Volume 51, Number 1
The Academy of Medicine, Singapore recently appointed an expert workgroup comprising gastroenterologists, general surgeons and anaesthesiologists to develop guidelines on the use of sedation during gastrointestinal (GI) endoscopy. The recommendations serve to guide clinical practice during sedation for GI endoscopy by non-anaesthesiologists in the hospital setting.
Proton-pump inhibitors (PPIs) are effective treatment for upper GI pathologies but their indiscriminate use could result in potential harms. A Singapore study had implemented a series of deprescribing interventions to curb PPI overutilisation, with findings supporting the safety of cautious deprescribing.
Editorial
Ensuring safe sedation during gastroendoscopy
Gastrointestinal (GI) endoscopy started in Singapore in 1968 with diagnostic endoscopic gastric examination, using flexible fibre-optics GI endoscopy. Fibre-optic flexible sigmoidoscopy and colonoscopy were introduced later. Most of these procedures were performed then without sedation. The patients needed to cooperate with the endoscopists and inability to complete the endoscopic...
Editorial
Proton pump inhibitors: When is it too much of a good thing?
The popularity of proton pump inhibitors (PPIs) among both prescribers and patients may be ascribed to their relative low cost, efficacy and safety profile. Introduced in the late 1980s, PPIs are benzimidazole derivative drugs that inhibit the hydrogen-potassium ATPase exchanger (“the proton pump”) on the luminal surface of the...
Editorial
Coagulopathy related to trauma: Is it time for a goal-directed approach?
Trauma represents a leading cause of death globally, and post-traumatic haemorrhage accounts for 40% of early mortality in spite of recent improvements in modern trauma care.1 Post-traumatic haemorrhage occurs primarily from direct injury to blood vessels, leading to exsanguination and hypovolaemic shock depending on the type and calibre of...
Original Article
The impact of deprescribing interventions on oral proton pump inhibitor utilisation in a Singapore tertiary hospital: A quality improvement initiative
The established efficacy of proton pump inhibitors (PPIs) in the treatment of upper gastrointestinal (GI) disorders, coupled with their perceived safety, have led to PPI overutilisation.1,2 Prescription of PPIs in absence of evidence-based indication, also known as low-value prescribing, is prevalent across the spectrum of healthcare settings.1-4 Within Singapore,...
Original Article
Novel transdermal device for delivery of triamcinolone for nail psoriasis treatment
Psoriasis is a chronic immune mediated inflammatory skin condition that affects about 2–4% of the Western populations, with rising incidence over the years.1,2 The presentation of psoriasis varies from mild localised plaques to more severe erythrodermic forms, with plaque-type psoriasis being the most common. It frequently affects the skin...
