Browsing by Author "Hettiarachchi, D."

Now showing 1 - 11 of 11

Changes in Government and Trends in Alcohol Consumption in Sri Lanka between 1989 and 2013
(College of Community Physicians of Sri Lanka, 2015) Pathmeswaran, A.; Perera, W.N.; Hettiarachchi, D.
A Comparative study on medical comorbidities among children with autism spectrum disorder and controls in a children’s hospital.
(Sri Lanka College of Paediatricians, 2017) Chandradasa, M.; Rohanachandra, Y.; Dahanayake, D.; Hettiarachchi, D.; Gunathilake, M.; Fernando, R.; Wijetunge, S.
INTRODUCTION: Autism spectrum disorder (ASD) is a neurodevelopmental disorder, in which medical disorders are known to occur higher than in the general paediatric population. This may indicate either that the neurodevelopmental disorder is acting as a risk factor or sharing a common pathophysiological mechanism with the medical disorder. We could not access any publications focusing on medical comorbidities in autism from Sri Lanka. OBJECTIVE: To compare the prevalence and types of medical comorbidities between children with ASD and outpatient controls presenting to a children’s hospital in Sri Lanka. METHOD: This was an observational analytical study using a case control design. Seventy three consecutive new enrolments diagnosed as ASD at the child psychiatric services of Lady Ridgeway Hospital were recruited to the study group. An age and gender matched group of children presenting to the outpatient department with minor physical problems were recruited as the comparison group. The presence of a medical disorder was determined retrospectively by perusal of medical records. RESULTS: The prevalence of febrile seizures, epilepsy, bronchial asthma, atopic dermatitis and recurrent gastrointestinal symptoms in the child were higher in the ASD group compared to the control group. The differences of the rates between groups for bronchial asthma and recurrent gastrointestinal symptoms were statistically significant. Also, pregnancy induced hypertension and gestational diabetes mellitus in the mother was higher in ASD group. CONCLUSIONS: The probability of co-occurrence of certain medical disorders is significantly higher in children with ASD (neurological, respiratory, gastrointestinal and dermatological disorders) in comparison to controls.
Field-based evaluation of Novaluron EC10 insect growth regulator, a chitin synthesis inhibitor against Dengue vector breeding in leaf axils of pineapple plantations in Gampaha district, Sri Lanka
(BioMed Central, 2020) Gunathilaka, N.; Ranathunga, T.; Hettiarachchi, D.; Udayanga, L.; Abeyewickreme, W.
BACKGROUND: Insect growth regulators (IGRs) are considered a novel group of insecticides to control mosquitoes. Novaluron is an IGR with benzoylphenyl urea insecticide, which inhibits chitin synthesis in insects and can reduce insect population density; it is also known to have a high margin of safety for mammals. METHODS: The effective minimum concentration of novaluron formulation EC10 was tested. Six pineapple plantations [control (n = 3) and test (n = 3)] were selected from Meerigama Medical Officer of Health area in Gampaha District, Sri Lanka. Fifteen plots (10 × 10 m) were demarcated in each site with a 200 m distance apart. Leaf axils of 450 pineapple plants (30 plants × 15 plots) were screened for immature stages of Aedes mosquitoes weekly for 12 weeks. The required concentration (20 ppm) of novaluron was sprayed onto the selected pineapple plants (n = 1350) individually in 3 selected test sites for 5-10 s. The reduction in the vector population was interpreted as the percentage of reduction in immature stages of Aedes mosquitoes. RESULTS: The 100% mortality of the Ae. aegypti larvae within 24 h was observed at 20 ppm (0.05 ml of novaluron 100 g/l in 250 ml of water) as the minimum dose. Variation in the number of Aedes larvae present in the control and intervention sites was found to be significantly different throughout the entire observational period (χ2 = 128.29, df = 11, P < 0.001). The total elimination of Aedes larvae continued for up to 2 weeks and a 50% reduction was observed until the 8th week. CONCLUSIONS: The present study emphasizes that novaluron (10% EC) can be used as an effective larvicide at the treatment dose of 20 ppm. The residual effect of the IGR lasted for 12 weeks with a functional efficacy of 8 weeks. The 100% reduction of larval breeding was observed up to the 2nd week after application and the percentage reduction of immature stages remained > 50% until the 8th week. The lowest reduction (34.2%) was observed at 12 weeks after the initial treatment. Therefore, re-treatment may be recommended based on the reduction in the efficacy of the IGR. Keywords: Aedes; Field efficacy; Insect growth regulator; Novaluron; Pineapple plantation.
Fifty liver transplants: a single centre experience of haemodynamic management in liver transplantation for cirrhosis [part 1]
(College of Surgeons of Sri Lanka, 2021) Gunetilleke, B.; Ranamuni, R.; Jayaweera, D.; Welikala, N.; Kerner, V.; Munasinghe, N.; Withanage, R.; Wickremasinghe, N.; Hewage, S.; Wijesuriya, N.; Rodrigo, U.; Mudalige, A.; Fernando, M.; Hettiarachchi, D.; Dissanayake, J.; Niriella, M.; Dassanayake, A.; Thilakaratne, S.; de Silva, J.; Siriwardana, R.; WIjesuriya, R.; Liyanage, C.
