Paul Anantharajah Tambyah
Email Address
mdcpat@nus.edu.sg
Organizational Units
MEDICINE
dept
YONG LOO LIN SCH OF MEDICINE
faculty
224 results
Publication Search Results
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Publication Risk Factors for Mortality in Cardiac Implantable Electronic Device (CIED) Infections: A Systematic Review and Meta-Analysis(MDPI, 2022-06-01) Ngiam, Jinghao Nicholas; Liong, Tze Sian; Sim, Meng Ying; Chew, Nicholas WS; Sia, Ching-Hui; Chan, Siew Pang; Lim, Toon Wei; Yeo, Tiong-Cheng; Tambyah, Paul Anantharajah; Loh, Poay Huan; Poh, Kian Keong; Kong, William KF; Dr Toon Wei Lim; MEDICINEBACKGROUND: Infections following cardiac implantable electronic device (CIED) implantation can require surgical device removal and often results in significant cost, morbidity, and potentially mortality. We aimed to systemically review the literature and identify risk factors associated with mortality following CIED infection. METHODS: Electronic searches (up to June 2021) were performed on PubMed and Scopus. Twelve studies (10 retrospective, 2 prospective cohort studies) were included for analysis. Meta-analysis was conducted with the restricted maximum likelihood method, with mortality as the outcome. The overall mortality was 13.7% (438/1398) following CIED infection. RESULTS: On meta-analysis, the male sex (OR 0.77, 95%CI 0.57-1.01, I2 = 2.2%) appeared to have lower odds for mortality, while diabetes mellitus appeared to be associated with higher mortality (OR 1.47, 95%CI 0.67-3.26, I2 = 81.4%), although these trends did not reach statistical significance. Staphylococcus aureus as the causative organism (OR 2.71, 95%CI 1.76-4.19, I2 = 0.0%), presence of heart failure (OR 1.92, 95%CI 1.42-4.19, I2 = 0.0%) and embolic phenomena (OR 4.00, 95%CI 1.67-9.56, I2 = 69.8%) were associated with higher mortality. Surgical removal of CIED was associated with lower mortality compared with conservative management with antibiotics alone (OR 0.22, 95%CI 0.09-0.50, I2 = 62.8%). CONCLUSION: We identified important risk factors associated with mortality in CIED infections, including Staphyloccocus aureus as the causative organism, and the presence of complications, such as heart failure and embolic phenomena. Surgery, where possible, was associated with better outcomes.Publication Singapore's health-care financing.(2013-11-30) Fong, J.M.; Tambyah, P.A.; MEDICINEPublication Methicillin-resistant Staphylococcus aureus endocarditis after transurethral prostatic resection(2005-03) Vasoo, S.; Chin, C.M.; Tambyah, P.A.; MEDICINE; SURGERYWe report the first case, to our knowledge, of methicillin-resistant Staphylococcus aureus endocarditis complicating transurethral prostatic resection for benign prostatic hyperplasia. The patient had been catheterized preoperatively because of urinary retention and, postoperatively, developed pyrexia with persistent methicillin-resistant S. aureus-positive blood cultures. The cause remained elusive, despite extensive investigations (including echocardiography), until he developed embolic phenomena pathognomonic of infective endocarditis 1 month into treatment with intravenous vancomycin. © 2005 Elsevier Inc.Publication Range of varicella zoster co-infections with covid-19, singapore(Korean Society of Infectious Diseases and Korean Society for Chemotherapy, 2021-06-01) Loh, J; Tham, SM; Tambyah, PA; Yan, G; Lee, CK; Chai, LYA; Prof Paul Anantharajah Tambyah; YONG LOO LIN SCHOOL OF MEDICINEThere have been recent descriptions of the novel coronavirus disease 2019 (COVID-19) presenting as 'varicella-like exanthem'. We report three cases of patients with Varicella- Zoster Virus (VZV) and COVID-19 co-infections, presenting in three varied