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.…
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).…
29th November 2021, Dr Chee L Khoo
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.…
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.…
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.…
10th October 2021, Dr Chee L Khoo
Updated 17th October 2021
You would have caught a bit of the announcement that some people may be due a Covid-19 vaccine booster. As usual, the announcement is not precise or detailed enough and now everyone is confused whether they are the intended target group for the booster. It is not a call to boosters for most vaccinated people.…
2nd October 2021, Dr Chee L Khoo
We generally see two categories of patients with high lipids, one who had normal lipids earlier on in life but developed high lipids later in life because of modern living and one whose lipids were already high when they were young (and slim and fit). Most of the scientific studies linking high lipids with cardiovascular (CV) events look at lipid levels at a snap point in time, at enrolment and the follow up period just aren’t long enough.…
13th September 2021, Dr Chee L Khoo
Phase 3 trials have inherent limitations in assessing vaccine safety because of the small number of participants and the sample population is generally reasonably young and healthy. They are often underpowered to identify less common adverse events. For example, the AZ interventional arm had about 11,000 participants and the interventional arm of the Pfizer Comirnaty vaccine had about 23,000 participants.…
14th August 2021, Dr Chee L Khoo
Shoulder pain has to be one of the most common musculoskeletal complaints in general practice. Rotator cuff pathology makes up at least 70% of those cases (1). It is commonly very debilitating, causing pain the whole night, causing significant reduction in function and often last for years. Apart from rest, analgesia, non-steroidal anti-inflammatory drugs, treatment options include physiotherapy, corticosteroid injections and surgical repair.…
27th June 2021, Dr Chee L Khoo
We all do it. Either we arrange for patients to come in once a year to have a “general check-up” or patients come in requesting one. There are no set rules what we check for and what blood tests to order. Somehow, patients feel better that they have been given a clean bill of health and at times, we feel that we have check them out properly and all is good.…