28th November 2020, Spectrum Radiology
Don’t we hate it? Paperwork, approvals, waiting for more forms, more tick boxes, scan and fax and more waiting. That is what happens frequently with workers comp cases when patients need more investigations. What if you can get someone else to do it? Someone else other than you practice staff.
You now have a choice.…
14th November 2020, Dr Chee L Khoo
It’s been at least 12 weeks since we started to wear facemasks at the practice full time with all face to face consultations. I must admit that during the first week, I did feel a bit suffocating with the mask on. I remember having to stop mid-sentence to catch my breath. I could sympathise with many patients, particularly patients who has COPD, asthma or heart failure.…
14th November 2020, Dr Chee L Khoo
We all know how difficult it is to treat iron deficiency anaemia (IDA) with oral iron supplements. Oral iron supplements not only cause constipation in many patients but they take forever to reverse the iron deficiency anaemia. Gastrointestinal absorption is a problem no matter how many iron tablets you take a day.…
27th October 2020, Dr Chee L Khoo
Some of you would have read about the use of the multi-use lancet devices for testing different individuals that was in mandatory quarantine in Victoria between March and August this year. The lancets were disposable but the device holding the lancets were not. I thought everyone knew. I was wrong. Judging by the comments online after the publication of that issue in the Medical Republic, I suspect many of you don’t actually know the infection risk these devices pose and I felt the imperative to write this urgent article.…
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.…
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.…
25th August 2020, Dr Chee L Khoo
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?…
27th July 2020, Dr Chee L Khoo
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?…
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.…
11th July 2020, Dr Chee L Khoo
Another month, another change to the immunisation schedule. You must have heard about the major changes to schedule from 1st July. There are changes to who should get the pneumonia vaccines and which pneumonia vaccine they should get under the National Immunisation Program (NIP). Oh, that is, if they don’t run out of stocks again.…
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.…
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.…