3rd dose for the non-immunocompromised – is it necessary?

13th November 2021, Dr Chee L Khoo

booster shots?

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.…

The skinny T2D – what do we have to watch out for?

29th October 2021, Dr Chee L Khoo

Which T2D?

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.…

Dyslipidaemia in the young – who should we suspect?

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.…

Covid-19 vaccine booster for the immunocompromised – who is eligible?

Booster jab, anyone?

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.…

Oral anti-viral against Covid-19 – how does it work?

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?…

Dyslipidaemia in young adults – should we be treating?

2nd October 2021, Dr Chee L Khoo

cumulative high lipids

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.…

Dapagliflozin Product Information – why a tiny omission means a lot?

25th September 2021, Dr Chee L Khoo

small omission

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.…

Covid-19 vaccination booster – why, when, what?

23rd September 2021, Dr Chee L Khoo

Booster anybody?

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.…

Comirnaty vaccine – how safe is it? What about myocarditis?

13th September 2021, Dr Chee L Khoo

mRNA covid-19 vaccines

Phase 3 trials have inherent limitations in assessing vaccine safety because of the small number of participants and the sample population is generally reasonably young and healthy. They are often underpowered to identify less common adverse events. For example, the AZ interventional arm had about 11,000 participants and the interventional arm of the Pfizer Comirnaty vaccine had about 23,000 participants.…

DOAC for valvular AF – is that allowed?

11th September 2021, Dr Chee L Khoo

stroke prevention in AF

You may recall when direct acting oral anti-coagulants (DOAC) first came out for treatment of atrial fibrillation (AF). Upon diagnosis of new AF, some GPs were hesitant to initiate a DOAC for the AF but instead refer patients to a cardiologist. There is a danger while waiting to see the cardiologist that the patient may incur a cerebrovascular accident (CVA).…