Browsing by Author "Gunatilake, S.B."

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Ante-mortem diagnosis of Alzheimer's disease (AD) by measuring medial temporal lobe (MTL) thickness on CT scans
(Sri Lanka Medical Association, 2003) de Silva, H.A.; Gunatilake, S.B.
Abstract Available
Anti-venom for snake bite in Sri Lanka
(Sri Lanka Medical Association, 2002) de Silva, H.J.; Fonseka, M.M.D.; Gunatilake, S.B.; Sellahewa, K.H.; Kularatne, S.A.M.
No Abstract Available
Apical cardiomyopathy : an important differential diagnosis in ischaemic chest pain
(Sri Lanka Medical Association, 1996) Seneviratne, S.L.; Premawardhena, A.P.; Ranasinghe, G.W.; Gunatilake, S.B.; de Silva, H.J.
Reports the cases of 1) a 54 year old man admitted with angina like pain of 3 hours. ECG showed deep ngative T waves in the anterolateral leads. But no septal Q waves. 2) a seventy year old man admitted with retrosternal chest pain and dyspnoea of 6 hours. ECG was as above. There were further investigations. Both patients had symptoms suggestive of apical hypertrophic cardiomyopathy
Benzathine penicillin for rheumatic fever prophylaxis
(Sri Lanka Medical Association, 1994) Gunatilake, S.B.
Comment on; Jayakkody RL, Kottegoda S.(Ceylon Med J. 1993 ; 38(4):171-3) No Abstract Available
Calcified Meningioma
(Sri Lanka Medical Association, 1994) Gunatilake, S.B.
No Abstract Available
A Case of self limiting Coomb's negative haemolytic anaemia following dengue shock syndrome
(Sri Lanka Medical Association, 2003) Medagoda, K.; Gunatilake, S.B.; de Silva, H.J.
No Abstract Available
Changing prescribing behaviour: early low dose aspirin in suspected acute myocardial infarction
(Elsevier, 1998) Seneviratne, S.L.; Gunatilake, S.B.; Adhikari, A.A.D.N.W.; Gunawardhana, P.; de Silva, H.J.
INTRODUCTION: Evidence obtained from large clinical trials would be of limited value, if such evidence does not reach the provider of care, and even when it reaches them, if they do not change their clinical behaviour accordingly. The aim of our study was to assess the effectiveness of intervention, aimed at changing prescribing behaviour of general practitioners (GPs) with regard to early low dose aspirin in patients with suspected acute myocardial infarction (MI). METHODS: A total of 96 GPs were sent a questionnaire assessing their knowledge and practices with regard to use of low dose aspirin in acute MI in November 1995 (Q1), June 1996 (Q2) and September 1996 (Q3). An 'intervention' was carried out with a view to changing GP prescribing of low dose aspirin is suspected acute MI after the first two questionnaires were sent. RESULTS: The results of this study seem to show that an intensive 'intervention' achieved success in changing prescribing behaviour of GPs. Although the intervention resulted in a overall significant increase in the prescription of low dose aspirin in suspected acute MI, it was seen that in the GPs who were aged <40 years the success achieved with the 'intervention' was greater when compared with that seen in those older than 40 years. CONCLUSION: Dissemination of information on new practices in medicine are important in the process of continuing medical education for doctors. A 'personal intervention' such as is described in this study seems to have good effect.
Coagulopathy and fibrinoloysis following the bite of a hump-nosed viper (Hypnale hypnale)
(Oxford University Press, 1996) Premawardhena, A.P.; Seneviratne, S.L.; Gunatilake, S.B.; de Silva, H.J.
No Abstract Available
Coagulopathy and fibrinolysis following the bite of a hump-nosed viper (Hypnale hypnale)
(Oxford University Press, 1996) Premawardena, A.P.; Seneviratne, S.L.; Jayanthi, S.; Gunatilake, S.B.; de Silva, H.J.
No abstract available
Current and emerging therapies in Parkinson's Disease
(Ceylon College of Physicians, 2006) Gunatilake, S.B.
No Abstract Available
Diagnosis and management of tuberculous meningitis
(State Pharmaceuticals Corporation, 1998) Gunatilake, S.B.
Driving and epilepsy in Sri Lanka
(Elsevier-W.B. Saunders, 1998) Seneviratne, S.L.; Gunatilake, S.B.; Adhikari, A.A.D.N.W.; de Silva, H.J.
