29th November 2021, Dr Chee L Khoo
If you are over 50 years old, there is no Medicare rebate for an MRI of the knee. They won’t do a “clean out” arthroscopy for symptom relief even if you have significant pain requiring opioids because the symptom relief is only temporary and you will end up needing a total knee replacement anyway.…
29th November 2021, Dr Chee L Khoo
One of our biggest fears is missing an atrial fibrillation (AF) and patient is discharged from hospital following their first embolic stroke. Almost all the automatic sphygmomanometers do not check for cardiac rhythm and I make it a point to put a finger on the pulse each time to make sure patients are in sinus rhythm.…
13th November 2021, Dr Chee L Khoo
The authority to prescribe a PCSK9 inhibitors for patients with resistant hyperlipidaemia under the PBS continues to be pretty complicated. We tried to simplified those numerous criteria back in December 2020 here when the criteria were “loosened” somewhat. This has facilitated my prescription of this important drug in those patients who have really, really high cardiovascular risk.…
13th November 2021, Dr Chee L Khoo
The TGA is examining data from Pfizer on the BNT162b2 vaccination in children between 5-11 years old as I write this article. The US FDA have already approved the vaccine for use in children of those age groups and the US CDC has recommended that children 5-11 years receive the vaccine.…
13th November 2021, Dr Chee L Khoo
The success of mass vaccination is demonstrated by the dramatic reduction in case numbers and deaths from Covid-19 infections since the introduction of the covid-19 vaccines worldwide. Countries such as UK, USA, Israel and Singapore started and completed their campaign very early in 2021. Their success has been challenged by the increasing breakthrough in those countries since June 2021.…
29th October 2021, Dr Chee L Khoo
Traditionally, we think of diabetes as either type 1 or type 2. That’s mainly because type 1 diabetes (T1D) was discovered first and type 2 diabetes (T2D) came later. Everything that was not T1D was T2D. T1D is an auto immune disease characterised by the death of the beta cells leading to insulin deficiency while T2D is a disease of both insulin resistance and insulin deficiency.…
24th October 2021, Dr Chee L Khoo
Last fortnight we explored the disease burden in patients who have high lipids from a very young age and the effect on their future cardiovascular risk. This consideration allows us to think about who should be aggressively treated and whom we can just safely watch, at least for a few years. It would be nice to be able identify who we should screen for high lipids from a young age so that we can start lifestyle measures early.…
10th October 2021, Dr Chee L Khoo
Updated 17th October 2021
You would have caught a bit of the announcement that some people may be due a Covid-19 vaccine booster. As usual, the announcement is not precise or detailed enough and now everyone is confused whether they are the intended target group for the booster. It is not a call to boosters for most vaccinated people.…
5th October 2021, Dr Chee L Khoo
The media is abuzz with this wonder oral drug for treatment of Covid-19 infection by Merck, Sharp & Dohme (MSD). We are talking about Molnupiravir, the broad spectrum anti-viral agent which inhibits replication of not just Covid-19 but many other viruses in cell culture. What is Molnupiravir? Who amongst the patients with Covid-19 infections will benefit from the drug?…
2nd October 2021, Dr Chee L Khoo
We generally see two categories of patients with high lipids, one who had normal lipids earlier on in life but developed high lipids later in life because of modern living and one whose lipids were already high when they were young (and slim and fit). Most of the scientific studies linking high lipids with cardiovascular (CV) events look at lipid levels at a snap point in time, at enrolment and the follow up period just aren’t long enough.…
25th September 2021, Dr Chee L Khoo
SGLT2 inhibitors (SGLT2i) have been shown to improve outcomes in patients with type 2 diabetes (T2D) and high cardiovascular risks as well as in patients with chronic kidney disease and heart failure regardless of diabetes status and independently of blood glucose levels or HbA1c. There is a little bit of a “catch” though, the eGFR.…
23rd September 2021, Dr Chee L Khoo
You have to agree that the covid-19 vaccines have been pretty effective in reducing the case numbers of covid-19 worldwide. However, over the last few months, with the emergence of the delta variant, there have been resurgence of the virus. Is it because delta variant is more contagious? Perhaps, the efficacy of the vaccines has waned as it’s coming up to 6 months for those who had their vaccines earlier in the year.…