13th December 2020, Dr Chee L Khoo
If you have been following GPVoice over the years, you would have realised that I am easily confused. I am confused again. Why are some patients who has had a TIA or minor stroke on aspirin and some on dual antiplatelet therapy (DAPT)? With supplies of some of these agents interrupted during the pandemic, can we swab one anti-platelet agent for another?…
28th November 2020, Spectrum Radiology
Don’t we hate it? Paperwork, approvals, waiting for more forms, more tick boxes, scan and fax and more waiting. That is what happens frequently with workers comp cases when patients need more investigations. What if you can get someone else to do it? Someone else other than you practice staff.
You now have a choice.…
27th November 2020, Dr Chee L Khoo
Coronaviruses compose a family within the Nidovirales order and replicate by use of a nested set of mRNAs. Four seasonal human coronaviruses (229E, NL63, OC43, and HKU1) have been identified as causing up to a third of community-acquired upper respiratory tract infections. Yet our knowledge about the immune response against this family of viruses is very limited.…
27th November 2020, Dr Chee L Khoo
Every so often you come across reports of some “ultra-rare” disease that has a treatment available now and you probably thought that it really doesn’t concern you or your patients. In a recent small study reported in The Lancet, Karine Clément, Erica van den Akker et. al. presented the results of setmelanotide in participants with proopio-melanocortin (POMC) gene mutation which is associated with severe childhood obesity.…
14th November 2020, Dr Chee L Khoo
It’s been at least 12 weeks since we started to wear facemasks at the practice full time with all face to face consultations. I must admit that during the first week, I did feel a bit suffocating with the mask on. I remember having to stop mid-sentence to catch my breath. I could sympathise with many patients, particularly patients who has COPD, asthma or heart failure.…
14th November 2020, Dr Chee L Khoo
We all know how difficult it is to treat iron deficiency anaemia (IDA) with oral iron supplements. Oral iron supplements not only cause constipation in many patients but they take forever to reverse the iron deficiency anaemia. Gastrointestinal absorption is a problem no matter how many iron tablets you take a day.…
25th October 2020, Dr Chee L Khoo
Although our numbers of new Covid-19 infections and community transmission is pretty good in comparison with most other countries in the world, it isn’t zero. This is as good as it gets for at least the next 12 months. One of the scariest things is transmission of the virus to the newborn if the pregnant mother has the Covid-19 infection.…
13th October 2020, Dr Chee L Khoo
Aortic aneurysm (AA) and aortic dissection (AD) are potentially fatal conditions. Without treatment, ruptured AA/AD carries a mortality rate of up to 90%. Population-based studies estimated the annual incidence to be 2.4 to 14.8 per 100 000 persons for AA (1-4) and 3.8 to 8.8 per 100 000 persons for AD (3,5-7). Although the incidence varied across countries, the number has universally increased over time (1-5,7).…
12th October 2020, Dr Chee L Khoo
We know from various diabetes prevention programs that intensive lifestyle interventions can be successful in reducing progression to diabetes. As GDM is more common in women with higher BMI and in the many high- risk groups and it is logical to ask the question “can we prevent GDM in these women?” If we could reduce progression of patients who has prediabetes to diabetes, we should, in theory, reduce prevalence of GDM in women who are at high risk of GDM.…
11th October 2020, Dr Chee L Khoo
There are a few “rare” medical diagnoses that are stuck in our minds since medical school days. They may be rare but it’s important not to miss them. Temporal arteritis, also known as giant cell arteritis (GCA) is one of those not so common conditions. It is actually not that rare. It is the most frequent primary systemic vasculitis with an annual incidence rate of 15–25 per 100,000 in Caucasians ≥50 years of age and it primarily affects medium- and large-sized vessels (1,2). When do you suspect GCA?…
29th September 2020, Spectrum Medical Imaging
Do your patients need Interventional procedures performed?
Interventional Radiology provides patients with access to a vast array of treatment options that do not require surgery. This is a rapidly expanding speciality which grows with every incremental advance in medical imaging technology. Spectrum provides Interventional Radiology services across Sydney in both Private and Public settings.…
27th September 2020, Dr Chee L Khoo
We know that hyperglycaemia is associated with increased cardiovascular mortality. We also know that in patients with diabetes, hypoglycaemia is also associated with increased cardiovascular morbidity and mortality. What about patients who don’t have diabetes and have low blood glucose (<4.0 mmol/L)? I am sure we all have patients who do not have diabetes but on screening blood tests, have BSL lower than 4.0 mmol/L.…