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 Liv. 52 in alcoholic liver disease: a prospective controlled trial(Elsevier, 2003) de Silva, H.A.; Saparamadu, P.A.M.; Thabrew, M.I.; Pathmeswaran, A.; Fonseka, M.M.D.; de Silva, H.J.Liv.52, a hepatoprotective agent of herbal origin, is used empirically for the treatment of alcoholic liver disease in Sri Lanka. We conducted acontrolled trial to assess the efficacy of Liv.52 in patients with alcoholic liver disease. Patients with evidence of alcoholic liver disease attending outpatient clinics were included in a prospective, double blind, randomized, placebo controlled trial. During the trial period, 80 patients who fulfilled inclusion criteria were randomly assigned Liv.52 (cases; n = 40) or placebo (controls) the recommended dose of three capsules twice daily for 6 months. All patients underwent clinical examination (for which a clinical score was computed), and laboratory investigations for routine blood chemistry and liver function before commencement of therapy (baseline). Thereafter, clinical assessments were done monthly for 6 months, while laboratory investigations were done after 1 and 6 months of therapy. There was no significant difference in the age composition, alcohol intake and baseline liver function between the two groups. The two-sample t-test was used to analyze data obtained after 1 and 6 months of therapy against baseline values. There was no significant difference in clinical outcome and liver chemistry between the two groups at any time point. There were no reports of adverse effects attributable to the drug. Our results suggest that Liv.52 may not be useful in the management of patients with alcohol induced liver disease.Item Geneder differences in undergraduate medical examination results in Sri Lanka(Sri Lanka Medical Association, 2000) de Silva, N.R.; Thabrew, M.I.; Saparamadu, P.A.M.; Jayawardena, D.R.K.C.; Arachchige, A.A.; Weerawardhane, M.; Gunawardene, Y.I.N.S.OBJECTIVE: To identify possible gender related differences in performance at undergraduate medical examinations in Sri Lanka. STUDY DESIGN AND METHODS: Results of examinations conducted by the faculty of medicine, University of Kelaniya in 1997 and 1998, and data published by the University Grants Commission (UGC) on final examinations conducted by 4 other Sri Lankan medical faculties (in the Universities of Colombo, Peradeniya, Ruhuna and Jaffna) in 1996 and 1997, were analysed for sex related differences.RESULTS: The proportion of women in each batch of students who sat for 8 examinations conducted at the faculty of medicine, University of Kelaniya in 1997 and 1998, ranged from 40.7 to 48.4% (average 44.3%). Among students sitting for the final MBBS examinations in other medical faculties in 1996 and 1997, the proportion of women ranged from 37.3% in Peradeniya to 53.7% in Jaffna. The proportions of women who obtained "classes" were higher than that of men in 12/15 examinations, with statistically significant differences in four. Higher proportions of men were referred or failed in all 8 examinations analysed; the differences were statistically significant in two. CONCLUSIONS: Women appear to do marginally better than men in undergraduate medical examinations in Sri Lanka.Item A Clinical and cost evaluation between outpatient endometrial biopsy and dilatation and curettage(Sri Lanka College of Obstetricians and Gynaecologists, 1997) Gunasekera, P.C.; Wijesinghe, P.S.; Saparamadu, P.A.M.Objective To evaluate the clinical and financial benefits of endometrial aspiration biopsy using a new aspiration device (Probet) over conventional dilatation and curettage. Design Comparison of histology and adequacy of samples obtained by endometrial aspiration and formal curettage. The histopathologist was blinded with regard to the biopsy method. Setting The gynaecology outpatient department of a teaching hospital. Patients 52 consecutive women requiring dilatation and curettage (D and C). Interventions Endometrial aspiration was performed in the out patient department and conventional D and C performed within 3 days. Main outcome measures Degree of discomfort to patients during endometrial aspiration was assessed by a visual analogue scale. Histological adequacy of the endometrial samples obtained was determined. The histological diagnosis of samples obtained by the two methods was passed. Cost of the two methods was determined. Results Eight patients experienced moderate to severe discomfort during endometrial aspiration. These were done for investigation of subfertility (2) and postmenopausal bleeding (6). Scanty or no endometrial aspirate was obtained in 9 women, 6 of whom had postmenopausal bleeding. No curettings were obtained in 5 of the women with postmenopausal bleeding. Active bleeding was present at the time of the procedure in 5 patients which was reported as blood clot and menstrual endometrium. In only 2 of the paired endometrial samples did the histological diagnosis differ from the specimen obtained by endometrial aspiration. Histological concordance was noted in 30 pairs. Conclusions Outpatient endometrial biopsy is acceptable to the majority of patients. Nulliparous and postmenopausal woman feel discomfort. Endometrial biopsy in the presence of active bleeding is of little value. There is good histological concordance between samples from endometrial aspiration is as ten times cheaper than conventional curettage