Development and validation of the INappropriate solid oral dosaGE form modification aSsessmenT (INGEST) Algorithm using data of patients with medication dysphagia from a neurology ward and nursing home in Singapore.

Objectives: This study aims to develop and validate a novel implicit tool to assist clinicians in resource-limited settings to promptly assess suitability for modification of solid oral dosage forms (SODFs) during medication prescribing, review and/or administration for patients with dysphagia.

Design: Literature review and a group discussion were conducted to elicit items for the construction of the INappropriate solid oral dosaGE form modification aSsessmenT (INGEST) algorithm. For its validation, inter-rater reliability among three independent users was evaluated.

An evaluation of the completeness of drug-drug interaction-related information in package inserts.

Purpose: The project aimed to evaluate the completeness of drug-drug interaction (DDI)-related information in package inserts (PIs) and develop a systematic approach to conduct the evaluation.

Methods: DDI-related information in the branded PIs of statins, macrolides, protease inhibitors and selected drugs of narrow therapeutic index (DNTI) were evaluated against the criteria distilled from the Food and Drug Administration (FDA) labelling recommendation guidance document. Decision trees were crafted and employed in the evaluation process.

Characterisation and outcomes of adult patients with paracetamol overdose presenting to a tertiary hospital in Singapore.

Introduction: Paracetamol is the most common pharmaceutical agent implicated in toxic exposure in Singapore. This study aimed to describe the characteristics of paracetamol overdose in the adult population managed at a tertiary healthcare facility in Singapore.

Methods: Medical records of adult patients hospitalised with a diagnosis of paracetamol overdose at National University Hospital, Singapore, over a three-year period from January 2011 to December 2013 were retrospectively reviewed.

Pentoxifylline-Induced Thrombocytopenia: A Case Report.

Pentoxifylline-induced thrombocytopenia is rare, and information is lacking about its presentation. We describe a 72-year-old Chinese male who developed thrombocytopenia after initiation of pentoxifylline for the treatment of chronic lower limb ischemia due to peripheral artery disease. Venous thromboembolism had been ruled out with an ultrasound.

Erythema multiforme secondary to dimenhydrinate in a patient with previous similar reactions to pamabrom.

Objective: To report a case of erythema multiforme secondary to dimenhydrinate and pamabrom cross-sensitivity.

Case Summary: A 22-year-old Chinese female presented with a complaint of lip mucosal ulceration with necrosis and stomatitis, worsening over the past 24 hours and associated with reduced oral intake and incomplete opening of the mouth. Presentation was accompanied by a generalized rash and genital mucosal involvement.

Identification and physicians' views of their commonly-used drug information sources in Singapore.

Aim: To examine physicians' use and views of various sources for general drug information and to determine the kind of drug-related questions they receive.

Method: An online survey of general practitioners who were Singapore Medical Association members was conducted. The survey consisted of questions about the physicians' demographics, the drug information source they used most often, their opinions on the information from that source, and the types of drug-related questions they received from patients.

Identification and evaluation of pharmacists' commonly used drug information sources.

Background: Given the rate at which new medications are introduced to the market, as well as the diversity of existing drugs, pharmacists frequently need to consult drug information (DI) sources. Currently, there is a lack of information about pharmacists' needs for and sources of DI in Singapore.

Objective: To examine where practicing pharmacists in Singapore usually obtain DI and how useful and satisfactory the source is to pharmacists and to determine the kind of drug-related questions pharmacists usually receive.

A cost analysis of Outpatient Parenteral Antibiotic Therapy (OPAT): an Asian perspective.

The concept of Outpatient Parenteral Antibiotic Therapy (OPAT) is relatively new in Asia. This study compared the actual costs and outcomes of care involving OPAT with conventional inpatient-only care at a university hospital in Singapore. Actual costs were obtained for selected patients enrolled in OPAT after 1 January 2005 and these costs were directly compared with those of age-, gender- and diagnosis-matched patients managed as inpatients only prior to the availability of OPAT in the preceding 12 months.

Factors affecting therapeutic compliance: A review from the patient's perspective.

Objective: To explore and evaluate the most common factors causing therapeutic non-compliance.

Methods: A qualitative review was undertaken by a literature search of the Medline database from 1970 to 2005 to identify studies evaluating the factors contributing to therapeutic non-compliance.

Results: A total of 102 articles was retrieved and used in the review from the 2095 articles identified by the literature review process.

Urethral stromal tumor with pacemaker cell phenotype.

Penile malignancies are rare in developed countries. The authors present a case of a penile urethral mesenchymal tumor occurring in a 51-year-old Caucasian male and displaying light microscopic, immunohistochemical, and ultrastructural features suggestive of a pacemaker cell type, combined with a lack of diagnostic features of any other established tumor category. The immunohistochemical profile was intensely positive for vimentin, PKC theta, and NSE and weakly positive to nonreactive for CD34 and smooth muscle actin, and entirely negative for CD117 (c-kit), S-100, and other markers.

Venacavoscopy during nephrectomy for renal cell carcinoma with inferior vena caval thrombus.

Purpose: Renal cell carcinoma with inferior vena caval thrombus remains a complex challenge for the urologist. Aggressive surgery to remove all tumor can result in long-term survival. Liver transplant techniques, assistance from cardiac surgeons and bypass techniques can yield optimal vascular control but there is still a blind element inside the inferior vena cava when the thrombus is evacuated.

Complete urinary tract extirpation: the University of Maryland experience.

Objectives: Complete urinary tract extirpation (CUTE) involves simultaneous bilateral nephroureterectomy, cystectomy or cystoprostatectomy, and the creation of a urinary diversion, if needed. Case reports of this operation have been published, but to our knowledge, this is the largest case series yet reported. We sought to evaluate the characteristics and outcomes of patients who underwent CUTE.

Effect of botulinum toxin on detrusor overactivity induced by intravesical adenosine triphosphate and capsaicin in a rat model.

Objectives: To assess the effects of intravesical injection of botulinum toxin type A (BTX) on a model of detrusor overactivity induced by intravesical infusions of adenosine triphosphate (ATP) and capsaicin. BTX has recently been used clinically to treat overactive bladder syndromes without a precise knowledge of the mechanism of action.

Methods: Twelve Sprague-Dawley rats underwent BTX injections.

Laparoscopic kidney donation from patients older than 60 years.

Background: The current study seeks to determine if the efficacy and safety of laparoscopic donor nephrectomy holds true when performed in patients older than 60 years of age.

Study Design: Medical records of 42 renal donors older than 60 years were reviewed compared with younger controls carefully matched for gender, race, nephrectomy side, auxiliary recipient procedures, and date of surgery.

Results: Preoperative baseline serum creatinine was identical in both groups (0.

Acetylcysteine treatment for non-acetaminophen-induced acute liver failure.

Objective: To evaluate the effectiveness of intravenous acetylcysteine in the treatment of non-acetaminophen-induced acute liver failure (ALF).

Data Sources: A search of MEDLINE (1966-March 2003), International Pharmaceutical Abstracts (1970-2003), and Cochrane Library (2003, issue 3) databases was conducted, using the search terms acetylcysteine, non-acetaminophen-induced hepatic failure, liver failure, intravenous, and treatment.

Data Synthesis: All of the studies found were small and do not provide conclusive evidence that acetylcysteine benefits this subgroup of patients.