Auto-immune arthropathy – understanding the IL-23/IL-17 pathway

26th February 2021, Dr Chee L Khoo

arthropathies

Back in medical school, we were taught that we have B-cells and T-cells. B-cells are responsible for humoral immunity and T-cells are responsible for cell-mediated immunity. T-cells could be killer cells or helper cells although we also have regulatory T-cells which tells the naïve T-cells how to behave. Of course, over the last 2-3 decades, we know more about what makes the regulatory T-cells decide what to tell these naïve cells.…

Covid-19 vaccines and pregnancy – what do you need to know?

13th February 2021, Dr Chee L Khoo

Covid-19 vaccine

As often occurs with new medications and vaccines, pregnant individuals were excluded from the clinical trials for these vaccines. As the vaccine roll out begins, women who are pregnant or planning to become pregnant will want to discuss the safety of the vaccines with their GP. We better be up to date with the relevant issues so that we can have a meaningful discussion with our patient.…

Aspirin for colorectal cancer prevention – who will benefit?

13th February 2021, Dr Chee L Khoo

colorectal cancer

Aspirin as a chemoprotective agent against colorectal cancer (CRC) has gone through quite exhaustive reviews over the last 20 years. After initially recommended against using aspirin for CRC prevention in 2007, the US Preventative Services Task Force (USPSTF) in 2015 recommended initiating low-dose aspirin use for the primary prevention of CVD and CRC in “adults aged 50 to 59 years who have a >10% 10-year CVD risk, are not at increased risk for bleeding, have a life expectancy of at least 10 years and are willing to take low-dose aspirin daily for at least 10 years” (1).…

Carotid artery stenosis – should I have diagnosed it earlier?

11th February 2021, Dr Chee L Khoo

CVA

We all have come across this awful scenario. Patient was admitted to hospital with a TIA or a stroke due to significant carotid stenosis. As good caring GPs, we looked back and wonder whether we should have known about the stenosis. After all, these patients often have other hallmarks of atherosclerosis, coronary artery disease or peripheral arterial disease and the usual cardiovascular risk factors and we should have suspected carotid stenosis.…

Game changer to EOI for Phase 1B vaccine roll-out

2nd February 2021, Dr Chee L Khoo

To jab or not to jab

Since my last post on the expression of interest (EOI) in participating in the Phase 1B covid-19 vaccine roll out, there have some changes and clarification to the silly announcements that may make it more acceptable to submit the EOI:

The National Booking System (NBS) has not been created yet and is unlikely to be ready in time for the launch of Phase 1B (if at all).…

Prostate artery embolisation – available now

PAE

29th January 2021, Spectrum Interventional Radiology

Benign Prostate Hypertrophy (BPH) is a prevalent condition in males that results in Lower Urinary Tract Symptoms (LUTS). BPH is present in 50% of males at 50yrs of age and increases to 90% of males at 90 years of age. Apart from trans-urethral resection of prostate (TURP) and dutasteride/tamsulosine, there is another longstanding and tested option.…

The big Covid-19 vaccine roll out con – don’t fall for it

24th January 2021, Dr Chee L Khoo

The big vaccine roll-out con

PERSONAL OPINION

Is it deliberate that we are given 10 days lead time to submit an expression of interest (EOI) to participate in the national Covid-19 vaccine Phase 1b roll-out? 18 pages of information released on a Friday afternoon in the hope that we might skim over the details and sign up without reading the fine print?…

Brain glucose control – a cause of type 2 diabetes?

17th January 2021, Dr Chee L Khoo

brain glucose control

The pathogenesis of type 2 diabetes involves insulin resistance, β-cell failure, α-cell over-activity and the loss of the incretins. The brain is responsible for homeostatic control of a broad range of variables upon which our survival depends. Why wouldn’t the brain be involved with glucose control?  There is increasing evidence that both the pancreas and the brain are jointly responsible for maintaining glucose within and tight setpoint.…

A message to all GPs from Dr Kerry Chant

Dear Colleague  

NSW Health would like to thank you for your continued work in the response to COVID-19.  In order to continue to identify any undetected cases and break chains of transmission, we need to remain vigilant.  The key to achieving this is to test people with even the very mildest symptoms of COVID-19.  While testing rates have been relatively high in recent weeks, we need to continue to encourage testing and remain on high alert. …

Covid-19 vaccination – is herd immunity achievable?

12th January 2021, Dr Chee L Khoo

Covid-19 vaccination

So, here we are. It’s almost 12 months since the beginning of the Covid-19 pandemic. A number of vaccines will become available within weeks. GPs can’t be the sole provider of the vaccines but we will a major part of the vaccination roll out program. We haven’t heard much from NSW Health on how the program will be rolled out, which will be the first subgroups we will be vaccinating nor will the vaccine ordering system be better than last year’s influenza vaccination program.…

Sex hormones and eye abnormalities – how are they related?

11th January 2021, Dr Chee L Khoo

Sex hormones are not just responsible for the function of the reproductive system. They are also responsible for bone and cardiovascular health. Interestingly, they are produced, not only by the gonads, but also by other organs (1,2) including the central nervous system (CNS). Well, the eye is a neural structure and there is increasing evidence that oestrogens exert a neuro-protective role (3,4).…