Browsing by Author "Wijesiriwardena, B."

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The Adrenal glands and their functions
(Sri Lanka Medical Association, 2007) de Silva, D.C.; Wijesiriwardena, B.
The adrenal glands secrete hormones essential for metabolism, regulation of blood pressure, and sodium and glucose homeostasis. Hypo- or hypersecretion of these hormones is life threatening. Understanding the physiological functions of adrenal hormones is a prerequisite to the management of adrenal gland disease.
Adrenal hypersecretion
(Sri Lanka Medical Association, 2007) Wijesiriwardena, B.; de Silva, D.C.
Hypersecretion from the adrenal glands is associated with hypertension. Causes include Conn syndrome, Cushing syndrome and phaechromocytoma. This article discusses their clinical features, diagnosis and treatment as well as the management of incidentally identified adrenal tumours (incidentaloma).
Adrenal insufficiency
(Sri Lanka Medical Association, 2007) Wijesiriwardena, B.; de Silva, D.C.
Adrenal insufficiency can be due to disease of the adrenal gland itself (primary adrenal deficiency) or of the hypothalamic or pituitary regulation of the adrenal gland (secondary adrenal insufficiency). This article discusses its causes, clinical features, diagnosis and treatment.
Dyspepsia
(Ceylon College of Physicians, 2001) Wijesiriwardena, B.; de Silva, H.J.
Intravenous N-acetylcysteine in dengue-associated acute liver failure
(Springer International, 2010) Kumarasena, R.S.; Senanayake, S.M.; Sivaraman, K.; de Silva, A.P.; Dassanayake, A.S.; Premaratna, R.; Wijesiriwardena, B.; de Silva, H.J.
No Abstract Available
Methyldopa use should be restricted
(Sri Lanka Medical Association, 1999) de Silva, H.A.; Hewavisenthi, J.; Wijesiriwardena, B.; Fonseka, M.M.D.
No Abstract Available
Neuroleptic malignanat syndrome without fever: a report of three cases
(BMJ Publishing Group, 2000) Peiris, D.T.S.; Kuruppuarachchi, K.A.L.A.; Weerasena, L.P.; Seneviratne, S.L.; Tilakaratne, Y.T.; de Silva, H.J.; Wijesiriwardena, B.
No Abstract Available.
Re-emergence of chikungunya in Sri Lanka: First confirmation of the 2006 outbreak by molecular diagnosis
(Sri Lanka Association for the Advancement of Science, 2007) Perera, E.D.T.; Wijesiriwardena, B.; Hapugoda, M.D.; Bandara, K.B.A.T.; Dayanath, M.Y.D.; Wellawaththage, L.C.; Gunawardena, N.K.; Hapuarachchi, C.; Abeyewickreme, W.
Chikungunya virus infection is clinically similar to many other acute febrile illnesses, such as dengue infection, malaria, west nile fever and leptospirosis. Rapid confirmation of the outbreak by laboratory diagnosis is important to ensure public health safety by appropriate patient management and controlling the disease. Molecular diagnosis by Reverse Transcriptase- Polymerase Chain Reaction (RT-PCR) assists rapid diagnosis. The objective of the present study was to determine the clinical manifestations of chikungunya confirmed patients in Sri Lanka. Venous blood samples and clinical information were collected from 66 chikungunya suspected patients having fever of less than 4 days from different geographical areas in Sri Lanka during the period September 2006 to February 2007. Serum samples were tested for chikungunya RNA by RT-PCR. Amplified products were visualized by agarose gel electrophoresis. Among 66 suspected patients, 51% (34/66) were positive for chikungunya by RT-PCR assay and 55.9% (19/34) were females. All age groups were affected similarly with the mean age of 41 years (range = 4 months to 80 years). Of the PCR positive 34, all had fever with either arthralgia or arthritis or both. Most of them had only pain in the joints without swelling (arthralgia only); 67.6% (23/34) in knee, 55.9% (19/34) in ankle, 50% (17/34) in wrist, 44.1% (15/34) in elbow and 52.9% (18/34) in small joints. Arthritis of ankle joint 35.2% (12/34) was more frequent compared with arthritis of the knee joint17.6% (6/34). PCR positive patients manifested more symptoms compared with PCR negative patients; 85.3% (29/34) headache, 79.4% (27/34) backache, 58.8% (20/34) nausea and 61.8% (21/34) vomiting. Compared with dengue, most of the chikungunya patients did not have dermatological manifestations. This is the first confirmation of the 2006 chikungunya outbreak in Sri Lanka. Some of the patients who had symptoms suggestive of chikungunya, tested by PCR were negative. These patients were probably suffering from other illnesses such as dengue. Acknowledgements: The International Atomic Energy Agency (TC SRL 6/028) for technical cooperation
Recent chikungunya outbreak in Sri Lanka 2006-2007
(Faculty of Tropical Medicine, Mahidol University, 2007) Abeyewickreme, W.; Bandara, K.B.A.T.; Dayanath, M.Y.D.; Sumanadasa, D.; Hapuarachchi, H.A.C.; Gunawardena, N.K.; Hapugoda, M.D.; Wijesiriwardena, B.; de Silva, S.; Perera, T.
