Institution
Gleneagles Hospital
Healthcare•Singapore, Singapore•
About: Gleneagles Hospital is a healthcare organization based out in Singapore, Singapore. It is known for research contribution in the topics: Population & Medicine. The organization has 454 authors who have published 570 publications receiving 14354 citations.
Papers published on a yearly basis
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University of Madras1, Cardiff University2, Health Protection Agency3, Karolinska University Hospital4, Aga Khan University5, Amrita Institute of Medical Sciences and Research Centre6, University of Queensland7, Gleneagles Hospital8, Northumbria Healthcare NHS Foundation Trust9, Apollo Hospitals10, Institute of Medical Sciences, Banaras Hindu University11
TL;DR: The prevalence of NDM-1, in multidrug-resistant Enterobacteriaceae in India, Pakistan, and the UK is investigated, and co-ordinated international surveillance is needed.
Abstract: Summary Background Gram-negative Enterobacteriaceae with resistance to carbapenem conferred by New Delhi metallo-β-lactamase 1 (NDM-1) are potentially a major global health problem. We investigated the prevalence of NDM-1, in multidrug-resistant Enterobacteriaceae in India, Pakistan, and the UK. Methods Enterobacteriaceae isolates were studied from two major centres in India—Chennai (south India), Haryana (north India)—and those referred to the UK's national reference laboratory. Antibiotic susceptibilities were assessed, and the presence of the carbapenem resistance gene bla NDM-1 was established by PCR. Isolates were typed by pulsed-field gel electrophoresis of XbaI-restricted genomic DNA. Plasmids were analysed by S1 nuclease digestion and PCR typing. Case data for UK patients were reviewed for evidence of travel and recent admission to hospitals in India or Pakistan. Findings We identified 44 isolates with NDM-1 in Chennai, 26 in Haryana, 37 in the UK, and 73 in other sites in India and Pakistan. NDM-1 was mostly found among Escherichia coli (36) and Klebsiella pneumoniae (111), which were highly resistant to all antibiotics except to tigecycline and colistin. K pneumoniae isolates from Haryana were clonal but NDM-1 producers from the UK and Chennai were clonally diverse. Most isolates carried the NDM-1 gene on plasmids: those from UK and Chennai were readily transferable whereas those from Haryana were not conjugative. Many of the UK NDM-1 positive patients had travelled to India or Pakistan within the past year, or had links with these countries. Interpretation The potential of NDM-1 to be a worldwide public health problem is great, and co-ordinated international surveillance is needed. Funding European Union, Wellcome Trust, and Wyeth.
2,680 citations
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Cleveland Clinic1, University of Edinburgh2, Heidelberg University3, Duke University4, Rush University Medical Center5, Hartford Hospital6, Pierre-and-Marie-Curie University7, University of Toronto8, Harvard University9, Brown University10, Imperial College London11, University of Texas Health Science Center at San Antonio12, University of Western Australia13, Gleneagles Hospital14, University of Rochester15, University of Paris16, University of Kentucky17, SUNY Downstate Medical Center18, Case Western Reserve University19
TL;DR: In this article, the authors compared the effect of clopidogrel and low-dose aspirin on the rate of myocardial infarction, stroke, or death from cardiovascular causes.
Abstract: Background Dual antiplatelet therapy with clopidogrel plus low-dose aspirin has not been studied in a broad population of patients at high risk for atherothrombotic events. Methods We randomly assigned 15,603 patients with either clinically evident cardiovascular disease or multiple risk factors to receive clopidogrel (75 mg per day) plus low-dose aspirin (75 to 162 mg per day) or placebo plus low-dose aspirin and followed them for a median of 28 months. The primary efficacy end point was a composite of myocardial infarction, stroke, or death from cardiovascular causes. Results The rate of the primary efficacy end point was 6.8 percent with clopidogrel plus aspirin and 7.3 percent with placebo plus aspirin (relative risk, 0.93; 95 percent confidence interval, 0.83 to 1.05; P = 0.22). The respective rate of the principal secondary efficacy end point, which included hospitalizations for ischemic events, was 16.7 percent and 17.9 percent (relative risk, 0.92; 95 percent confidence interval, 0.86 to 0.995; P = 0.04), and the rate of severe bleeding was 1.7 percent and 1.3 percent (relative risk, 1.25; 95 percent confidence interval, 0.97 to 1.61 percent; P = 0.09). The rate of the primary end point among patients with multiple risk factors was 6.6 percent with clopidogrel and 5.5 percent with placebo (relative risk, 1.2; 95 percent confidence interval, 0.91 to 1.59; P = 0.20) and the rate of death from cardiovascular causes also was higher with clopidogrel (3.9 percent vs. 2.2 percent, P = 0.01). In the subgroup with clinically evident atherothrombosis, the rate was 6.9 percent with clopidogrel and 7.9 percent with placebo (relative risk, 0.88; 95 percent confidence interval, 0.77 to 0.998; P = 0.046). Conclusions In this trial, there was a suggestion of benefit with clopidogrel treatment in patients with symptomatic atherothrombosis and a suggestion of harm in patients with multiple risk factors. Overall, clopidogrel plus aspirin was not significantly more effective than aspirin alone in reducing the rate of myocardial infarction, stroke, or death from cardiovascular causes. (ClinicalTrials.gov number, NCT00050817.)
