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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.…

The role of breast MRI in breast cancer detection

Many countries now recommend annual MRI screening in conjunction with mammography for high risk groups. The only problem is that different countries define high risk differently. Medicare item 63464 can be used for the surveillance and diagnosis of women under 50 years of age at high risk of developing breast cancer, and who have no signs or symptoms of the disease.…

Metformin in Pregnancy – first do no harm?

27th February 2019, Dr Chee L Khoo

Primum non nocere (first do no harm) is quite an appropriate term when is comes to managing pregnant women who either have dysglycaemia or are at risk of dysglycaemia. While there is no question that hyperglycaemia during pregnancy is associated with both poor maternal and foetal outcomes as well as epigenetic changes which can affect the next generation, who and how to treat is still debatable.…

Undiagnosed pelvic pain – is it pelvic congestion syndrome?

22nd December 2018, Dr Chee L Khoo

Endometriosis is the most frequently diagnosed condition in women with chronic pelvic pain. What if they can’t find endometriosis on laparoscopy? In 60% of women with chronic pelvic pain, the cause remained unknown. A significant proportion of these women may suffer from pelvic congestion syndrome (PVC). Is this one of those “idiopathic” type condition which is diagnosed when all tests are negative?…

Anti-phospholipid antibodies – how much do you know?

27th November 2018, Dr Chee L Khoo

I recently saw a young lady whose mother had anti-phospholipid syndrome (APL) . She is now worried whether she has the same problem and request some blood tests. She is otherwise fit and healthy. Sure, among other things, I ordered APL antibodies hoping that the pathologist will know what I was looking for. Pretty straight forward so far until the results of her tests came back.…

GDM Diagnosis & Management – SWS leading the way

8th November 2018, Dr Chee L Khoo

When there is so much talk about gestational diabetes (GDM), you can’t help but think that just about every pregnant woman has GDM in south west Sydney (SWS). After all, if you look at the “high risk” group that you ought to be screening for GDM, there is hardly any woman in SWS that is not in the high risk category.…

PCOS diagnosis – an end to the dog breakfast?

11th October, 2018, Dr Chee L Khoo

The original diagnostic criteria for polycystic ovary syndrome (PCOS) put forward after the first international conference on PCOS in 1990 was oligo-anovulation and hyperandrogenism or hyperandrogenaemia in the absence of all other endocrinopathies. This was based on expert consensus rather than clinical research data. The Rotterdam criteria 2003 added ultrasound as a third diagnostic marker and to allow for a diagnosis of PCOS if two of the three criteria were met.…

Prenatal programming – can it affect offspring mental outcomes?

11th October 2018, Dr Chee L Khoo

Epigenetics is the modification of the DNA that changes a gene’s expression without altering the nucleotide sequence. DNA methylation and histone modifications are the most commonly studied epigenetic mechanisms by which cell structure and function can be altered during embryogenesis. The in-utero environment can lead to prenatal programming by which genes are activated or deactivated.…

3D Mammogram – is there a role in clinical practice?

30th September, 2018, Dr Chee L Khoo

There is no question that screening mammograms have led to a decline in late stage breast cancers. There have been a gradual decrease in breast cancer mortality, at least partly, due to the introduction of screening mammograms over the last 25 years. But screening mammograms are not perfect. In women with dense breast tissue, the sensitivity of mammogram decreases.…

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