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Internal Medicine

Smart intraocular pressure sensors – coming to a centre near you

June 1, 2018, Dr Chee L Khoo We are all familiar with 24-hour BP monitor. We are also familiar with 24-hour Holter monitor and continuous glucose monitoring. We now have 24-hour intraocular pressure monitor. It doesn’t actually monitor intraocular pressure but the effects of it…

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Continuous Glucose Monitoring coming to general practice – are you ready?

May 15, 2018, Dr Chee L  Khoo You probably think that insulin pump (so-called continuous subcutaneous insulin infusion or CSII) and continuous glucose monitoring (CGM) are all to do with Type 1 diabetes (T1D) in diabetes centres and you probably don’t need to know about…

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Non-invasive liver elastography – a new era in liver disease assessment

May 15, 2018, Dr Ahmed Mayat (Medical Imaging Campbelltown) Gold standard for diagnosis and staging of liver fibrosis is liver biopsy.  This is, however an invasive procedure with its associated complications. Liver Elastography is a simple non-invasive method to assess liver fibrosis.  A special ultrasound…

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Hepatitis C treatment in general practice – my first case

May 15, 2018, Dr Chee L Khoo Kylie was known to have chronic hepatitis c infection for many years. She had been busy for the last 2-3 years being pregnant. We talked about anti-viral treatment as soon as she finished with breast feeding her last…

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Smoking, alcohol, hot tea and oesophageal cancer – how are they related?

May1, 2018, Dr Chee L Khoo We all know that smoking and alcohol are associated with increased risk of oesophageal cancer. A recent large study from China looked at 456,155 people and found 1731 esophageal cancers over 9.2 years. They noticed that there was an…

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SGLT2 inhibitor/DPP4 inhibitor combo under PBS – sorting out the confusion

May 1, 2018 Dr Chee L Khoo When I wrote the article last fortnight about new SLT2 inhibitor/DPP4 inhibitor combo now on the PBS, the situation was still very confused. Since that article, more information has  come to light. Yes, we are allowed to use…

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Getting T2D to target – two heads better than one

April 15, 2018, Dr Chee L Khoo To get our patients with type 2 diabetes (T2D) to glycaemic target using oral agents,  you can either use an SGLT2 inhibitor (SGLT2i) or a DPP4 inhibitor DPP4i) after metformin (with or without a sulphonylurea) but not both….

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Complementary vs Conventional Medicine – it doesn’t have to be like that!

April 2018, Dr Chee L Khoo The term complementary medicine refers to a group of diagnostic and therapeutic disciplines that exist largely outside the institutions where conventional health care is provided and taught. The wide range of disciplines classified as complementary medicine makes it difficult…

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Multi-disciplinary care of T2D – does it work in primary care?

April 2018, Dr Chee L Khoo Multi-disciplinary care (MDC) is often hailed as THE comprehensive management for patients with type 2 diabetes (T2D). We refer these patients to podiatrists, exercise physios, dietitians, diabetes educators and sometimes, endocrinologists. Now, that is MDC, isn’t it? We are…

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Ketosis may improve glycaemic control – can we use it in T2D therapy?

April 2018, Dr Chee L Khoo Ketogenesis is the production of ketone bodies (KB) when glucose levels decline and the glucagon:insulin ratio is high. When the body is deprived of glucose, KB act as an alternative fuel source for brain, heart, kidneys and skeletal muscles….

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Prostate MRI – A case study

A 60 year old man presents with a rising PSA despite several previously negative transrectal prostate biopsies. A prostate MRI demonstrates a circumscribed small region of low T2 signal intensity within the left lateral peripheral zone at the gland base. This region demonstrates moderately restricted water…

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A GP guide to understanding prostate MRI – the PI-RADS scoring system

April 2018, Dr Chee L Khoo Forget about whether PSA screening saves lives or not. What is the next step when a PSA level comes back elevated. Obviously if the PSA is >10 or much higher, they need referral to a urologist for biopsies. What…

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