Browsing by Author "Biyanwila, C."

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    Intravenous N-acetylcysteine in acute liver failure associated with dengue infection
    (Sri Lanka Medical Association, 2010) Rumarasena, R.S.; Senanayake, S.M.; de Silva, A.P.; Biyanwila, C.; Dassanayake, A.S.; Premaratna, R.; V/ijesiriwardena, B.; de Silva, H.J.
    BACKGROUND: Acute liver failure is rare in dengue but has a poor outcome. N-acetylcysteine (HAC) improves survival in early stage non-acetaminophen acute liver failure. However, its usefulness has not been established in dengue associated acute liver failure. OBJECTIVES: To determine the benefit of intravenous NAC in acute liver failure due to dengue. Methods; Outcome of consecutive adult patients with serologically confirmed dengue infection associated acute liver failure (INR>1.5 with encephalopathy) was retrospectively analysed. They received NAC by intravenous infusion for 72 hours in addition to supportive management. None had taken paracetamol above the therapeutic dose, used hepatotoxic drugs or abused alcohol. Serology for Hepatitis A, B, C, leptospira, and rickettsiae was negative. All patients had negative computerized tomography of the brain. RESULTS: There were 18 patients, (10 females) aged 22-68 years. 11 had dengue hemorrhagic fever (grade 1 and 2), 7 had dengue shock syndrome, 12 had pleural effusions and 8 had ascites. 15 patients had acute liver failure and 3 acute on chronic liver failure (previously diagnosed cirrhotics). 14 patients had early stage hepatic encephalopathy (coma grades I-II), and 4 had advanced encephalopathy (coma grades III-IV). All patients with coma grades l-II recovered completely, while 3 with coma grades III-IV died. None had adverse effects attributable to NAC. CONCLUSION: These preliminary observations suggest that using intravenous NAC in the early stages of dengue associated liver failure is safe and may benefit patients.
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    Stroke patient's knowledge about stroke
    (Sri Lanka Medical Association, 2001) Gunatilake, S.B.; Biyanwila, C.; Liyanage, B.
    BACKGROUND: Little is known about stroke patient's general knowledge about stroke symptoms, risk factors, pathology and available treatments. This information is important for implementation of preventive programs. OBJECTIVE: This study attempts to determine the knowledge of stroke patients about the illness after they were discharged from hospital. METHODS: Consecutive patients attending the outpatient clinics following discharge from hospital after a first-ever stroke were included in the study. A structured, standardised interview using a questionnaire was performed by two doctors. Age and sex matched patients attending the clinic for non-vascular illnesses were used as a control group. RESULTS: During a period of two months 48 patients were recruited. Of them 17 had been educated upto GCE ordinary level. All 48 patients knew of at least one stroke symptom and over 90% knew that paralysis, speech disturbance and walking difficulty are stroke symptoms. Only 20 (42%) knew that the primary organ involved was the brain and of them only five knew that a stroke is due to thrombosis or haemorrhage. Thirteen patients (27%) were not aware of any risk factors and 33 (73%) knew that hypertension is a risk factor. Smoking was identified as a risk factor by 21 (44%), but 29 (60%) didn't know that stopping smoking reduces the stroke risk. Only 30 patients (62%) knew that stroke can be prevented and 37 (77%) said that stroke is an emergency. All except four patients had sought medical advice the same day. CONCLUSIONS: Our patients have a good knowledge of stroke symptoms and seek medical advice early. Awareness of risk factors are average but the knowledge about the organ involved and the pathology was poor.