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 A review of oculotoxicity in iodine overdose(College of Ophthalmologists of Sri Lanka, 2019) Medagoda, K.; Salvin, K.A.Item A conjunctival myxoid stromal tumor (COMST) mimicking phlyctenulosis: A case report and brief review of the literature(Elsevier, 2022) Medagoda, K.; Salvin, K.A.; Mahendra, B.A.G.G.Purpose: This is a case report of a patient with a conjunctival myxoid stromal tumor (COMST), mimicking a phlyctenulosis. Tumors of the conjunctiva and cornea occupy a large spectrum ranging from benign lesions of myxoma to aggressive, life-threatening malignancies. Phlyctenulosis and phlyctenular keratoconjunctivitis are hypersensitivity reactions to a foreign antigen. Observations: A 64-year-old male presented with six-month history of non-painful lump in the conjunctiva of the left eye. It was a mobile, non-tender, non-ulcerated, non-hemorrhagic, non-pigmented lesion and was non-adherent to the sclera. The differential diagnosis of phlyctenulosis or a soft tissue tumor was considered. The lesion was completely excised. The microscopy showed an ill-defined hypocellular myxoid lesion composed of stellate and spindle-shaped cells with eosinophilic cytoplasm, containing round-ovoid and spindle-shaped nuclei with a vesicular chromatic pattern. The tumor cells were diffusely and strongly positive for vimentin and CD 34 and were negative for S100. The immunomorphological features were compatible with a conjunctival myxoid stromal tumor. Complete systemic evaluation excluded the possible association with systemic myxomas. Conclusions and importance: Myxoid tumors of the conjunctiva are benign tumors, however, they can mimic other benign conditions like phlyctenulosis or more sinister lesions like malignant tumors. Therefore, it is important to do an excisional biopsy to ascertain the definitive pathology of an indeterminate conjunctival lesion. COMST may be the index presentation for the detection of previously undiagnosed myxoma syndromes. One such association is with cardiac myxomas, which can result in vascular embolic events. Therefore, it is important to do cardiac screening in all patients diagnosed with a COMST.Item Heterotopic salivary gland tissue in the gastro-oesophageal junction: a rare entity(College of Pathologists of Sri Lanka, 2021) Dharani, K.; Medagoda, K.; Kumarage, S.K.; Mahendra, B.A.G.G.Introduction: Gastric and pancreatic heterotopia are the two most common types of heterotopias seen in the gastrointestinal tract (GIT). These are the two most common types of heterotopias seen in the oesophagus as well. The occurrence of heterotopic salivary gland tissue (HSGT) in the GIT is rare, and most reported cases are colorectal and anal lesions with only a few cases involving the oesophagus. Case report: A 69-year-old man presented with a seven-month history of gastro-oesophageal reflux disease (GORD). The upper gastrointestinal endoscopy showed a moderate hiatus hernia with a pale pink mucosal patch close to the gastro-oesophageal junction. The biopsy showed oesophageal tissue with morphological changes of mild reflux oesophagitis. The submucosal tissue contained organized glandular structures with mucinous glands and intercalated ducts resembling mature salivary gland tissue. There was no evidence of Barrett oesophagus, dysplasia or neoplasm. Discussion and conclusion: HSGT is most commonly seen in the head and neck region of the body, and its occurrence in the GIT is rare. Occurrence of oesophageal HSGT is extremely rare and most cases have presented with symptoms of GORD. Although HSGT is usually benign and a rare phenomenon, clinicians and pathologists need to be aware of this condition to prevent a delay in diagnosis and inappropriate management.