12th March 2023, Dr Chee L Khoo
Myopia, especially high myopia is associated with increased risk of irreversible blinding conditions, including myopic retinopathy, retinal detachment, choroidal neovascularisation, and glaucoma (1-4) leading to a heavy cost burden on individuals and communities (5). So, it makes sense to see whether we could prevent or delay the onset of myopia or at least slow its progression.…
11th March 2023, Dr Chee L Khoo
Where did it come from? You would have fielded questions from more than a few patients about this new wonder cholesterol lowering drug that is coming to Australia “soon”. That’s what one of the current affairs media was hinting during the week. Of course, they make it sound as if everyone on statins is crying with muscle aches and pains.…
Spectrum Medical Imaging, 28th February 2023
Uterine fibroids are benign (non-cancerous) tumours of the
uterus. They are clinically apparent in up to 25% of women
and, with newer imaging techniques, the true clinical
prevalence may be higher (up to 77% ). Although most do
not cause symptoms, uterine fibroids can cause severe
problems for some women who have the condition.…
27th February 2023, Dr Chee L Khoo
We might see one case every 5 years in primary care. It might not be common but a missed diagnosis can be devastating. Patients rarely present to emergency department or the vascular surgeon without presenting to primary care first. Giant cell arteritis (GCA) is now thought of as a systemic inflammatory disease. Although glucocorticoids remain the mainstay of treatment , in the last few decades, new knowledge have dramatically changed the way we diagnose and treat GCA.…
27th february 2023, Dr Chee L Khoo
We have covered many aspects of the diagnosis, definition and management of heart failure quite extensively over the last 18 months on GPVoice. If you have been following the conversation, you will realise that the diagnosis previously very subjective. We depended much on symptoms according to the New York Heart Association (NYHA) classification to guide diagnosis, investigations and most importantly, management.…
13th February 2023, Dr Chee L Khoo
Survival rates amongst our cancer patients have improved dramatically over the years with the advent of better chemotherapy regimen. This is particularly the case in breast cancer and the different lymphomas. One of the adverse effects is cardiotoxicity in patients exposed to anthracyclines which can be life-threatening and can occur immediately or in the longer term.…
13th February 2023, Dr Chee L Khoo
Now that I know how common metabolic-dysfunction associated fatty liver disease (MAFLD) is especially amongst those patients with elements of metabolic syndrome, it’s hard not to assume that every second patient have MAFLD. We also know that not all MAFLD has abnormal liver function tests (LFTs). So, if you only suspect or screen only those with abnormal LFts, then you are going to miss many MAFLD.…
29th January 2023, Dr Chee L Khoo
We have always regarded HDL-Cholesterol (HDL-C) as the good guys. In the 1970s, the Framingham Heart Study showed that HDL-C was negatively associated with the development of cardiovascular disease (CVD) (1). Thus, we have regarded HDL as anti-atherogenic lipoprotein and expected HDL-C-raising therapy to reduce CVD events. However, there have been recent reports of the associations of high HDL-C and osteoporosis and fractures in healthy older adults.…
29th January 2023, Dr Chee L Khoo
We looked at the difference in definitions between non-alcoholic and metabolic-dysfunction associated fatty liver disease (so-called NAFLD vs MAFLD) in the last issue of GPVoice. There are many similarities and overlap between the two entities. At the end of the day, does it really matter we call the diseases. Since writing the article, I have diagnosed quite a few MAFLD and taken the appropriate next steps in the management.…
4th January 2023, Dr Chee L Khoo
The term non-alcoholic fatty liver disease (NAFLD) was first coined by Ludwig in 1980. It was rather an exclusive diagnostic term to exclude the other liver disease from being included in the definition. If your liver disease relates to excessive alcohol intake, drugs or autoimmune conditions, it cannot be included in the diagnosis.…
4th January 2023, Dr Chee L Khoo
The most recent US Prevention Services Task Force (USPSTF) recommendations pour cold water onto its use in primary prevention of CVD in April 2022 (1). We explored the details and rationale behind that turnaround recently. The recommendation for use of aspirin for prevention of colorectal cancer is lumped in together with the recommendation for CVD prevention.…
29th December 2022, Spectrum Medical Imaging
Last week we explored coronary artery calcium score and looked at how the score is really more than a score. There is a lot more details than just a number in the report. Spectrum also has a team of subspecialist Cardiac Radiologists and Cardiologists who are trained in cardiovascular imaging interpretation. The report has details that allows us to proceed to the next stage of the cardiovascular risk assessment.…