25th August 2020, Dr Chee L Khoo
Moderately severe to severe acne can have significant psychological harm associated with low self-esteem, poor perception of one’s body, social isolation, and depressive symptoms. Patients often believe that consumption of various food contribute to their acne development and severity. Although chocolate, fatty foods, and milk are frequently thought to be responsible is there any evidence on the role of nutrition in acne?…
14th August 2020, Dr Chee L Khoo
Most women would prefer not to take any medications during the pregnancy for fear of any potential teratogenic effects on the foetus. However, for some women, the use of anti-depressants is necessary. Managing these mental disorders during pregnancy and the post-partum period can be challenging (1-2) but effective management can maintain maternal and infant health (3), improve maternal prenatal health care practices (4) and improve maternal-infant attachment (5).…
13th August 2020, Dr Chee L Khoo
We all know the usefulness of highly sensitive troponin (hsTn) in diagnosing acute myocardial infarction in daily practice. hsTn has also been demonstrated to be strongly associated with recurrent events in patients with stable atherosclerotic cardiovascular disease (ASCVD) (1-7). However, hsTn is not routinely used in clinical practice in this population of patients.…
27th July 2020, Dr Chee L Khoo
Just pause and think for just one minute. Over the last 12 months, how many atrial fibrillations have you picked up incidentally on ECG? How many silent old acute myocardial infarct have you seen on ECG in a patient with diabetes? How many ST and T wave changes have you seen on ECG which suggest ischaemia which requires further investigations?…
26th July 2020, Dr Chee L Khoo
Whenever we think about management of hyperglycaemia in patients with type 2 diabetes (T2D), we usually think about the most efficacious hypoglycaemic agent we can find (and on the PBS). If you look carefully at most management guidelines, lifestyle measures appears at the very top of the algorithm, side by side metformin. Sadly, it is often not the most prominent and usually, dismissed as an important part of the treatment algorithm.…
20th July 2020, Dr Chee L Khoo
This is not a riddle. I often ask my medical students and patients this question and they all look at me strangely. How does this relate to medical science? Of course, we are talking about pes anserinus (PA). For those of you who remember your anatomy, PA relates to the 3 tendons that are attached to the medial aspect of the knee.…
14th July 2020, Dr Chee L Khoo
A little more than 12 months ago, we discussed how to implement a successful weight loss program in patients with type 2 diabetes following the lines of the successful DiRECT trials from the UK. I presented data to demonstrate that it can all be done in Australian primary care. My study was accepted as an oral presentation at last year’s Australian Diabetes Congress.…
12th July 2020, Dr Chee L Khoo
One month ago, we discussed Ozempic®(semaglutide) as the new GLP-1 agonist kid on the block in the treatment of hyperglycaemia in patients with type 2 diabetes (T2D). We foreshadowed that it will be coming real soon. Well, sooner than I thought. Ozempic® went on the PBS on the 1st July. What we didn’t know was what the restrictions will be when prescribing for patients with T2D.…
11th July 2020, Dr Chee L Khoo
Another month, another change to the immunisation schedule. You must have heard about the major changes to schedule from 1st July. There are changes to who should get the pneumonia vaccines and which pneumonia vaccine they should get under the National Immunisation Program (NIP). Oh, that is, if they don’t run out of stocks again.…
29th June 2020, Dr Chee L Khoo
One in three patients with diabetes will develop diabetic foot ulcers (DFU). This typically occurs in the setting of peripheral artery disease, peripheral neuropathy and trauma. Foot ulcers invariably leads to lower extremity amputation (LEA) and both are associated with significant morbidity and mortality. We know that poor glycaemic control contributes to the development of DFU and LEA.…
28th June 2020, Dr Chee L Khoo
In type 1 diabetes (T1D), the β-cell die rapidly from a massive immunological assault and practically all the β-cells are quickly lost and hence, there is an absolute deficiency of insulin secretion. Using auto-antibody screening, we can define T1D. Do you realise that we don’t actually have a definition for type 2 diabetes (T2D).…
13th June 2020, Dr Chee L Khoo
We are not talking about whether front line workers should wear a mask or not. We are talking about masks for the general public. Even as medical practitioners, we are confused. How does the average member of the public decide whether to wear masks or not? There are so many different opinions from numerous different quarters.…