Browsing by Author "Gunaratne, L."

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Identifying the offending species in snakebite: a clinical score for use in community based epidemiological surveys
(Sri Lanka Medical Association, 2004) Pathmeswaran, A.; Fonseka, M.M.D.; Kasturiratne, A.; Nandasena, S.; Gnanatilaka, G.K.; Gunaratne, L.; de Silva, A.P.; Lalloo, D.C.; de Silva, H.J.
INTRODUCTION: Hospital data on snakebite fails to account for victims who do not reach hospital or who seek alternative treatment. In community surveys, identification of biting species is very difficult because the offending snake may sometimes not even be seen, is infrequently captured or killed, and antigen detection cannot be used in this setting. OBJECTIVE: To develop and validate a clinical score to identify biting species. METHODS: We identified 10 features relating to bites of the 6 venomous snakes in Sri Lanka (3 relating to circumstances of a bite and 7 clinical features of envenoming). Based on these, we developed a score applying different weightings to individual features depending on the species of snake. We then constructed 60 artificiaLdata sets containing different clinical scenarios, typical and atypical, for bites of a particular species. They were used to make adjustments to the score and determine cut-off values for identification (total ≥60/100 + difference of ≥5/100 from second highest score). The score was prospectively validated on 134 cases of snakebite with definite species identification, six months after the incident. RESULTS: Data were available from 25 cobra bites, 32 hump-nosed viper bites, 27 krait bites, 30 Russel's viper bites and 20 saw-scaled viper bites. Sensitivity/specificity of the score were: cobra 76/99, kraits 85/99, RV 70/99, HNV 97/83, SSV 100/83. 114 (85%) cases were correctly identified. 17 (12.7%) were misidentified, and 3 (2.3%) could not be identified. Conclusions: This score identifies the offending snake species with reasonable accuracy, and may be suitable for use in epidemiologicai surveys.
Some thoughts on the Spatial and Architectural Impacts
(University of Kelaniya, 2005) Gunaratne, L.
A different economy with an emphasis on the spice trade was introduced by the Portuguese in the early 16th century. With military suppression, a new system of towns, transport routes and some changes in land use resulted in the maritime region of Sri Lanka. These spatial transformations were more noticeable in the Wet Zone lowlands. Colombo, a new fortress settlement created by them, emerged as the main city of naval, military and commercial importance. The new intrusion of military technology in the form of cannons and firearms brought in its wake a new type of urban fortifications and related structures. These structures were planned by Portuguese military designers. They were built by Portuguese craftsmen and African slaves for the hard unskilled labour, all of whom were usually sent from Goa. The materials in general, were local. Perhaps, the most important and prominent exogenous building type to be introduced was the Christian church. The Portuguese period is one noted for its unusual violence. At least eight momentous events in the destruction of local cities of economic, military and cultural significance to the indigenous population are identified in this paper. Also a large number of major building sites of very special cultural and religious importance were destroyed and at least five of them are identified and briefly discussed. No places of worship sacred to the local population survived the Portuguese in the relatively large extent of territory they held. Often churches were built in the locations where Buddhist temples and Hindu kovils were destroyed. Several of these sites are also identified. It has also to be recognized that the Portuguese building methods made a substantial and positive impact on the vernacular architectural tradition of Sri Lanka, a tradition which still survives even today though somewhat diminished by other subsequent influences.