Urolithin reduces aging effects – what is it?

13th February, 2021, Dr Chee L Khoo

getting older

One of the signs of getting old is that you are increasingly drawn to articles about efforts to reduce the effects of aging on health and age-related conditions. The positive effects of direct urolithin A (UA) administration in health, aging, and age-related conditions have been identified in several recent studies. UA is a gut microbiome derived natural compound that only 40% of people can naturally convert from dietary precursors at meaningful levels.…

Covid-19 antivirals – how to prescribe them

12the February 2022, Dr Chee L Khoo

covid-19 antivirals

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).…

Pfizer vaccine adverse reaction – is that myocarditis?

28th January, 2022, Spectrum Medical Imaging


Quite a few months ago, we explored the safety of Pfizer’s Comirnaty vaccine especially in young people. In particular, we looked at the increase in the incidence of myocarditis following Pfizer’s Comirnaty vaccines. We publish the list of symptoms that may suggest myocarditis but diagnosis is not always straight forward.

Medicare has now introduced an item number which allows Cardiac MRIs to be bulk billed if you suspect myocarditis.…

Quadruple therapy for heart failure – no more excuses

27th January 2022, Dr Chee L Khoo

At GPVoice, we have covered the management of heart failure fairly comprehensively over the last couple of years. In particular, we explored the cardiovascular benefits of SGLT2 inhibitors in patients with type 2 diabetes (T2D) especially in patients with heart failure. Initial studies looked at patients with heart failure with reduced ejection fraction (HFrEF) although subsequent studies found the benefits was also seen in patients with preserve ejection fraction (HFpEF) although only empagliflozin has reported.…

Severe asthma – what is beyond triple therapy?

26th January 2022, Dr Chee L Khoo

severe asthma

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.…

Omicron wave – A GP survival guide

January 7th, 2022, Dr Chee L Khoo

the omicron wave

There is a trend across the medical specialties to make their guidelines a live document as emerging data comes thick and fast these days. 12 months is a long time for once a year updates. But when you have guidelines or protocols that are updated on a daily basis, it could mean that either there are really, really lots of data coming through or those guidelines are not based on scientific data.…

Diabetes – who ends up in hospital these days?

3rd January 2022, Dr Chee L Khoo

Diabetes is associated with a whole myriad of complications. Traditionally, complications were categorised into macrovascular and microvascular complications. We have added  heart failure and  arrhythmias to that list. We have made much headway and have seen declines in non-fatal incidence of these traditional diabetes complications, in parallel with declines in all-cause mortality in people diagnosed with diabetes.…

EGFR – not the renal one

1st January 2022, Dr Chee L Khoo

This definitely wasn’t in the curriculum when I left med school (alright, it was more than 30 years ago now) but I don’t remember being updated about its relevance. I am talking about the epidermal growth factor receptor (EGFR). It is not really in the realm of general practice as such but we do have patients coming back from the oncologist with a tumour bearing an EGFR gene mutation.…

The GE Revolution Ascend – Deep Learning in Radiology

25th December, 2021, Spectrum Medical Imaging

Revolution Ascend

As CT procedure volume grows – reaching an all-time high ahead of the COVID-19 pandemic – so too does the need to optimise CT protocols and expand patient positioning options to help expedite exams and accommodate more patients. The actual scan itself only takes a few minutes and the remainder of the time is dedicated to patient prep – including positioning the patient and identifying the correct protocols and settings, plus image reconstruction and report time.…

Prostate cancer and statins – a complex relationship

25th December 2021, Dr Chee L Khoo

PSA screening

There is increasing evidence that supports an inverse association between statin use and cancer risk. The findings for prostate cancer, particularly advanced disease, are the most promising of all cancers studied. There are studies suggesting the usefulness of statins in secondary and tertiary prevention. For example, patients undergoing radiotherapy for prostate cancer improved their prostate specific survival if they are on statins.…

Amylin agonist – a new class of anti-obesity agents

24th December 2021, Dr Chee L Khoo


Obesity is often the core underlying pathology leading to many degenerative and inflammatory diseases. Unfortunately, there is no easy fix to treat obesity. Over the last 12 months we have explored a number of novel molecules which have proven efficacious in reducing fat mass in patients with obesity with or without diabetes. We last looked at the up and coming tirzepatide.…

Obese yet skinny? – triple trouble

12th December 2021, Dr Chee L Khoo

old and weak or weak and old?

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.…