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Surgery

Floppy Iris Syndrome – is your patient at risk?

12th November 2018, Dr Chee L Khoo Intraoperative floppy iris syndrome (IFIS) was first described by Chang and Campbell. It is characterised by floppiness of the iris, miosis and ultimately, iris prolapse through the surgical wounds. It can occur during surgery for cataract and if…

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Morton’s Neuroma – is it a neuroma?

1st September, 2018, Dr Chee L Khoo It would seem to me that just about every doctor who graduated from Australian medical schools know about Morton’s neuroma. It’s part of the long list of differential diagnoses of forefoot pain but either I have missed many…

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Lynch Syndrome – what GPs need to know

1st August, 2018, Dr Chee L Khoo Although one third of patients with colorectal cancer (CRC) have a family history of cancer, only 5% of all patients with CRC have an identifiable cause to their cancer predisposition. Most of these identifiable predispositions are inherited mutations…

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Tamsulosin for renal calculi – does it help?

July 15th 2018, Dr Chee L Khoo Have you noticed that an increasing number of patients with renal stones discharged from emergency department are prescribed tamsulosin. It makes perfect sense, doesn’t it? Tamsulosin is an alpha blocker and by inhibiting the smooth muscles in the…

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Interventional Radiology – so many places you can stick a needle at!

July 1st, 2018, Spectrum Radiology It’s absolutely amazing where and what they can inject or biopsy these days. The list is just mind boggling. Ok, not everyone is equipped and experienced to do those procedures. And the outcome does depend on the expertise of the…

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Tonsillectomy – do they affect future immunity?

July 1st, 2018, Dr Chee L Khoo I am sure you have been asked by parents of young patients about to undergo tonsillectomy +/- adenoidectomy whether the removal of the tonsils will affect future immunity since the tonsils and adenoids are integral to the body’s…

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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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Opioids or codeine not recommended? What do we do with patients with severe back and leg pains?

May 1, 2018 Dr Chee L Khoo Chronic, persistent low back, lower extremity pain, and radicular pain may be secondary to disc herniation, disc disruption, disc degeneration, facet joint disease, spinal stenosis, or post lumbar surgery syndrome resulting in disc-related pain with or without radiculitis….

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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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Prostate Cancer – to screen or not to screen

April 15, 2018, Dr Chee L Khoo Last fortnight we review the PI-RADS score in relation to prostate MRI and i thought we might go through a real case study and how it relates to general practice. Otherwise well 42 year old gentleman with no…

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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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