Browsing by Author "de Silva, B.A."
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Item Acid aspiration Syndrome(Sri Lanka College of Obstetricians and Gynaecologists, 2007) de Silva, B.A.; Herath, H.M.R.P.; Wijesinghe, P.S.No Abstract AvailableItem Dengue fever in pregnancy- a mamagement dilemma(College of Anaesthesiologists of Sri Lanka, 2003) de Silva, B.A.; Wijesekera, C.; Fernandopulle, R.C.; Fernando, W.S.; Palihawadana, T.S.Item Dengue fever with bleeding manifestations in pregnancy: our experience(Sri Lanka College of Obstetricians and Gynaecologists, 2004) de Silva, B.A.; Palihawadana, T.S.; Fernando, W.S.; Wijesinghe, P.S.Dengue fever, a mosquito borne flavivirus infection is endemic in Sri Lanka. An increased number of cases are seen in the recent past. An increase in the number of patients with secondary infection who are prone to develop complications such as bleeding manifestations, are expected due to repeated outbreaks of the disease, We report four cases of serologically confirmed Dengue fever. Different management strategies were adopted in each patient according to the clinical circumstances. Three antenatal mothers presented in 33, 38 and 39 weeks of POA and bleeding manifestations were present in all three of them. One of them died of an intracerebral haemorrhage after Caesarean section to deliver a stillborn following intrauterine death. Post Partum Haemorrhage (PPH) was experienced in another mother following caesarean section. In one patient bleeding manifestation appeared 2 days following normal delivery. She was managed conservatively. Though the clinical presentations may be similar to that of non pregnant patients, there can be many pitfalls in diagnosis and management of dengue fever occurring in pregnancy. Two of the patients described above developed acute dengue viral hepatitis, which needs to be differentiated from HELLP syndrome and acute fatty liver of pregnancy. Serological tests have a special place in diagnosis than in the non pregnant patients. The classical criteria used to identify Dengue Haemorrhagic fever (DHF), such as an increased haemotocrit and postural hypotension were not present in these patients. In management, the administration of intravenous fluids needed to be more closely observed. They seemed to be more prone to develop bleeding manifestations than non pregnant patients and therefore platelet transfusions were required in early stages. Early interventions to deliver the baby, if the other circumstances permit, seem to offer a better outcome in patients presenting in the antenatal period.Item Lifestyle correlates of cardiovascular risk factors in a Sri Lankan population(Sri Lanka Medical Association, 2008) Pinidiyapathirage, M.J.; Kasturiratne, A.; de Silva, B.A.; Perera, D.M.; Ramanayake, R.P.J.C.; Sumathipala, W.L.A.H.; Mizoue, T.; Makaya, M.OBJECTIVES: To determine the association between selected lifestyle risk behaviours (physical activity-PA, smoking and fruit, vegetable and alcohol consumption) and cardiovascular risk factors in an urban Sri Lankan population. DESIGN, SETTING AND METHODS: A random sample of 3650 individuals between 35-64 years resident in the Ragama MOH area were selected from the electoral list. A validated, interviewer-administered, food frequency questionnaire and a physical activity questionnaire were used to collect data. Blood samples were analysed for serum lipid and fasting blood glucose (FBG) concentrations. RESULTS: Of the 2602 participants (males:46%), 47% reported low physical activity (PA), 51% sub-optimal fruit consumption, 13% sub-optimal vegetable consumption, 6% excess alcohol consumption and 16% were current smokers. A significantly higher percentage of males reported moderate to high physical activity, had a lower BMI, consumed more alcohol, smoked currently and consumed less fruits. Vegetable consumption was similar between sexes. In females, risk behaviours were not associated with serum lipid and FBG concentrations. Among males, those reporting a low PA had a significantly higher percentage with serum triglyceride concentrations >150mg/dl and FBG >110mg/dl. A significantly higher percentage of male smokers had a serum total cholesterol concentration >200mg/dl and serum LDL concentration >100mg/dl. Excessive alcohol consumption in males was associated with high triglyceride concentrations (>150mg/dl). Serum lipid and FBG levels were similar among those with different fruit and vegetable consumption patterns, CONCLUSION: Low physical activity, smoking and excessive alcohol consumption were associated with serum lipid and FBG concentrations in males. Fruit and vegetable consumption was not correlated with risk factors.