2,464 citations
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University of Delhi1, University of New South Wales2, Post Graduate Institute of Medical Education and Research3, University of Hong Kong4, University of Kelaniya5, The Aga Khan University Hospital6, University College London7, Chulalongkorn University8, Capital Medical University9, University of Malaya10, Huazhong University of Science and Technology11, Bangabandhu Sheikh Mujib Medical University12, French Institute of Health and Medical Research13, Jaslok Hospital14, Iwate Medical University15, Gleneagles Hospital16
TL;DR: The original proposed definition of ACLF was found to withstand the test of time and identify a homogenous group of patients presenting with liver failure, which led to the development of the final AARC consensus.
Abstract: The Asian Pacific Association for the Study of the Liver (APASL) set up a working party on acute-on-chronic liver failure (ACLF) in 2004, with a mandate to develop consensus guidelines on various aspects of ACLF relevant to disease patterns and clinical practice in the Asia-Pacific region. Experts predominantly from the Asia–Pacific region constituted this working party and were requested to identify different issues of ACLF and develop the consensus guidelines. A 2-day meeting of the working party was held on January 22–23, 2008, at New Delhi, India, to discuss and finalize the consensus statements. Only those statements that were unanimously approved by the experts were accepted. These statements were circulated to all the experts and subsequently presented at the Annual Conference of the APASL at Seoul, Korea, in March 2008. The consensus statements along with relevant background information are presented in this review.
1,125 citations
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TL;DR: The finding that soya products may protect against breast cancer in younger women is of interest since these foods are rich in phyto-oestrogens.
794 citations
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Safdarjang Hospital1, Apollo Hospitals2, Kasturba Medical College, Manipal3, All India Institute of Medical Sciences4, Sri Ramachandra University5, Nizam's Institute of Medical Sciences6, St. John's Medical College7, Sterling Hospitals8, Gleneagles Hospital9, Christian Medical College & Hospital10, Global Hospitals Group11, Government Medical College, Thiruvananthapuram12, PSG Institute of Medical Sciences and Research13, Sanjay Gandhi Post Graduate Institute of Medical Sciences14, Tata Memorial Hospital15, University College of Medical Sciences16, Jawaharlal Institute of Postgraduate Medical Education and Research17, Manipal Hospitals18, Mahatma Gandhi Institute of Medical Sciences19
TL;DR: A high burden of candidemia in Indian ICUs, early onset after ICU admission, higher risk despite less severe physiology score at admission and a vast spectrum of agents causing the disease with predominance of C. tropicalis is highlighted.
Abstract: A systematic epidemiological study on intensive care unit (ICU)-acquired candidemia across India. A prospective, nationwide, multicentric, observational study was conducted at 27 Indian ICUs. Consecutive patients who acquired candidemia after ICU admission were enrolled during April 2011 through September 2012. Clinical and laboratory variables of these patients were recorded. The present study is an analysis of data specific for adult patients. Among 1,400 ICU-acquired candidemia cases (overall incidence of 6.51 cases/1,000 ICU admission), 65.2 % were adult. Though the study confirmed the already known risk factors for candidemia, the acquisition occurred early after admission to ICU (median 8 days; interquartile range 4–15 days), even infecting patients with lower APACHE II score at admission (median 17.0; mean ± SD 17.2 ± 5.9; interquartile range 14–20). The important finding of the study was the vast spectrum of agents (31 Candida species) causing candidemia and a high rate of isolation of Candida tropicalis (41.6 %). Azole and multidrug resistance were seen in 11.8 and 1.9 % of isolates. Public sector hospitals reported a significantly higher presence of the relatively resistant C. auris (8.2 vs. 3.9 %; p = 0.008) and C. rugosa (5.6 vs. 1.5 %; p = 0.001). The 30-day crude and attributable mortality rates of candidemia patients were 44.7 and 19.6 %, respectively. Logistic regression analysis revealed significant independent predictors of mortality including admission to public sector hospital, APACHE II score at admission, underlying renal failure, central venous catheterization and steroid therapy. The study highlighted a high burden of candidemia in Indian ICUs, early onset after ICU admission, higher risk despite less severe physiology score at admission and a vast spectrum of agents causing the disease with predominance of C. tropicalis.
322 citations
Authors
Showing all 458 results
Name | H-index | Papers | Citations |
---|---|---|---|
Ashish K. Jha | 87 | 503 | 30020 |
John M. Hutson | 60 | 586 | 14781 |
Soon-Chye Ng | 38 | 116 | 4491 |
Zhang-Jin Zhang | 36 | 176 | 4777 |
Timothy William | 33 | 109 | 3448 |
Punit Sharma | 29 | 179 | 2516 |
Kenji c | 25 | 310 | 2328 |
Acw Lee | 24 | 146 | 1732 |
Mahesh K. Goenka | 23 | 123 | 1661 |
Calvin S.L. Fones | 21 | 30 | 1991 |
Kok Ann Gwee | 21 | 39 | 2875 |
B. Gibbons | 20 | 39 | 1361 |
Chun-Tao Wai | 20 | 54 | 2270 |
Kok-Ann Gwee | 19 | 49 | 1540 |
Amit Maydeo | 19 | 82 | 1619 |