Browsing by Author "Weerasinghe, O.M.S."

Filter results by typing the first few letters
Now showing 1 - 2 of 2
  • No Thumbnail Available
    Item
    Behaviour of Cytokines IL10, IL6 and IFy during late febrile and immediate defervercent phases of Dengue
    (Sri Lanka Medical Association, 2014) Weerasinghe, O.M.S.; Premaratna, R.; Gomes, L.; Perera, J.; Silva, S.; Abeyratna, C.; Kasturiratne, A.; Malavige, N.; de Silva, H.J.
    INTRODUCTION AND OBJECTIVES: Cytokines have been implicated in dengue (DF) pathogenesis. Behaviour of cytokines during the late febrile phase (LFP) and immediate defeversence have not been studied, but may be useful to understand the pathophysiology of disease progression and effect of interventions. METHODS: A preliminary prospective study was performed to investigate 1L-10, IL6 and IFy (pg/ml) responses during the late febrile phase (around fifth day) and immediate defervestence in confirmed (NSlAg positive} dengue patients. Demographic, clinical and laboratory data were collected. Two samples of 1 m! serum were obtained during the above stages of the illness and stored at -80°C to assess cytokine levels. Cytokine levels were compared between phases (LFP and afebrile) and stages (DF, precritical and critical dengue shock syndrome (DSS)). LFP cytokine levels were compared for disease stages using one-way Anova test. RESULTS: 18 patients (11 males, mean age 26 years (SD 10.6)) were studied. There were 3 DF, 9 precritical and 6 criticaj DSS based on national guidelines. Mean temperature during LFP and defervescent phases were 102.07°F (SD 0.98) and 98.53°F (SD 0.26). Median (interquartile range) of IL10, IL6 and IFy in LFP were 164.3 (90.8 - 259.5), 26 (12.7-54.6), 246.5 (117.5-511.8) and during defervescent phase were 17.4 (6A-112.2), 11.9 (4.9-28.2), 2.58 (0.0-58.4) respectively. LFP IL10 significantly correlated with disease stages (F-3.99, P-0.041), IL6 and IFy had no correlation. CONCLUSIONS: All three cytokines rapidly declined with defervecence. IL10 in febrile phase showed significant correlation with disease severity.
  • No Thumbnail Available
    Item
    Effect of single dose methyl prednisolone in severe illness associated with dengue fever
    (Sri Lanka Medical Association, 2010) Premaratna, R.; Jayasinghe, K.G.N.U.; Liyanaarachchi, E.W.; Weerasinghe, O.M.S.; Pathmeswaran, A.; Williams, H.S.A.; de Silva, S.T.; de Silva, A.P.; de Silva, H.J.
    INTRODUCTION AND OBJECTIVES: Role of steroids in the management of severe illness associated with dengue fever (SIDF) remains controversial. However, steroids are widely used in severe dengue. METHODS: Patients admitted to Professorial Medical Unit, CNTH, with SIDF during the recent dengue fever outbreak, a single dose intravenous methylprednisolone (MP) was administered as a rescue measure. Clinical and management data of 18 such patients (6 males) who were treated with MP (Group A) are presented here. [Definition of SIDF: fever >100F persisting after the fourth day of illness, without evidence of secondary bacterial infection together with a systolic BP <100mmHg and a postural drop of >20mmHg and the presence of or rapidly developing ascites or pleural effusions]. Fresh frozen plasma (FFP) rather than crystalloids were used to prevent worsening of third space fluid loss and pulmonary oedema on recovery. RESULTS: The mean(SD) age [yrs] 29 (11), and clinical parameters when SIDF was detected; duration of illness[days]: 5.6(1.9), fever[F]; 102(1) , systolic BP[mmHgj; 91(12), Hb[g/dl]: 14.2(3.1), PCVjTTJ: 42(7.2), platelets[xlOy/L]: 25(13), and resuscitation parameters; crystalloids [L/Kg]: 0.32(0.1), FFP[u]: 2(1.1). deaths: 0/18, time to defervasence[days); 1(2)], time to haemodynamic stability[Hrs]: 5.8(5.8), number needing ICU care 5/18. CONCLUSIONS: These preliminary observations appear to suggest beneficial effects of timely given single dose MP in the management of SIDF.