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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Item Aetiology of cirrhosis in a tertiary referral centre in Sri Lanka(Wiley Blackwell Scientific Publications, 2005) Dassanayake, A.S.; Mettananda, K.C.D.; de Silva, A.P.; de Silva, H.J.INTRODUCTION: Alcoholic liver disease is widely believed to be the commonest cause of cirrhosis in Sri Lanka. However, with the rising prevalence of obesity and diabetes, non-alcoholic steatohepatitis (NASH) is increasingly being diagnosed. Despite being situated in an intermediate to high transmission region, the prevalence of both hepatitis B (o2%) and C ( 1%) is low in our population. AIMS: To study the aetiology of cirrhosis in a tertiary referral centre in Sri Lanka. METHODS: We analysed the database of outpatients with cirrhosis maintained since 2001, reviewing records with regard to aetiology. A diagnosis of cirrhosis was established on clinical, biochemical and radiological evidence, and confirmed histologically when required. A detailed alcohol and drug history was obtained from all cirrhotic patients. Hepatitis B and C serology, iron and copper studies, and an autoimmune screen were also performed. RESULTS: Records of 101 patients were analysed (male:female 5 78:23, mean age 38.3 years (SD 17.5)). The aetiology of cirrhosis was as follows: alcohol 64 patients (63.4%, male:female 5 60:4), cryptogenic 24 (23.8%, male:female 5 12:12), chronic hepatitis B four (all males), autoimmune hepatitis four (all females), Wilson’s disease two (both females), previously diagnosed NASH two (one male, one female), and chronic hepatitis C one (male). The prevalence of diabetes was 45% among patients with cryptogenic cirrhosis compared to 27% among patients with other causes. CONCLUSIONS: Alcohol remains the commonest cause of cirrhosis in our patients. Cryptogenic cirrhosis was the second commonest cause overall, and the commonest among females. The high prevalence of diabetes among patients with cryptogenic cirrhosis suggests an aetiology of previously undetected NASH.Item Profile of gastric varices among Sri Lankan cirrhotics(Wiley Blackwell Scientific Publications, 2012) Ranawaka, C.K.; Mettananda, K.C.D.; de Alwis, R.; Miththinda, J.K.N.D.; Wijewantha, H.S.; Niriella, M.A.; Dassanayake, A.S.; de Silva, A.P.; de Silva, H.J.BACKGROUND AND AIMS: Gastric varices (GV) can result in life threatening bleeding with a higher mortality than esophageal varices. There have been no studies on the characteristics of GV among Sri Lankan cirrhotics. Aim of this study was to perform a descriptive analysis of GV among a cohort of Sri Lankan cirrhotic population. METHODS: We analyzed medical records of all upper gastrointestinal endoscopies performed on cirrhotics, at the University Endoscopy Unit, Colombo North Teaching Hospital, Ragama, Sri Lanka from 2006 to 2011. Characteristics of GV, demographics, indications and fi ndings at endoscopy were analyzed and they were compared among patients with Oesophageal varices (EV). RESULTS: Out of 641 cirrhotics screened, 628 had a complete data set for analysis. GV was detected in 70 (11%) patients; male:female 8.7:1.3; mean age 55 (SD = ± 10.7) years. From these 48/70 had EV (Gastro Oesophageal Varices GOV1 – 18/48, GOV2 – 30/48) in addition to GV. Only 22/70 had Isolated GV (IGV1–10, IGV2–12). Among patients with GV 38 (54%) had portal hypertensive gastropathy and 3 (4%) had gastric antral vascular ectasia. Nineteen (27%) of GV were detected on presentations with UGIB (6 with IGV, 13 with GOV), whereas 51 (73%) were detected on routine screening. EV was detected in 288 (46%) of cirrhotics (Isolated EV 240, GOV 48). Seventy seven (32%) of EV were detected on presentations with UGIB, whereas 163 (68%) were detected on routine screening. There was no statistically significant difference on presentation with UGIB between isolated EV (77/240) vs. IGV (6/22) patients (p = 0.64; χ2 = 0.2). CONCLUSION: The profi le of GV among our cirrhotics is comparable to previous reports from other centres. Findings suggest that in cirrhotic patients presenting with UGIB, a careful search for the presence of GV is as important as identifying EV, even among patients who have EV.