Assessing liver fibrosis – the many different techniques

13th March 2023, NIA Diagnostic Imaging

liver fibrosis

Over the last few weeks, we have explored the many issues relating to metabolic dysfunction associated fatty liver disease (MAFLD). We looked at what else we need to do after you diagnosed MALFD. In particular, we highlighted the need to assess the degree of fibrosis in each patient with MAFLD. With the continuous advances in technology, a wide range of new techniques and imaging modalities have emerged, thus allowing for improved diagnosis of various diseases and pathologies.…

Myopia – can we prevent it?

12th March 2023, Dr Chee L Khoo

Myopia, especially high myopia is associated with increased risk of irreversible blinding conditions, including myopic retinopathy, retinal detachment, choroidal neovascularisation, and glaucoma (1-4) leading to a heavy cost burden on individuals and communities (5). So, it makes sense to see whether we could prevent or delay the onset of myopia or at least slow its progression.…

Cholesterol lowering – new kid on the block

11th March 2023, Dr Chee L Khoo

Where did it come from? You would have fielded questions from more than a few patients about this new wonder cholesterol lowering drug that is coming to Australia “soon”. That’s what one of the current affairs media was hinting during the week. Of course, they make it sound as if everyone on statins is crying with muscle aches and pains.…

Uterine fibroids – another treatment option

Spectrum Medical Imaging, 28th February 2023

Uterine fibroids

Uterine fibroids are benign (non-cancerous) tumours of the
uterus. They are clinically apparent in up to 25% of women
and, with newer imaging techniques, the true clinical
prevalence may be higher (up to 77% ). Although most do
not cause symptoms, uterine fibroids can cause severe
problems for some women who have the condition.…

Giant cell arteritis – current state of play

27th February 2023, Dr Chee L Khoo

We might see one case every 5 years in primary care. It might not be common but a missed diagnosis can be devastating. Patients rarely present to emergency department or the vascular surgeon without presenting to primary care first. Giant cell arteritis (GCA) is now thought of as a systemic inflammatory disease. Although glucocorticoids remain the mainstay of treatment , in the last few decades, new knowledge have dramatically changed the way we diagnose and treat GCA.…

NYHA Classification for HF – how useful is it?

27th february 2023, Dr Chee L Khoo

SOBOE

We have covered many aspects of the diagnosis, definition and management of heart failure quite extensively over the last 18 months on GPVoice. If you have been following the conversation, you will realise that the diagnosis previously very subjective. We depended much on symptoms according to the New York Heart Association (NYHA) classification to guide diagnosis, investigations and most importantly, management.…

Heart failure in cancer survivors – who is at risk?

13th February 2023, Dr Chee L Khoo

Survival rates amongst our cancer patients have improved dramatically over the years with the advent of better chemotherapy regimen. This is particularly the case in breast cancer and the different lymphomas. One of the adverse effects is cardiotoxicity in patients exposed to anthracyclines which can be life-threatening and can occur immediately or in the longer term.…

Acute appendicitis – combining history with imaging

13th February 2023, NIA Diagnostic Imaging

Acute appendicitis?

A 30 year old woman presented to her GP with a two-day history of right sided abdominal/pelvic pain. There was associated severe nausea. On examination, there was tenderness in the right lower quadrant with guarding. A pelvic ultrasound was requested.

With this request, differential diagnosis may include haemorrhagic cyst, dermoid cyst, ovarian torsion, ectopic pregnancy or endometriosis.…

MAFLD – who and how should we screen?

13th February 2023, Dr Chee L Khoo

Steatosis

Now that I know how common metabolic-dysfunction associated fatty liver disease (MAFLD) is especially amongst those patients with elements of metabolic syndrome, it’s hard not to assume that every second patient have MAFLD. We also know that not all MAFLD has abnormal liver function tests (LFTs). So, if you only suspect or screen only those with abnormal LFts, then you are going to miss many MAFLD.…

HDL-Cholesterol – can too much of a good become a bad thing?

29th January 2023, Dr Chee L Khoo

HDL-C- good or bad guy?

We have always regarded HDL-Cholesterol (HDL-C) as the good guys. In the 1970s, the Framingham Heart Study showed that HDL-C was negatively associated with the development of cardiovascular disease (CVD) (1). Thus, we have regarded HDL as anti-atherogenic lipoprotein and expected HDL-C-raising therapy to reduce CVD events. However, there have been recent reports of the associations of high HDL-C and osteoporosis and fractures in healthy older adults.…

Different breasts, different densities hence, different screening techniques

29th January 2023, Spectrum Medical Imaging

Breasts not only come in different sizes and shapes but have different composition and densities. The breast density also changes with age, body composition and genetic factors. 50% of women in the US have dense breasts and dense breast tissue can camouflage early breast cancer. Yet, we only have standardised mammography and screening schedules. The Volpara is an AI software platform that provides an individualised risk assessment and screening recommendations based on the composition of the breast of the woman.…

MAFLD – the next steps after diagnosis

29th January 2023, Dr Chee L Khoo

MAFLD

We looked at the difference in definitions between non-alcoholic and metabolic-dysfunction associated fatty liver disease (so-called NAFLD vs MAFLD) in the last issue of GPVoice. There are many similarities and overlap between the two entities. At the end of the day, does it really matter we call the diseases. Since writing the article, I have diagnosed quite a few MAFLD and taken the appropriate next steps in the management.…