24th September 2020, Dr Chee L Khoo
Since Covid-19 pandemic started 6-7 months ago, there have been a deluge of reports coming out in the medical and lay press and sometimes it is hard to keep track of what is real and what is just logical. Because Covid-19 is primarily a respiratory pathogen, infection begins in the nasal and nasopharyngeal mucosa with high viral load especially at the beginning of the infection.…
14th September 2020, Dr Chee L Khoo
We have many patients who have borderline high fasting glucose in their routine check-up. In non-pregnant adults, we have been able to use HbA1c as a generic screening test for type 2 diabetes (T2D) for some time. Unfortunately, neither non-diabetic fasting glucose readings nor HbA1c totally exclude the presence of diabetes. I am sure you have come across patients with non-diabetic fasting glucose and HbA1c but yet fail their oral glucose tolerance test (OGTT).…
14th September 2020, Dr Chee L Khoo
Over the last decade, there has been a push for a less glucocentric management of diabetes. For some, less glucocentric means accepting poorer glycaemic control in our patients with diabetes. It was meant to direct us to not be fixated on managing glucose control without looking at other aspects of the diabetes complications.…
14th September 2020, Dr Chee L Khoo
Tell me this is not, broadly, what you have in mind when you think about gestational diabetes mellitus (GDM). We know that hyperglycaemia and pregnancy does not mix well. GDM is not quite full-blown diabetes in pregnancy but is nonetheless, associated with risks for the mother and infant and with long-term metabolic consequences in both mother and child.…
25th August 2020, Dr Chee L Khoo
Moderately severe to severe acne can have significant psychological harm associated with low self-esteem, poor perception of one’s body, social isolation, and depressive symptoms. Patients often believe that consumption of various food contribute to their acne development and severity. Although chocolate, fatty foods, and milk are frequently thought to be responsible is there any evidence on the role of nutrition in acne?…
14th August 2020, Dr Chee L Khoo
Most women would prefer not to take any medications during the pregnancy for fear of any potential teratogenic effects on the foetus. However, for some women, the use of anti-depressants is necessary. Managing these mental disorders during pregnancy and the post-partum period can be challenging (1-2) but effective management can maintain maternal and infant health (3), improve maternal prenatal health care practices (4) and improve maternal-infant attachment (5).…
13th August 2020, Dr Chee L Khoo
We all know the usefulness of highly sensitive troponin (hsTn) in diagnosing acute myocardial infarction in daily practice. hsTn has also been demonstrated to be strongly associated with recurrent events in patients with stable atherosclerotic cardiovascular disease (ASCVD) (1-7). However, hsTn is not routinely used in clinical practice in this population of patients.…
27th July 2020, Spectrum Radiology
General Electric (GE) set the standard for low-dose imaging back in 2008 with an iterative reconstruction technology capable of lowering dose by 50 percent. While that benchmark continues to change, GE introduced Deep Learning Image Reconstruction, a system which uses artificial intelligence to combine the low dose of iterative reconstruction with a “classic-looking” image texture of filtered back projection.…
27th July 2020, Dr Chee L Khoo
Just pause and think for just one minute. Over the last 12 months, how many atrial fibrillations have you picked up incidentally on ECG? How many silent old acute myocardial infarct have you seen on ECG in a patient with diabetes? How many ST and T wave changes have you seen on ECG which suggest ischaemia which requires further investigations?…
26th July 2020, Dr Chee L Khoo
Whenever we think about management of hyperglycaemia in patients with type 2 diabetes (T2D), we usually think about the most efficacious hypoglycaemic agent we can find (and on the PBS). If you look carefully at most management guidelines, lifestyle measures appears at the very top of the algorithm, side by side metformin. Sadly, it is often not the most prominent and usually, dismissed as an important part of the treatment algorithm.…
20th July 2020, Dr Chee L Khoo
This is not a riddle. I often ask my medical students and patients this question and they all look at me strangely. How does this relate to medical science? Of course, we are talking about pes anserinus (PA). For those of you who remember your anatomy, PA relates to the 3 tendons that are attached to the medial aspect of the knee.…
14th July 2020, Dr Chee L Khoo
A little more than 12 months ago, we discussed how to implement a successful weight loss program in patients with type 2 diabetes following the lines of the successful DiRECT trials from the UK. I presented data to demonstrate that it can all be done in Australian primary care. My study was accepted as an oral presentation at last year’s Australian Diabetes Congress.…