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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Author: search.filters.author.Bandara, N.K.B.K.R.G.W.

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    Comparison of clinical and laboratory parameters between Rickettsiosis positive and negative children
    (Sri Lanka Medical Association, 2013) Premaratna, R.; Karunasekara, K.A.W.; Fernando, M.A.M.; de Silva, L.; Chandrasena, T.G.A.N.; de Silva, H.J.; Miththinda, J.K.N.D.; Mufeena, M.N.F.; Madeena, K.S.K.; Bandara, N.K.B.K.R.G.W.
    INTRODUCTION AND OBJECTIVES: Identification of clinical or biochemical parameters that differentiate rickettsioses from other fevers would help in clinical practice to reduce morbidity and mortality associated with childhood rickettsioses. METHODS: Clinical and laboratory parameters of 22 confirmed paediatric rickettsioses (SFG-16/22, ST-5/22, Mixed-1) were compared with those of 24 with fever who were negative for rickettsioses, based on data received by the Rickettsial Disease Diagnostic and Research Laboratory (RDDRL), Faculty of Medicine, University ofKelaniya. Results: Comparisons of clinical and laboratory parameters between rickettsioses vs non-rickettsioses were mean(SD); age in months 56.59 (43.9) vs 78.13 (42.08) (p=0.1); fever duration 9.81 days (4.5) vslO.68 days (8.79) (p-0.68); fever intensity 102.80F (1.03) vs 102.440F (1.23) (p=0.4); fever spikes per day 2.33 (0.67) vs 2.68 (0.75) (p=0.186); headache 12/22 vs 11/24 (p=0.64); body-aches 9/22 vs 9/24 (p-0.52); pain in arms and legs 6/9 vs 7/9 (p=0.5); joint pains 6/22 vs 7/24 (p=O.S9); cough 14/22 vs 9/24 (p=0.0*7); shortness of breath 5/22 vs 2/24 (p=0.19); eschar (all ST) 4/22 vs 0/24 (p=0.02); rash 14/22 vs 14/24 (p=0.69); maculo-papular rash!3/14 vs 12/14 (p=0.91); diarrhoea 4/22 vs 4/24 (p-0.89); lymphadenopathy 7/22 vs 8/24 (p=0.913); spleenl/22 vs 5/24 (p=0.18); total WBC 11.U109/L (4.8) vs 9.8xl09/L (4.8) (p=0.36); N-84.8% (13.8) vs 5.4(2) (p=0.29); ESR IstHr 46.3mm (26.7) vs 81.8mm (10.2) (p=0.37); CRP 42.1mg/dl vs 56.7mg/dl (6.7) (p=0.46); SCOT 51.2iu/L (32.1) vs 248.7iu/L (678) (p=0.43); SGPT 50.2iu/L (51.4) vs 170.7iu/L (404) (p=0.44). CONCLUSIONS: In paediatric patients, no clinical or biochemical parameter could differentiate rickettsioses from other aetiologies. Presence of eschars would help to diagnose scrub typhus. However laboratory confirmation is needed to differentiate SFG from other fevers.
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    Rickettsial infections in acute coronary syndromes
    (Sri Lanka Medical Association, 2013) Mettananda, K.C.D.; Danansuriya, D.S.T.; Bandara, N.K.B.K.R.G.W.; de Silva, H.J.; Premaratna, R.
    INTRODUCTION AND OBJECTIVES: Rickettsiae are a group of obligate intraceliular pathogens which invade endothelial cells causing vasculopathy. Vasculitis of any cause may result in acute coronary syndromes (ACS). Objectives were to assess the prevalence of Rickettsial infections in patients with ACS from Western province, Sri Lanka. METHODS: Prospective patients from Western province with ACS admitted to Professorial Medical Unit, Colombo North Teaching Hospital, Ragama from April-December 2011 were recruited as the study group. A matched control group was selected from in-ward-patients without fever or ACS. Serum samples (2ml) collected at enrolment and after 2 weeks were analysed. Rickettsial-antibody (IgG) titre >128, or a rising or a declining titre were considered positive for acute rickettsioses. A static titre was considered as previous exposure to rickettsioses (sero-prevalence). RESULTS: Of the 46 patients with ACS 11 (23.9%) were male and of the 52 controls 26 (50%) were male. Mean age was, ACS=60.7 years and controls= 55.98 years. None had evidence of acute rickettsiel infection. In ACS group, 3 and 7 were positive for [gG-OT-Orientia tsutsugamushi (prevalence=0.065) and lg-RC-Rickettsia conori (prevalence=0.152) respectively. In the control group 2 were positive for IgG-OT( prevalence = 0.038) and 6 for IgG-RC (prevalence = 0.115). There was no significant difference in sero-pre valence of rickettsie- antibodies in the study group compared to controls; odds-ratio IgG-OT 1.744 (CI, 0.278-10.928) and IgG-RC 1.376 (CI, 0.427-4.438). CONCLUSION: Sero-prevaSence of Orientia tsutsugamushi was 0.038 while that of Rickettsia conori was 0.115 in the selected population. Rickettsia conori was more prevalent than Orientia tsutsugamushi in the Western province of Sri Lanka. There was no significant association between sero-prevalence of rickettsioses and acute-coronary-syndromes.
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    Progress report of Rickettsial disease diagnostic and research laboratory (RDDRL), Faculty of Medicine, University of Kelaniya
    (Sri Lanka Medical Association, 2009) Premaratna, R.; Chandrasena, T.G.A.N.; Bandara, N.K.B.K.R.G.W.; Rajapakse, R.P.V.J.
    INTRODUCTION: RDDRL was established at Faculty of Medicine, University of Kelaniya (FMUK) in June 2008 in collaboration with Centers for Disease Control and Prevention, Atlanta, Georgia, USA and Faculty of Veterinary Medicine, University of Peradeniya. OBJECTIVES: We present the contribution of RDDRL towards the diagnosis of ricketsioses over the 5 months since its inception. RESULTS: 84 acute serum samples were analysed [56 from Colombo North Teaching Hospital (CNTH), 4 from Teaching Hospital Jaffna (THJ), 7 from Base Hospital Kamburupitiya (BHK) 3 from Lady Ridgeway Hospital (LRH), 2 from Infectious Disease Hospital (IDH), 2 from Colombo South Teaching Hospital (CSTH), and 10 from the private sector hospitals (PVT)]. 48/84 (57%) had diagnostic titers; 31 (65%) for Rickettsia conorii (RC) and 17 (35%) for Orientia tsutsugamushi (OT). The total (%) positives for each hospital were; CNTH: 22/56 (39%), BHK: 7/7 (100%), Jaffna: 3/4 (75%), LRH: 1/3 (33%), IDH: 1/2 (50%), CSTH: 0/2(0%) and PVT: 8/10 (80%). The district total (ROOT); Gampaha: 33 (26:7), Matara: 7 (3:4), Jaffna: 3 (0:3), Puttlam: 5 (2:3). The mode (range) duration of febrile illness at the time of request was 14 (3-90) days and 6 samples were from severe complicated patients; 2-encephaiitis, 2-'Neuroleptic malignant syndrome', 1-muiti-organ failure and 1-severe gastroenteritis. CONCLUSIONS: Out of the clinically suspected patients, 57% were positive for rickettsiosis; 65% caused by R. conorii and 35% by O. tsutsugamushi. However, the request for serological diagnosis was made after a considerable delay in the majority of cases.