9th April 2023, Dr Chee L Khoo
One of the most important contributor to atherosclerosis is elevated cholesterol levels. Familial hypercholesterolaemia (FH) is a genetic disease that manifests as a disorder of cholesterol metabolism by mutations in hereditary genes usually in an autosomal dominant manner. Data suggest that 1 in 200 Caucasians are heterozygous for FH and that 1 in 160,000–300,000 are homozygous, which are much higher prevalence than those estimated a decade earlier (1).…
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.…
25th September 2022, Dr Chee L Khoo
We looked at the Australian guidelines on management of heart failure (HF) recently and in particular, how it impacts upon the management of these patients in primary care. The guidelines recommended the four pillars of management but also reinforced the categories of HF. Did you know that the numbers that define the different categories of HF is somewhat arbitrary?…
28th August 2022, Dr Chee L Khoo
We know that low density lipoprotein cholesterol (LDL-C) is a risk factor for atherosclerotic cardiovascular disease (ASCVD). We also know that reducing LDL-C levels can significantly reduce those risks irrespective of whether they have established cardiovascular disease or not (1). That means reducing LDL-C works in secondary as well as primary prevention. However, even when LDL-C is well-controlled in statin-treated ASCVD patients, there is still a residual risk of cardiovascular disease.…
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.…
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.…
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.…
8th April 2022, Dr Chee L Khoo
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.…
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.…
12the February 2022, Dr Chee L Khoo
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).…
26th January 2022, Dr Chee L Khoo
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.…
12th December 2021, Dr Chee L Khoo
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.…