Knee Osteoarthritis – is jogging good or bad?

24th May 2020, Dr Chee L Khoo

In primary care, we are frequently preventing disease or at least we try to. Apart from lifestyle measures, we prescribe statins, anti-hypertensive, aspirin and beta-blockers to reduce cardiovascular events. What about arthritis? In patients who do not have arthritis (yet) but are at high risk of degenerative osteoarthritis, is there something we can do to reduce the patients’ risk of progressing to full blown arthritis?…

Double thalassaemia – it’s more than double trouble

thalassaemia

22nd May 2020, Dr Chee L Khoo

Let’s imagine we have a pregnant woman who tested positive for β-thalassaemia trait (minor) on antenatal screening blood tests. If both partners carry the same thalassaemia trait, there is a 25% chance of having a baby with thalassaemia major. Thus, we are advised to screen her partner for thalassaemia as well. Say, the partner’s blood picture is normal with no microcytosis and high performance cation-exchange chromatography (HPLC) shows normal levels of HbA2 and HbF.…

Covid-19 and T2D – when two pandemics meet

13th May 2020, Dr Chee L Khoo

Covid-19 have exposed the numerous risks patients with type 2 diabetes (t2D) face when the two pandemics meet head on. We have seen that patients with diabetes are over-represented in patients hospitalised with Covid-19 in Wuhan. Patients with diabetes are also affected more severely if they contracted Covid-19 especially if glycaemic control is suboptimal.…

Can flu vaccination really reduce Covid-19 infection?

11th May 2020, Dr Chee L Khoo

flu vaccination and Covid-19

Most of you would have run out of flu vaccines by now. The bad news is that we don’t know when new stocks will arrive. So much for the assurance from the government in mid-March that “there is enough vaccines for all who needs them” but “go to your GP now anyway”.…

Coronary revascularisations – do they save lives?

28th April 2020, Dr Chee L Khoo

The incidence and mortality from coronary artery disease in Australia continue to decline. Coronary revascularisation consisting of percutaneous coronary intervention and coronary artery bypass graft (CABG) is rapidly increasing as the standard of care for coronary artery disease. There have been numerous trials comparing CABG with percutaneous coronary intervention (PCI) and so far, no studies have convincingly shown any overall difference between the two revascularisation strategies.…

Covid-19 – how many are asymptomatic?

26th April 2020, Dr Chee L Khoo

Although the Covid-19 pandemic seems to be under some control, we are still in danger of a second wave if we relaxed the social distancing rules too much too quickly. One of the big unknowns is what is the proportion of people with SARS-COV-2 who are asymptomatic? These are the people we are not testing.…

Diabetes and Covid-19 – the disease doesn’t take a break

11th April 2020, Dr Chee L Khoo

You are probably overwhelmed by the whole Covid-19 saga. Just because we are dealing with Covid-19 “everywhere”, doesn’t mean existing chronic diseases can take a breather. Patients with chronic illness especially diabetes and hypertension are affected by the current Covid-19 chaos in more ways then one. GPs play a vital role in managing these patients during this difficult and challenging time especially when there is much emphasis on telehealth.…

Covid-19 – to ACEi or not to ACEi?

10th April 2020, Dr Chee L Khoo

It’s amazing how quickly news travel during a pandemic. A bit of information came out a few weeks ago that suggests SARS-CoV-2 enters the body via the angiotensin converting enzyme receptor 2 (ACE2) present in abundance in pulmonary tissues. Initial reports out of Wuhan found that patients with chronic obstructive pulmonary disease (COPD), diabetes and hypertension were at higher risks of getting the infection as well as developing the severe form of Covid-19 if they do get the infection.…

Fighting Covid-19 – do you want to be a hero?

We all have that warm fussy feeling inside every time they talk about the frontline “heroes”. You say “that’s me”. We all contribute towards the fight against the Covid-19 pandemic. The UK recently acknowledge the hardworking frontline health care workers (HCWs) with the “clap hands for frontline workers” campaign to acknowledge the dangerous work that we do. That’s what we sign up for – to save human lives.…

Covid-19 – who should we swab?

25th March 2020, Dr Chee L Khoo

They tell us that patients need to have 1) returned from overseas (any country will do now) OR been in contact with someone confirmed to have coronavirus infection AND 2) Flu symptoms with FEVER before we swab for Covid-19. Otherwise, we just reassure the patient that no they can’t have the swab and yes, they probably don’t have coronavirus infection.…

Covid-19 – reporting from primary care frontline

I told you last week that I am no expert and despite that I did write an article about the coronavirus. Well, I am doing that again this week but this time with a little more information and little bit more “expertise”. We have been getting oodles of feeds from many sources and I don’t know about you, but, all these bulletins really don’t help us working at the frontline.…

Coronavirus disaster plan – is there one?

14th March 2020, Dr Chee L Khoo

I have been holding off writing about the coronavirus so far as I didn’t think that I have the expertise. I would be out of my depth. It’s been coming up to three months since the world woke up to Wuhan. It’s been 6 weeks since Australia banned all flights from China. It was only a matter of time before the virus run rampant in Australia causing mayhem.…