Time to get together as GPs

26th June 2022, Dr Chee L Khoo

Tell me, what time did you get home last night? When did you last work a Saturday or a Sunday? When did you last truly spend time with the whole family? I bet you still fly economy class when you last went overseas. I am not telling you anything you don’t already know. Our rebates have not gone up for > 20 years.…

Fibromyalgia – which drug for which symptom?

23rd May 2022, Dr Chee L Khoo


We all know that the term fibromyalgia is a wishy-washy term used to cover something rather imprecise. Don’t get me wrong. I am not doubting the syndrome but just the name used to refer to the constellation of symptoms of widespread chronic pain, easy physical exhaustion, cognitive difficulties, depressed mood, sleep problems and digestive problems.…

Acute Achilles tendon rupture – is non-surgical treatment just as good?

11th May 2022, Dr Chee L Khoo

I was fortunate to have received ample orthopaedic experience in my training days. I was all destined to be an orthopaedic surgeon but changed my mind. I have seen a few complete Achilles tendon rupture and assisted in many successful surgical repair. Conceptually, you can’t imagine how anyone can plantar flex again if the tendon ends are not reattached surgically.…

Cardiovascular risk predictors – are they any good?

8th April 2022, Dr Chee L Khoo

CV Risk Calculator

CVD is the major cause of mortality and morbidity in patients with type 2 diabetes (T2D). There are many hundreds of cardiovascular risk prediction tools around. Well, whenever you have many versions of a particular tool, it usually tells us that none of them are particularly good in what they are meant to do – that is to predict the risk of a cardiovascular event.…

Image guided injections – what goes where?

28th March 2022, Spectrum Medical Imaging

I have to admit that even I get confused as to what imaging modality is needed to assist in image guided injections. Is it ultrasound guided or is it CT guided. The table below makes the whole choice easy to follow. Image guided injections is a very effective treatment modality in patients with spinal joint related pain whether it involves facet joints in the lumbosacral or cervical spine or the root canal of the spine.…

Covid-19 antivirals – how to prescribe them

12the February 2022, Dr Chee L Khoo

covid-19 antivirals

There is quite a bit of things to know about these medications for patients who are infected with covid-19 who are at high risk of severe disease. Whether we like it or not, we have to know them. The number of patients who qualify may not be large but we need to know who needs them and how to prescribe them as they need to be started early in the disease and not when they become sick (severe).…

Severe asthma – what is beyond triple therapy?

26th January 2022, Dr Chee L Khoo

severe asthma

How many reps have you seen recently promoting their bronchodilators? It’s all very confusing to me with the LAMA/LABA combo and now they have inhaled corticosteroids in the triple combo puffers. Who are these puffers for? Initially, they suggest triple therapy for COPD but they are now recommending the same for patients with severe asthma if the traditional LABA/ICS combo is not controlling the asthma.…

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.…

Cataract surgery delay – does it contribute to dementia risk?

11th December 2021, Dr Chee L Khoo


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).…

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.…

Dyslipidaemia in the young – who should we suspect?

24th October 2021, Dr Chee L Khoo

Last fortnight we explored the disease burden in patients who have high lipids from a very young age and the effect on their future cardiovascular risk. This consideration allows us to think about who should be aggressively treated and whom we can just safely watch, at least for a few years. It would be nice to be able identify who we should screen for high lipids from a young age so that we can start lifestyle measures early.…