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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Item The use of personal protective equipment in endoscopy: what should the endoscopist wear during a pandemic?(Taylor & Francis, 2021) Jayasena, H.; Abeynayake, D.; Niriella, M.; de Silva, H.J.; de Silva, A.Endoscopists are at high risk of exposure and nosocomial transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 virus) when performing endoscopic procedures due to the highly aerosol generating nature of these procedures. At present, there is still no consensus among endoscopists with regards to the type of protective equipment to be worn by healthcare workers, when performing endoscopy during the coronavirus 2019 (COVID-19) pandemic. This review encompasses a summary of currently published guidelines related to the use of personal protective equipment (PPE) when performing endoscopic procedures during the COVID-19 pandemic. With increasing calls to rationalize the use of PPE due to shortages in global supply chains, the review offers a concise summary on the most appropriate and adequate use of PPE when performing endoscopy during the pandemic. It is expected that these adaptations in the use of PPE during the pandemic will help to improve standards of care and safety of healthcare workers.Item Features of Covid-19 patients detected during community screening: A study from a rural hospital in Sri Lanka.(The Sri Lanka Medical Association., 2020) Senanayake, A.P.; Indrakantha, D.; Sumathipala, S.; Wanigasuriya, K.; Kularathne, S.; Lekamwasam, S.; Jayasinghe, S.; de Silva, H.J.; Siribaddana, S.ABSTRACT: We studied the clinical course and virus shedding of all patients referred to Welikanda Hospital, in one month. There were 53 positives for Covid-19 by PCR. 24 (45%) were male, with an age range of 11-94 years. Of these, 41 (77%) were asymptomatic, 9 had cough, 4 had sore throat and six had fever. Pulse, blood pressure, respiratory rate and capillary oxygen were normal in all. A proportion of them had poor prognostic factors: asthma (n=4), hypertension (n=11), age above 60 years (n=9), and diabetes (n=11). Lymphopenia was seen in 20 and elevated CRP in 14. Viral shedding continued beyond 14 days in several persons and continued in symptomatic patients for a significantly longer time than asymptomatic patients. Covid-19 was an asymptomatic or mild illness in this group of people. Several of them continued to be RT-PCR positive even after 14 days. Such cases are an important source of community spread.Item Clinical research during the COVID-19 pandemic: Gastroenterology researchers' perspective(BMJ Publishing Group, 2020) Niriella, M.A.; de Silva, A.P.; de Silva, H.A.; de Silva, H.J.No Abstract availableItem Masks in COVID-19: let's unmask the evidence(Taylor & Francis, 2021) de Silva, A.P.; Niriella, M.A.; de Silva, H.J.INTRODUCTION: One of the main issues in the novel coronavirus 2019 (COVID-19) pandemic has been the lack of uniformity of recommendations for the usage of face masks. AREAS COVERED : While Asian countries started using masks early during the epidemic, most Western countries were slow to do so. To avoid such situations, clear guidelines, need to be established, not only regarding the use of masks but also the type of mask to suit different situations. In this article, we will examine the types of masks and review the recommendations for their use based on the available evidence for each type of mask. EXPERT OPINION: We explore future needs in research-related mask use in COVID-19 pandemic, improvements to be made in mask design, adopting guidelines for the use of masks and the psycho-social aspects of widespread and prolonged mask use. Keywords: COVID-19; masks; pandemic; prevention; respiratory protection; spread.Item An epidemiological model to aid decision-making for COVID-19 control in Sri Lanka(Public Library of Science, 2020) Ediriweera, D.S.; de Silva, N.R.; Malavige, G.N.; de Silva, H.J.BACKGROUND: Sri Lanka diagnosed its first local case of COVID-19 on 11 March 2020. The government acted swiftly to contain transmission, with extensive public health measures. At the end of 30 days, Sri Lanka had 197 cases, 54 recovered and 7 deaths; a staged relaxing of the lockdown is now underway. This paper proposes a theoretical basis for estimating the limits within which transmission should be constrained in order to ensure that the case load remains within the capacity of Sri Lanka's health system. METHODS: We used the Susceptible, Infected, Recovered (SIR) model to explore the number of new infections and estimate ICU bed requirement at different levels of R0 values after lifting lockdown restrictions. We developed a web-based application that enables visualization of cases and ICU bed requirements with time, with adjustable parameters that include: population at risk; number of identified and recovered cases; percentage identified; infectious period; R0 or doubling time; percentage critically ill; available ICU beds; duration of ICU stay; and uncertainty of projection. RESULTS: The three-day moving average of the caseload suggested two waves of transmission from Day 0 to 17 (R0 = 3.32, 95% CI 1.85-5.41) and from Day 18-30 (R = 1.25, 95%CI: 0.93-1.63). We estimate that if there are 156 active cases with 91 recovered at the time of lifting lockdown restrictions, and R increases to 1.5 (doubling time 19 days), under the standard parameters for Sri Lanka, the ICU bed capacity of 300 is likely to be saturated by about 100 days, signaled by 18 new infections (95% CI 15-22) on Day 14 after lifting lockdown restrictions. CONCLUSION: Our model suggests that to ensure that the case load remains within the available capacity of the health system after lifting lockdown restrictions, transmission should not exceed R = 1.5. This model and the web-based application may be useful in other low and middle income countries which have similar constraints on health resources.Item COVID-19 and gastroenterology: clinical insights and recommendations for gastroenterology care providers(Universitetsforlager/Informa Healthcare, 2020) Niriella, M.A.; de Silva, A.P.; Liyanage, K.I.; Sarin, S.K.; de Silva, H.J.ABSTRACT: While the COVID-19 pandemic evolves, we are beginning to understand the role the gastrointestinal tract plays in the disease and the impact of the infection on the care of patients with gastrointestinal (GI) and liver diseases. We review the data and understanding around the virus related to the digestive tract, impact of the pandemic on delivery of GI services and daily gastroenterology clinical practice, and the effects on patients with pre-existing GI diseases. KEYWORDS: COVID-19; gastroenterology; hepatology; pandemic.