Medicine
Permanent URI for this communityhttp://repository.kln.ac.lk/handle/123456789/12
This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
Browse
2 results
Search Results
Item The establishment of a population-specific reference value for the ruler drop test for the clinical assessment of reaction time(Elsevier, 2023) Rajapaksha, S.; Kitulwatte, I.; Senarathne, U.; Edirisinghe, A.; Perera, P.BACKGROUND: Reaction time (RT) is the interval between a stimulus and an appropriate voluntary response in an individual. Alcohol is known to result in delayed RT. In Sri Lanka, an alleged drunken driver is legally subjected to a medico-legal examination to confirm or exclude impairment. The guideline for examining a drunk person in Sri Lanka includes the ruler drop test (RDT) as a test of RT. RDT is a simple test of visual reaction time in which the subject attempts to stop a falling ruler, and the height fallen is used to determine the time taken to react to the event. However, a formal study has yet to be carried out to establish population-specific reference values to interpret RDT results. METHODS: A cross-sectional descriptive study was conducted using 903 adults ≥18 years. A nonparametric approach was applied for deriving the reference values based on an inter-percentile interval. RESULTS: The study population consisted of 56.6% females, and the mean age of the participants was 41.6 years. Most (95%) of the study population could catch the ruler at or less than 40.0 cm of average height. The average height on RDT increased from younger to older age groups. However, subgrouping based on other variables, including sex, age, and alcohol consumption, did not show any statistically significant difference. CONCLUSIONS: The population-specific cut-off limit to identify alcohol intoxication by RDT in a Sri Lankan adult is 'average height' >40 cm.Item Electrical injury of the neck and cardiac air embolism: a novel mechanism of death(Humana Press, 2009) Kitulwatte, I.; Pollanen, M. S.We report a case of air embolism in an industrial worker complicating a deep electrical injury in the neck. He was found dead in an upright position while his chest and head were resting on top of a live transformer. At autopsy, there were multiple electrical burns involving the face, neck, chest, and arms. There was a deep electrical burn associated with hemorrhage in the neck involving the skin, underlying subcutaneous tissue, strap muscles, and the thyroid gland. The internal examination showed a prominently bulging right atrium, which was filled with air and not blood. At autopsy, when the pericardium was filled with water and the right atrium opened, a large number of bubbles emerged. We concluded that death was due to air embolism complicating electrical damage to the neck veins. This case illustrates that acute complications of electrical burns rather than electrocution-related cardiac arrhythmia can be the mechanism of death in rare electricity-related deaths. It also reveals the difficulties encountered by the pathologist in determining the exact mechanism of death when there are competing mechanisms.