86, 95% CI, 0.71-1.03) nor in HCQ plus AZM treatment group (RR 1.28, 95% CI, 0.76-2.14) in comparison to controls. Meta-regression analysis showed that age was the factor that significantly affected mortality (
  <0.00001).
 
  The meta-analysis found that there was no clinical benefit of using either HCQ by itself or in combination with AZM for the treatment of COVID-19 patients. Hence, it may be prudent for clinicians and researchers to focus on other therapeutic options that may show greater promise in this disease.
 The meta-analysis found that there was no clinical benefit of using either HCQ by itself or in combination with AZM for the treatment of COVID-19 patients. Hence, it may be prudent for clinicians and researchers to focus on other therapeutic options that may show greater promise in this disease.Advances in cytotoxic chemotherapy, surgical oncology, genomic medicine, targeted small molecule treatment, cancer immunotherapy and biology-driven precision radiation oncology have resulted in significant improvements in outcomes of cancer treatment, with an increasing number of patients achieving long-term disease control or even being potentially cured. Concurrent advances in palliative care and geriatric oncology have also helped to ensure that patients are managed holistically by considering their physical, social, psychological and emotional needs in a personalised manner.As of 27 October 2020, there have been 57,980 confirmed cases of COVID-19 in Singapore, with 28 fatalities. To summarise the Singapore experience in managing and containing COVID-19 based on available published data and from relevant sources, a review of literature using research databases such as PubMed and OVID Medline, along with non-peer-reviewed articles and other sources, was conducted with the search terms 'COVID-19' and 'Singapore'. Research conducted in Singapore has provided insight into the clinical manifestations and period of infectivity of COVID-19, demonstrated evidence of pre-symptomatic transmission, linked infection clusters using serological tools, and highlighted aspects of hospital-based environmental contamination. It has also provided guidance for diagnostic testing and has described immune and virologic correlates with disease severity. Evidence of effectiveness of containment measures such as early border control, rigorous contact training, and calibrated social distancing measures have also been demonstrated. Singapore's multipronged strategy has been largely successful at containing COVID-19 and minimising fatalities, but the risk of re-emergence is high.
  With the unprecedented challenges imposed on the modern healthcare system due to the COVID-19 pandemic, innovative solutions needed to be swiftly implemented to maintain clinical oversight on patient care. Telemedicine was introduced in Singapore in community-based haemodialysis (HD) centres to comply with the Ministry of Health's directives on movement restriction of healthcare workers and related measures to minimise the spread of SARS-CoV-2 in healthcare facilities.
 
  We describe here our experience of 26 community haemodialysis centres in Singapore, analysing clinical audit data, as well as comparing hospitalisation and mortality rates as outcomes in the time frames of pre- and post-introduction of telemedicine.
 
  We found that the hospitalisation rate was 13.9% (95% CI 5.6%-21.5%, 
  <0.001) lower in the period after telemedicine rounds were introduced. The mortality rates per 100 person-years (95% CI) were 11.04 versus 7.99 in the compared groups, respectively, with no significant increase in mortality during the months when telemedicine was performed.
 
  Patients received appropriate care in a timely manner, with telemedicine implementation, and such measures did not lead to suboptimal healthcare outcomes. Telemedicine was a successful tool for physician oversight under movement control measures implemented during the COVID-19 pandemic and may continue to prove useful in the 'new normal' era of healthcare delivery for HD patients in community-based dialysis centres, operated by the National Kidney Foundation in Singapore.
 Patients received appropriate care in a timely manner, with telemedicine implementation, and such measures did not lead to suboptimal healthcare outcomes. Telemedicine was a successful tool for physician oversight under movement control measures implemented during the COVID-19 pandemic and may continue to prove useful in the 'new normal' era of healthcare delivery for HD patients in community-based dialysis centres, operated by the National Kidney Foundation in Singapore.
  The human papillomavirus (HPV) vaccine has been reported to lead to clinical clearance of lesions when used as an off-label treatment for recalcitrant extragenital warts. The aim of the study is to evaluate the therapeutic and adverse effects of HPV vaccine as an adjunctive therapy for treatment-resistant acral warts.
 
  Patients with persistent warts despite first and second line therapies, and subsequently receiving the quadrivalent HPV vaccine between July 2013 and June 2016 as an adjunctive treatment for recalcitrant warts at the National Skin Centre, were included.
 
  Twenty-six patients with a median age of 34 years (range 8 to 77 years) were treated with the HPV vaccine. Nineteen (73.1%) patients completed 3 doses of the vaccine, of whom 5 (26%) achieved complete clearance, 8 (42%) had partial clearance and 6 (32%) did not respond to the vaccine. Among the 4 patients who received 2 doses of the vaccine, 3 (75%) had complete clearance whereas 1 (25%) had partial improvement of their warts. None of the patients reported adverse reactions.
 
  Our study suggests a potential adjunctive role of the HPV vaccine in the treatment of acral warts recalcitrant to conventional therapy.
 Our study suggests a potential adjunctive role of the HPV vaccine in the treatment of acral warts recalcitrant to conventional therapy.
  Presently, robotic hepatopancreatobiliary surgery (RHPBS) is increasingly adopted worldwide.  https://www.selleckchem.com/products/gsk963.html  This study reports our experience with the first 100 consecutive cases of RHPBS in Singapore.
 
  Retrospective review of a single-institution prospective database of the first 100 consecutive RHPBS performed over 6 years from February 2013 to February 2019. Eighty-six cases were performed by a single surgeon.
 
  The 100 consecutive cases included 24 isolated liver resections, 48 pancreatic surgeries (including 2 bile duct resections) and 28 biliary surgeries (including 8 with concomitant liver resections). They included 10 major hepatectomies, 15 pancreaticoduodenectomies, 6 radical resections for gallbladder carcinoma and 8 hepaticojejunostomies. The median operation time was 383 minutes, with interquartile range (IQR) of 258 minutes and there were 2 open conversions. The median blood loss was 200ml (IQR 350ml) and 15 patients required intra-operative blood transfusion. There were no post-operative 90-day nor in-hospital mortalities but 5 patients experienced major (> grade 3a) morbidities.