Internal Medicine

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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DVT – how does duplex US look for it?

11th October, 2023, NIA Deep vein thrombosis (DVT) is a medical condition associated with significant morbidity and mortality. It is vital that a rapid diagnosis can be acquired since DVT can result in severe complications including the development of pulmonary embolism (PE). The consequences of PE can be life-threatening. About 10% of PEs are fatal […]

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COPD – which puffer/s?

10th September 2023, Dr Chee L Khoo We looked at the new understanding of the pathophysiology of COPD last fortnight. Armed with that information, we may be able to make sense of which puffer to use for which patient and what to escalate during their exacerbations. We already do that but, I must admit, rather […]

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The GOLD guidelines – what do you need to know?

27th August 2023, Dr Chee L Khoo I thought I knew how to diagnose COPD when I see one. I thought I knew everything I need to know as a GP in managing COPD. I mean, how hard can it be? LABA, LAMA +/- ICS. If in doubt, put them on a triple puffer. Might […]

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That receding hairline – what treatment is best?

13th August 2023, Dr Chee L Khoo Many of the male doctors are slowly losing the battle against male pattern alopecia. It’s either thinning or receding. For those who are not there yet, it’s coming. We are also seeing women joining the club. Androgenetic alopecia (AGA) is the most common form of hair loss in […]

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Testosterone Replacement Therapy – why can’t GPs prescribe them?

26th July 2023, Dr Chee L Khoo It is coming up to 10 years now when we, as GPs, were suddenly not allowed to prescribe TRT for our patients with low serum testosterone levels. The rationale cited at the time was that testosterone replacement therapy (TRT) was potentially harmful because we were told that TRT […]

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Alzheimer Disease treatment – another kid on the block?

26th July 2023, Dr Chee L Khoo First it was aducanumab then lecanemab. Now it’s donanemab. All of them purportedly showed statistically significant improvement in clinical outcomes although the “significance” is hotly debated. Although aducanumab was the first to be approved by FDA (June 2021), the limited clinical improvement together with the increased risk of […]

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