22nd April 2021, Dr Chee L Khoo
We know migraines as recurrent episodes of headache, associated with symptoms such as nausea, photophobia and phonophobia. While we have agents that can treat acute migraine pretty effectively, many patients with migraines have frequent episodes. These patients with frequent migraines should be offered migraine prophylaxis. Unfortunately, amongst patients with frequent migraines, only 3–13% receive migraine preventive treatment [1,2].…
13th April 2021, Dr Chee L Khoo
Every time the government overpromise and underdeliver, we are the ones that have to deal with the public whose expectations have been led unnecessarily high for political reasons. With the issue of clots relating to the AZ vaccine on the front page over the last week or so, patients are now utterly confused and look to their GP for advice as to where and when to proceed.…
9th April 2021, Dr Chee L Khoo
We are all aware of the treatment inertia in the management of patients with diabetes. In patients with heart failure, several drug classes have demonstrated significant but independent survival benefit. Quadruple therapy with an angiotensin receptor–neprilsyin inhibitor (ARNI), evidence-based β-blocker, mineralo-corticoid receptor antagonist (MRA) and sodium glucose cotransporter 2 inhibitor (SGLT2i) can cumulatively reduce the risk of death by 73% over 2 years (1).…
5th April 2021, Dr Chee L Khoo
Last week we explored the association of thromboembolism following vaccination with AstraZeneca (AZ) vaccine. This adverse event was first reported in two patients in Austria which is then followed by more reports in Germany and the rest of Europe. One man in Victoria was recently reported to have similar adverse effects following the AZ vaccine.…
29th March 2021, Dr Chee L Khoo
463 million adults are living with diabetes globally, and this number is estimated to rise to 700 million by 2045. Interestingly, 60% of them live in Asia. By 2030, without intervention, both China and India combined will have almost half a billion of people with diabetics. While lifestyle issues and epigenetics play significant roles in the ever increasing prevalence of type 2 diabetes (T2D), white rice feature prominently in the Asian diet.…
27th March 2021, Dr Chee L Khoo
It all started when the Austrian regulatory authority suspended the use of a batch of AstraZeneca (AZ) vaccine on March 9th after a patient was diagnosed with multiple thrombosis and died 10 days after vaccination, and another was hospitalised with pulmonary embolism after being vaccinated. At least 16 other countries follow suit and suspended the use of AZ vaccine.…
13th March 2021, Dr Chee L Khoo
Medical treatment options for type 2 diabetes (T2D) have increased over the last decade and enhance the possibility of individualised treatment strategies where insulin is still one of them. In spite of the advancements in treatment options, less than one-third of the population with diabetes achieve their glycaemic target. What if I tell you that there is a new treatment option available that has been shown to significantly reduce HbA1c, hypoglycaemia, hospitalisation, complications and diabetic medications?…
12th March 2021, Dr Chee L Khoo
I don’t about you but I seem to be bombarded by emails championing the wonderful things that cannabis oil can do. I even had a pharmaceutical rep swinging by to ask why I wasn’t prescribing cannabis oil for my patients. I even have a specialist (of sorts) that recommended that my patient come and discuss cannabis oil for his condition with me.…
!2th March 2021, Dr Chee L Khoo
A substantial number of myocardial infarctions (MIs) are asymptomatic (silent MI (SMI)) or associated with minor and atypical symptoms and are found accidentally during routine electrocardiogram (ECG) examinations that reveal the existence of abnormal Q waves. The risk factors for occurrence of SMI are increasing age, hypertension, existing coronary artery disease and diabetes.…
27th February 2021, Dr Chee L Khoo
Even though there should be no panic in the roll out, as more and more is being flashed across our TV screen, patients may start queuing up at the practice agitating to be first to be vaccinated. We all still have our normal patients to look after everyday and we need some pre-planning to avoid being snowed under and causing stress to GPs and their staff.…
26th February 2021, Dr Chee L Khoo
Back in medical school, we were taught that we have B-cells and T-cells. B-cells are responsible for humoral immunity and T-cells are responsible for cell-mediated immunity. T-cells could be killer cells or helper cells although we also have regulatory T-cells which tells the naïve T-cells how to behave. Of course, over the last 2-3 decades, we know more about what makes the regulatory T-cells decide what to tell these naïve cells.…
13th February 2021, Dr Chee L Khoo
As often occurs with new medications and vaccines, pregnant individuals were excluded from the clinical trials for these vaccines. As the vaccine roll out begins, women who are pregnant or planning to become pregnant will want to discuss the safety of the vaccines with their GP. We better be up to date with the relevant issues so that we can have a meaningful discussion with our patient.…