ways. These cases highlight the need for heightened alertness to how such co-infections can present, to pick up overlapping 'dual pathologies' during this current pandemic given that infection control measures including airborne precautions are crucial for both COVID-19 and VZV.Publication The costs of nosocomial resistant gram negative intensive care unit infections among patients with the systemic inflammatory response syndrome- a propensity matched case control study(BioMed Central Ltd., 2015) Vasudevan A.; Memon B.I.; Mukhopadhyay A.; Li J.; Tambyah P.A.; MEDICINE; STATISTICS & APPLIED PROBABILITYPublication International Journal of Infectious Diseases: from the past quarter-century to the next(Elsevier B.V., 2021-08-01) Petersen, E.; Lee, S. S.; Blumberg, L.; Kramer, L. D.; Obiero, C.; Al-Abri, S.; Abubakar, A.; Pinto, T. C. A.; Yapi, B. R.; Tambyah, P. A.; Holmes, A. H.; MEDICINEPublication A Comparison of retrieved Respiratory Viral Load emitted by infected SARS-CoV-2 patients(2022-06-11) Tham, Kwok Wai; Coleman, Kristen; Tay, Douglas; Ong, Ong; Tan, Kai Sen; Milton, Don; Koh, ming hui; Chow, TK; Chen, Mark; Tambyah, Paul; Assoc Prof Kwok Wai Tham; MEDICINE; MICROBIOLOGY AND IMMUNOLOGY; DUKE-NUS MEDICAL SCHOOL; BUILDINGViral RNA in fine (< 5 m) aerosols from 13 patients infected by the SARS-CoV-2 virus were obtained using the Gesundheit-II (G-II) equipment which collects respiratory emissions. The collection was performed in isolation wards of the National Centre for Infectious Diseases of Singapore under an approved protocol. The patients breathed normally for 30 minutes, talk, and sing for 15 minutes each (with 30 minutes rest in between activity) into a specially designed aerosol collector in two size fractions. The coarse fraction (> 5 m) and the fine aerosols (< 5 m) are subsequently collected and subjected to PCR analysis for their viral load quantification. Viral RNA detected from 59% of the patients showed that patients earlier in illness were more likely to emit detectable RNA, and loads differed significantly between breathing, talking, and singing.Publication Case report: Two human Streptococcus suis infections in Borneo, Sabah, Malaysia(2017) Rajahram, G.S; Hameed, A.A; Menon, J; William, T; Tambyah, P.A; Yeo, T.W; MEDICINEBackground: Streptococcus Suis (S.suis) is increasingly being recognised as a potentially preventable emerging zoonotic infection in humans with a global distribution. It is a major cause of meningitis especially among those in contact with pigs and has also been associated with a toxic shock syndrome. Case presentations: We report the first two human cases from Sabah, Borneo, Malaysia which expands the global reach of this important pathogen. Here, we illustrate their epidemiological risk factors, clinical presentation and resulting sequelae of both patients. Conclusion: The continued public health threat of zoonotic infections such as S.suis, highlights the need for accurate epidemiological surveillance, regulation of pig farming, slaughtering and continued advocacy of best practices for pork preparation and consumption. © 2017 The Author(s).Publication Editorial: To kill a mocking bird flu?(2008-06) Chow, V.T.; Tambyah, P.A.; Goh, K.T.; MEDICINE; MICROBIOLOGYPublication COVID-19 vaccines under the International Health Regulations – We must use the WHO International Certificate of Vaccination or Prophylaxis(Elsevier B.V., 2021-03-01) Petersen, Eskild; Lucey, Daniel; Blumberg, Lucille; Kramer, Laura D.; Al-Abri, Seif; Lee, Shui Shan; Abreu Pinto, Tatiana de Castro; Obiero, Christina W.; Rodriguez-Morales, Alfonso J.; Yapi, Richard; Abubakar, Aisha; Tambyah, Paul Anantharajah; Holmes, Allison; Chen, Lin H.; MEDICINE