Browsing by Author "Ranaweera, A.G.R.M.A."

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The long term outcome of a cohort of Sri Lankan patients with ulcerative colitis at two tertiary care hospitals: preliminary results
(Sri Lanka Medical Association, 2011) Senanayaka, S.M.; Fernandopulle, A.N.R.; Wijesinghe, N.T.; Ranaweera, A.G.R.M.A.; Kasturiratne, A.; Pathmeswaran, A.; Nawaratne, N.M.M.; de Silva, A.P.; de Silva, H.J.
INTRODUCTION AND OBJECTIVES: Inflammatory bowel disease, especially ulcerative colitis (UC), is increasing in many 'non-western' populations. Although clinical impressions are that UC has a mild clinical course in these populations, long term outcomes have been poorly studied. Methods: In this ongoing retrospective cohort study conducted at the Gastroenterology clinics of the Colombo North Teaching hospital and the National Hospital of Sri Lanka, patients diagnosed with ulcerative colitis (UC) were assessed for 3 outcomes: colectomy, development of colorectal carcinoma and death. Registered patients not attending the clinic during the past 4 weeks or their families were contacted by telephone to obtain clinical details and survival status. The cause of death was confirmed from clinical records and death certificates. RESULTS: Of 414 registered patients with UC, to date, details of 274 (66%) (mean age 44.9 (SD 13.6) years, M:F =1:1.13) were available for analysis. The mean duration of follow up was 6.8 (SD 6.5) years. Cumulative rates for colectomy, colorectal carcinoma and death were 3.3%, 1.1% and 1.1% respectively. At 1, 5, 10 and 15 years, cumulative cancer free survival proportions were 0.99, 0.99, 0.99 and 0.98, cumulative colectomy free survival proportions were 0.99 0.96, 0.96 and 0.96, and cumulative survival proportions were 0.99, 0.99, 0.98 and 0.98 respectively. The proportions of patients who had none of these three outcomes were 0.98, 0.95, 0.93 and 0.92. CONCLUSIONS: In this cohort of Sri Lankan patients with UC, rates of colectomy, colorectal carcinoma and death were rare, indicating a benign disease course.
Pulmonary arterial hypertension in thalassaemia patients- does splenectomy and disease severity increase the risk?
(Sri Lanka Medical Association, 2011) Premawardana, N.P.; Nandasiri, A.S.D.; Ranaweera, A.G.R.M.A.; Nishad, A.A.N.; Silva, D.P.S.I.; Premawardhena, A.P.
INTRODUCTION AND OBJECTIVES: Pulmonary arterial hypertension (PAH) has been described in patients with thalassaemia. A causative association with splenectomy has been postulated. Our previous observations differed from this. We aimed to study these factors in our patients. METHODS: Pulmonary artery pressure (PAP) and other data of thaiassaemics attending the Thalassaemia Unit, Ragarna were studied using clinic records. PAP was measured using trans-thoracic 2D echocardiography. Four categories were separately analysed: thalassaemia major (TM) with splenectomy (A) and without (B), thalassaemia intermedia (TI) with splenectomy (C) and without (D). PAH was defined as PAP over 25 mm Hg. RESULTS: A total of 74 patients were studied, 60 (81%) with TM and 14 (19%) with TI. 25 of TMs (41%) and 10 of TIs (71%) had splenectomy (p <0.05). Mean ages (SD) of TM and TI were 20.71(8.4) and 32.6 (13.3) years respectively. Those of categories ABCD were 20.9 (7.4), 20.7 (9.1), 27 (9.6) and 46 (12.3) years. A total of 16 (21.6%) of all patients had PAH (95% CI13.8-32.3). This included 13 (21.7%) TM patients and three (21.4%) with TI (p-0.98). The prevalence of PAH was 17.1% (95 CI 8.4-33.5) in splenectomised thalassaemia patients and 25.6% (95% CI 16.5-43.8) in non splenectomised patients (p= 0.37), and in categories A,B,C,D were 16%, 23%, 20% and 25% respectively. Mean of PAP of splenectomised with PAH is 39 mmHg (SD=4.5) and in non splenectomised with PAH was 34.9 mmHg (SD=5.3) (p=0.8). CONCLUSIONS: PAH is a significant complication in patients with thalassaemia. However the severity of disease nor the splenectomy status were found to be causatively linked in our study.