Browsing by Author "Tilakaratne, Y."

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Effects of propanolol and nitrates on exercise capacity and nitrates on exercise capacity, respiratory minute volume and capillary oxygen saturation during exercise in cirrhotic patients with portal hypertension
(Blackwell Scientific Publications, 2002) Premaratna, R.; Sathischandra, H.; Tilakaratne, Y.; Shantharaj, W.; de Silva, H.J.
A cross over study was performed in 16 cirrhotic patients with portal hypertension and oesophageal varices to assess the effects of propranolol and nitrates on the exercise capacity, respiratory minute volume and capillary oxygen saturation during exercise. All had normal peak expiratory flow rates, spirometry, chest X-ray, electrocardiography, ECHO cardiography, cardiac ejection fraction>55%, absent intra-pulmonary arterio-venous shunts (IPAVS) on contrast enhanced ECHO, and a haemoglobin>11 g/dl. Minute volume, capillary O(2) saturation and pulse rate, were measured during progressive exercise testing up to maximum exercise capacity. Testing was done on inclusion, after 1 month of treatment with propranolol (dose adequate for 25% reduction in resting pulse rate) and after another month of treatment with propranolol plus isosorbide dinitrate (ISDN). An age matched group of cirrhotics (n=9) (with no evidence of portal hypertension and had normal cardio respiratory functions as defined above) acted as controls. We observed a significant reduction in the minute volume at maximum exercise after both modes of treatment when compared to the pre-treatment values and the values of controls. There was a non-significant increase in capillary oxygen saturation. None of them had a reduction inexercise capacity after treatment. In conclusion, treatment with propranolol or a combination of propranolol and a nitrate dose not seem to impairexercise performance in patients who have hepatic cirrhosis with portal hypertension.
Neurological melioidosis complicated by cerebral venous sinus thrombosis
(Ceylon College of Physicians, 2020) Abeysundara, P.K.; Nishad, A.A.N.; Perera, W.N.M.; de Silva, H.; Piyarathne, R.; Rathnayaka, R.M.P.M.; Arulmoly, K.; Umakanth, M.; Premaratna, R.; Tilakaratne, Y.
ABSTRACT: Melioidosis is a systemic disease endemic in Southeast Asia and Northern Australia. The spectrum of the disease varies from asymptomatic infection to severe systemic manifestations. Timely diagnosis and treatment of melioidosis is a challenge due to its atypical presentations. We report a case of melioidosis causing cerebral abscesses and cerebral venous sinus thrombosis. Occurrence of these neurological manifestations in melioidosis is rare and it is a difficult condition to diagnose and treat. Timely diagnosis was a challenge in this patient due to the atypical presentation and the use of empirical antibiotics in the primary care setting. Limited laboratory diagnostic capability also contributed to this delay. KEYWORDS: Melioidosis, Cerebral abscess, Cerebral venous sinus thrombosis
Non-secretory multiple myeloma
(Sri Lanka Medical Association, 2003) Ranasinghe, K.N.; Tilakaratne, Y.; de Silva, H.J.
No Abstract available
Parasuicide by self-injection of an organophosphate insecticide
(SAGE Publishing, 2001) Premaratna, R.; Tilakaratne, Y.; Fonseka, M.M.D.; Gunatilake, S.B.; de Silva, H.J.
Parasuicide by ingestion of organophosphate (OP) insecticides is common in Sri Lanka, but the use of the parateral route to self administer the poison is extremely rare. We report a patient who deliberately injected herself intramuscularly with an OP compound with suicidal intent. The clinical manifestations of OP poisoning were unpredictable and posed a therapeutic problem
Self-limiting cerebellar ataxia following organophosphate poisoning
(SAGE Publishing, 2003) Fonseka, M.M.D.; Medagoda, K.; Tilakaratne, Y.; Gunatilake, S.B.; de Silva, H.J.
Deliberate self-harm by ingestion of organophosphate insecticides is a common health problem in Sri Lanka. The poisoning results in an initial life-threatening cholinergic crisis and several intermediate and late neurological and psychiatric manifestations. A patient who developed self-limiting cerebellar signs 8 days after ingestion of dimethoate, an organophosphorous insecticide, is reported on
Severe hepatic dysfunction associated with falciparum malaria
(SEAMEO Regional Tropical Medicine and Public Health Project, 2001) Premaratna, R.; Gunatilake, A.K.E.; de Silva, N.R.; Tilakaratne, Y.; Fonseka, M.M.D.; de Silva, H.J.
We describe severe hepatic dysfunction associated with an attack of falciparum malaria in six Sri Lankan patients. Clinicians working in areas endemic for malaria should be made aware of this unusual complication.