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25th October 2021, Spectrum Medical Imaging

Sydney Southwest Private Hospital

One of the very few beneficial things over the lockdown period is the easier availability of radiological services. Most radiological practices have reported reduction in throughput during the recent outbreaks. As we emerge from the lockdown, referrals for medical imaging is increasing and with the increase, an increasing wait time for services is happening.…

24th October 2021, Dr Chee L Khoo

Last fortnight we explored the disease burden in patients who have high lipids from a very young age and the effect on their future cardiovascular risk. This consideration allows us to think about who should be aggressively treated and whom we can just safely watch, at least for a few years. It would be nice to be able identify who we should screen for high lipids from a young age so that we can start lifestyle measures early.…

Booster jab, anyone?

10th October 2021, Dr Chee L Khoo

Updated 17th October 2021

You would have caught a bit of the announcement that some people may be due a Covid-19 vaccine booster. As usual, the announcement is not precise or detailed enough and now everyone is confused whether they are the intended target group for the booster. It is not a call to boosters for most vaccinated people.…

5th October 2021, Dr Chee L Khoo

The media is abuzz with this wonder oral drug for treatment of Covid-19 infection by Merck, Sharp & Dohme (MSD). We are talking about Molnupiravir, the broad spectrum anti-viral agent which inhibits replication of not just Covid-19 but many other viruses in cell culture. What is Molnupiravir? Who amongst the patients with Covid-19 infections will benefit from the drug?…

2nd October 2021, Dr Chee L Khoo

cumulative high lipids

We generally see two categories of patients with high lipids, one who had normal lipids earlier on in life but developed high lipids later in life because of modern living and one whose lipids were already high when they were young (and slim and fit). Most of the scientific studies linking high lipids with cardiovascular (CV) events look at lipid levels at a snap point in time, at enrolment and the follow up period just aren’t long enough.…

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25th September 2021, Dr Chee L Khoo

small omission

SGLT2 inhibitors (SGLT2i) have been shown to improve outcomes in patients with type 2 diabetes (T2D) and high cardiovascular risks as well as in patients with chronic kidney disease and heart failure regardless of diabetes status and independently of blood glucose levels or HbA1c. There is a little bit of a “catch” though, the eGFR.…

23rd September, Spectrum Medical Imaging

CT angiogram

We all know the restrictions we all have in who we can order an ECG, stress test or stress echocardiogram for since the change in Medicare rebates some months ago. I am confused about the various eligibility criteria. You know what happens when are all confused? We stop ordering them to the detriment to patient care.…

23rd September 2021, Dr Chee L Khoo

Booster anybody?

You have to agree that the covid-19 vaccines have been pretty effective in reducing the case numbers of covid-19 worldwide. However, over the last few months, with the emergence of the delta variant, there have been resurgence of the virus. Is it because delta variant is more contagious? Perhaps, the efficacy of the vaccines has waned as it’s coming up to 6 months for those who had their vaccines earlier in the year.…

13th September 2021, Dr Chee L Khoo

mRNA covid-19 vaccines

Phase 3 trials have inherent limitations in assessing vaccine safety because of the small number of participants and the sample population is generally reasonably young and healthy. They are often underpowered to identify less common adverse events. For example, the AZ interventional arm had about 11,000 participants and the interventional arm of the Pfizer Comirnaty vaccine had about 23,000 participants.…

11th September 2021, Dr Chee L Khoo

stroke prevention in AF

You may recall when direct acting oral anti-coagulants (DOAC) first came out for treatment of atrial fibrillation (AF). Upon diagnosis of new AF, some GPs were hesitant to initiate a DOAC for the AF but instead refer patients to a cardiologist. There is a danger while waiting to see the cardiologist that the patient may incur a cerebrovascular accident (CVA).…

9th September 2021, Dr Chee L Khoo

heart failure and SGLT2 inhibitors

You already know that SGLT2 inhibitors, as a class, have been shown to reduce the development and progression of heart failure in patients with diabetes (1-3). Incidentally, it has also been shown to do the same in patients with heart failure but without diabetes. Life used to be simple.…

real world data

26th August 2021, Dr Chee L Khoo

The Delta variant, first identified in India in December 2020, spread rapidly throughout a mostly unvaccinated country and caused massive numbers of cases, hospitalisations, and deaths. It’s now responsible for the outbreaks spreading across the world. This includes countries that have high vaccination rates. In the UK, the Delta variant has spread rapidly.…