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 Exploring the impact of occupational exposure: A study on cardiovascular autonomic functions of male gas station attendants in Sri Lanka(Wiley periodicals LLC on behalf of the physiological society and the American physiological society, 2024-10) Warnakulasuriya, T.; Medagoda, K.; Kottahachchi, D.; Luke, D.; Wadasinghe, D.; Rathnayake, P.; Ariyawansa, J.; Dissanayake, T.; Sandeepani, P.; De Silva, D.C.; Devanarayana, N.M.Fuel dispensing at fuel stations is performed manually by unprotected male gas station attendants in Sri Lanka, who have long working hours. These workers are exposed to hydrocarbon fuels associated with multiple health effects by modulation of the autonomic nervous system. This study was performed to determine cardiovascular autonomic functions among fuel pump attendants in Sri Lanka. Fuel pump attendants (n = 50) aged between 19 and 65 years were identified for the study from seven fuel stations. They were compared with age- and gender-matched controls (n = 46) without occupational exposure to fuel. A physical examination was performed before the autonomic function and heart rate variability (HRV) assessment. There were no significant differences in weight, height, or BMI between the study and the control populations (p > 0.05). Both the systolic blood pressure (SBP) (Mann Whitney U (MWU) = 743.5, p = 0.003) and diastolic blood pressure (DBP) (MWU = 686.5, p = 0.001) were significantly higher among the gas station attendants compared to controls. Valsalva ratio was significantly higher among the study group (MW U = 874.00, p = 0.043) compared to controls. The HRV analysis showed significantly higher SDNN and SD2 (MWU = 842.00, p = 0.034, and MWU = 843.50, p = 0.035 respectively) among the gas station attendants compared to controls. The changes to the cardiovascular autonomic parameters among those exposed to fuel vapor as a gas station attendant indicate an increase in sympathetic outflow to the vessels. In the occupational setting as fuel pump attendants need periodic monitoring.Item Chronic myeloid leukaemia with generalized lymphadenopathy – a high risk category(The Sri Lanka College of Haematologists, 2022) Prasanni, W.D.D.; Williams, H.S.A.; Costa, Y.J.; Dissanayake, T.Chronic myeloid leukaemia (CML) presenting with generalized lymphadenopathy is an uncommon manifestation of CML. Lymphadenopathy in these patients could be due to extramedullary involvement by myeloid cells with all stages of maturation, blast infiltration, co-existing lymphoproliferative disorder or reactive lymphadenopathy. We report a case of a 38-year-old male with CML in chronic phase and generalized lymphadenopathy at diagnosis. He transformed to blast crisis within 14 weeks of diagnosis despite tyrosine kinase inhibitor (TKI) therapy. This case indicates that CML patients with lymphadenopathy are at high risk of disease progression and early blast transformation and therefore candidates for aggressive treatment.Item Analysis of urine culture isolates from seven laboratories of Sri Lanka: National Laboratory Based Surveillance of Sri Lanka College of Microbiologists in 2014(Sri Lankan Society for Microbiology, 2016) Jayatilleke, S.K.; Patabendige, G.; Dassanayake, M.; Karunaratne, G.K.D.; Perera, J.; Perera, R.R.D.P; Wijesooriya, W.R.P.L.I.; Sunil-Chandra, N.P.; Kottahachchi, J.; Athukorala, D.; Dissanayake, T.INTRODUCTION: National Laboratory Based Surveillance of Antimicrobial Resistance in urinary isolates conducted by the Sri Lanka College of Microbiologists was started in 2011 in collaboration with the Ministry of Health of Sri Lanka. METHODS: Pooled susceptibility data of urine culture isolates with a colony count of ≥105 CFU/ml from samples of non-catheterised patients received in 2014 were analysed using WHONET 5.6 software. RESULTS: The majority of the isolates (3975/4979:79.8%) were Gram negative enteric organisms, commonly known as coliforms. The other bacterial isolates identified were Enterococcus spp. (254), Pseudomonas spp. (194), coagulase negative staphylococci (59), Staphylococcus aureus (36), Acinetobacter spp. (35) and Group B β-haemolytic streptococci (18). The coliforms isolated from adults attending outpatient clinics (n=277) had 55.2% susceptibility to cephalexin and cephradine, 54% to amoxycillin/clavulanic acid, 65.1% to nitrofurantoin, 48.3% to norfloxacin, 63.4 % to cefotaxime, 86.4% to gentamicin, 97.4% to imipenem and 100% to meropenem. The isolates from adult hospitalized patients (n=1297) had 39.5% susceptibility to cefotaxime, 87.9% to meropenem, 62.6% to gentamicin and 31.9% to ciprofloxacin. Coliforms isolated from paediatric outpatients (n=182) had 58.5% susceptibility to cephalexin and cephradine, 58.5% to amoxycillin/clavulanic acid, 80% to nitrofurantoin, 85% to cefotaxime, 86.5% to gentamicin and 89.7% to meropenem. Those from paediatric hospitalized patients (n= 663) had 64.6% susceptibility to cefotaxime, 90.5% to meropenem and 80.2% to gentamicin. CONCLUSION: Coliforms, the commonest category of organisms isolated had high resistance rate in hospitalized patients whereas the resistance was less in outpatients, especially in the paediatric age group.