BACKGROUND: Chikungunya(CHIK) is a viral disease transmitted by Aedes mosquitoes. Cases with symptoms of CHIK had been reported from several parts of Sri Lanka in 2006-2007. Laboratory testing of samples is a prime requirement for confirmation of transmission. OBJECTIVES: To confirm CHIK infection in suspected patients by rapid Reverse Transcription Polymerase Chain Reaction Assay(RT-PCR), find out manifestations specific for CHIK infection and study the transmission of CHIK virus by vector mosquitoes. METHODOLOGY: Serura. samples and information on clinical manifestations were collected from 189 chikungunya-suspected patients from different geographical areas in Sri Lanka from September 2006 to September 2007. Samples were tested for Chikungunya RNA by RT-PCR. Amplified products were visualized by agarose gel electrophoresis. Adult mosquitoes were also collected from chikungunya case-reported stations. They were tested for Chikungunya RNA through RT-PCR-followed by agarose gel electrophoresis assay. RESULTS: Of the CHIK-suspected patients reported from all parts of the island 86/189 (45.5%) were positive for CHIK virus. Of the PCR positive 06, all had fever with either arthralgia or arthritis or both. Headache (95.3%) and backache (84.6%) were also common among above patients. Eight percent (4/50) of both species of Aedes mosquitoes were RT-PCR positive. DISCUSSION: RT- PCR is important in early diagnosis of the infection and differentiation from dengue fever. The most common clinical symptoms observed were fever with either arthralgia, arthritis or both. Both Aedes aegypti and Aedes. albopictus are important in transmitting the disease.
Safety of low dose subcutaneous adrenaline used as prophylaxis against acute reactions to anti-venom serum (AVS) in patients bitten by snakes
(Sri Lanka Medical Association, 2002) Dassanayake, A.S.; Karunanayake, P.; Kasturiratne, K.T.A.A.; Fonseka, M.M.D.; Wijesiriwardena, B.; Gunatilake, S.B.; de Silva, H.J.
INTRODUCTION: Low dose subcutaneous adrenaline significantly reduces acute adverse reactions to AVS in patients envenomed following snake bite. OBJECTIVES: To further study the safety of low dose subcutaneous adrenaline. METHODS: We prospectively studied patients with snake bite envenoming in two units of the Colombo North Teaching Hospital, Ragama, from April 2000 to October 2001. Patients who satisfied inclusion criteria were given 0.25ml 1:1000 adrenaline subcutaneously immediately before administration of AVS. They were observed for adverse effects, and pulse and blood pressure (BP) were recorded before and at frequent intervals for one hour after giving adrenaline. In patients who developed reactions to AVS, subsequent pulse and BP measurements were not included for analysis. Results: 51 patients [M:F=35:16; mean age 34.8yrs (SD 14)] were included in the study. No significant changes in mean pulse rate or BP were observed following administration of subcutaneous adrenaline. Adverse reactions to AVS occurred in 15 (29.4%) patients. There were 4 (7.8%) other complications: one (2%) death due to suspected intracerebral haemorr-hage in a 65yr old man who also had coagulopathy, and developed an adverse reaction to AVS which required treatment with adrenaline; 3 (5.9%) patients, who also had coagulopathy, developed small haematomas at the subcutaneous injection site. CONCLUSIONS: Low dose subcutaneous adrenaline did not cause significant changes in pulse rate or BP. The 3 small haematomas could be directly attributed to the injection. Although the death is unlikely to be directly related to subcutaneous adrenaline, we suggest further studies on the safety of this prophylactic treatment before recommending its routine use.
Safety of subcutaneous adrenaline as prophylaxis against acute adverse reactions to anti-venom serum in snakebite
(Sri Lanka Medical Association, 2002) Dassanayake, A.S.; Karunanayake, P.; Kasturiratne, K.T.A.A.; Fonseka, M.M.D.; Wijesiriwardena, B.; Gunatilake, S.B.; de Silva, H.J.
OBJECTIVES: To study the safety of low dose subcutaneous adrenaline given as prophylaxis against acute adverse reactions to anti-venom serum(AVS) in patients bitten by snakes. METHODS: Patients admitted with snakebite envenoming who satisfied inclusion criteria were given 0.25 ml of 1:1000 adrenaline subcutaneously immediately before administration of AVS. They were observed for adverse effects, and pulse and blood pressure (BP) were monitored. RESULTS: 51 patients [35 males, mean age 34.8 years (SD 14)] were included in the study. Adverse reactions to AVS occurred in 15 (29.4%) patients. There was one death from suspected cerebral haemorrhage, and 3 (5.9%) patients developed small haematomas at the subcutaneous injection site. There were no significant changes in mean pulse or BP following administration of subcutaneous adrenaline. CONCLUSIONS: Low dose subcutaneous adrenaline did not cause significant changes in pulse rate or BP. Although the death was unlikely to be directly related to subcutaneous adrenaline, we suggest further studies on the safety of this prophylactic treatment before its routine use.