Covid-19 vaccination – is herd immunity achievable?

12th January 2021, Dr Chee L Khoo

Covid-19 vaccination

So, here we are. It’s almost 12 months since the beginning of the Covid-19 pandemic. A number of vaccines will become available within weeks. GPs can’t be the sole provider of the vaccines but we will a major part of the vaccination roll out program. We haven’t heard much from NSW Health on how the program will be rolled out, which will be the first subgroups we will be vaccinating nor will the vaccine ordering system be better than last year’s influenza vaccination program.…

Sex hormones and eye abnormalities – how are they related?

11th January 2021, Dr Chee L Khoo

Sex hormones are not just responsible for the function of the reproductive system. They are also responsible for bone and cardiovascular health. Interestingly, they are produced, not only by the gonads, but also by other organs (1,2) including the central nervous system (CNS). Well, the eye is a neural structure and there is increasing evidence that oestrogens exert a neuro-protective role (3,4).…

In interventional radiology, sometimes you block vessels, other times you unblock them.

27th December, 2020, Spectrum Radiology

Interventional radiology

This month Dr Yehia El Hgar from Spectrum Interventional Radiology discuss two interesting cases: one a 39-year-old female with constant heaviness in the pelvis associated with urinary frequency and severe disabling menorrhagia and the other a 29-year-old female with a past history of left lower limb DVT and underwent a left iliac vein thrombectomy and venoplasty.…

Angiopoeitin-like 3 inhibitors – new therapy for hypercholesterolaemia

27th December 2020, Dr Chee L Khoo

Every time we come across some rare genetic disorder, we learn more about the intricacies of metabolism. Nothing is more true when it comes to lipid and lipoprotein metabolism. Familial combined hypolipidemia (FCHL) is a relatively recently recognised autosomal recessive disorder characterised by globally reduced levels of LDL and HDL cholesterol and triglyceride, with no apparent adverse effects.…

PCSK9 inhibitors on PBS – who can be on it?

24th December 2020, Dr Chee L Khoo

PBS Authority

It’s been a couple of years since we first previewed the PCSK9 inhibitors (PCSK9i) on the PBS for patients with dyslipidaemia despite maximal statins and ezetimibe. Since then PCSK9i have been demonstrated in many trials of its efficacy in patients with high cardiovascular risk with dyslipidaemia despite maximally tolerated statins. The qualifying criteria  under the PBS has significantly loosened and suddenly we all have a number of patients who will meet those PBS criteria.…

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.…

Stroke prevention – are two agents better than one?

13th December 2020, Dr Chee L Khoo

Stroke prevention

If you have been following GPVoice over the years, you would have realised that I am easily confused. I am confused again. Why are some patients who has had a TIA or minor stroke on aspirin and some on dual antiplatelet therapy (DAPT)? With supplies of some of these agents interrupted during the pandemic, can we swab one anti-platelet agent for another?…

Taking the hassles out of workers comp referrals

28th November 2020, Spectrum Radiology

paperwork galore

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.…

Covid-19 vaccines – what are the issues?

27th November 2020, Dr Chee L Khoo

Covid-19 vaccine

Coronaviruses compose a family within the Nidovirales order and replicate by use of a nested set of mRNAs. Four seasonal human coronaviruses (229E, NL63, OC43, and HKU1) have been identified as causing up to a third of community-acquired upper respiratory tract infections. Yet our knowledge about the immune response against this family of viruses is very limited.…

Pro-opio-melanocortin deficiency obesity – what has it taught us?

obese kids?

27th November 2020, Dr Chee L Khoo

Every so often you come across reports of some “ultra-rare” disease that has a treatment available now and you probably thought that it really doesn’t concern you or your patients. In a recent small study reported in The Lancet, Karine Clément, Erica van den Akker et. al. presented the results of setmelanotide in participants with proopio-melanocortin (POMC) gene mutation which is associated with severe childhood obesity.…

Does wearing a facemask cause hypoxia?

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.…