Omicron wave – A GP survival guide

January 7th, 2022, Dr Chee L Khoo

the omicron wave

There is a trend across the medical specialties to make their guidelines a live document as emerging data comes thick and fast these days. 12 months is a long time for once a year updates. But when you have guidelines or protocols that are updated on a daily basis, it could mean that either there are really, really lots of data coming through or those guidelines are not based on scientific data.…

Diabetes – who ends up in hospital these days?

3rd January 2022, Dr Chee L Khoo

Diabetes is associated with a whole myriad of complications. Traditionally, complications were categorised into macrovascular and microvascular complications. We have added  heart failure and  arrhythmias to that list. We have made much headway and have seen declines in non-fatal incidence of these traditional diabetes complications, in parallel with declines in all-cause mortality in people diagnosed with diabetes.…

EGFR – not the renal one

1st January 2022, Dr Chee L Khoo

This definitely wasn’t in the curriculum when I left med school (alright, it was more than 30 years ago now) but I don’t remember being updated about its relevance. I am talking about the epidermal growth factor receptor (EGFR). It is not really in the realm of general practice as such but we do have patients coming back from the oncologist with a tumour bearing an EGFR gene mutation.…

The GE Revolution Ascend – Deep Learning in Radiology

25th December, 2021, Spectrum Medical Imaging

Revolution Ascend

As CT procedure volume grows – reaching an all-time high ahead of the COVID-19 pandemic – so too does the need to optimise CT protocols and expand patient positioning options to help expedite exams and accommodate more patients. The actual scan itself only takes a few minutes and the remainder of the time is dedicated to patient prep – including positioning the patient and identifying the correct protocols and settings, plus image reconstruction and report time.…

Prostate cancer and statins – a complex relationship

25th December 2021, Dr Chee L Khoo

PSA screening

There is increasing evidence that supports an inverse association between statin use and cancer risk. The findings for prostate cancer, particularly advanced disease, are the most promising of all cancers studied. There are studies suggesting the usefulness of statins in secondary and tertiary prevention. For example, patients undergoing radiotherapy for prostate cancer improved their prostate specific survival if they are on statins.…

Amylin agonist – a new class of anti-obesity agents

24th December 2021, Dr Chee L Khoo

Obesity

Obesity is often the core underlying pathology leading to many degenerative and inflammatory diseases. Unfortunately, there is no easy fix to treat obesity. Over the last 12 months we have explored a number of novel molecules which have proven efficacious in reducing fat mass in patients with obesity with or without diabetes. We last looked at the up and coming tirzepatide.…

Obese yet skinny? – triple trouble

12th December 2021, Dr Chee L Khoo

old and weak or weak and old?

We touched on the subject of osteosarcopenia on a number of occasions over the years. These are people who have weak bones and have lost muscles. These are often older patients that have become weak for various reasons. Aging reduces the quality and strength of bones and muscles and increases body fat, which lead to the simultaneous occurrence of sarcopenia, osteopenia, and adiposity.…

SGLT2i and heart failure benefits – does it matter which type?

11th Dec 2021, Dr Chee L Khoo

hospitalisation for heart failure

By now, most of you would be familiar with the significant cardiovascular benefits with all the SGLT2 inhibitors (SGLT2i). This is particularly stark in the reduction in hospitalisation for heart failure (Hhf). Of course, patients with heart failure is not a homogeneous group. There is heart failure with preserved ejection fraction (HFpEF) and heart failure with reduced ejection (HFrEF).…

Cataract surgery delay – does it contribute to dementia risk?

11th December 2021, Dr Chee L Khoo

Cataracts

Cataract is a leading cause of blindness worldwide, affecting more than 35 million people globally and causing blindness in approximately 20 million. Visual impairment is an important dementia risk. Addressing sensory loss from visual impairment that affects older adults may be a potentially modifiable risk factor for dementia in late life (1,2) Because sensory impairments and dementia are both strongly associated with aging the link between sensory impairment and dementia may have important implications for individual and global public health, particularly if interventions to improve sensory function reduce dementia risk (3).…

Image guided injections – what goes where for which condition?

29th November 2021, Spectrum Medical Imaging

image guided injections

If you are like me, you will be confused as which joints or joint can be injected for which clinical condition. Then you need to know whether they are ultrasound guided procedures or CT scan guided procedures. There just a myriad of musculoskeletal conditions that can improve with corticosteroid injections. Spectrum Medical Imaging has assembled a team of subspecialist interventional and musculoskeletal expert radiologists to assist us in managing our patients with these conditions.…

PRP injections for knee OA – do they work?

29th November 2021, Dr Chee L Khoo

Knee osteoarthritis

If you are over 50 years old, there is no Medicare rebate for an MRI of the knee. They won’t do a “clean out” arthroscopy for symptom relief even if you have significant pain requiring opioids because the symptom relief is only temporary and you will end up needing a total knee replacement anyway.…

Micro-AF – harbinger of AF?

29th November 2021, Dr Chee L Khoo

One of our biggest fears is missing an atrial fibrillation (AF) and patient is discharged from hospital following their first embolic stroke. Almost all the automatic sphygmomanometers do not check for cardiac rhythm and I make it a point to put a finger on the pulse each time to make sure patients are in sinus rhythm.…