Letter to the Editor
HLA-B*5801 testing: Is it time to consider mandatory testing prior to prescribing allopurinol in Singapore?
Dear Editor,
Stevens-Johnsons Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are severe, life- threatening mucocutaneous reactions that most commonly occur as drug-related reactions.1 In recent years, several risk factors for the develop- ment of SJS/TEN, such as genetic factors, have been identified. Notably, carriers of the HLA-B*5801 and HLA-B*1502 alleles ...
Letter to the Editor
Validating two international warfarin pharmacogenetic dosing algorithms for estimating the maintenance dose for patients in Singapore
Dear Editor,
Predicting optimal warfarin dosing is difficult due to complex pharmacodynamics and pharmacokinetics, narrow therapeutic index and susceptibility to many factors.1 Genetic variations of the CYP2C9 and VKORC1 enzymes, occurring in different frequencies in different populations, play a significant role in determining warfarin dosing.1-4 Using pharmacogenetic dosing algorithms to...
Editorial
Incorporating assessment of fibrinogen gene polymorphisms and bleeding risk in patients treated with direct oral anticoagulants
Direct oral anticoagulants (DOACs) have become entrenched as the dominant anticoagulant over the last decade for patients with venous thrombosis and atrial fibrillation.1 Compared to warfarin, bleeding risk is similar or lower for patients on DOACs but clinically relevant bleeding is still a risk, especially for patients with impaired...
Editorial
Pharmacokinetic and pharmacogenomic considerations in managing use of nirmatrelvir-ritonavir and molnupiravir and dermatological treatments
The COVID-19 pandemic has been unprecedented in its impact on global health, economic, financial, psychosocial and political systems. The World Health Organization estimates approximately 627 million confirmed cases and 6.5 million deaths reported globally.1 In Singapore, the swift and prompt public health response of the government during the early...
Letter to the Editor
An initial experience with laser haemorrhoidoplasty in addition to mucopexy for symptomatic haemorrhoids
Dear Editor,
Symptomatic haemorrhoids is the most common anorectal disorder, where up to 75% of people experience symptoms sometime in their lives.1
The current gold standard for the surgical management of haemorrhoids is the Milligan-Morgan haemorrhoidectomy,2 with unrivalled long-term results.3 However, the technique is associated with significant postoperative pain,4,5 leading to...
Original Article
Use of Low Molecular Weight Heparin for Prevention of Deep Vein Thrombosis in Total Knee Arthroplasty—A Study of its Efficacy in an Asian Population
The role of thromboprophylaxis in total knee replacement (TKR) remains controversial. In several reports, the incidence of deep vein thrombosis (DVT) has been significant.
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Others
Case Report on Recombinant Coagulation Factor VIIa in the Treatment of Three Haemophilia A Patients with Inhibitors in Singapore
Development of inhibitors against factor VIII is one of the main complications in the treatment of haemophiliacs. Inhibitors block the procoagulant effects of factor VIII and prevent the successful arrest of bleeding episodes when administered to these haemophiliacs.
This article is available only as a PDF. Please click on “Download...
Review Article
When Less is More: Can We Abandon Prophylactic Platelet Transfusion in Dengue Fever?
Dengue fever (DF) is the most common mosquito-borne human viral illness worldwide, and has rapidly spread to reach hyper-endemic proportions in the urban tropics over the last quarter of a century. With an estimated 2.5 billion people at risk and a global annual incidence of 50 million cases, DF...
Others
Challenges and Pitfalls in the Introduction of Pharmacogenetics for Cancer
Pharmacogenetics, by definition, refers to the study of genetic differences in metabolic pathways which can affect an individual’s responses to drugs in terms of both therapeutic and adverse effects. In recent years, there have been several success stories such as HER2 for trastuzumab in breast cancer and VKORC1/CYP2C9 for...