Regulations regarding driving for patients with epilepsy vary from country to country. They are well implemented in developed countries, but this is not the case in countries such as Sri Lanka. The aims of this study were to study characteristics of a cohort of patients with epilepsy who were driving or riding a vehicle at present, and study the attitudes of a representative sample of doctors, patients with epilepsy and the general population regarding aspects of driving by patients with epilepsy. Patients with epilepsy attending the medical clinics at the Colombo North General Hospital, Ragama, who were driving, were given a questionnaire and interviewed in order to assess their seizure characteristics. Another questionnaire was administered to epileptic patients visiting the clinics, a sample from the general population (relatives visiting in-patients at the University Medical Unit selected randomly), doctors working at the General Hospital in Ragama and the Base Hospital in Negombo, and general practitioners in the Gampaha district, where these two hospitals are situated, which was designed to assess their views regarding driving by persons with epilepsy. Of the patients with epilepsy interviewed 24.8% were presently driving a vehicle, of them 51% were riding a motorcycle. The attitudes of the general public and patients to driving by epileptic patients were at opposite ends of the spectrum; 97% of the general public being opposed to driving by persons with epilepsy, while epileptics themselves being of the view that the rules should be lax. Doctors thought that there should be some regulations against driving by epileptic patients. These facts must be considered when setting implementable regulations regarding driving by epileptics in developing countries.
Efficacy of rivastigmine on activities of daily living in Sri Lankan patients with Alzheimer disease and on improving caregiver burden: a prospective study
(Sri Lanka Medical Association, 2005) de Silva, H.A.; Pathmeswaran, A.; Gunatilake, S.B.
OBJECTIVE: This open label, parallel group, prospective cohort study investigated the efficacy of rivastigmine treatment on activities of dailyliving (ADL) in patients with mild to moderate Alzheimer's disease (AD) and the possible benefits of this therapy on caregiver stress levels. METHODS: Thirty eight consecutive patients with mild to moderate AD were recruited; 22 received rivastigmine 3-6 mg twice daily (treatment group) for 20 weeks. Sixteen patients who did not receive rivastigmine served as the control group. The 17-item ADL Index was used to assess ADL and to determine the presence of functional deterioration. Caregivers were evaluated with the Caregiver Stress Scale (CSS). Each patient was required to have a committed caregiver and all caregivers were interviewed and administered the ADL Index and the Caregiver Stress Scale (CSS) at the start of treatment (week 0) and at the end of 20 weeks of treatment (week 20). RESULTS: Patients in the control group showed a significant decline in ADL Index score at 20 weeks compared to rivastigmine-treatedpatients (difference in mean ADL Index score = 8.5; p < 0.001). At week 20, mean change from baseline scores for CSS total and individual domain scores were better for caregivers in the treatment group than those in the control group (CSS total mean difference = 19.2). CONCLUSION: We conclude that treatment of AD patients with rivastigmine for 20 weeks produces a significant improvement in patient ADL functioning, and lower levels of caregiver stress.
Envenoming due to snake bite during pregnancy
(Oxford University Press, 2002) Seneviratne, S.L.; de Silva, C.E.; Fonseka, M.M.D.; Pathmeswaran, A.; Gunatilake, S.B.; de Silva, H.J.
No Abstract Available
Epilepsy and outcome of pregnancy
(Sri Lanka Medical Association, 2005) Gunatilake, S.B.; Senanayake, A.E.S.; Mapa Pathirana, T.S.L.; Balasooriya, B.L.H.; Mettananda, K.C.D.
BACKGROUND: Pregnancy in women with epilepsy is associated with increased obstetric risks and adverse fetal outcomes. OBJECTIVE: To study the effect of epilepsy and its treatment on pregnancy and the offspring. Methods: All females with epilepsy who had given birth or had a miscarriage were included in the sample. Two medical officers using a questionnaire, elicited from them their obstetric history, the presence of any noticeable mental or physical defects in their children, and the antiepileptic drugs they have been taking during the pregnancy. RESULTS: Forty five mothers were enrolled to the study. Their mean age was 32.8 years (SD 9.5). Forty of them had idiopathic epilepsy. The 45 mothers have given birth to 73 children. Nine mothers have had abortions but two were not on medication during the pregnancy, and five have had pre-term deliveries. None of the children had any congenital abnormalities. Two'children were having epilepsy and one had speech delay. Five mothers have not taken the drugs during the pregnancy. Commonly prescribed drug was carbamazepine (55%), and sodium valproate was taken by 12% and a combination of carbamazepine and valproate was taken by 21%. CONCLUSIONS: The adverse effects of epilepsy and drugs on the pregnancy are negligible in this sample. It appears that the prevalent fear of a bad pregnancy outcome is exaggerated and further larger studies are needed to confirm this.
