Quadruple therapy for heart failure – why is there treatment inertia?

9th April 2021, Dr Chee L Khoo

Quadruple therapy

We are all aware of the treatment inertia in the management of patients with diabetes. In patients with heart failure, several drug classes have demonstrated significant but independent survival benefit. Quadruple therapy with an angiotensin receptor–neprilsyin inhibitor (ARNI), evidence-based β-blocker, mineralo-corticoid receptor antagonist (MRA) and sodium glucose cotransporter 2 inhibitor (SGLT2i) can cumulatively reduce the risk of death by 73% over 2 years (1).…

Prostate artery embolisation – available now


29th January 2021, Spectrum Interventional Radiology

Benign Prostate Hypertrophy (BPH) is a prevalent condition in males that results in Lower Urinary Tract Symptoms (LUTS). BPH is present in 50% of males at 50yrs of age and increases to 90% of males at 90 years of age. Apart from trans-urethral resection of prostate (TURP) and dutasteride/tamsulosine, there is another longstanding and tested option.…

Covid-19 vaccine roll out – something to get excited about?

14th December 2020, Dr Chee L Khoo

Covid-19 vaccine

We explored the Covid-19 vaccine candidates in the last issue. You would have read that the Pfizer vaccine has been approved and has been rolled out in UK and US. I have yet to come across the full disclosure of the trial anywhere. The Oxford/AstraZeneca trial has been published in full and it is worthwhile dissecting the study and ponder the implications as other vaccines are being rolled out internationally and will hit Australian shores in early 2021.…

Weekly insulin is coming. Is it any good?

13th December 2020, Dr Chee Khoo


First, we have twice daily then once daily GLP1 injections. This was followed by weekly GLP1 injectables. The same is occurring with the insulins. Once daily insulins have been around for a few years and is well established as basal insulins in patients with type 1 and type 2 diabetes. We now have a weekly insulin coming onto the market.…

New RACGP Diabetes Management Guidelines – what’s new?

8th August 2020, Dr Chee L Khoo

Keeping up-to-date?

Two years is an awfully long time in diabetes management updates. Well, that’s exactly how long it has been since the last RACGP diabetes management guidelines was last updated. There have been a deluge of data pouring in to help guide us in our management of patients with type 2 diabetes. The “handbook” is actually looking more like an encyclopaedia now with 198 pages of information.…

Abbreviated breast MRI – how useful is it?

8th July 2020, Spectrum Radiology

Adjunct screening with dynamic contrast-enhanced (DCE)-MRI was first recommended for women at high (>20%) lifetime risk of breast cancer, facilitating earlier cancer detection and reducing interval cancers. Even in women at average risk of breast cancer, there is evidence that they might also benefit from screening MRI.

Apart from the cost of MRI equipment, other costs include the relatively long acquisition, limiting high-volume patient throughput and interpretation times involved in a full diagnostic protocol.…

Covid-19 – can’t swab? Can xrays help?

We all know how restricted the criteria for swabbing patients for Covid-19. You may consider perhaps, a chest rays may help. Although there are lots of studies describing the “classic” ground glass appearance on CXR or Chest CT, Unfortunately, in practical terms, they are not useful. It may actually endanger your radiology colleagues and their staff unless we work as a team during this difficult period.…

Heart Failure in diabetes – getting more complicated?

10th February 2020, Dr Chee L Khoo

Diabetes can either be the sole perpetrator of the heart failure or be an accomplice to other cardiac disease such as coronary artery disease or myocarditis. Diabetic cardiomyopathy can manifest itself either as a restrictive cardiomyopathy with heart failure with preserved ejection fraction (HFpEF) or as a dilated cardiomyopathy with heart failure wth reduced ejection fraction (HFrEF).…

Changing paradigms in breast cancer screening – the arrival of Abbreviated breast MRI

22nd June 2019, Dr Chee L Khoo

Screening mammography has been shown in many prospective, randomised, clinical trials to reduce breast cancer deaths by between 25-40% (1-4). Unfortunately, small but high-grade cancers can be masked by the presence of dense breast tissues or may be confused as benign breast disease in mammograms. In fact, in countries that have national breast screening mammography programs, advanced breast cancers have not decreased (5,6).…