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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.…
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
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.…
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?…
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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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.…
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.…
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.…
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.…
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).…
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
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.…