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Internal Medicine

Oral glucose tolerance test – what should the 1 hour reading be?

15th August 2018, Dr Chee L Khoo Diabetes can be diagnosed using a myriad of criteria – fasting glucose >7.0mmol/L, 2-hour post prandial  >11.0 mmol/L or HbA1c > 6.5%. There are limitations to each of those tests and it is not one size fits all….

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Stroke Prevention – are two agents better than one?

15th August 2018, Dr Chee L Khoo Following an acute coronary event we know that two anti-platelets are better than aspirin alone in preventing further coronary events. What about a cerebro-vascular events? Following a mild CVA or a TIA, we would normally commenced aspirin to…

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The many faces of hypoglycaemia

2nd August, 2018, Dr Chee L Khoo I first met Jack 14 years ago when he was diagnosed with T2D from an OGTT in 2005. He was a 47 years old then.  He was a busy businessman with no time for exercise and eating out…

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Prostatic arterial embolisation – another option for BPH

1st August, 2018, Dr Chee L Khoo Benign prostatic hyperplasia (BPH) is increasingly more common when men gets older. Transurethral resection of prostate (TURP) is still the gold standard treatment for most patients. Since alpha-adrenergic antagonists (also called alpha blockers) came to market, TURP is…

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Lynch Syndrome – what GPs need to know

1st August, 2018, Dr Chee L Khoo Although one third of patients with colorectal cancer (CRC) have a family history of cancer, only 5% of all patients with CRC have an identifiable cause to their cancer predisposition. Most of these identifiable predispositions are inherited mutations…

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After Metformin, which agent is better?

1st August, 2018, Dr Chee L Khoo After metformin and sulphonylurea, under the PBS we can choose between a DPP4 inhibitor, an SGLT2 inhibitor, a thiazolidinedione or a GLP1-RA injectable. Because of the potential adverse effects of cardiac failure with thiazolidinedione, realistically, it’s a three…

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Healthy lifestyles – how useful are they?

1st August, 2018, Dr Chee L Khoo We all know that unhealthy lifestyles are major risk factors for many chronic diseases and premature deaths. Many studies previously have reported that reduction in these unhealthy lifestyles can lead to increase in life expectancy of between 7.4…

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Omega 3 oils & CV disease – does it help?

July 15, 2018, Dr Chee L Khoo I must declare my personal interest in this discussion. I have been taking omega-3 fish oil supplements for years to reduce my triglycerides. I am also on a statin for my hypercholesterolaemia and the fish oil is to…

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Diagnosing Diabetes – is one reading enough?

July 15, 2018, Dr Chee L Khoo Diabetes can be diagnosed if fasting glucose is >7.0 mmol/L, 2 hour post prandial > 11.0 mmol/L and/or HbA1c >6.5. However, clinical guidelines recommend that we repeat testing within a “short period of time” to reduce the possibility…

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Gastrointestinal Malignancies in Cystic Fibrosis

July 15, 2018, Dr Chee L Khoo It’s always sad to lose a patient due to complications of a disease. It’s even harder if the patient is another doctor especially if the disease has well recognised complications. Many of you may have read about the…

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Tamsulosin for renal calculi – does it help?

July 15th 2018, Dr Chee L Khoo Have you noticed that an increasing number of patients with renal stones discharged from emergency department are prescribed tamsulosin. It makes perfect sense, doesn’t it? Tamsulosin is an alpha blocker and by inhibiting the smooth muscles in the…

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Diabetes & Cancer – it’s a two way sword.

July 1st, 2018, Dr Chee L Khoo With early diagnosis and improved treatment, many of our cancer patients have increased survival. You may already have noticed that many of our patients being managed in the multi-disciplinary oncology units are routinely promoting healthy lifestyles. Chronic co-morbidities…

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