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.Premaratna, R.End date: 2009

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Now showing 1 - 10 of 38
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    Occurence of tick bits and serological evidence of exposure to rickettsioses among Sri Lankan military personnel
    (International Society for Infectious Diseases, 2009) Premaratna, R.; Chandrasena, T.G.A.N.; Nawasiwatte, B.M.T.P.; Kulasiry, K.I.R.; Rajeev, S.; Bandara, K.B.K.R.G.W.; Rajapakse, R.P.V.J.; Kularatna, S.A.M.; de Silva, H.J.
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    Predicted cost benifits of establishment of Ricckettsial didease diagnostics in Sri Lanka
    (American Society of Rickettsiology, 2008) Premaratna, R.; Dissanayake, I.; Chandrasena, T.G.A.N.; Attanayake, N.; de Silva, H.J.
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    Rickettsial infections and their clinical presentations in the Western Province of Sri Lanka: A hospital based study
    (American Society of Rickettsiology, 2007) Premaratna, R.; Loftis, A.D.; Chandrasena, T.G.A.N.; Dasch, G.A.; de Silva, H.J.
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    The role of antioxidants in filarial infection
    (Royal Society of tropical medicine and Higiene (RSTMH), American Society of tropical medicine and Higiene(ASTMH), British Society for Parasitology, 2000) Premaratna, R.; Chandrasena, T.G.A.N.; Senarath, S.; Chandrasena, L.G.; de Silva, N.R.; de Silva, H.J.
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    The Recto-Anal Inhibitory Reflex (RAIR): abnormal response in diabetics suggests an intrinsic neuro-enteropathy
    (BMJ Publishing, 1997) Deen, K.I.; Premaratna, R.; Fonseka, M.M.D.; de Silva, H.J.
    INTRODUCTION: The recto-anal inhibitory reflex (RAIR) is characterized by reflex relaxation of the anal canal in response to electrical stimulation of the rectal mucosa, and is mediated by nitrergic neural plexuses within the gut wall. Impairment of this reflex may lead to incontinence. AIM: To measure anal canal pressures, anal mucosal electrosensation and RAIR in diabetic patients and correlate these measurements with incontinence for gas or faeces. METHODS: Anal canal pressure, RAIR and continence was evaluated in 30 diabetic patients [Male:Female=13:17, median age 57 years (range 37- 70)], and these data were compared with similar data obatained from 22 age and sex matched 'healthy' controls [Male:Female= 9:13, median age 51 years (range 19 - 65 )]. Median duration of diabetes was 8 years (range 3 -30 ). 12 (40%) of the 30 diabetics had impaired continence for gas (n=12) and liquid faeces (n=3). None ofthe controls had incontinence. RESULTS: Maximum resting anal canal pressure (MRP) was [median (range)]: Patients 30mmHg (20-75) vs. Controls 40mmHg (20-105), P=0.61. Maximum squeeze pressure (MSP) [median (range)]: Patients 65mmHg (30- 150) vs. Controls 84mmHg (35-230), P=0.59. Threshold rectal mucosal eletrosensation (RMES-T) [median (range)]: Patients 27 mA (5-40) vs. Controls l3mA (5-28), P=0.03. Maximum tolerable rectal mucosal electrosensation [median (range)]: Patients 40 mA (20-60) vs. Controls 20 mA (10-30), P=0.042 (all comparisons using Wilcoxon rank test). RAIR was present in 8, abnormal in 5 (1 with incontinence), and absent in 17 (II with incontinence) diabetics while it was present in 18 and abnormal in 4 controls (test of proportion, P=0.03 I). CONCLUSIONS: RAIR was impaired in significantly more patients with diabetes than controls implying impairment of intrinsic neuronal function. All diabetic patients with incontinence had impaired or absent RAIR. Impairment of this reflex may be a useful predictor of incontinence in diabetics.
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    Etiology of fever of unknown origin in a selected group of Sri Lankan patients with prompt responses to Doxycycline
    (Centers for disease control and Prevention, 2008) Dasch, G.A.; Premaratna, R.; Rajapakse, R.P.; Chandrasena, T.G.A.N.; Eremeeva, M.E.; de Silva, H.J.