ABSTRACT: Cirrhosis with end stage liver disease (ESLD) is a leading cause of non-communicable disease related deaths in Sri Lanka. Liver transplantation is the only curative treatment for patients with ESLD. The complex multisystem involvement and unique cardiovascular profile characteristic of ESLD present formidable challenges during liver transplantation. Management of the rapid and varied hemodynamic changes during surgery requires an in depth understanding of the physiological effects of each intervention. Based on the current literature and the experience gained at our center during the management of 50 liver transplants, we present optimization strategies and perioperative hemodynamic interventions which we use to ‘Fast track’ recovery following liver transplantation. KEYWORDS: Liver transplantation, cirrhosis, non-alcoholic fatty liver disease, alcohol related liver disease
Fifty liver transplants: a single centre experience of haemodynamic management in liver transplantation for cirrhosis [part 2]
(The College of Surgeons of Sri Lanka, 2021) Gunetilleke, B.; Ranamuni, R.; Jayaweera, D.; Welikala, N.; Kerner, V.; Hettiarachchi, D.; Munasinghe, N.; Withanage, R.; Wickremasinghe, N.; Hewage, S.; Fernando, M.; Hettiarachchi, D.; Niriella, M.; Dassanayake, A.; Thilakaratne, S.; Wijesuriya, R.; Liyanage, C.; Siriwardana, R.; Dissanayake, J.; Wijesuriya, N.; Rodrigo, U.; Rodrigo, U.; Mudalige, A.; de Silva, J.
Globally, an estimated one million deaths occur annually due to complications of cirrhosis. Cirrhosis with end stage liver disease [ESLD] is a leading cause death due to non- communicable diseases in Sri Lanka. Non-alcoholic fatty liver disease [NAFLD] and alcohol related liver disease [ARLD] are the principal causes of ESLD due to cirrhosis in Sri Lanka. Liver transplantation remains the only curative treatment for such patients. Multiorgan dysfunction and hemodynamic instability characteristic of ESLD adds to the complexity of perioperative care in liver transplantation. Maintenance of stable hemodynamics including optimal hemostasis forms the core of the anaesthetic strategy in liver transplantation.
A Juvenile sex offender with Attention Deficit Hyperactivity Disorder
(BbW Publisher, 2018) Chandradasa, M.; Hettiarachchi, D.; Fernando, R.; Gunathilake, M.; Wijetunge, S.; Tennakoon, A.
BACKGROUND: Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder manifesting in early life. These children are more vulnerable to sexual abuse as victims and offenders. This is a case report of a teenager with previously undiagnosed ADHD presenting with an alleged act of sexual offending. CASE REPORT: According to the 14-year-old accused, he has engaged in penetrative anal intercourse with another schoolmate. that similar past incidents had involved a teenage male relative and insertion of foreign bodies to his anus repeatedly by him. On assessment the accused had features of inattention, such as difficulty in sustaining attention, failing to finish work and features of impulsivity, such as difficulty waiting for his turn and intruding on others. He was diagnosed with ADHD according to Diagnostic and Statistical Manual of Mental disorders (DSM 5) clinical criteria which were supported by the Sinhalese adaptation of the Swanson, Nolan and Pelham questionnaire. The assessment of the non-verbal intelligence was in the normal range, but his school performance was far below the average. DISCUSSION: Undiagnosed ADHD contributes to academic impairment and inappropriate sexual behaviour. It is possible that the described adolescent’s impulsiveness and inattention contributed to his academic failure and risky sexual behaviour. Early detection and proper management of this disorder may have reduced the risk of such behaviour in him.
The new normal of medical education - challenges and opportunities
(South East Asia Regional Association for Medical Education (SEARAME), 2020) Karunathilake, I.M.; Dissanayake, V.H.W.; Yasawardena, S.; Abegunawardena, A.; Raviraj, S.; Wijesinghe, P.S.; Anthony, A.A.; Wijesinghe, R.A.N.K.; Bowatte, S.; Wickramaratne, N.; Pathirana, K.D.; Pilapitiya, S.; Edirisinghe, S.; Hettiarachchi, D.; Kohombange, C.; Olipeliyawa, A.
No abstract available
A One year follow up study of persistent motor tic disorder treated with risperidone in a children’s hospital in Sri Lanka
(Sri Lanka College of Paediatricians, 2017) Chandradasa, M.; Hettiarachchi, D.; Rohanachandra, Y.; Wijetunge, S.
