Medicine

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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty

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1987 - 198911990 - 19999

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    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
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    The Effect of acyclovir on the acute and latent murine gammaherpesvirus-68 infection of mice
    (Sage Publishing, 1994) Sunil-Chandra, N.P.; Efstathiou, S.; Nash, A.A.
    Mice inoculated intranasally with murine gammaherpesvirus-68 were used to evaluate the efficacy of acyclovir (ACV) in the treatment of acute and latent infections. Effectiveness was measured by infectious virus assay of the lung (site of active replication) and infectious centre assay of spleen cells (site of latency). Intraperitoneal administration of ACV at 6-h intervals starting soon after inoculation was more effective in reducing infectious virus in the lung than was treatment with 12-hourly injections commencing 3 days post-infection.
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    Pathogenesis of murine gammaherpesvirus infection in mice deficient in CD4 and CD8 T cells
    (American Society for Microbiology., 1993) Ehtisham, S.; Sunil-Chandra, N.P.; Nash, A.A.
    Murine gammaherpesvirus is a natural pathogen of wild mice. The virus infects alveolar cells and spleen cells during the primary infection and establishes a latent/persistent infection in B lymphocytes. Little is known about the immunological response to gammaherpesviruses during a primary infection. To address this issue, we investigated the pathogenesis of murine herpesvirus 68 (MHV-68) infection in mice deficient in CD4 or CD8 T-cell populations. Infection of the lung and spleen were greatly exacerbated in CD8-deficient mice, reflected by elevated virus titers in the lung and an increase in the number of infected splenocytes located around germinal centers. This finding contrasts with clearance of virus from the lung and spleen by day 12 postinfection in CD4-depleted animals. These data clearly indicate a major role for CD8 T cells in recovery from an acute MHV-68 infection. Whereas CD4 T cells fail to influence the course of infection in the lung, they do contribute to lymphoproliferation seen in the spleen (splenomegaly) during the primary infection. The significance of these results are discussed in relation to the immune response to other herpesviruses, in particular Epstein-Barr virus, with which MHV-68 shares similar molecular and biological properties.
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    Lymphoproliferative disease in mice infected with murine gammaherpesvirus 68
    (American Assn. of Pathologists; Elsevier, 1994) Sunil-Chandra, N.P.; Arno, J.; Fazakerley, J.; Nash, A.A.
    Murine gammaherpesvirus is a natural pathogen of wild rodents. In the laboratory it establishes an infection of epithelial cells and persists in B lymphocytes in a latent form. Inbred mice chronically infected with the virus develop a lymphoproliferative disease (LPD) similar to that seen in patients infected with Epstein-Barr virus. The frequency of LPD over a period of 3 years was 9% of all infected animals, with 50% of these displaying high grade lymphomas. The incidence of LPD was greatly increased when infected mice were treated with cyclosporin A. The majority of mice used in the experiments were BALB/c, although lymphomas were detected in mice on other genetic backgrounds, ie, CBA and B10Br. Lymphomas were associated with both lymphoid and nonlymphoid tissues (liver, lung, and kidney). In all cases of lymphomas studied thus far, there was a mixed B cell (B220+ve) and T cell (CD3+ve) phenotype. The B cells were light chain restricted, indicative of a clonal origin. Variable numbers of virus genome-positive cells were detected by in situ hybridization in and around the lymphomas. In contrast, no lytic antigen-positive cells were detected, indicating that genome-positive cells were either latently infected or undergoing an abortive infection. These observations suggest that murine gammaherpesvirus-infected mice may be an important model to study the pathogenesis of LPD associated with other gammaherpesviruses, such as Epstein-Barr virus.
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    Murine gammaherpesvirus 68 establishes a latent infection in mouse B lymphocytes in vivo
    (Microbiology Society, 1992) Sunil-Chandra, N.P.; Efstathiou, S.; Nash, A.A.
    Murine gammaherpesvirus 68 (MHV-68) is able to persist in spleen cells of infected mice. To determine the cell type harbouring persistent virus, spleen cells from infected animals were separated into immunoglobulin (Ig)-positive (B cell-enriched), Ig-negative (T cellenriched) and plastic-adherent (macrophage-enriched) fractions. These cells were co-cultivated with permissive BHK-21 cells in an infectious centre assay. The consistent recovery and enrichment of infectious centres in the Ig-positive fraction clearly demonstrates that B cells are a major site of virus persistence/latency. This observation indicates that MHV-68 is biologically similar to Epstein-Barr virus and other members of the B cell lymphotropic gammaherpesvirus 1 subgroup.
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    The Recto-Anal Inhibitory Reflex (RAIR): abnormal response in diabetics suggests an intrinsic neuro-enteropathy
    (BMJ Publishing, 1997) Deen, K.I.; Premaratna, R.; Fonseka, M.M.D.; de Silva, H.J.
