Browsing by Author "Kularatne, W.N.S."

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Adult respiratory distress syndrome complicating typhoid fever
(Published by the London School of Hygiene and Tropical Medicine by Blackwell, 1993) de Silva, H.J.; Kularatne, W.N.S.; Wijewickrema, R.; Thevanesam, V.
No Abstract Available
Aplastic anaemia complicating hepatitis A virus infection
(Sri Lanka Medical Association, 1993) de Silva, H.J.; de Mel, W.C.P.; Kularatne, W.N.S.
We report three patients with aplastic anaemia complicating hepatitis A virus infection. The pathogenesis and management of this rare complication which usually carries a poor prognosis, are briefly discussed.
Prevalence of hepatitis C virus markers in Sri Lankan patients with alcoholic cirrhosis
(Blackwell Scientific Publications, 1994) de Silva, H.J.; Vitarana, T.; Ratnatunga, N.; Breschkin, A.; Withane, N.; Kularatne, W.N.S.
A high prevalence of antibodies against hepatitis C virus (HCV) has been reported in patients with alcoholic cirrhosis. There are, however, doubts regarding the specificity of the first generation anti-HCV antibody assays used. We prospectively investigated HCV status in 47 Sri Lankan patients with alcoholic cirrhosis. A first generation assay (Ortho HCV enzyme-linked immunosorbent assay [ELISA]) and two second generation tests (Abbott HCV enzyme immunoassay and United Biomedical Incorporated HCV enzyme immunoassay) were used. Positive results were confirmed by the second generation recombinant immunoblot assay (RIBA 2). Of the 47 patients (46 males, mean age 41.7 years), 17 (36.2%) had previously had one or more blood or plasma transfusions. Seven (14.9%) of the samples were positive for anti-HCV antibodies using the Ortho-HCV ELISA, but only one (2.1%) sample was positive when tested with the second generation assays. The positive result was confirmed by RIBA 2. The prevalence of HCV in the patients was low despite many of them being exposed to blood or blood products. Hepatitis C virus, therefore, may not be an important pathogenic factor in alcoholic cirrhosis in Sri Lanka
Relationship between routine biochemical liver function tests and severity of liver damage in alcoholic patients
(The Kandy Society of Medicine, 1993) de Silva, H.J.; Ratnatunga, N.; Wickremasinghe, A.R.; Kularatne, W.N.S.
SUMMARY: The aim of this study was to investigate the relationship between routine biochemical liver function tests (LFT) that are perfoimed in Sri Lankan hospitals and the severity of liver damage (assessed histologically) in alcoholics. Results of routine LFT (serum bilirubin, SOFT, albumin and prothrombin time.) were correlated to histological changes in the liver in 50 (49 males and one female, mean age 46.6 years) out of 76 patients who were admitted to hospital with problems related to alcohol dependence. There was no mortality, and only minimal morbidity associated with the liver biopsy procedure. When 3 or more LFT were abnormal irreversible liver damage was always present histologically. When only 1 or 2 LFT were abnormal irreversible changes occurred in 42.9%. However, of 9 patients in whom all 4 LFT were normal, 7 (77.8%) had abnormal liver histology, including 4 (44.4%) with irreversible changes. Although there was a strong relationship between widespread abnormalities in routine LFT and irreversible liver damage, many patients with irreversible liver damage may have gone undetected if reliance was placed solely on these tests. Therefore, a liver biopsy is recommended for accurate assessment of the severity of liver damage in alcoholic patients.
Severe fatty change with hepatocellular necrosis following bite by a Russell's viper
(Oxford University Press, 1992) de Silva, H.J.; Ratnatunga, N.; de Silva, U.; Kularatne, W.N.S.; Wijewickrema, R.
No Abstract Available