Conference Papers

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This collection contains abstracts of conference papers, presented at local and international conferences by the staff of the Faculty of Medicine

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2017 - 20182

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Author: search.filters.author.Amarasena, P.Has files: No

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    Pseudo polycythaemia and its association with cardio-metabolic risk factors: A preliminary descriptive analysis from a tertiary care hospital
    (Sri Lanka Medical Association, 2018) de Silva, S.T.; Amarasena, P.; Dias, M.A.D.H.; Lakmini, K.M.S.; Premathilaka, L.H.R.A.; Ranatunga, R.J.K.L.D.; Moratuwegama, H.M.D.; Siriwardana, S.R.; Niriella, M.A.; Premawardhena, A.P.
    INTRODUCTION AND OBJECTIVES: Polycythaemia is the result of either an actual increase in red cell mass (true) or relative reduction in plasma volume (spurious). Spurious or pseudo-polycythaemia (PP) is a poorly-researched entity with unexplained increase in mortality noted in previous studies. We aimed to characterize PP and determine an association between PP and metabolic syndrome (MS) in a Sri Lankan clinic-based population. METHODS: Consecutive, consenting adults > 18 years, with two consecutive haemoglobin levels> l 6.5mg/dL and > 16mg/dL and/or PCV >49% and >48% in men and women respectively, with non-tourniquet samples taken few days apart in a well-hydrated state, were recruited from clinics of University Medical Unit, Colombo North Teaching Hospital and from the private sector. Interviewer-administered questionnaire was used to gather data.RESULTS: 46 participants were recruited: 3 (6.5%) had primary polycythemia, 5 (10.9%) had secondary polycythemia due to identifiable causes. 38 (82.6%) patients had PP [mean age 42.2 (SD=l5.2) years and 36 (94.7%) were males]. Of these 14 (36.8%) had diabetes, 22 (57.9%) had hypertension, 25 (65.8%) had hyperlipidemia and 25 (65.8%) were obese. 19 (50%) had fatty liver, 23 (60.5%) were light smokers, 8 (21.1%) consumed alcohol beyond safe limits, 6 (15.8%) had increased neck circumference, 1 (2.6%) had ischemic heart disease, 2 (5.3%) had chronic kidney disease and 2 (5.3%) had hyperuricaemia. Comparison of PP and secondary polycythemia with regard to prevalent components of MS was not possible due to small numbers.CONCLUSION: Components of MS were prevalent among those with PP. The significance of this finding remains unexplained. This needs to be replicated in a larger sample to establish whether these are independent risk factors for the development of PP.
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    Familial thrombocytopaenia in three male siblings
    (Sri Lanka Medical Association, 2017) Amarasena, P.; Premawardhena, A.P.; Herath, H.R.B.M.; Seneviratne, S.L.
    INTRODUCTION & OBJECTIVES: Familial thrombocytopaenia is uncommon. Specific molecular defects have been identified in some families. We describe three male siblings with thrombocytopaenia and other immune related findings. The parents are healthy and non-related. METHODS: Clinical and investigative findings were obtained from the brothers and their parents. RESULTS: Case 1: A 15 year old male presented with spontaneous ecchymotic patches and oral mucosal bleeding. Platelet count was 1000/mm3, mild hepatomegaly was present on ultrasonography and IgA was raised. As the response to IV methyl-prednisolone was poor, IVIG, prednisolone and azathioprine were used. He has had recurrent RT infections and as his latest platelet counts are suboptimal, Rituximab is being considered. Case 2: A 19 year old male was found to have thrombocytopaenia whilst being investigated for a large scalp haematoma aged 2 years. He had been treated with oral prednisolone and needed pulse IV dexamethasone. Presently he is off steroids and the platelet count is 54000/mm3. Serum IgM is reduced and IgA is raised. He has chronic bilateral lower limb eczema, an atrio-fascicular accessory pathway and gets recurrent RT infections. Case 3: A 12 year old male had fever, cervical lymphadenopathy and hepatosplenomegaly aged 3 years. He then developed AIHA and thrombocytopaenia. The thrombocytopaenia persisted and was treated with prednisolone and cyclosporine. Aged 9 years, he developed SLE and a year later, class IV lupus nephritis was found on renal biopsy. CONCLUSION: An AR or XR genetic cause is likely in this family. The identification of the exact molecular defect may help with selecting appropriate medications to target abnormal immune pathways.