Surgery

Pancreatic cancer screening – why are we not there yet?

10th September, 2019. Dr Chee L Khoo Let’s face it. We all dread the diagnosis of pancreatic cancer in any of our patients. There aren’t too many red flags that we can rely on to warn us that something is not right with this deep seated abdominal organ. Many of the symptoms are either subtle […]

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Abbreviated breast MRI – what is it?

22nd June 2019, Spectrum Medical Imaging Dynamic contrast enhanced breast – MRI must contain a minimal number of MRI sequences that is necessary to detect small enhancing breast lesions. What if we cut down the number of sequences but yet have enough accuracy to detect small early cancers? That’s what AB-MRI is – less number […]

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Paediatric intracranial tumours – ordering the right test

A meningioma is a benign tumour that arises from the meninges. Meningiomas are often slow-growing, however in some instances, they may be fast-growing and their effects on adjacent brain tissue, nerves or vessels may cause serious disability. Timely access to a Bulk Billable MRI scan can enable a quick diagnosis and appropriate referral for neurosurgery without […]

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Fournier’s gangrene & SGLT2i – how rare is it?

23rd March 2019, Dr Chee L Khoo You may remember receiving warnings recently from the Therapeutics Goods Administration (TGA) about a serious “rare” infection, called necrotising fasciitis of the perineum, also referred to as Fournier’s gangrene (FG). FG is reported to be associated with the use of SGLT2 inhibitors in patients with type 2 diabetes […]

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How long does a knee replacement last?

23rd February 2019, Dr Chee L Khoo Joint replacement is the mainstay treatment for advanced arthritis. Unfortunately, almost all joint replacements fail over time. We are frequently asked by patients “how long does the replacement last?”. It’s important to know how long a joint is supposed to last because it determines the “ideal” age to […]

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Case Study – man with increasing neck pain for one month

44-year-old male with 1 month of increasing neck pain was referred for a cervical spine injection. A CT scan of the cervical spine two weeks prior (Figure A), revealed foraminal narrowing at the C5-6 level. There was a significant difference between the new scan and the previous scan. There was severe destruction of the C5-6 […]

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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 not anticipated, it increases the risk of posterior capsule rupture, […]

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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 or it’s not that common. I’m also not sure what […]

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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 in genes that regulate growth processes in colonic stem cells […]

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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 ureter, it facilitates the passage of stone into the bladder. […]

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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 operator. Have a look at the list of interventional procedures possible here. […]

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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 immune response. I have had those questions asked of me […]

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