Journal/Magazine Articles
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This collection contains original research articles, review articles and case reports published in local and international peer reviewed journals by the staff members of the Faculty of Medicine
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Item Characteristics and survival of advanced untreated hepatocellular carcinoma of non-viral etiology(Indian Society of Gastroenterology, 2024) Ekanayaka, S.P.N.; Luke, N.; Thilakarathne, S.B.; Dassanayake, A.; Gunetilleke, M.B.; Niriella, M.A.; Siriwardana, R.C.INTRODUCTION AND OBJECTIVES Hepatocellular carcinoma (HCC) is an aggressive tumor and presents late. The underlying etiology of HCC is changing rapidly. HCC in Sri Lanka is unique due to its predominant non-viral etiology (nvHCC) but lacks survival data.METHOD Data was collected from patients who presented with HCC from 2011 to 2018. There were 560/568 (98.6%) nvHCC. The patients who were not candidates for tumor-specific treatment (149/560 [26.7%]) were selected. Population characteristics, demographic data, tumor characteristics, survival and factors affecting survival were analyzed.RESULTS The median age was 64 years (range 30-88) and 86% (n = 129) were males. As many as 124 (83%) were cirrhotic. The overall performance score was 80%. Nearly 21/124 tumors were detected in cirrhotic screening. Tumors were single nodular in 32 (21%), up to three nodules in 28 (18%), more than three nodules in 33 (22%) and diffusely infiltrating in 56 (37%). The major venous invasions were present in 78 (52.3%). Extra-hepatic tumor spread was seen in 19 (12.7%) (lungs 13 [72.2%], bones 2 [11.1%]). The median survival of patients receiving palliative care was three months (1-43 months). Tumor size and cirrhotic status were significant predictors in univariate analysis.CONCLUSION A quarter of nvHCCs were not amenable to treatment at presentation as they had dismal survival.Item Tropical liver disease.(Elsevier, 2023) Beeching, N.; Dassanayake, A.The liver is frequently involved in infections that are prevalent in different regions of the tropics, and chronic liver disease, sometimes with multiple aetiological explanations, is an important cause of early morbidity and mortality. This article describes some hepatic and biliary problems that are seen in the tropics or can be imported from resource-poor settings. The epidemiology of hepatitis A is changing in many areas and hepatitis E is now recognized in a wide range of tropical and non-tropical settings. Vaccines have been developed against hepatitis E. Hepatitis B and C continue to cause chronic liver disease, cirrhosis and hepatocellular carcinoma, but these can be eclipsed in epidemiological importance by the sequelae of the emerging epidemic of non-alcoholic fatty liver disease in many parts of the tropics. The pathophysiology of acute and chronic liver disease caused by aflatoxins is better understood, as is the relationship of veno-occlusive disease of the liver to pyrrolizidine alkaloids. Self-poisoning with hepatotoxins is common in many countries. The diagnosis and management of cystic hydatid disease of the liver has been rationalized, based on a systematic approach to the classification of imaging findings.Item Tropical liver disease(Elsevier Ltd, 2019) Beeching, N.; Dassanayake, A.ABSTRACT: The liver is frequently involved in infections that are prevalent in different regions of the tropics, and chronic liver disease, sometimes with multiple aetiological explanations, is an important cause of early morbidity and mortality. This article describes some hepatic and biliary problems that are seen in the tropics or can be imported from resource-poor settings. The epidemiology of hepatitis A is changing in some areas, and hepatitis E is now recognized in an increasing range of tropical and non-tropical settings. Vaccines have been developed against hepatitis E. Hepatitis B and C continue to cause chronic liver disease, cirrhosis and hepatocellular carcinoma, but these can be eclipsed in epidemiological importance by the sequelae of the emerging epidemic of non-alcoholic fatty liver disease in many parts of the tropics. The pathophysiology of acute and chronic liver disease caused by aflatoxins is better understood, as is the relationship of veno-occlusive disease of the liver to pyrrolizidine alkaloids. Self-poisoning with hepatotoxins is common in many countries. The diagnosis and management of cystic hydatid disease of the liver has been rationalized, based on a systematic approach to the classification of imaging findings. © 2019Item Tropical liver disease(Elsevier, 2015) Beeching, N.; Dassanayake, A.The liver is frequently involved in infections that are prevalent in different regions of the tropics, and chronic liver disease, sometimes with multiple aetiological explanations, is an important cause of early morbidity and mortality. This article describes some hepatic and biliary problems that are seen in the tropics, or which may be imported from resource-poor settings. The epidemiology of hepatitis A is changing in some areas and hepatitis E is now recognized in an increasing range of tropical and non-tropical settings. Vaccines have been developed against hepatitis E. Hepatitis B and C continue to cause chronic liver disease, cirrhosis and hepatocellular carcinoma, but these may be eclipsed in epidemiological importance by the sequelae of the emerging epidemic of non-alcoholic fatty liver disease in many parts of the tropics. The pathophysiology of acute and chronic liver disease due to aflatoxins is better understood, as is the relationship of veno-occlusive disease of the liver to pyrrolizidine alkaloids. Self-poisoning with hepatotoxins is common in many countries. The diagnosis and management of cystic hydatid disease of the liver has been rationalized, based on a systematic approach to the classification of imaging findings.Item Tropical liver disease(Elsevier-Medicine Publishing, 2007) Beeching, N.; Dassanayake, A.No Abstract Available