27th January 2024, A/Prof Chee L Khoo
We are all pretty much used to weekly GLP1-RA injections for our patients with type 2 diabetes (T2D). Certainly, a lot less needles compared with the once daily or twice daily GLP1-RA injections and therefore more acceptable to patients (including those without diabetes!). Weekly GLP-1 are efficacious in reducing fasting as well as postprandial glucose.…
13th January 2024, Conjoint A/Prof Chee L Khoo
Amiodarone started life as an anti-angina drug but it’s used primarily for its anti-arrhythmic properties these days. That’s not because it is such a good anti-arrhythmic agent (AAD) but because there just aren’t that many good and safe anti-arrhythmic agents around. We are all aware of amiodarone’s thyroid effects (hypo or hyper) and we monitor them closely as long as they are on amiodarone.…
13th January 2024, Conjoint A/Prof Chee L Khoo
When we think about extreme physical activity (EPA) such as marathon running, apart from the perceived issue of wearing out knee and hip joints (that’s another issue, another day), we think about the cardiovascular risks or benefits that comes with this intense physical activity. We explored the issue of marathon running and cardiovascular risks 9 months ago here.…
27th December 2023, A/Prof Chee L Khoo
When we think about extreme physical activity (EPA) such as marathon running, apart from the perceived issue of wearing out knee and hip joints (that’s another issue, another day), we think about the cardiovascular risks or benefits that comes with this intense physical activity. We explored the issue of marathon running and cardiovascular risks 9 months ago here.…
27th December 2023, A/Prof Chee L Khoo
Not surprisingly, if dysglycaemia is the major contributor to microvascular complications in type 2 diabetes (T2D), the same complications must plaque our patients with type 1 diabetes (T1D. However, we haven’t had many major advances in the management for chronic kidney disease (CKD) and cardiovascular disease (CVD) in patients with T1D for decades.…
10th December 2023, A/Prof Chee L Khoo
We don’t get old and weak. Actually, if we get weak, we become old. We all see that in practice. It doesn’t matter how old our patient is. When they become weak, they slow down. They can’t walk very far and they don’t. They become weaker and weaker. They have difficulty get off a chair.…
30th November, Spectrum Medical Imaging
The midfoot consist of 5 bones, cuboid, navicular and three cuneiform bones. These bones articulate with the base of the five metatarsals. In the Lisfranc injuries, it is these articulations (and their ligamemts) that are damage. Sometimes, there are fractures easily seen on plain xrays. Sometimes, one can see separation of the bones on plain xrays.…
27th November 2023, A/Prof Chee L Khoo
Although moderate to severe acne is pretty common in primary care, our management tends to be haphazard. We have our favourite topical and oral therapy but I am not sure that that is evidence-based nor pathophysiological in our approach. When all else fails, we refer on to our friendly dermatologist. I recently attended a brilliant lecture at the Melbourne GPCE presented by Dr Ryan de Cruz, a Melbournian dermatologist.…
25th November 2023, A/Prof Chee L Khoo
Cervical screening for cervical cancer for the prevention of cervical cancer has to be one of the most successful campaigns in primary care. For most, instead of having an intimate check every two years, doing it every 5 years is such a relief. For others, it is still having to endure an insertion of a vaginal speculum.…
14th November 2023, A/Prof Chee L Khoo
Obesity is a recognised risk factor for cardiovascular disease (CVD). We are all used to treating cardiovascular risk factors such as hypertension, dyslipidaemia and diabetes in an attempt to reduce CV events. We should also treat the obesity, shouldn’t we? Logically, weight reduction should lead to reduction in CV events but, unfortunately, lifestyle changes and pharmacological interventions to reduce obesity have not been shown to improve cardiovascular outcomes (1-5).…
12th November 2023, Conjoint Assoc. Prof Chee L Khoo
It is pretty standard for us to treat an infective exacerbation of COPD with antibiotics and a shot of oral corticosteroids, usually oral prednisolone for 5-7 days. Almost all of them seems to get better with that regimen. Or do they? We explored when to use and when not to use inhaled corticosteroids (ICS) in COPD in the September 2023 issue.…
12th November 2023, NIA Diagnostic Imaging
Epigastric pain has to be one of the most common presenting symptoms in primary care. The differential diagnoses include cholelithiasis and cholecystitis. With increasing prevalence of obesity and type 2 diabetes, the prevalence of gallbladder disease is also increasing. Often, abdominal ultrasound can confirm or exclude gallbladder disease but sometimes, the results are inconclusive or we suspect additional bile duct obstruction.…