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Repetitive transcranial magnetic stimulation for major depression and obsessive-compulsive disorders in Singapore

Repetitive transcranial magnetic stimulation (rTMS) is a novel and noninvasive neuromodulation therapy used for treatment-resistant major depressive disorder (MDD)1 and obsessive-compulsive disorder (OCD).2 OCD and depression are disabling psychiatric disorders, which have a detrimental impact on individuals, their families and society.3,4 The lifetime prevalence of depression is high at...

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...

Response to letters arising from publication of the Academy of Medicine, Singapore clinical guideline on the use of sedation by non-anaesthesiologists during gastrointestinal endoscopy in the hospital setting

Dear Editor, The Academy of Medicine, Singapore (AMS) guideline on the use of sedation by non-anaesthesiologists during gastrointestinal endoscopy in the hospital setting and an accompanying editorial were published in the January 2022 issue of the Annals.1,2 An evidence-based approach was used with reference made to relevant published literature. The...

Continuous Infusion 5-fluorouracil as Salvage Chemotherapy in Patients with Advanced Colorectal Cancer

Studies have shown beyond doubt that chemotherapy for metastatic colorectal cancer prolongs survival, impedes progression and stabilises disease. Compared with supportive care alone, it could also provide considerable benefits in terms of improved quality of life. This article is available only as a PDF. Please click on “Download PDF” on...

The Role of Single Nucleotide Polymorphisms (SNPs) in Understanding Complex Disorders and Pharmacogenomics

With the Human Genome Project well underway and targeted to be completed by 2001, the full set of nucleotide sequences of a reference human genome will soon be available. The realisation now is that there is a need to explore and characterise inter-individual variation. This article is available only as...

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...

Electrocardiographic Changes in Patients with Cutaneous Leishmaniasis Treated with Systemic Glucantime

Antimonial compounds are regarded as the treatment of choice for cutaneous leishmaniasis (CL). The efficacy of sodium stibogluconate (pentostam) and the other compound of antimoniate meglumine antimoniate (glucantime) were reported in 1937 and 1946, respectively. This article is available only as a PDF. Please click on “Download PDF” on top...

A Cross-sectional Study of Primary-care Physicians in Singapore on Their Concerns and Preparedness for an Avian Influenza Outbreak

Outbreaks of avian influenza (AI) caused by the H5N1 subtype in several Asian countries have raised concern all over the world. AI is endemic in several parts of Asia. To date, there have been more than 200 human cases of AI virus infection, mainly as a result of poultry-to-human...

Optimising Radiation Therapy Techniques for Tumours of the Central Nervous System

Tumours of the central nervous system (CNS) are a diverse group of pathologies with varying natural histories and outcomes. The presence of adjacent sensitive neural structures limits the role of surgery to achieve complete tumour excision; similarly, the blood-brain barrier restricts the penetration and activity of many systemic chemotherapy...

Lamotrigine-induced Stevens-Johnson syndrome and toxic epidermal necrolysis in Singapore: A case series

Dear Editor, With the advancements in pharmacogenetics, potential genetic associations with severe cutaneous adverse drug reactions (SCAR)—which include Stevens- Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN)—have been proposed. Lamotrigine is one of the 2 anticonvulsants found to be highly associated with SJS/TEN from the 2008 EuroSCAR study. Several...

Personalised Medicine for Psoriasis: A Real Possibility Ahead

In the last decade, our understanding of psoriasis has increased by leaps and bounds, resulting in many new targeted therapies being introduced for those with recalcitrant psoriasis. However, despite the plethora of new treatment options and biologics to treat the most difficult cases of psoriasis, dermatologists are still confronted...

Inter-Ethnic Differences—How Important is it in Cancer Treatment?

Inter-individual differences in drug responses are well recognised and may be due to genetic or environmental differences. These genetic or environmental influences may also result in inter-ethnic or inter-geographic differences in drug response. Indeed, drug regulatory authorities are beginning to acknowledge these differences. For example, in 1999, the United...