    INTRODUCTION: The recto-anal inhibitory reflex (RAIR) is characterized by reflex relaxation of the anal canal in response to electrical stimulation of the rectal mucosa, and is mediated by nitrergic neural plexuses within the gut wall. Impairment of this reflex may lead to incontinence. AIM: To measure anal canal pressures, anal mucosal electrosensation and RAIR in diabetic patients and correlate these measurements with incontinence for gas or faeces. METHODS: Anal canal pressure, RAIR and continence was evaluated in 30 diabetic patients [Male:Female=13:17, median age 57 years (range 37- 70)], and these data were compared with similar data obatained from 22 age and sex matched 'healthy' controls [Male:Female= 9:13, median age 51 years (range 19 - 65 )]. Median duration of diabetes was 8 years (range 3 -30 ). 12 (40%) of the 30 diabetics had impaired continence for gas (n=12) and liquid faeces (n=3). None ofthe controls had incontinence. RESULTS: Maximum resting anal canal pressure (MRP) was [median (range)]: Patients 30mmHg (20-75) vs. Controls 40mmHg (20-105), P=0.61. Maximum squeeze pressure (MSP) [median (range)]: Patients 65mmHg (30- 150) vs. Controls 84mmHg (35-230), P=0.59. Threshold rectal mucosal eletrosensation (RMES-T) [median (range)]: Patients 27 mA (5-40) vs. Controls l3mA (5-28), P=0.03. Maximum tolerable rectal mucosal electrosensation [median (range)]: Patients 40 mA (20-60) vs. Controls 20 mA (10-30), P=0.042 (all comparisons using Wilcoxon rank test). RAIR was present in 8, abnormal in 5 (1 with incontinence), and absent in 17 (II with incontinence) diabetics while it was present in 18 and abnormal in 4 controls (test of proportion, P=0.03 I). CONCLUSIONS: RAIR was impaired in significantly more patients with diabetes than controls implying impairment of intrinsic neuronal function. All diabetic patients with incontinence had impaired or absent RAIR. Impairment of this reflex may be a useful predictor of incontinence in diabetics.
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    Prolapsed haemorrhoids and anorectal manometry - do haemorrhoids prolapse due to reduction in the anorectal pressures ?
    (Sri Lanka Medical Association, 1998) Samarasekera, D.N.; Suraweera, P.H.R.
    Abstract Available
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    2'-Deoxy-5-ethyl-beta-4'-thiouridine inhibits replication of murine gammaherpesvirus and delays the onset of virus latency
    (International Medical Press, 1999) Barnes, A.; Dyson, H.; Sunil-Chandra, N.P.; Collins, P.; Nash, A. A.
    The antiviral thionucleoside analogue 2'-deoxy-5-ethyl-beta-4'-thiouridine (4'-S-EtdU) was shown to be a more potent inhibitor of gammaherpesvirus infection than acyclovir. This compound inhibits replication of murine herpesvirus (MHV)-68 in the lungs of mice when given 3 days post-infection. However, as with other nucleoside analogues, it was unable to prevent the establishment of latency, despite delaying the onset of latent infection in the spleen. In contrast, virus persistence in the lung was inhibited following drug treatment, although persistence was re-established in mice when treatment was suspended after 12 days. These data suggest that 4'-S-EtdU is a highly effective inhibitor of murine gamma herpesvirus replication and as such provides a powerful tool to study the pathogenesis of this virus in vivo.
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    One day general practice morbidity survey in Sri Lanka
    (Oxford University Press, 1998) de Silva, N*.; Mendis, K.
    BACKGROUND: National morbidity surveys provide valuable data for monitoring the health needs of populations, health policy planning and design of medical curricula. In order to meet a long-standing need for such information in Sri Lanka, a nationwide general practice morbidity survey was conducted for the first time in 1996. OBJECTIVES: We aimed to identify people's needs by determining the reasons for encounter or the demand for care with GPs/family physicians, to illustrate the pattern of morbidity in general practice and to determine the average daily workload of GPs in Sri Lanka. METHOD: A random sample of 75 GPs were requested to complete a Practitioner Profile Questionnaire (PPQ) and to record on an encounter form (EF) the reason/s for encounter (RFE) and problems managed during all consultations on 4 July. Central coding of the RFEs and problems defined was done using the International Classification of Primary Care (ICPC). RESULTS: Forty GPs (53.3 percent) completed the PPQ, while the EF received a response from 34 (43.3 percent). The GP profile showed a male to female ratio of 7:1, none below 35 years and none qualified after 1984. The average daily workload was 74. It was estimated that GPs handle at least 26.5percent of the primary care morbidity. Children accounted for 32 percent of consultations. There was a significantly higher proportion of children (P 0.0001) and of the elderly (P 0.05) in the consulting population compared with the general population. In 2068 encounters, 3448 RFEs and 2087 problems had been recorded. Respiratory and General chapters included 55 percent of the RFEs. By ICPC rubrics, 27 of the top thirty RFEs were for common symptoms. In addition to acute illnesses, asthma, hypertension and diabetes as well as preventive care activities were within the top 12 problems managed. CONCLUSIONS: The fact that many common illnesses, chronic diseases and preventive treatments are dealt with in general practice shows the necessity to include family medicine in the undergraduate curriculum of all medical schools. Undergraduate and postgraduate training in family medicine should concentrate more on child care and care of the elderly. Suitable incentives may be necessary to motivate younger doctors to become GPs to meet,the medical care needs of the community.
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    Single dose treatment of mixed helminth infections--a comparison of three different regimes
    (Sri Lanka Medical Association, 1987) de Silva, D.G.H.; Lionel, N.D.; Premaratne, U.N.; Warnasuriya, N.; Soysa, P.E.; Fonseka, P.H.
    No abstract available
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