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 and post-processed in a high-spatial-frequency reconstruction algorithm.…

Precision medicine in diabetes – are we there yet?

30th October 2023, Dr Chee L Khoo


When we think about precision medicine, we usually think about some fancy, expensive genetic tests that can help us determine ahead of time who is at risk of some serious diseases. This may allow us to target these patients early and reduce morbidity and mortality. There is connotation that only the rich in rich countries can afford these tests and once again, patients in low and middle income countries (LMIC) will miss out on these state of the art expensive tests.…

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 was and many international bodies have got together since then and put together a consensus nomenclature for metabolic dysfunction associated steatotic liver disease or MASLD (pronounced MASL-D).…

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 and 5% will cause death later despite diagnosis and treatment.…

Enteric-coated aspirin – are they any better than plain aspirin?

11th October 2023, Dr Chee L Khoo

Antiplatelet therapy

Aspirin is commonly used as an anti-platelet agent for the prevention of acute coronary syndromes and cerebrovascular accidents. Its role in secondary prevention is well established but its role in primary prevention remains very complicated and very debatable. There is no question that aspirin is definitely beneficial in reducing events especially in patients at high risk of cardiovascular events.…

Omega-6 fatty acids – are they still the bad guys?

11th October 2023, Dr Chee L Khoo

Oils ain’t oils

Current U.S. dietary guidelines do recommend higher intake of omega-6 polyunsaturated fatty acids (n-6 PUFA) to reduce the risk of coronary heart disease (1,2). This pro-Omega-6 fatty acid stance remains rather contentious. While there is data supporting cholesterol benefits of linoleic acid (LA), the predominant dietary n-6 PUFA and higher dietary n-6 PUFA (predominantly LA) is associated with lower CHD risk in prospective cohort studies (3), not all cohort studies have confirmed these benefits (4).…

Amyand hernia – what is it?

28th September 2023, Spectrum Medical Imaging

A groin swelling has to be one of the most common pathology that affects the groin area. Of course, we will all be looking out for hernias. There are all sorts of hernia in the inguinal or groin area. This week, we explore the case of a Amyand Hernia. What is an amyand hernia?…

Tirzepatide is finally here – what’s the big deal?

28th September 2023, Dr Chee L Khoo

Five years ago, we previewed the arrival of the twincretins. These are agents which contain both incretins, GLP1 and GIP. Back then, agent LY3298176 was shown to cause significant weight loss and reduction in glucose. Two years ago, agent LY3298176 finally had a name – tirzepatide. Two years ago, we looked briefly at the clinical trials comparing tirzepatide with various glucose lowering agents.…

CT-guided spinal injections – what to order?

12th September 2023, NIA Diagnostic Imaging

Back pain has to be one of the most common ailments we see in general practice. Pain may originate from nerve root irritation, facet joint dysfunction, degenerative disc disease or poor muscle function or even osteoporotic fractures. There has been numerous systematic reviews and meta-analyses and most have highlighted how ineffective cortisone injections are in relieving the symptoms in the medium and long term.…

HFpEF – does semaglutide help?

12th September 2023, Dr Chee L Khoo


We have a number of drug classes that are helpful in reducing mortality in patients with heart failure with reduced ejection fraction. But when it comes to heart failure with preserved ejection fraction, SGLT2 inhibitors are the only class that have shown to be of use. ARNI, MRA or betablockers helps with HFrEF but in HFpEF?…

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 haphazardly. It, kind of, depends on what samples I have in the drug cupboard or when the last pharma rep came to sell their ware.…