Internal Medicine

Reducing LDL-C for brain health – how low do we need to go?

27th April 2025, A/Prof Chee L Khoo We recently looked at the LDL-C levels needed to stabilise plaque progression and the LDL-C levels needed to cause plaque regression. Plaque stabilisation and regression leads to reduction in cardiovascular events. Dyslipidaemia (especially LDL-C) is also associated with cognitive impairment and dementia and reducing those numbers with statin […]

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CKD – high protein intake or not?

12th September 2024, A/Prof Chee L Khoo Inadequate protein intake in older adults may cause impairments of muscle mass and muscle function as well as impairment in immune function. Higher protein intake has been associated with increased muscle mass and strength, slower rate of bone loss, higher bone mineral density, lower risk of frailty, and […]

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Does salt reduction really reduce BP and CVD?

21st July 2024, A/Prof Chee L Khoo I know this what we were all led to believe – high salt intake independently contributes to high blood pressure and ultimately, increases cardiovascular disease (CVD). Further, reducing salt intake will reduce blood pressure and thence, cardiovascular disease. We may sometimes wonder how strong the evidence for both […]

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Intravenous iron for iron deficiency – can you give too much?

13th July 2024, A/Prof Chee L Khoo Iron deficiency can occur in a number of scenarios. It can arise from blood loss (gastrointestinal, gynaecological), inadequate dietary sources or limited absorption in inflammatory conditions (e.g CKD, heart failure or diabetes). Oral iron supplements not only can have annoying GI side effects but absorption is poor under […]

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The 4th Pillar in treatment of CKD

31st May 2024, A/Prof Chee L Khoo Renin-angiotensin system (RAS) inhibitors and SGLT2 inhibitors have been the cornerstone treatment of chronic kidney disease (CKD) for many years now. They have been shown to protect kidneys and at the same time reduce adverse cardiovascular outcomes. Finerenone was recently shown to do the same. These three agents […]

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Colchicine to reduce CVD – is it prime time yet?

12th May 2024, A/Prof Chee L Khoo We are used to using colchicine for acute treatment of gout but colchicine has also proven itself a key pharmacotherapy in the treatment of cardiovascular conditions such as pericardial disease (1), post-operative atrial fibrillation (2) and coronary artery disease (3). Colchicine disrupts the inflammatory response in acute gout […]

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BP control – a novel way to address medication adherence?

24th February 2024, A/Prof Chee L Khoo We all know how important it is for BP control in prevention cardiovascular, cerebrovascular and renal complications. We are also aware of the difficulty is improving medication adherence. We have a broad range of effective BP lowering medications covering diverse classes of medications. Anti-hypertensives work only if our […]

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Amiodarone toxicity – nastier than you think

13th January 2024, Conjoint A/Prof Chee L Khoo Amiodarone started life as an anti-angina drug but it’s used primarily for its anti-arrhythmic properties these days. That’s not because it is such a good anti-arrhythmic agent (AAD) but because there just aren’t that many good and safe anti-arrhythmic agents around. We are all aware of amiodarone’s […]

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Marathon running – putting science into practice

27th December 2023, A/Prof Chee L Khoo When we think about extreme physical activity (EPA) such as marathon running, apart from the perceived issue of wearing out knee and hip joints (that’s another issue, another day), we think about the cardiovascular risks or benefits that comes with this intense physical activity. We explored the issue […]

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CKD in T1D – any advances in management?

27th December 2023, A/Prof Chee L Khoo Not surprisingly, if dysglycaemia is the major contributor to microvascular complications in type 2 diabetes (T2D), the same complications must plaque our patients with type 1 diabetes (T1D. However, we haven’t had many major advances in the management for chronic kidney disease (CKD) and cardiovascular disease (CVD) in […]

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High Resolution Chest CT

2nd November 2023, Spectrum Medical Imaging There is still many cases of Covid-19 infection sprouting here and there. We are now seeing patients with ongoing cough and we sometimes suspect long Covid amongst them. A high resolution CT (HRCT) of the chest is a CT technique in which thin-slice images of the chest are obtained […]

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MAFLD to MASLD – another name change again?

28th October 2023, A/Prof Chee L Khoo It’s all deja-vu again. In January, we discussed the name change from NAFLD to MAFLD. We also discussed how the metabolic dysfunction fatty liver disease (MAFLD) nomenclature and definition were not quite universally accepted internationally. Somehow, we knew that MAFLD was really a temporary placeholder. And indeed, it […]

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