Gynae and Obs
12th March 2019, Dr Chee L Khoo
When couples present for investigations of infertility, semen analysis is one of the earliest investigations we order. Every so often, the results come back with reduced sperm numbers, motility or normal forms. It is frustrating as a GP when we are unable to advise them what they can take to improve their sperm parameters.…
Many countries now recommend annual MRI screening in conjunction with mammography for high risk groups. The only problem is that different countries define high risk differently. Medicare item 63464 can be used for the surveillance and diagnosis of women under 50 years of age at high risk of developing breast cancer, and who have no signs or symptoms of the disease.…
27th February 2019, Dr Chee L Khoo
Primum non nocere (first do no harm) is quite an appropriate term when is comes to managing pregnant women who either have dysglycaemia or are at risk of dysglycaemia. While there is no question that hyperglycaemia during pregnancy is associated with both poor maternal and foetal outcomes as well as epigenetic changes which can affect the next generation, who and how to treat is still debatable.…
22nd December 2018, Dr Chee L Khoo
Endometriosis is the most frequently diagnosed condition in women with chronic pelvic pain. What if they can’t find endometriosis on laparoscopy? In 60% of women with chronic pelvic pain, the cause remained unknown. A significant proportion of these women may suffer from pelvic congestion syndrome (PVC). Is this one of those “idiopathic” type condition which is diagnosed when all tests are negative?…
27th November 2018, Dr Chee L Khoo
I recently saw a young lady whose mother had anti-phospholipid syndrome (APL) . She is now worried whether she has the same problem and request some blood tests. She is otherwise fit and healthy. Sure, among other things, I ordered APL antibodies hoping that the pathologist will know what I was looking for. Pretty straight forward so far until the results of her tests came back.…
8th November 2018, Dr Chee L Khoo
When there is so much talk about gestational diabetes (GDM), you can’t help but think that just about every pregnant woman has GDM in south west Sydney (SWS). After all, if you look at the “high risk” group that you ought to be screening for GDM, there is hardly any woman in SWS that is not in the high risk category.…
11th October, 2018, Dr Chee L Khoo
The original diagnostic criteria for polycystic ovary syndrome (PCOS) put forward after the first international conference on PCOS in 1990 was oligo-anovulation and hyperandrogenism or hyperandrogenaemia in the absence of all other endocrinopathies. This was based on expert consensus rather than clinical research data. The Rotterdam criteria 2003 added ultrasound as a third diagnostic marker and to allow for a diagnosis of PCOS if two of the three criteria were met.…
11th October 2018, Dr Chee L Khoo
Epigenetics is the modification of the DNA that changes a gene’s expression without altering the nucleotide sequence. DNA methylation and histone modifications are the most commonly studied epigenetic mechanisms by which cell structure and function can be altered during embryogenesis. The in-utero environment can lead to prenatal programming by which genes are activated or deactivated.…
30th September, 2018, Dr Chee L Khoo
There is no question that screening mammograms have led to a decline in late stage breast cancers. There have been a gradual decrease in breast cancer mortality, at least partly, due to the introduction of screening mammograms over the last 25 years. But screening mammograms are not perfect. In women with dense breast tissue, the sensitivity of mammogram decreases.…
15th September, 2018, Dr Chee L Khoo
Nausea and vomiting affects up to 80% of pregnancies but severe nausea and vomiting in early pregnancy or hyperemesis gravidarum (HG) can affect up to 1% of pregnancy. As GPs, we are often the first port of call for these women. We know how debilitating it is to those women. There is also an significant economic impact not just because of many of these women ended up in hospital on more than one occasion before 20 weeks of gestation but many (and often their partners) can’t go to work during this period.…
Increasingly, women are now requesting non invasive prenatal screening. Spectrum Medical Imaging now offers a comprehensive non-invasive prenatal screening at Liverpool.
For patient convenience, they provide pre-test discussion, a viability/dating scan, GeneStyle NIPS and 13 week structural scan. NIPS results are available within 5 days. Genetic counselling for NIPS if required post test.
Click here for more details.…
April 2018, Dr Chee L Khoo
Another day, another study published on the good or bad about metformin use in pregnancy. There is a lot of confusion and unknowns about the benefit or safety of metformin to the mother-to-be or to the long-term outcome of the baby. When there is a lot of conflicting data coming our way, we need to sit back and look at the overall picture of hyperglycaemia in pregnancy and its management before we can make sense of these studies.…