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 Pseudoainhum associated with lepromatous leprosy: A very rare association in modern world(Chinese Medical Association Publishing House, 2023) Nishad, A.A.N.; Pathman, M.; Uwyse, S.A.; Mendis, A.; Abeysundara, P.K.; de Silva, A.P.INTRODUCTION: Pseudoainhum (dactylolysis spontanea) is characterized by the development of a fibrous band around the digit that gradually leads to autoamputation. Digital pain associated with Pseudoainhum may not be evident in patients with neuropathic conditions. Here, we present a rare case of pseudoainhum patient, which describes a very rare association of pseudoainhum with leprosy. CASE PRESENTATION: A 48 year old male with lepromatous leprosy, with resorption of digits, charcot joints and tropical ulcers was seen in the clinic. The forth digit of the left hand had a narrowing due to a fibrous band at the 2nd inter phalangeal joint with shiny tethering distal phalanx. He could not recall the duration of the ainhum. He was not suffering from any pain.DISCUSSION: The current report describes a very rare association of pseudoainhum with leprosy. The case involved a 48-year-old man in the dermatology ward with lepromatous leprosy presenting with a pseudoainhum. CONCLUSION: This case highlights the possibility of delayed presentation of patients with pseudoainhum to physicians when the patients have underlying neuropathic conditions that prevent feeling finger pain and cause abnormal appearance of the digits, especially in leprosy.Item Neurological melioidosis complicated by cerebral venous sinus thrombosis(Ceylon College of Physicians, 2020) Abeysundara, P.K.; Nishad, A.A.N.; Perera, W.N.M.; de Silva, H.; Piyarathne, R.; Rathnayaka, R.M.P.M.; Arulmoly, K.; Umakanth, M.; Premaratna, R.; Tilakaratne, Y.ABSTRACT: Melioidosis is a systemic disease endemic in Southeast Asia and Northern Australia. The spectrum of the disease varies from asymptomatic infection to severe systemic manifestations. Timely diagnosis and treatment of melioidosis is a challenge due to its atypical presentations. We report a case of melioidosis causing cerebral abscesses and cerebral venous sinus thrombosis. Occurrence of these neurological manifestations in melioidosis is rare and it is a difficult condition to diagnose and treat. Timely diagnosis was a challenge in this patient due to the atypical presentation and the use of empirical antibiotics in the primary care setting. Limited laboratory diagnostic capability also contributed to this delay. KEYWORDS: Melioidosis, Cerebral abscess, Cerebral venous sinus thrombosisItem The Thal-index with the BTT prediction.exe to discriminate ß-thalassaemia traits from other microcytic anaemias(Pagepress, Italy, 2012) Nishad, A.A.N.; Pathmeswaran, A.; Wickremasinghe, A.R.; Premawardhena, A.Several attempts have been made previously to differentiate -thalassaemia trait (BTT) from other microcytic anaemias using formulae with red cell (RC) parameters. Presently available formulae have low sensitivity and specificity. We wanted to develop a more precise algorithm, which could be used in situations where the gold-standard test for thalassaemia diagnosis: the high performance liquid chromatography (HPLC) is not available. The study was carried out prospectively from November 2008 to March 2010 from randomly collected blood samples with a mean cell volume (MCV) of less than 80 fL. HbA2 measured by HPLC was used to diagnose BTT. We used Fishers stepwise linear discriminant function analysis to develop an algorithm with RC parameters. Calculated new index Thal-index was then subjected to receiver operating characteristic curve analysis to identify best cutoff to discriminate BTT from other microcytic blood films. Software was developed to predict the BTT status (BTT prediction.exe). New index, referred to as the Thal-index, was calculated using discriminant function analysis and is given as Thal-index=[(0.615MCV) +(0.518mean corpuscular hemoglobin)+ (0.446red cell distribution width)]. A value of 59 for Thal-index has 90% sensitivity and 85% specificity for differentiating BTT from other microcytic anaemias. This showed better sensitivity and specificity compared to other formulae presently used (i.e., Mentzer in Eshani, et al.). Our study gives a better answer to set-up where HPLC is not available. Although this cannot replace HPLC, BTT prediction.exe is useful to predict instantly and is the first ever computer program available for this function