    BACKGROUND: Most patients with long duration of fever go undiagnosed in settings where diagnostic facilities are inadequate. Untreated rickettsial infections cause extended fevers; while both scrub typhus and tick typhus are re-emerging diseases in Sri Lanka, laboratory facilities to specifically diagnose rickettsial infections in Sri Lanka are not available. METHODS: We collected 2 ml venous blood from febrile patients who had no etiological diagnosis after 7 days of hospital admission, but who showed rapid clinical response to doxycycline, to verify whether they had experienced a rickettsial infection. Acute serum samples were analysed using IFA for rickettsial infections caused by Orientia tsutsugamushi, Rickettsia conorii and Rickettsia typhi. A positive IgG IFA titer >1:128 was used to define a probable case of rickettsial infection. RESULTS: 28 patients [15 males, mean age 32.5 (SD 9.2 yrs)] were studied. Mean duration of fever at admission was 6.1 days (SD 3.1). Two patients had features suggestive of encephalitis and two had erythema nodosum. Others had no specific clinical features. Routine investigations were inconclusive and blood cultures were negative. IgG-IFA titer of >128 was found in 10 for R. conorii, 6 for O. tsutsugamushi and 6 for both R. conorii and O. tsutsugamushi. None were positive for R. typhi. Six were negative for all tests. One patient with encephalitis and one with erythema nodosum had high titers for R. conorii. CONCLUSIONS: The majority of Sri Lankan patients with undiagnosed fever responding promptly to doxycycline had a rickettsial etiology. Patients with rickettsioses exhibit varied clinical presentations so greater use of doxycycline for patients with extended fevers in rickettsial-endemic settings with inadequate diagnostic facilities appears warranted. The high proportion of patients with tick typhus and antibodies against both spotted fever and scrub typhus rickettsiae was unexpected based on previous studies of patients from the same region who were confirmed to have scrub typhus by serology and by the presence of the classic eschar. It is unknown whether the etiology of tick typhus and vector(s) transmitting this agent on the Western lowland region of Sri Lanka are the same as those responsible for spotted fevers in the central hill country of Sri Lanka.
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    Clearance of microfilaraemia and red blood cell glutathione peroxidase(GPX) levels in asymptomatic microfilaraemics after single dose and 14 days’ treatment with diethyl carbamazine citrate(DEC) 
    (Sri Lanka Medical Association, 2001) Premaratna, R.; Chandrasena, T.G.A.N.; Abeyewickreme, W.; de Silva, N.R.; Chandrasena, L.G.; de Silva, H.J.
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    Clearance of microfilaraemia and red blood cell glutathione peroxidase(GPX) levels in asymptomatic microfilaraemics after single dose and 14 days’ treatment with diethyl carbamazine citrate(DEC)
    (Wiley, 2001) Premaratna, R.; Chandrasena, T.G.A.N.; Abeyewickreme, W.; de Silva, N.R.; Chandrasena, L.G.; de Silva, H.J.
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    Red blood cell antioxidant levels after treatment with diethyl carbamazine
    (Wiley, 2001) Premaratna, R.; Chandrasena, T.G.A.N.; Abeyewickreme, W.; de Silva, N.R.; Chandrasena, L.G.; de Silva, H.J.
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    Lymphoedema management knowledge and practices among patients attending filariasis clinics in the Gampaha District, Sri Lanka
    (Sri Lanka College of Microbiologists, 2004) Chandrasena, T.G.A.N.; Premaratna, R.; de Silva, N.R.
    INTRODUCTION: Little information is available on methods of treatment practiced by Sri Lankan patients with filarial lymphoedema. The burden of acute dermatolymphagioadenitis (ADLA) attacks in these patients is also unclear. OBJECTIVES: To determine knowledge, perceptions and practices regarding lymphoedema management and the burden of ADLA attacks among patients with lymphoedema attending filariasis clinics. METHODS: The survey was carried out in the Gampaha district. Semi structured questionnaires were deployed to assess knowledge, practices and perceptions regarding morbidity alleviation in filarial lymphoedema. The burden of ADLA attacks was estimated using one-year recall data. RESULTS: 66 patients (22 males: 44 females) mean age 51.18 years SD 13.9% were studied. Almost two thirds of the population was aware of the importance of skin and nail hygiene, limb elevation and use of footwear. Washing was practiced"bn a daily and twice daily basis by 40.9% and 48.5% respectively. However limb elevation, exercise and use of footwear were practiced by 21 -42.4% (while seated and lying down), 6% and 34.8% respectively. Regular intake of DEC was considered important by the majority (n=61. 92.4%). Most (65.2%) had received health education from the filariasis clinics. Among patients who sought private care (n~48) the average cost of treatment of an ADLA attack was Rs. 737.91. Only 18.2% had feelings of isolation and reported community reactions ranging from sympathy to fear and ridicule. CONCLUSIONS: Filariasis clinics seem to play an important role in the dissemination of knowledge regarding morbidity control. Referral of lymphoedema patients to morbidity control clinics is recommended.