Hypoglycaemia in non-diabetics – is it a problem?


27th September 2020, Dr Chee L Khoo

We know that hyperglycaemia is associated with increased cardiovascular mortality. We also know that in patients with diabetes, hypoglycaemia is also associated with increased cardiovascular morbidity and mortality. What about patients who don’t have diabetes and have low blood glucose (<4.0 mmol/L)? I am sure we all have patients who do not have diabetes but on screening blood tests, have BSL lower than 4.0 mmol/L.…

Do you know this giant lurking in SWS?

27th August 2020, Dr Chee L Khoo

I first met him in December 2014 just before he started work at Western Sydney University in 2015. For someone who has just arrived in south west Sydney, I was most impressed to see how well he grasped the problems we have with the quality of care in patients with diabetes in our area.…

Acne – are dietary factors relevant?

25th August 2020, Dr Chee L Khoo

diet and acne

Moderately severe to severe acne can have significant psychological harm associated with low self-esteem, poor perception of one’s body, social isolation, and depressive symptoms. Patients often believe that consumption of various food contribute to their acne development and severity. Although chocolate, fatty foods, and milk are frequently thought to be responsible is there any evidence on the role of nutrition in acne?…

Deleting ECG item numbers in primary care – whose idea was it?

27th July 2020, Dr Chee L Khoo

GP: the brains behind ECGs

Just pause and think for just one minute. Over the last 12 months, how many atrial fibrillations have you picked up incidentally on ECG? How many silent old acute myocardial infarct have you seen on ECG in a patient with diabetes? How many ST and T wave changes have you seen on ECG which suggest ischaemia which requires further investigations?…

Medical Nutritional Therapy – why are you not prescribing it?

26th July 2020, Dr Chee L Khoo

Whenever we think about management of hyperglycaemia in patients with type 2 diabetes (T2D), we usually think about the most efficacious hypoglycaemic agent we can find (and on the PBS). If you look carefully at most management guidelines, lifestyle measures appears at the very top of the algorithm, side by side metformin. Sadly, it is often not the most prominent and usually, dismissed as an important part of the treatment algorithm.…

Double thalassaemia – it’s more than double trouble


22nd May 2020, Dr Chee L Khoo

Let’s imagine we have a pregnant woman who tested positive for β-thalassaemia trait (minor) on antenatal screening blood tests. If both partners carry the same thalassaemia trait, there is a 25% chance of having a baby with thalassaemia major. Thus, we are advised to screen her partner for thalassaemia as well. Say, the partner’s blood picture is normal with no microcytosis and high performance cation-exchange chromatography (HPLC) shows normal levels of HbA2 and HbF.…

CovidSafe App – should we install the app?


11th May 2020, Dr Chee L Khoo

Although the Covid-19 pandemic seems to be under some control, we are still in danger of a second wave if we relaxed the social distancing rules too much too quickly. One of the big unknowns is what is the proportion of people with SARS-COV-2 who are asymptomatic? These are the people we are not testing.…

Covid-19 treatment – why chloroquine?

28th March 2020, Dr Chee L Khoo

Covid-19 belong to the subfamily Coronavirinae in the family of Coronaviridae of the order Nidovirales, and this subfamily includes four genera: α-coronavirus, β-coronavirus, γ-coronavirus, and δ-coronavirus. The new 2019 nCoV (or Covid-19), which belongs to β-coronavirus can infect the lower respiratory tract and cause pneumonia in humans, but it seems that the symptoms are milder than SARS and MERS.…

Covid-19 – who should we swab?

25th March 2020, Dr Chee L Khoo

They tell us that patients need to have 1) returned from overseas (any country will do now) OR been in contact with someone confirmed to have coronavirus infection AND 2) Flu symptoms with FEVER before we swab for Covid-19. Otherwise, we just reassure the patient that no they can’t have the swab and yes, they probably don’t have coronavirus infection.…

Covid-19 – reporting from primary care frontline

I told you last week that I am no expert and despite that I did write an article about the coronavirus. Well, I am doing that again this week but this time with a little more information and little bit more “expertise”. We have been getting oodles of feeds from many sources and I don’t know about you, but, all these bulletins really don’t help us working at the frontline.…

Coronavirus disaster plan – is there one?

14th March 2020, Dr Chee L Khoo

I have been holding off writing about the coronavirus so far as I didn’t think that I have the expertise. I would be out of my depth. It’s been coming up to three months since the world woke up to Wuhan. It’s been 6 weeks since Australia banned all flights from China. It was only a matter of time before the virus run rampant in Australia causing mayhem.…