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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
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Item World Bank prescription for health(Ceylon Medical Association, 1996) Fonseka, C.No abstract availableItem Should Sri Lanka reconsider its rubella immunisation strategy?(Ceylon Medical Association, 1997) Gunasekara, P.C.; Gunasekara, D.P.No abstract availableItem Suicide by suffocation with a plastic bag(Ceylon Medical Association, 1998) Tennakoon, U.A.; Jayawardena, H.Death by suffocation using a plastic bag has not been recorded in Sri Lanka. We report such a case here. Findings at the scene, the history, and autopsy and laboratory investigations assisted in arriving at the conclusion of suicide.Item The treatment of ulcerative colitis: from cure to a new disease(Ceylon Medical Association, 1994) de Silva, H.J.No abstract availableItem Hemoglobin E-beta-thalassemia: Progress report from the international study group(Blackwell Publishing, 2005) Premawardhena, A.; de Silver, S.; Arambepola, M.; Olivieri, N.F.; Vichinsky, E.P.; Merson, L.; Muraco, G.; Allen, A.; Fisher, C.; Peto, T.; Weatherall, D.J.A long-term observational study of Hb E-beta-thalassemia in Sri Lanka is beginning to define some of the genetic and environmental factors that are responsible for its remarkable phenotypic variability. In this population there is a very small difference between the steady-state hemoglobin levels between the mild and severe phenotypes, and it has been possible to stop transfusion in many of those who have been on long-term treatment of this kind. These preliminary observations, made over the last 7 years, provide directions for future research into this increasingly important disease.Item 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 availableItem An audit of patient perception regarding labour pain and provision of analgesia in a teaching hospital.(College of Anaesthesiologists of Sri Lanka, 2005) Gunetilleke, B.BACKGROUND: Provision of adequate analgesia in labour remains a neglected aspect of our health care system. The perception and attitudes of patients regarding labour pain and analgesia has not received sufficient attention. METHODS: A questionnaire was adminlstered by the investigator to parturients In a teaching hospital prior to and after delivery. RESULTS: All patients had received regular antenatal care. Patients anticipated severe pain In labour (PItem A patient with polytrauma including a severe head injury, haemothorax and cardiac tamponade(College of Anaesthesiologists of Sri Lanka, 2009) Gunetilleke, B.Item Paraspinal extramcduallry erythropoiesis- a rare cause of spinal cord compression: two case reports(Sri Lanka Medical Association, 2004) Arambepola, M.; Premawardhena, A.P.; de Silva, S.; Olivieri, N.; Weatherall, D.J.INTRODUCTION: Extrameduallry erythropoiesis (EME) is characterized by the appearance of haemopoietic tissue outside the bone marrow. When EME occurs, albeit rarely, outside the liver and spleen problems may occur. We describe two patients with haemoglobin E- [β thalassaemia who had spinal cord compression, due to EME masses which was reversed with treatment with hydroxyurea and hypertransfusion. PATIENT A: Was a 27year old with HbE -(β thalassaemia. His mean pre transfusion haemoglobin level was 5.5 g/dl. He presented with a six-month history of progressive numbness of his legs. On examination he was found to be paraparetic. The magnetic resonance scan (MRI) showed external compression of the spinal cord between the 4th and 8th thoracic vertebrae. Patient was put on a hypertransfusion regimen and hydroxyurea and made a complete recovery within 4 weeks. Patient B: Was a 9 year old boy with a diagnosis of Haemoglobin E [β thalassaemia who presented with paraplegia which had developed over 3 months. His spinal MRI showed two masses one in the upper thoracic vertebrae and the other at the 1st lumbar level. He was commenced on hydroxyurea and hypertransfusiion to maintain pre-transfusion haemoglobin at >9.5g/dl) and his neurological recover was remarkable. Six months later he had no neurological deficit. DISCUSSION: The above cases highlight the potentially dangerous complications of EME when it involves the spinal cord. They also highlight that even lesions which are sufficiently large to cause complete paraplegia are potentially reversible. Hypertransfusion, hydroxyurea, surgery and previously been used with varying success. The problem remains in deciding the optimal method of management.Item Sensitization patterns of allergens among asthmatics in Sri Lanka(Lippincott Williams & Wilkins, 2007) Weerasinghe, A.; Weerasinghe, S.; Amarasena, M.; Medagoda, K.; Katelaris, C.H.Introduction: The sensitization pattern among asthmatics in Sri Lanka is unknown. Objectives: To determine the sensitization pattern among asthmatics in Sri Lanka. Methodology: The study was carried out in forty physician-diagnosed asthmatic patients. Twenty two non-asthmatics were recruited as controls. Sensitization to 12 allergens was assessed by skin prick test using standardized allergen extracts. A skin wheal diameter, 3mm greater than the negative control was considered a positive reaction. Results: The mean age of asthmatics was 32.4 years (range 9Y59) and 57.5% were males. The mean age of controls was 32.2 years (range 14Y58) and 59.1% were males. The analysis of the data showed that 97.5% asthmatics had positive skin reaction to at least one allergen compared to 72.7% prevalence in the control group. The common allergens among asthmatics were Dermatophagoides pteronyssinus (77.5%), blomia (65.5%), cockroach (55%), storage mite (35%), latex (20%)), cat fur (17.5%), aspergillus (12.5%), grass pollen (12.5%), cow’s milk (12.5%) egg white (10%) cereals (7.5%) and dog hair (5.%). The pattern of sensitization among non-asthmatics was Dermatophagoides pteronyssinus (54.5%), cockroach (50%), blomia (36.4%), aspergillus (36.4%), grass pollen (27.3%), storage mite (22.7%), cow`s milk (18.2%), latex (13.6%), egg white (13.6%), cereals (13.6%), dog hair (9.1%) and cat fur (9.1%). Sixty two percent (n = 25) of the asthmatics had at least one other allergic manifestation while non-asthmatics with other allergic manifestation were 36.4% (n = 8). Other allergic manifestations in the asthmatic group were rhinitis alone 22 (55%), eczema alone 1(2.5%) and both rhinitis & eczema 2(5%) whereas in the non-asthmatic group it was rhinitis alone 7 (31%), eczema alone 0% and both rhinitis and eczema 1(4.5%). The pattern of sensitization for mites alone, cockroaches alone and mites and cockroaches in the asthmatic group with rhinitis (n = 24) was 23 (57%), 11(27%) and 11(27%) and in the non-asthmatic group with rhinitis (n = 7) was 3 (13%), 4 (18%) and 3 (13%) respectively. Conclusion: The results show that mites, and cockroaches are the most common sensitizing allergens in asthmatics and the commonest association of asthma was rhinitis in Sri Lanka.