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Acid suppression in infants – 2 questions to ponder before prescribing

13th July 2019, Dr Chee L Khoo

Gastroesophageal acid reflux disease in babies is a common presentation in general practice. Crying, frequent vomiting or regurgitation and sometimes poor weight gain can transform a lovely and cute baby into a monster. Acid suppressants, including proton pump inhibitors (PPIs) and histamine H2-receptor antagonists (H2RAs) are increasingly being prescribed for this debilitating (to both baby and parents) condition.…

At least 3 other reasons why you should use GLP1-RAs early in diabetes management

13th July 2019, Dr Chee L Khoo

New anti-diabetic agents are coming thick and fast. It is easy to get confused as to which agent to use. For injectables, there are currently at least a dozen different insulin preparations and 5 GLP1 -Receptor Analogues (GLP1-RAs) available in Australia. Some are on the Pharmaceutical Benefits Scheme (PBS), some not. It is easy to put them all in the too hard basket.…

Cardiovascular health – are eggs in or out?

13th July 2019, Dr Chee L Khoo

First, it’s not good, then it’s Ok and now we are not sure. Maybe it is, maybe it isn’t. We are talking about eggs and the association with cardiovascular disease and mortality. It’s stuck in many of our and our patients’ minds that eggs are no good. It doesn’t help when the 2015-2020 Dietary Guidelines for Americans came out with somewhat contradictory recommendations: “ (1) Cholesterol is not a nutrient of concern for overconsumption” and (2) “Individuals should eat as little dietary cholesterol as possible while consuming a healthy eating pattern” (1).…

Fasting or non-fasting lipid levels – doesn’t it really matter?

22nd June 2019, Dr Chee L Khoo

It is standard to measure blood lipids after an 8-12 hour fast. Pretty much all our guidelines for management of cardiometabolic conditions are based on these fasting blood levels. The actual reading is important because it guides us to determine whether a patient is commenced on a statin or not. Do meals affect lipid levels?…

The young T2D – more trouble ahead than you think

13th May 2019, Dr Chee L Khoo

You are already seeing the worrying trend of younger and younger patients being diagnosed with type 2 diabetes (T2D). My youngest is 25 years old when first diagnosed with T2D. I am sure many of you have patients younger than that. Of course, we need to make sure that these are not patients with type 1 diabetes.…

Ramadan is here – do we need to do anything different with patients with diabetes?

13th May 2019, Dr Chee L Khoo

Ramadan is the holy month for Muslims, falling in the ninth lunar month in the Islamic calendar year. Because the timing of Ramadan is linked to the sighting of the new moon, the timing of this month varies. Ramadan is a period of worship, self-discipline, austerity and charity. The most important significance of Ramadan is that Muslims are required to observe fasting during daylight hours.…

Diabetes inducing drugs – who is next on the list?

13th May 2019, Dr Chee L Khoo

The list of drugs that increase the risk of type 2 diabetes (T2D) is increasing. We know statins (1,2), anti-psychotics (3) and many of the anti-retroviral (4) and immunosuppressant agents (5) have been shown to increase the risk of T2D. We also heard last year about the ACE inhibitors. Recent studies have implicated the 5α-reductase inhibitors, the drugs that we use to treat benign prostatic hypertrophy (BPH) as well.…

Sitting on a pot of gold in general practice

26th November 2018, Dr Chee L Khoo

We sit on a large repository of data in general practice. A small subset of the data that can be useful is the individual patient data that can facilitate patient care. This subset (in the right set up) is what the myhealthrecord is hoping to host in the cloud but that is another story for another day.…

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