Excessive fibrinolysis: the coagulopathy following Merrem's hump-nosed viper( Hypnale hypnale) bites
(1998) Premawardhena, A.P.; Seneviratne, S.L.; Gunatilake, S.B.; de Silva, H.J.
In 56 patients with proven hump-nosed viper (Hypnale hypnale) bites, 12 (21.4 percent) developed continued oozing of blood from the site of the bite and a prolonged clotting time. Further investigations showed low fibrinogen levels and increased fibrinogen degradation products in plamsa. The bleeding time, platelet count, prothrombin time, and partial thromboplastin time with kaolin were normal. The bite of this snake can be complicated with a coagulopathy in which excessive fibrinolysis seems to be the main abnormality
Family study of epilepsy in first degree relatives
(Sri Lanka Medical Association, 2005) Gunatilake, S.B.; Senanayake, A.E.S.; Mapa Pathirana, T.S.L.; Balasooriya, B.L.H.; Mettananda, K.C.D.
OBJECTIVE: Genetic factors play a role in the aetiology of epilepsies. This study was designed to evaluate the family history of epilepsy in the first degree relatives of probands with epilepsy. METHODS: A sample of 434 patients with epilepsy attending the Neurology Clinics of the North Colombo Teaching Hospital was interviewed by two medical officers using a standard questionnaire during a period of three months starting August 2004. Type, and cause of epilepsy, and whether or not any of their family members had seizures were recorded. RESULTS: Of the 434 patients 237 were females and 198 were males. The mean age was 28 years (SD 14). 404 patients (93.7%) had idiopathic epilepsy. 57 (13%) patients had a family history of epilepsy and their mean age of onset was 15.9 years (SD 11.7). Of them 56 were having idiopathic epilepsy. First degree relatives affected were arents~30, siblings-25 and offspring-1. Seventeen probands gave a history of consanguinity in the parents and of the ones with a family history of epilepsy only one proband had parental consanguinity. Five patients had more than one family member affected. CONCLUSIONS: A family history of 13% is significantly high when compared with normal population figures of around 5 to 8 per 1000. This provides strong evidence that in our population also genetic factors play an important part in the aetiology of epilepsy.
A Family with alkaptonuria showing quasidominant inheritance
(Sri Lanka Medical Association, 1999) de Silva, A.P.; Seneviratne, S.L.; Gunatilake, S.B.; Fonseka, M.M.D.; Jayasekera, R.; de Silva, H.J.
No Abstract Available
Follow-up of patients with stroke
(Sri Lanka Medical Association, 2003) Gunatilake, S.B.; Karunaratne, A.; Gnanathilake, G.K.; Silva, H.K.M.S.
BACKGROUND: Stroke is the commonest cause of adult disability. Information about the long-term outcome following a stroke is important for planning rehabilitation services. No long-term follow up studies looking at prognosis are available from Sri Lanka. Aims: To study the follow up pattern of a cohort of stroke patients admitted to hospital. METHODS: We planned a follow up assessment of all first-ever stroke patients admitted to the University Medical Unit in the North Colombo Teaching Hospital. This is an on-going study and was started on August 15, 2001. Validated Rankin Disability scale was used to grade the disability of patients at the time of discharge, and at follow-up. Follow-up defaulters were contacted by telephone or letter. This paper presents the data on the follow-up of the first 100 patients. RESULTS: During the period between August 15, 2001 and November 15, 2002, 152 patients with stroke were admitted. Of the first 100 patients all have completed six months after the stroke and of them 14 have died, and 58 have attended the six-month follow up with 28 defaulting. At discharge from hospital 34 were having minor or no disability (group 1) and 61 were having moderate or severe disability (group 2). Of the. 58 who attended the six-month follow up 44 were in group 1 and 14 were in group 2. Of the defaulters 7 were in group 1 and 21 were in group 2. Six-month follow-up rate was 72%. CONCLUSIONS: Follow up rate was inadequate despite incentives given to attend. 14 of the patients came for follow up despite a severe disability. Of the 28 defaulters 21 had a severe disability at discharge and only six were from remote areas. Reason for default is not clear from our study.
Headaches and a normal neurological examination
(The Kandy Society of Medicine, 1996) Gunatilake, S.B.