30th August 2024, A/Prof Chee L Khoo
Up until GLP1RAs +/- GIPs were shown to be efficacious in assisting patients lose weight and keeping the weight off, long term sustainable weight loss was practically unachievable. Not everyone wants to or is able to afford bariatric surgery to assist in weight loss. Even then, the weight loss is usually not sustainable. International guidelines (including Australian) include medical nutritional therapy in the management of obesity.…
24th August 2024, A/Prof Chee L Khoo
Last fortnight we looked at the effects of hypertriglyceridaemia (HTG) on atherosclerosis. We explored the source and metabolism of triglycerides (TG). We saw how important lipoprotein lipase was in regulating plasma TG. Triglyceride levels are closely related to plasma triglycerides rich lipoprotein (TRL) and TRL remnants. All three components penetrate through the endothelium into the subendothelial space where atherosclerotic inflammation occur.…
24th August 2024, A/Prof Chee L Khoo
Plasma glucose levels is such a simple test that we take for granted its reliability. The glucose level is absolutely critical in many of our clinical management. It governs whether we diagnose someone with diabetes or not and that have many regulatory implications. We have discussed the diagnosis and management of gestational diabetes mellitus (GDM) and how it affects maternal and offspring outcomes and future risks to both.…
11th August 2024, NIA Diagnostic Imaging
CT enterography (CTE) plays a vital role in the management of Crohn’s disease, a chronic inflammatory bowel disease (IBD). Crohn’s disease is the most common indication for a CTE, primarily used to determine diagnosis and complications (5) to guide effective treatment, and for monitoring disease progression and response to treatment.
WHAT IS CROHN’S DISEASE?…
High salt intake is said to independently contribute to high blood pressure and ultimately, increase cardiovascular disease (CVD). There are also many other diseases that are similarly associated with high salt intake. How robust is the evidence though? As we ponder about the associations, we may or may not push the message of salt reduction as strongly as we should.…
25th July 2024, A/Prof Chee L Khoo
The current gold standard for screening for gestational diabetes mellitus (GDM) for women with no risk factors for hyperglycaemia is an oral glucose tolerance test (OGTT) at 24-28 weeks’ gestation. Women with risk factors are recommended to have an OGTT in the first trimester. Unfortunately, many women are nauseous during the first trimester and performing an OGTT during that time can be very unpalatable.…
21st July 2024, A/Prof Chee L Khoo
I know this what we were all led to believe – high salt intake independently contributes to high blood pressure and ultimately, increases cardiovascular disease (CVD). Further, reducing salt intake will reduce blood pressure and thence, cardiovascular disease. We may sometimes wonder how strong the evidence for both statements is. As we ponder about the associations, we may or may not push the message of salt reduction as strongly as we should.…
20th July 2024, A/Prof Chee L Khoo
Chronic obstructive pulmonary disease (COPD) is not just a disease of obstructed airways. In a significant proportion of COPD sufferers, there is an inflammatory component to the disease. This not only affects the aetiology of the disease and its exacerbations but also its management. We are used to using all sorts of bronchodilators to keep the obstructed airways opened and inhaled corticosteroids (ICS) to tackle the inflammatory component.…
13th July 2024, A/Prof Chee L Khoo
Iron deficiency can occur in a number of scenarios. It can arise from blood loss (gastrointestinal, gynaecological), inadequate dietary sources or limited absorption in inflammatory conditions (e.g CKD, heart failure or diabetes). Oral iron supplements not only can have annoying GI side effects but absorption is poor under the best of conditions.…
30th June 2024, A/Prof Chee L Khoo
We are all aware of the exacerbations in patients with chronic obstructive pulmonary disease (COPD) especially when they are discharged from hospital back to primary care. We tend to forget that each time a patient with COPD have flare up or chest infection, that represent an exacerbation of COPD. Now, you may think it’s just a matter of semantics and coding but it’s more than that.…
10th June 2024, A/Prof Chee L Khoo
There will always be a certain degree of fat free mass (i.e. muscle) loss with any weight loss. While the makers of the GLP1/GIP agonists will tell you that overall, there is more fat loss than muscle loss, it is still a concern for the long term health of patients who lose muscles which may not be restored.…
31st May 2024, A/Prof Chee L Khoo
It’s coming to almost 10 years now when suddenly, we were not able to prescribe testosterone replacement therapy (TRT) to men with hypogonadism or low testosterone levels under the PBS. This came on the back of a decision by the US FDA in March 2015 to restrict the prescription of TRT (1).…