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

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2012 - 20182

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Author: search.filters.author.Weerasinghe, S.Has files: Yes

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    Long-term survival of a patient with single atrium and single ventricular heart: a case report
    (Sri Lanka Medical Association, 2018) Lohithalingam, P.; Lakmini, K.M.S.; Weerasinghe, S.; Pereira, T.; Premaratna, R.
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    Clinically helpful rickettsial disease diagnostic IgG titers in relation to duration of illness in an endemic setting in Sri Lanka
    (Biomed Central, 2012) Premaratna, R.; Weerasinghe, S.; Ranaweera, A.; Chandrasena, T.G.A.N.; Bandara, N.W.; Dasch, G.A.; de Silva, H.J.
    BACKGROUND: Although an initial IFA-IgG titer greater or equal to 1/64 or 1/128 is considered positive in presumptive diagnosis, in clinical practice in an endemic setting for rickettsioses in Sri Lanka, some patients with IFA-IgG titer of 1/128 for either spotted fever group (SFG) or scrub typhus (ST) did not respond to treatment. FINDINGS: To determine a clinically helpful diagnostic algorithm, IFA-IgG results of serologically confirmed treatment responders were analyzed in relation to duration of illness at sampling. Of 146 suspected SFG, 3 responders of 25 patients had titers ≤1/128 with < 7 days of illness while all 9 with titers ≥1/256 responded (false negative with 1/256 cutoff was 12%, false positive was 0%). For illness > 7 days, the false negative and positive rates were 4.3% (3/59) and 11.3% (6/53). Of 115 suspected ST, false negative and positive rates with ≥1/256 cutoff at <7 days of illness were 14.2% (2/14) and 0% (0/8) respectively while > 7 days, false negative and positive rates were 2% (1/51) and 0% (0/42). CONCLUSIONS: For clinical decision making, duration of illness at sampling is important in interpreting serology results in an endemic setting. If sample is obtained ≤7 day of illness, an IgG titer of ≤1/128 requires a follow up sample in the diagnosis and > 7 days of illness, a single ≥1/256 titer is diagnostic for all ST and 90% of SFG.