INTRODUCTION: Transient tics are common in children. In persistent motor tic disorders, single or multiple motor tics persist for more than a year. OBJECTIVE: To determine the one year outcome of persistent motor tic disorder treated with risperidone in a group of Sri Lankan children. METHOD: New patients presenting to the Child and Adolescent Mental Health Services of the Lady Ridgeway Hospital for Children in Colombo were screened for tics. Diagnosis was made by a consultant psychiatrist according to the Diagnostic and Statistical Manual of mental disorders 5th edition (DSM-5). The children were prospectively followed up for a period of one year with monthly assessments. Patients treated solely with oral risperidone from the beginning were analysed. In all children dose of risperidone ranged from 0.25-2 mg/day. Of all children with tics, only children with persistent motor tic disorder were included in the follow up. The symptom severity was measured using the Yale Global Tic Severity Scale (YGTSS). A reduction of the YGTSS score by 35% was considered as a satisfactory response to treatment. The presence of comorbid psychiatric disorders was assessed clinically as well as by using the Swanson, Nolan and Pelham teacher and parent rating scale 4th version and Yale Brown obsessive compulsive scale. Ethical approval was obtained from the ethical review committee of the Lady Ridgeway Hospital. RESULTS: Of the screened patients, 123 children were diagnosed with a persistent motor tic disorder at the beginning of the study. Of these, 17 were excluded because of irregular attendance at the monthly assessments and 3 were excluded as the diagnosis was changed to Tourette syndrome due to the detection of new symptoms. Eye blinking and shoulder shrugging were the commoner tic types in participants. Attention deficit hyperactivity disorder was the commonest comorbid psychiatric disorder. After 12 months follow up, 78.6% of participants responded to risperidone with a predefined 35% lessened tic severity score according to the YGTSS. The percentage of children with comorbid ADHD who had responded to risperidone at 35% YGTSS score reduction was significantly low compared to the children without ADHD (p<0.05). There was no statistically significant difference in the treatment response according to age, gender, complexity of tics or type of tics. CONCLUSIONS: After one year follow up, 79% of children with persistent motor tic disorder responded satisfactorily to risperidone. The percentage of children with comorbid ADHD who responded satisfactorily to risperidone was significantly low compared to the children without ADHD (p<0.05).
Serious bodily harm related to Obsessions from Sri Lanka
(Zagreb, 2017) Chandradasa, M.; Champika, L.; Hettiarachchi, D.; Wijetunge, S.; Mendis, J.
Symptomatology of COVID-19 - Lessons from a meta-analysis across 13 countries
(Manipal College of Medical Science Pokhara,Nepal, 2021) Gamakaranage, C.; Hettiarachchi, D.; Ediriweera, D.; Jayasinghe, S.
Background: COVID-19 pandemic has resulted in varying clinical manifestations and mortality rates. There is no consensus on the symptomatology that would guide researchers and clinicians. Aims and Objectives: The objective was to identify symptoms and their frequencies of COVID-19 with a meta-analysis of studies from several countries. Materials and Methods: Data sources: A systematic review using PubMed and Google Scholar data sources and reference tracing were used to identify 7176 articles. Eligibility criteria: Suitable articles were selected manually with selection criteria and 14 original articles included in meta-analysis. Data abstraction and analysis: PRISMA guidelines used for data abstraction and a table was generated by feeding it with numbers and proportions of each symptom described. A meta-analysis was carried out using random effect models on each symptom separately across the studies and their prevalence rates and 95% confident intervals were calculated. Results: Selected 14 studies, either cross-sectional or cohort studies are analyzed. There were 2,660 confirmed cases of COVID-19. The majority were from China (n=2,439, 91.7%) and remainder from the Netherlands, Italy, Korea, and India and one article from Europe. There were a total of 32 symptoms identified from the meta-analysis and additional 7 symptoms were identified from reference searching. The most common symptoms were (prevalence >50%): fever (79.56%, 95% CI: 72.17–86.09%), malaise (63.3%, 95% CI: 53.1–73.0%), cough (56.7%, 95% CI: 48.6–64.6%), and cold (55.6%, 95% CI: 45.2–65.7%). Symptoms of intermediate incidence (5–49%) were anosmia, sneezing, ocular pain, fatigue, sputum production, arthralgia, tachypnea, palpitation, headache, chest tightness, shortness of breath, chills, myalgia, sore throat, anorexia, weakness, diarrhea, rhinorrhea, dizziness, nausea, altered level of consciousness, vomiting, and abdominal pain. Rare symptoms (<5%): tonsil swelling, hemoptysis, conjunctival injection, lymphadenopathy, and rash. Conclusion: We found (25/32, from meta-analysis) symptoms to be present in ≥5% of cases which could be considered as “typical” symptoms of COVID-19. The list of symptoms we identified is different from those documents released by the WHO, CDC, NHS, Chinese CDC, Institute Pasteur and Mayo Clinic. The compiled list would be useful for future researchers to document a comprehensive picture of the illness.
බෞද්ධ අධ්‍යාපනය: එහි දාර්ශනික හා මනෝවිද්‍යාත්මක පදනම
(Postgraduate Institute of Pali and Buddhist Studies, University of Kelaniya, 1999) Hettiarachchi, D.