Conference Papers

Now showing 1 - 4 of 4

Impact of acalypha indica (Kuppamenia) phytochemicals on glucose-6-phosphate dehydrogenase deficiency: two clinical case studies
(College of Chemical Pathologists of Sri Lanka, 2024) Fernando, K.; Fernando, N.; Dayanath, B.K.T.P.; Williams, S.; Premawardhena, A.
INTRODUCTION Acalypha indica, known as “kuppamenia” in Sinhala, plays a significant role in ayurvedic medicine in Sri Lanka. Despite its medicinal use, certain phytochemicals within the plant have been linked to oxidative stress-induced haemolysis in individuals deficient in glucose-6-phosphate dehydrogenase (G6PD) enzyme activity. However, we know very little regarding those chemicals due to a dearth of literature. Here, we present two cases highlighting the impact of Acalypha indica ingestion on individuals with G6PD deficiency.CASE PRESENTATION Case 1: A 65-year-old man presented with jaundice, pallor, and haematuria after consuming “Kuppamenia mallum”. His peripheral blood picture showed bite cells and Heinz bodies. Positive Brewer’s test raised the clinical suspicion of G6PD deficiency. He received blood transfusions during the acute phase and was discharged upon improvement of symptoms. Low levels of G6PD enzyme at the follow-up visit confirmed the diagnosis. Case 2: A 61-year-old male presented with respiratory distress, jaundice and haematuria, accompanied by peripheral cyanosis and hypotension. He was admitted following four days of continuous ingestion of Acalypha indica. Peripheral oxygen saturation was low, and Heinz bodies were evident in the peripheral blood film. Blotting paper methaemoglobinaemia assessment revealed a level of 70%. Despite optimal medical management, he succumbed to a cardiac arrest on the fourth day of admission.DISCUSSION AND CONCLUSIONS Despite its antioxidant properties, Acalypha indica can precipitate acute haemolysis in G6PD-deficient individuals. Symptomatology and outcomes vary with the amount ingested, underscoring the necessity for research into identifying potentially toxic phytochemicals and their concentrations.
Correlation of genotype with phenotype in beta thalassaemia intermedia in Sri lanka
(Thalassaemia International Federation, 2015) Perera, P.S.; Silva, D.P.S.I.; Hapugoda, M.; Wickramarathne, M.N.; Wijesiriwardena, I.; Efremov, D.G.; Fisher, C.A.; Weatherall, D.J.; Premawardhena, A.
Abstract Available
A Descriptive study of deep vein thrombosis (DVT) in a tertiary care hospital
(Sri Lanka Medical Association, 2008) Botheju, W.I.K.; Navaratne, A.C.R.; Somarathne, C.K.; Balasooriya, B.L.P.P.; Wijebandara, R.J.K.S.; Mandawala, M.B.S.N.; Ruwanpathirana, T.; Kasturiratne, K.T.A.A.; Hewawitharana, C.P.; Rathnasena, B.G.N.; Fernando, P.; Wijesinghe, P.S.; Premawardhena, A.
OBJECTIVE: The incidence and risk factors for DVT are not well established for the Sri Lankan population. Though believed to be an effective screening tool for DVT, the Well's Clinical score is not widely used in Sri Lankan hospitals. DESIGN, SETTING AND METHODS: Over a period of 8 months, a total of 23274 patients who presented to four units (including one general medical, one general surgical, one Gynaecology & Obstetrics, and the Orthopedic ward) of the North Colombo (Teaching) Hospital were screened for asymmetrical limb swelling more than 2 cm. The latter group were subjected to risk assessment for DVT, Well's scoring and CDU (Colour Duplex Ultrasound). RESULTS: Of the 23274 patients, 93 (0.4%) had unilateral limb swelling of which 12 (12.9%) were CDU confirmed to have DVT (0.5 per 1000). Limb swelling for more man two weeks was significantly commoner among DVT patients when compared to those without DVT (75% Vs 25.9%: p=0.001). None of the patients had been evaluated with the Well's score as a guide to refer for CDU by the relevant clinical teams. In 55 (59.1%) subjects, Well's score was 0 or less (minimum probability of DVT) and there were no subjects with DVT in this group. All 12 patients with DVT had a moderate or high probability Wells score. CONCLUSIONS: Overall incidence of DVT in the study population was lower than in other comparable published studies from Asia. Well's score which was underused by the clinicians is a highly sensitive screening tool for DVT.
The variable phenotypes of haemoglobin D in Sri Lankan patients
(Sri Lanka Medical Association, 2006) Premawardhena, A.; Arambepola, M.; Weatherall, D.
INTRODUCTION: There are only few reports of the occurrence of the variant haemoglobin, haemoglobin D Punjab (β 121 Glu-Gln) in Sri Lanka and its clinical spectrum has not been well documented. MATERIALS AND METHODS: During the clinical study of patients attending the thalassaemia clinic at Teaching Hospital Kurunegala we identified several individuals with haemoglobin D, some of whom had co-inherited it with other haemoglobin disorders. They were diagnosed using High Performance Liquid Chromatography (Bio Rad, USA) and later confirmed by polymerase chain reaction. CLINICAL STUDIES: Family 1: (Hb D-p thalassaemia) Describes a family with two individuals with haemoglobin D- β thalassaemia. Both were mildly anaemic but had severe hypochromasia and microcytosis. They were otherwise well. Family 2: (Hb D- Hb S disease) The propositus was an eight year old girl who presented with several episodes of sickling crises. Parents were carriers for Hb S and Hb D. Family 3: (Hb D- Hb E disease) The propositus was an individual with Hb E- Hb D disease. She was clinically well and the only abnormality was severe hypochromasia and microcytosis. DISCUSSION: Hb D when co-inherited with Hb E or thalassaemia does not appear to cause clinically significant disease. The co-inheritance of Hb D with Hb S, however, results in severe disease leading to sickling crises. Even though Hb D commonly does not cause severe disease, knowledge of its occurrence is important as the hypochromasia and microcytosis associated with it may lead to unnecessary iron therapy.

Conference Papers

Browse

Filters

Settings

Sort By

Results per page

Search Results