Journal/Magazine Articles

Permanent URI for this collectionhttp://repository.kln.ac.lk/handle/123456789/13

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

Browse

Author: search.filters.author.Fernando, N.Has files: No

Search Results

Now showing 1 - 3 of 3
  • No Thumbnail Available
    Item
    Effect of antimicrobial agents on inflammatory cytokines in acute Leptospirosis
    (American Society for Microbiology, 2018) Fernando, N.; de Silva, R.; Hadunnetti, S.M.; Karunanayake, L.; de Silva, N.L.; de Silva, H.J.; Rajapakse, S.; Premawansa, S.
    The aim of this study was to assess the inflammatory cytokine response and possible association with antimicrobial treatment with penicillin, ceftriaxone, and doxycycline in acute leptospirosis. In the early acute stage, interleukin-10 (IL-10) levels were higher in mild cases than in severe cases (P = 0.01). IL-6 and IL-8 levels were low in patients who received >5 antimicrobial doses (P < 0.01). IL-8 levels were negatively correlated with the number of ceftriaxone doses administered (r = -0.315; P = 0.031). Further studies are needed to evaluate the possible downregulation of proinflammatory cytokines by ceftriaxone in leptospirosis.
  • No Thumbnail Available
    Item
    Clinical and laboratory associations of severity in a Sri Lankan cohort of patients with serologically confirmed leptospirosis: a prospective study
    (Oxford : Oxford University Press, 2015) Rajapakse, S.; Weeratunga, P.; Niloofa, M.J.; Fernando, N.; Rodrigo, C.; Maduranga, S.; de Silva, N.L.; de Silva, H.J.; Karunanayake, L.; Handunnetti, S.
    BACKGROUND: Leptospirosis results in significant morbidity and mortality. This study elucidates markers of severity in a cohort of Sri Lankan patients. METHODS: Patients presenting to three healthcare institutions in the Western province of SriLanka with leptospirosis serological confirmed by the microscopic agglutination test (MAT) were included. Prospective data regarding demographic, clinical and laboratory parameters was extracted. Univariate associations and subsequent multivariate logistic regression models were constructed. RESULTS: The study included 232 patients, with 68.5% (159) demonstrating severe disease. Significant associations of severe disease at a significance level of p<0.05 were fever >38.8°C on presentation, age >40 years, muscle tenderness, tachycardia on admission, highest white cell count >12 350/mm(3) and <7900/mm(3), highest neutrophil percentage >84%, haemoglobin >11.2 g/dL and <10.2 g/dL, packed cell volume (PCV) >33.8% and <29.8%, lowest platelet count <63 500/mm(3), highest alanine transaminase (ALT) >70 IU/L and hyponatremia with sodium <131mEq/L. On multivariate analysis, PCV <29.8% (p=0.011; OR 3.750; CI: 1.394-10.423), ALT >70 IU/L (p=0.044; OR 2.639; CI: 1.028-6.774) and hyponatremia <131mEq/L (p=0.019; OR 6.413; CI: 1.353-30.388) were independent associations of severe disease. CONCLUSIONS: Severity associations were demonstrated with both clinical and laboratoryparameters. There is a need for novel biomarkers for prediction of severity in leptospirosis. © The Author 2015. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
  • No Thumbnail Available
    Item
    Validation of the Sinhala translation of Edinburgh Postnatal Depression Scale
    (Sri Lanka Medical Association, 2008) Rowel, D.; Jayawardana, P.; Fernando, N.
    INTRODUCTION:To determine the validity and reliability of the Sinhalese translation of the Edinburgh Postnatal Depression Scale (EPDS) as a screening instrument to detect antenatal and postnatal depression. METHOD: Two hundred and sixty five antenatal women and 204 postnatal women attending the field polyclinics of the Medical Officer of Health (MOH) area Kolonnawa participated in the study. Psychiatric diagnosis based on ICD 10 Classification of Mental and Behavioural Disorders was the 'gold standard' and the receiver operating characteristic (ROC) analysis was used to evaluate the test performance of the translated EPDS for antenatal and postnatal depression separately. Reliability was tested using test-retest method and computing intra-class correlation coefficients. RESULTS: A cut-off score of 9 was selected as the best to screen for depression, in antenatal (sensitivity 90.7% and specificity 86.8%) andpostnatal women (sensitivity 89.9% and specificity 78.9%). The intra-class correlation coefficients of the instrument for antenatal and postnatal women were 0.95 (95% CI = 0.82 - 0.99) and 0.96 (95% CI = 0.86 - 0.99). CONCLUSION: The Sinhalese translation of the EPDS is a valid and a reliable instrument to screen for depression in antenatal and postnatal women in Sri Lanka.