Fournier’s gangrene & SGLT2i – how rare is it?
23rd March 2019, Dr Chee L Khoo You may remember receiving warnings recently from the Therapeutics Goods Administration (TGA) about a serious “rare” infection, called necrotising fasciitis of the perineum, also referred to as Fournier’s gangrene (FG). FG is reported to be associated with the…
Haemorrhagic stroke – is that cerebral amyloid angiopathy?
10th March 2019, Dr Chee L Khoo About 10% of all strokes are haemorrhagic strokes. In about 10% of cases of primary intracerebral haemorrhage (ICH), cerebral amyloid angiopathy (CAA) is regarded as a possible cause. The recurrence rate of ICH is significantly higher in patients…
Can Vitamin C reduce plasma glucose?
22nd February 2019, Dr Chee L Khoo Increased oxidative stress appears to be a significant factor leading to insulin resistance, dyslipidaemia, β-cell dysfunction, impaired glucose tolerance and ultimately leading to type 2 diabetes (T2D). Ascorbic acid (AA) is a water soluble anti-oxidant that reduces oxidative…
Losing weight: Different diets for different patients – are we there yet?
13th February 2019, Dr Chee L Khoo It’s all too confusing. It used to be low fat diet. It’s now low carbohydrate (carb) diet. Some studies show that low carb diet loses more weight than low fat diet while others show the opposite. Yet, other…
Case Study – man with increasing neck pain for one month
44-year-old male with 1 month of increasing neck pain was referred for a cervical spine injection. A CT scan of the cervical spine two weeks prior (Figure A), revealed foraminal narrowing at the C5-6 level. There was a significant difference between the new scan and…
The adipocyte – a very busy cell
27th January 2019, Dr Chee L Khoo Energy consumption, regulation and storage vital for the survival of the organism. We have specialised cells that manages the above but often, the cells do a bit of each depending on the energy needs of the organism at…
Do all fat kids develop diabetes? If not, who does?
27th January 2019, Dr Chee L Khoo As GPs we often see little kids already carrying extra weight and we know that many of these will go on to become overweight or obese adults. Many overweight kids and overweight adults will go on to develop…
Fasting glucose – is it still relevant when managing patients with T2D?
27th January 2019, Dr Chee L Khoo It’s tempting to rely too much on HbA1c when managing our patients with type 2 diabetes (T2D). It is not uncommon to come across patients with pretty optimal HbA1c (under 6.5-7.0%) and we pat them on the back…
Is there a doctor on the plane?
9th January 2019, Dr John Goswell According to a recent article in JAMA, in flight emergencies occur in about 1:600 flights. This comforting statistic should allow doctors to relax and enjoy their holidays. Not so for me. I have answered the call “Is there a…
Investigating ischaemic stroke in a young patient
5th January, 2019, Dr Chee L Khoo The incidence of ischaemic strokes in young adults is on the increase. Worldwide, it has risen up to 40% over the past decades. This contrasts with the decreasing incidence of stroke in older adults. It’s never a good…
Cholecystokinin (CCK) – more than just a gallbladder hormone
4th January 2019, Dr Chee L Khoo When you treat a medical condition with an agent with known intended effects, it is not uncommon that we come across some of the unintended effects of the agent. Glucagon-like peptide 1 receptor antagonists (GLP1-RAs) are very useful…
Management of Huntington’s Disease – where are we at?
4th January 2019, Dr Chee L Khoo Huntington Disease (HD) was first described in 1872 by George Huntington, MD, in his paper “On Chorea”. HD is an autosomal-dominant, neurodegenerative disorder that is caused by expansion of a cytosine-adenine-guanine (CAG) triplet repeat in the huntingtin gene…
