath. I could sympathise with many patients, particularly patients who has COPD, asthma or heart failure.…

Aortic aneurysm and fluoroquinolones don’t mix well – do they?

13th October 2020, Dr Chee L Khoo

Aortic aneurysm (AA) and aortic dissection (AD) are potentially fatal conditions. Without treatment, ruptured AA/AD carries a mortality rate of up to 90%. Population-based studies estimated the annual incidence to be 2.4 to 14.8 per 100 000 persons for AA (1-4) and 3.8 to 8.8 per 100 000 persons for AD (3,5-7). Although the incidence varied across countries, the number has universally increased over time (1-5,7).…

Knee Osteoarthritis – is jogging good or bad?

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?…

Aspirin – which cancers will it benefit?

The US Preventive Services Task Force (USPSTF) recommends low-dose aspirin use for the prevention of cardiovascular disease among average-risk individuals aged 50 to 59 years with a 10% or greater 10-year risk of cardiovascular disease (1). Long-term regular aspirin use is also associated with reduced risk of obesity- and inflammation-associated cancers, particularly colorectal cancer (CRC) (2,3). Numerous follow up trials have consistently demonstrated significant reductions in risk in GI cancers – the NIH-AARP (4), the Nurses Health Study (5) and the Health Professionals Follow-up study (6,7).…

Osteomyelitis – diagnosis is not always straight forward

26th November 2019

The symptoms of acute osteomyelitis include pain, swelling, warmth and redness over the affected part. Sometimes, there are systemic signs of fever and fatigue. Plain xrays may review osteolytic lesions, periosteal reaction or may be totally normal. Sometimes, we may need to resort to MRI to clinch the diagnosis. This month’s case illustrate the difficulty with diagnosis when the symptoms and signs are not straight forward.…

Helicobacter pylori and gastric cancer – is there a point of no return?

23rd November 2019, Dr Chee L Khoo

Treatment of helicobacter pylori infection (HPi) has been shown to reduce the incidence of gastric cancer (GC) worldwide (1,2). HPi may cause chronic inflammation which can lead to precancerous conditions. Since HPi is not always symptomatic and many patients may have untreated HPi for decades. Surely, if you have untreated HPi for decades, you might still be at risk of GC years down the track despite eradication of the infection.…

Prostate Artery Embolisation

PAE is an embolisation procedure. It is a new application of a longstanding tried and tested technology. Embolisation is the deliberate occlusion of vessels in the body, in this case the arteries to the prostate.  The objective of PAE is to stem the blood flow to the prostate, targeting the enlarging tissue and rendering it ischaemic (reduced supply of oxygenated blood).…

Pancreatic cancer and T2D – how are they related?

6th October 2019. Dr Chee L Khoo

Last month we looked at the state of play with screening for the deadly disease, pancreatic ductal adenocarcinoma (PDAC). We saw how it may not be useful to screen the general population with the technology that we have but there are select higher risk groups where screening may be useful. Long standing type 2 diabetes (T2DM) is a modest risk factor for PDAC.…

Diagnosis of breast invasive ductal carcinoma – a case study

26th September 2019. Spectrum Medical Imaging

Breast cancer is the most common cancer affecting women. In 2019, it is estimated that 19,535 Australians will be diagnosed with breast cancer. However it is important to remember that most women survive breast cancer. Diagnosis of breast cancer patients in early stages is one of important aspects of breast cancer treatment. Among of many diagnostic platforms, imaging techniques are main diagnostic approaches which could provide valuable data on patients with breast cancer.…

Breast cancer – should we offer risk reducing medications?

26th September 2019. Dr Chee L Khoo

We put patients at high risk of cardiovascular events on statins as primary prevention. We sometimes put patients with high risk of cerebrovascular disease on aspirin to prevent strokes. What about patients who are at high risk of breast cancer? Now, these are not patients who already had breast cancer. We are talking about patients who have not had cancer but are at higher than average risk of developing breast cancer.…