GDM Screening – Can HbA1c replace OGTT during the pandemic?

14th September 2020, Dr Chee L Khoo

We have many patients who have borderline high fasting glucose in their routine check-up. In non-pregnant adults, we have been able to use HbA1c as a generic screening test for type 2 diabetes (T2D) for some time. Unfortunately, neither non-diabetic fasting glucose readings nor HbA1c totally exclude the presence of diabetes. I am sure you have come across patients with non-diabetic fasting glucose and HbA1c but yet fail their oral glucose tolerance test (OGTT).…

GDM screening – who, when and how?

14th September 2020, Dr Chee L Khoo

Tell me this is not, broadly, what you have in mind when you think about gestational diabetes mellitus (GDM). We know that hyperglycaemia and pregnancy does not mix well. GDM is not quite full-blown diabetes in pregnancy but is nonetheless, associated with risks for the mother and infant and with long-term metabolic consequences in both mother and child.…

Ultrasound at Spectrum – reduced waiting time

Spectrum Medical Imaging, 23rd August 2020

Spectrum Medical Imaging Liverpool is proud to announce the opening of 2 additional ultrasound rooms in our practice at 171 Bigge Street. This increased capacity will reduce waiting times for elective scans.

Spectrum is pleased to announce the installation of the latest Voluson™ ultrasound machine. The Voluson™ is a dedicated Obstetrics & Gynaecology machine which aids in problem solving complex cases using ground-breaking technology including unique foetal heart tools and using specialised ultrasound probes.…

Anti-depressants in pregnancy – which agent is less bad?

14th August 2020, Dr Chee L Khoo

Most women would prefer not to take any medications during the pregnancy for fear of any potential teratogenic effects on the foetus. However, for some women, the use of anti-depressants is necessary. Managing these mental disorders during pregnancy and the post-partum period can be challenging (1-2) but effective management can maintain maternal and infant health (3), improve maternal prenatal health care practices (4) and improve maternal-infant attachment (5).…

Abbreviated breast MRI – how useful is it?

8th July 2020, Spectrum Radiology

Adjunct screening with dynamic contrast-enhanced (DCE)-MRI was first recommended for women at high (>20%) lifetime risk of breast cancer, facilitating earlier cancer detection and reducing interval cancers. Even in women at average risk of breast cancer, there is evidence that they might also benefit from screening MRI.

Apart from the cost of MRI equipment, other costs include the relatively long acquisition, limiting high-volume patient throughput and interpretation times involved in a full diagnostic protocol.…

Double thalassaemia – it’s more than double trouble

thalassaemia

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.…

Pregnancy Medical Imaging – A personalised one stop shop for pregnant women

Pregnancy medical imaging can provide vital diagnostic information about a developing baby including gestational age, checking for multiple pregnancies, congenital anomalies and/or problems with the placenta, monitoring foetal position and growth, and the level of amniotic fluid.

Who would have thought that the radiologist is now a friend of GPs when we look after pregnant women. Radiologists are key members of clinical teams who frequently make the first diagnosis of many medical conditions in children, adults and often the unborn baby.…

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.…

Abbreviated breast MRI – what is it?

22nd June 2019, Spectrum Medical Imaging

Dynamic contrast enhanced breast – MRI must contain a minimal number of MRI sequences that is necessary to detect small enhancing breast lesions. What if we cut down the number of sequences but yet have enough accuracy to detect small early cancers? That’s what AB-MRI is – less number of sequences but yet enough to detect small lesions. …

Ramadan is here – do we need to do anything different with patients with diabetes?

13th May 2019, Dr Chee L Khoo

Ramadan is the holy month for Muslims, falling in the ninth lunar month in the Islamic calendar year. Because the timing of Ramadan is linked to the sighting of the new moon, the timing of this month varies. Ramadan is a period of worship, self-discipline, austerity and charity. The most important significance of Ramadan is that Muslims are required to observe fasting during daylight hours.…

Low birth weight and future cardiovascular risk – how are they connected?

13th April 2019, Dr Chee L Khoo

We know that overweight children have higher future risk of cardiovascular disease and diabetes.  Ironically, babies who are small at birth or during infancy also have increased rates of cardiovascular disease and diabetes as adults. It is thought that foetal undernutrition at different stages of gestation are somehow link to this increased risk, but the underlying mechanism is not fully understood.…

Can drugs and supplements improve sperm quality?

12th March 2019, Dr Chee L Khoo

When couples present for investigations of infertility, semen analysis is one of the earliest investigations we order. Every so often, the results come back with reduced sperm numbers, motility or normal forms. It is frustrating as a GP when we are unable to advise them what they can take to improve their sperm parameters.…